Minnesota Legislature
SF 821
as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
Current Version - as introduced
1.1 A bill for an act 1.2 relating to state government; making changes to public 1.3 assistance programs, health care programs, continuing 1.4 care for persons with disabilities, and children's 1.5 services; establishing the Community Services Act; 1.6 changing estate recovery provisions for medical 1.7 assistance; modifying local public health grants; 1.8 appropriating money; amending Minnesota Statutes 2002, 1.9 sections 16A.724; 62J.692, subdivision 4, by adding a 1.10 subdivision; 62Q.19, subdivision 1; 69.021, 1.11 subdivision 11; 144.1222, by adding a subdivision; 1.12 144.125; 144.128; 144.1483; 144.1488, subdivision 4; 1.13 144.1491, subdivision 1; 144.1502, subdivision 4; 1.14 144.551, subdivision 1; 144A.4605, subdivision 4; 1.15 144E.11, subdivision 6; 145.88; 145.881, subdivision 1.16 2; 145.882, subdivisions 1, 2, 3, 7, by adding a 1.17 subdivision; 145.883, subdivisions 1, 9; 145A.02, 1.18 subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 1.19 subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 1.20 adding a subdivision; 145A.11, subdivisions 2, 4; 1.21 145A.12, subdivisions 1, 2, by adding a subdivision; 1.22 145A.13, by adding a subdivision; 145A.14, subdivision 1.23 2; 147A.08; 148.5194, subdivisions 1, 2, 3, by adding 1.24 a subdivision; 148.6445, subdivision 7; 153A.17; 1.25 245.4874; 245A.10; 245B.06, subdivision 8; 246.54; 1.26 252.27, subdivision 2a; 252.46, subdivision 1; 256.01, 1.27 subdivision 2; 256.476, subdivisions 1, 3, 4, 5, 11; 1.28 256.935, subdivision 1; 256.955, subdivision 2a; 1.29 256.9657, subdivision 1; 256.969, subdivisions 2b, 3a; 1.30 256.9754, subdivisions 2, 3, 4, 5; 256.984, 1.31 subdivision 1; 256B.055, by adding a subdivision; 1.32 256B.056, subdivisions 1a, 1c; 256B.057, subdivisions 1.33 1, 1b, 2, 3b, 9; 256B.0595, subdivisions 1, 2; 1.34 256B.06, subdivision 4; 256B.061; 256B.0625, 1.35 subdivisions 13, 20, 23, by adding subdivisions; 1.36 256B.0635, subdivisions 1, 2; 256B.0913, subdivisions 1.37 2, 4, 5, 6, 7, 8, 10, 12; 256B.0915, subdivision 3; 1.38 256B.0945, subdivisions 2, 4; 256B.15, subdivisions 1, 1.39 1a, 2, 3, 4, by adding subdivisions; 256B.19, 1.40 subdivisions 1, 1d; 256B.195, subdivision 4; 256B.32, 1.41 subdivision 1; 256B.431, subdivisions 2r, 23, 32, 36, 1.42 by adding subdivisions; 256B.434, subdivision 4; 1.43 256B.48, subdivision 1; 256B.501, subdivision 1, by 1.44 adding a subdivision; 256B.5012, by adding a 1.45 subdivision; 256B.5015; 256B.69, subdivisions 2, 4, 1.46 5c, by adding a subdivision; 256B.75; 256B.76; 2.1 256D.03, subdivisions 3, 4; 256D.06, subdivision 2; 2.2 256D.46, subdivisions 1, 3; 256D.48, subdivision 1; 2.3 256E.081, subdivision 3; 256F.10, subdivision 6; 2.4 256G.05, subdivision 2; 256I.02; 256I.04, subdivision 2.5 3; 256I.05, subdivisions 1, 1a, 7c; 256J.01, 2.6 subdivision 5; 256J.02, subdivision 2; 256J.08, 2.7 subdivisions 35, 65, 82, 85, by adding subdivisions; 2.8 256J.09, subdivisions 2, 3, 3a, 3b, 8, 10; 256J.14; 2.9 256J.20, subdivision 3; 256J.21, subdivision 2; 2.10 256J.24, subdivisions 3, 5, 6, 7, 10; 256J.30, 2.11 subdivision 9; 256J.32, subdivisions 2, 4, 5a, by 2.12 adding a subdivision; 256J.37, subdivision 9, by 2.13 adding subdivisions; 256J.38, subdivisions 3, 4; 2.14 256J.42, subdivisions 4, 5, 6; 256J.425, subdivisions 2.15 1, 1a, 2, 3, 4, 6, 7; 256J.45, subdivision 2; 256J.46, 2.16 subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9, 2.17 13, by adding subdivisions; 256J.50, subdivisions 1, 2.18 8, 9, 10; 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 2.19 subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 2.20 5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 2.21 256J.62, subdivision 9; 256J.645, subdivision 3; 2.22 256J.66, subdivision 2; 256J.67, subdivisions 1, 3; 2.23 256J.69, subdivision 2; 256J.75, subdivision 3; 2.24 256J.751, subdivisions 1, 2, 5; 256L.02, by adding a 2.25 subdivision; 256L.03, subdivision 5; 256L.04, 2.26 subdivision 1; 256L.05, subdivisions 3, 3a, 3c, 4; 2.27 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3; 2.28 256L.09, subdivision 4; 256L.15, subdivisions 1, 2, 3; 2.29 259.67, subdivision 4; 260B.157, subdivision 1; 2.30 260B.176, subdivision 2; 260B.178, subdivision 1; 2.31 260B.193, subdivision 2; 260B.235, subdivision 6; 2.32 261.063; 295.55, subdivision 2; 295.58; 326.42; 2.33 393.07, subdivision 10; 514.981, subdivision 6; 2.34 518.551, subdivision 7; 518.6111, subdivisions 2, 3, 2.35 4, 16; 524.3-805; Laws 1997, chapter 203, article 9, 2.36 section 21, as amended; proposing coding for new law 2.37 in Minnesota Statutes, chapters 144; 145; 145A; 148C; 2.38 256B; 256D; 256I; 256J; 514; proposing coding for new 2.39 law as Minnesota Statutes, chapter 256M; repealing 2.40 Minnesota Statutes 2002, sections 62J.694, 2.41 subdivisions 1, 2, 2a, 3; 144.126; 144.1484; 144.1494; 2.42 144.1495; 144.1496; 144.1497; 144.395, subdivisions 1, 2.43 2; 144.396; 144.401; 144.9507, subdivision 3; 144A.36; 2.44 144A.38; 145.56, subdivision 2; 145.882, subdivisions 2.45 4, 5, 6, 8; 145.883, subdivisions 4, 7; 145.884; 2.46 145.885; 145.886; 145.888; 145.889; 145.890; 145.9266, 2.47 subdivisions 2, 4, 5, 6, 7; 145.928, subdivision 9; 2.48 145A.02, subdivisions 9, 10, 11, 12, 13, 14; 145A.10, 2.49 subdivisions 5, 6, 8; 145A.11, subdivision 3; 145A.12, 2.50 subdivisions 3, 4, 5; 145A.14, subdivisions 3, 4; 2.51 145A.17, subdivision 2; 148.5194, subdivision 3a; 2.52 148.6445, subdivision 9; 245.4712, subdivision 2; 2.53 245.4886; 245.496; 254A.17; 256.955, subdivision 8; 2.54 256.973; 256.9752; 256.9753; 256.976; 256.977; 2.55 256.9772; 256B.055, subdivision 10a; 256B.057, 2.56 subdivision 1b; 256B.0625, subdivisions 5a, 35, 36; 2.57 256B.0917; 256B.0928; 256B.0945, subdivisions 6, 7, 8, 2.58 9, 10; 256B.095; 256B.0951; 256B.0952; 256B.0953; 2.59 256B.0954; 256B.0955; 256B.195, subdivision 5; 2.60 256B.437, subdivision 2; 256B.5013, subdivision 4; 2.61 256E.01; 256E.02; 256E.03; 256E.04; 256E.05; 256E.06; 2.62 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 256E.11; 2.63 256E.115; 256E.12; 256E.13; 256E.14; 256E.15; 256F.01; 2.64 256F.02; 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 2.65 256F.08; 256F.10, subdivision 7; 256F.11; 256F.12; 2.66 256F.14; 256J.02, subdivision 3; 256J.08, subdivisions 2.67 28, 70; 256J.24, subdivision 8; 256J.30, subdivision 2.68 10; 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 2.69 1a, 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 2.70 256J.52, subdivisions 1, 2, 3, 4, 5, 5a, 6, 7, 8, 9; 2.71 256J.55, subdivision 5; 256J.62, subdivisions 1, 2a, 3.1 3a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74, 3.2 subdivision 3; 256J.751, subdivisions 3, 4; 256J.76; 3.3 256K.30; 256L.02, subdivision 3; 256L.04, subdivision 3.4 9; 257.075; 257.81; 260.152; 626.562; Laws 1988, 3.5 chapter 689, article 2, section 251; Laws 2000, 3.6 chapter 488, article 10, section 29; Laws 2001, First 3.7 Special Session chapter 9, article 13, section 24; 3.8 Minnesota Rules, parts 4736.0010; 4736.0020; 3.9 4736.0030; 4736.0040; 4736.0050; 4736.0060; 4736.0070; 3.10 4736.0080; 4736.0090; 4736.0120; 4736.0130; 4763.0100; 3.11 4763.0110; 4763.0125; 4763.0135; 4763.0140; 4763.0150; 3.12 4763.0160; 4763.0170; 4763.0180; 4763.0190; 4763.0205; 3.13 4763.0215; 4763.0220; 4763.0230; 4763.0240; 4763.0250; 3.14 4763.0260; 4763.0270; 4763.0285; 4763.0295; 4763.0300; 3.15 9505.0324; 9505.0326; 9505.0327; 9545.2000; 9545.2010; 3.16 9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 3.17 9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 3.18 9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 3.19 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.20 ARTICLE 1 3.21 WELFARE REFORM; PUBLIC ASSISTANCE MODIFICATIONS 3.22 Section 1. Minnesota Statutes 2002, section 256.935, 3.23 subdivision 1, is amended to read: 3.24 Subdivision 1. [FUNERAL EXPENSES.] On the death of any 3.25 person receiving public assistance through MFIP, the county 3.26 agency shall pay an amount for funeral expenses not exceeding 3.27 the amount paid for comparable services under section 261.035 3.28 plus actual cemetery charges. No funeral expenses shall be paid 3.29 if the estate of the deceased is sufficient to pay such expenses 3.30 or if the spouse, who was legally responsible for the support of 3.31 the deceased while living, is able to pay such expenses; 3.32 provided, that the additional payment or donation of the cost of 3.33 cemetery lot, interment, religious service, or for the 3.34 transportation of the body into or out of the community in which 3.35 the deceased resided, shall not limit payment by the county 3.36 agency as herein authorized. Freedom of choice in the selection 3.37 of a funeral director shall be granted to persons lawfully 3.38 authorized to make arrangements for the burial of any such 3.39 deceased recipient. In determining the sufficiency of such 3.40 estate, due regard shall be had for the nature and marketability 3.41 of the assets of the estate. The county agency may grant 3.42 funeral expenses where the sale would cause undue loss to the 3.43 estate. Any amount paid for funeral expenses shall be a prior 3.44 claim against the estate, as provided in section 524.3-805, and 4.1 any amount recovered shall be reimbursed to the agency which 4.2 paid the expenses.The commissioner shall specify requirements4.3for reports, including fiscal reports, according to section4.4256.01, subdivision 2, paragraph (17). The state share shall4.5pay the entire amount of county agency expenditures.Benefits 4.6 shall be issued to recipients by thestate orcounty subject to 4.7 provisions of section 256.017. 4.8 Sec. 2. Minnesota Statutes 2002, section 256.984, 4.9 subdivision 1, is amended to read: 4.10 Subdivision 1. [DECLARATION.] Every application for public 4.11 assistance under this chapterand/oror chapters 256B, 256D, 4.12256K, MFIP program256J, and food stamps or food support under 4.13 chapter 393 shall be in writing or reduced to writing as 4.14 prescribed by the state agency and shall contain the following 4.15 declaration which shall be signed by the applicant: 4.16 "I declare under the penalties of perjury that this 4.17 application has been examined by me and to the best of my 4.18 knowledge is a true and correct statement of every material 4.19 point. I understand that a person convicted of perjury may 4.20 be sentenced to imprisonment of not more than five years or 4.21 to payment of a fine of not more than $10,000, or both." 4.22 Sec. 3. Minnesota Statutes 2002, section 256D.06, 4.23 subdivision 2, is amended to read: 4.24 Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions 4.25 of subdivision 1, a grant of emergency general assistance shall, 4.26 to the extent funds are available, be made to an eligible single 4.27 adult, married couple, or family for an emergency need, as 4.28 defined in rules promulgated by the commissioner, where the 4.29 recipient requests temporary assistance not exceeding 30 days if 4.30 an emergency situation appears to exist and(a) until March 31,4.311998, the individual is ineligible for the program of emergency4.32assistance under aid to families with dependent children and is4.33not a recipient of aid to families with dependent children at4.34the time of application; or (b)the individual or family is(i)4.35 ineligible for MFIP or is not a participant of MFIP; and (ii) is4.36ineligible for emergency assistance under section 256J.48. If 5.1 an applicant or recipient relates facts to the county agency 5.2 which may be sufficient to constitute an emergency situation, 5.3 the county agency shall, to the extent funds are available, 5.4 advise the person of the procedure for applying for assistance 5.5 according to this subdivision. An emergency general assistance 5.6 grant is available to a recipient not more than once in any 5.7 12-month period. Funding for an emergency general assistance 5.8 program is limited to an amount equal to the actual state 5.9 expenditure for emergency general assistance in fiscal year 5.10 2002. Each fiscal year, the commissioner shall allocate to 5.11 counties the money appropriated for emergency general assistance 5.12 grants based on each county agency's average share of state's 5.13 emergency general expenditures for the immediate past three 5.14 fiscal years, and may reallocate any unspent amounts to other 5.15 counties. Any emergency general assistance expenditures by a 5.16 county above the amount of the commissioner's allocation to the 5.17 county must be made from county funds. 5.18 Sec. 4. Minnesota Statutes 2002, section 256D.46, 5.19 subdivision 1, is amended to read: 5.20 Subdivision 1. [ELIGIBILITY.] A county agency must grant 5.21 emergency Minnesota supplemental aidmust be granted, to the 5.22 extent funds are available, if the recipient is without adequate 5.23 resources to resolve an emergency that, if unresolved, will 5.24 threaten the health or safety of the recipient. For the 5.25 purposes of this section, the term "recipient" includes persons 5.26 for whom a group residential housing benefit is being paid under 5.27 sections 256I.01 to 256I.06. 5.28 Sec. 5. Minnesota Statutes 2002, section 256D.46, 5.29 subdivision 3, is amended to read: 5.30 Subd. 3. [PAYMENT AMOUNT.] The amount of assistance 5.31 granted under emergency Minnesota supplemental aid is limited to 5.32 the amount necessary to resolve the emergency. An emergency 5.33 Minnesota supplemental aid grant is available to a recipient no 5.34 more than once in any 12-month period. Funding for emergency 5.35 Minnesota supplemental aid is limited to an amount equal to the 5.36 actual state expenditure for emergency Minnesota supplemental 6.1 aid in state fiscal year 2002. Each fiscal year, the 6.2 commissioner shall allocate to counties the money appropriated 6.3 for emergency Minnesota supplemental aid grants based on each 6.4 county agency's average share of state's emergency Minnesota 6.5 supplemental aid expenditures for the immediate past three 6.6 fiscal years, and may reallocate any unspent amounts to other 6.7 counties. Any emergency Minnesota supplemental aid expenditures 6.8 by a county above the amount of the commissioner's allocation to 6.9 the county must be made from county funds. 6.10 Sec. 6. Minnesota Statutes 2002, section 256D.48, 6.11 subdivision 1, is amended to read: 6.12 Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county 6.13 agency shall determine whether a recipient needs a protective 6.14 payee when a physical or mental condition renders the recipient 6.15 unable to manage funds and when payments to the recipient would 6.16 be contrary to the recipient's welfare. Protective payments 6.17 must be issued when there is evidence of: (1) repeated 6.18 inability to plan the use of income to meet necessary 6.19 expenditures; (2) repeated observation that the recipient is not 6.20 properly fed or clothed; (3) repeated failure to meet 6.21 obligations for rent, utilities, food, and other essentials; (4) 6.22 evictions or a repeated incurrence of debts; or (5) lost or 6.23 stolen checks; or (6) use of emergency Minnesota supplemental6.24aid more than twice in a calendar year. The determination of 6.25 representative payment by the Social Security Administration for 6.26 the recipient is sufficient reason for protective payment of 6.27 Minnesota supplemental aid payments. 6.28 Sec. 7. Minnesota Statutes 2002, section 256J.01, 6.29 subdivision 5, is amended to read: 6.30 Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall 6.31 administer a compliance system for the state's temporary 6.32 assistance for needy families (TANF) program, the food stamp 6.33 program,emergency assistance,general assistance, medical 6.34 assistance, general assistance medical care, emergency general 6.35 assistance, Minnesota supplemental aid, preadmission screening, 6.36 child support program, and alternative care grants under the 7.1 powers and authorities named in section 256.01, subdivision 2. 7.2 The purpose of the compliance system is to permit the 7.3 commissioner to supervise the administration of public 7.4 assistance programs and to enforce timely and accurate 7.5 distribution of benefits, completeness of service and efficient 7.6 and effective program management and operations, to increase 7.7 uniformity and consistency in the administration and delivery of 7.8 public assistance programs throughout the state, and to reduce 7.9 the possibility of sanction and fiscal disallowances for 7.10 noncompliance with federal regulations and state statutes. 7.11 Sec. 8. Minnesota Statutes 2002, section 256J.02, 7.12 subdivision 2, is amended to read: 7.13 Subd. 2. [USE OF MONEY.] State money appropriated for 7.14 purposes of this section and TANF block grant money must be used 7.15 for: 7.16 (1) financial assistance to or on behalf of any minor child 7.17 who is a resident of this state under section 256J.12; 7.18 (2)employment and training services under this chapter or7.19chapter 256K;7.20(3) emergency financial assistance and services under7.21section 256J.48;7.22(4) diversionary assistance under section 256J.47;7.23(5)the health care and human services training and 7.24 retention program under chapter 116L, for costs associated with 7.25 families with children with incomes below 200 percent of the 7.26 federal poverty guidelines; 7.27(6)(3) the pathways program under section 116L.04, 7.28 subdivision 1a; 7.29(7) welfare-to-work extended employment services for MFIP7.30participants with severe impairment to employment as defined in7.31section 268A.15, subdivision 1a;7.32(8) the family homeless prevention and assistance program7.33under section 462A.204;7.34(9) the rent assistance for family stabilization7.35demonstration project under section 462A.205;7.36(10)(4) welfare to work transportation authorized under 8.1 Public LawNumber105-178; 8.2(11)(5) reimbursements for the federal share of child 8.3 support collections passed through to the custodial parent; 8.4(12)(6) reimbursements for the working family credit under 8.5 section 290.0671; 8.6(13) intensive ESL grants under Laws 2000, chapter 489,8.7article 1;8.8(14) transitional housing programs under section 119A.43;8.9(15) programs and pilot projects under chapter 256K; and8.10(16)(7) program administration under this chapter; 8.11 (8) the diversionary work program under section 256J.95; 8.12 (9) the MFIP consolidated fund under section 256J.626; and 8.13 (10) the Minnesota department of health consolidated fund 8.14 under Laws 2001, First Special Session chapter 9, article 17, 8.15 section 3, subdivision 2. 8.16 Sec. 9. Minnesota Statutes 2002, section 256J.08, is 8.17 amended by adding a subdivision to read: 8.18 Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a 8.19 case that would be part of the child only TANF program under 8.20 section 256J.88. 8.21 Sec. 10. Minnesota Statutes 2002, section 256J.08, is 8.22 amended by adding a subdivision to read: 8.23 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 8.24 "Diversionary work program" or "DWP" has the meaning given in 8.25 section 256J.95. 8.26 Sec. 11. Minnesota Statutes 2002, section 256J.08, is 8.27 amended by adding a subdivision to read: 8.28 Subd. 28b. [EMPLOYABLE.] "Employable" means a person is 8.29 capable of performing existing positions in the local labor 8.30 market, regardless of the current availability of openings for 8.31 those positions. 8.32 Sec. 12. Minnesota Statutes 2002, section 256J.08, is 8.33 amended by adding a subdivision to read: 8.34 Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means 8.35 the following, if committed against a family or household member 8.36 by a family or household member: 9.1 (1) physical harm, bodily injury, or assault; 9.2 (2) the infliction of fear of imminent physical harm, 9.3 bodily injury, or assault; or 9.4 (3) terroristic threats, within the meaning of section 9.5 609.713, subdivision 1; criminal sexual conduct, within the 9.6 meaning of section 609.342, 609.343, 609.344, 609.345, or 9.7 609.3451; or interference with an emergency call within the 9.8 meaning of section 609.78, subdivision 2. 9.9 (b) For the purposes of family violence, "family or 9.10 household member" means: 9.11 (1) spouses and former spouses; 9.12 (2) parents and children; 9.13 (3) persons related by blood; 9.14 (4) persons who are residing together or who have resided 9.15 together in the past; 9.16 (5) persons who have a child in common regardless of 9.17 whether they have been married or have lived together at any 9.18 time; 9.19 (6) a man and woman if the woman is pregnant and the man is 9.20 alleged to be the father, regardless of whether they have been 9.21 married or have lived together at anytime; and 9.22 (7) persons involved in a current or past significant 9.23 romantic or sexual relationship. 9.24 Sec. 13. Minnesota Statutes, section 256J.08, is amended 9.25 by adding a subdivision to read: 9.26 Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence 9.27 waiver" means a waiver of the 60-month time limit for victims of 9.28 family violence who are complying with an employment plan in 9.29 section 256J.521, subdivision 3. 9.30 Sec. 14. Minnesota Statutes 2002, section 256J.08, 9.31 subdivision 35, is amended to read: 9.32 Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means 9.33 110 percent of the transitional standard as specified in section 9.34 256J.24, subdivision 7. 9.35 Sec. 15. Minnesota Statutes 2002, section 256J.08, is 9.36 amended by adding a subdivision to read: 10.1 Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for 10.2 purposes of an extension to the 60-month time limit under 10.3 section 256J.425, subdivision 3, clause (3), means the person 10.4 has a disorder in one or more of the psychological processes 10.5 involved in perceiving, understanding, or using concepts through 10.6 verbal language or nonverbal means. Learning disabled does not 10.7 include learning problems that are primarily the result of 10.8 visual, hearing, or motor handicaps, mental retardation, 10.9 emotional disturbance, or due to environmental, cultural, or 10.10 economic disadvantage. 10.11 Sec. 16. Minnesota Statutes 2002, section 256J.08, 10.12 subdivision 65, is amended to read: 10.13 Subd. 65. [PARTICIPANT.] "Participant" means a person who 10.14 is currently receiving cash assistance or the food portion 10.15 available through MFIPas funded by TANF and the food stamp10.16program. A person who fails to withdraw or access 10.17 electronically any portion of the person's cash and food 10.18 assistance payment by the end of the payment month, who makes a 10.19 written request for closure before the first of a payment month 10.20 and repays cash and food assistance electronically issued for 10.21 that payment month within that payment month, or who returns any 10.22 uncashed assistance check and food coupons and withdraws from 10.23 the program is not a participant. A person who withdraws a cash 10.24 or food assistance payment by electronic transfer or receives 10.25 and cashes an MFIP assistance check or food coupons and is 10.26 subsequently determined to be ineligible for assistance for that 10.27 period of time is a participant, regardless whether that 10.28 assistance is repaid. The term "participant" includes the 10.29 caregiver relative and the minor child whose needs are included 10.30 in the assistance payment. A person in an assistance unit who 10.31 does not receive a cash and food assistance payment because the 10.32personcase has been suspended from MFIP is a participant. A 10.33 person who receives cash payments under the diversionary work 10.34 program under section 256J.95 is a participant. 10.35 Sec. 17. Minnesota Statutes 2002, section 256J.08, is 10.36 amended by adding a subdivision to read: 11.1 Subd. 65a. [PARTICIPATION REQUIREMENTS OF 11.2 TANF.] "Participation requirements of TANF" means activities and 11.3 hourly requirements allowed under title IV-A of the federal 11.4 Social Security Act. 11.5 Sec. 18. Minnesota Statutes 2002, section 256J.08, is 11.6 amended by adding a subdivision to read: 11.7 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 11.8 illness, injury, or incapacity, a "qualified professional" means 11.9 a licensed physician, a physician's assistant, a nurse 11.10 practitioner, or in the case of spinal subluxation, a licensed 11.11 chiropractor. 11.12 (b) For mental retardation and intelligence testing, a 11.13 "qualified professional" means an individual qualified by 11.14 training and experience to administer the tests necessary to 11.15 make determinations, such as tests of intellectual functioning, 11.16 assessments of adaptive behavior, adaptive skills, and 11.17 developmental functioning. These professionals include licensed 11.18 psychologists, certified school psychologists, or certified 11.19 psychometrists working under the supervision of a licensed 11.20 psychologist. 11.21 (c) For learning disabilities, a "qualified professional" 11.22 means a licensed psychologist or school psychologist with 11.23 experience determining learning disabilities. 11.24 (d) For mental health, a "qualified professional" means a 11.25 licensed physician or a qualified mental health professional. A 11.26 "qualified mental health professional" means: 11.27 (1) for children, in psychiatric nursing, a registered 11.28 nurse who is licensed under sections 148.171 to 148.285, and who 11.29 is certified as a clinical specialist in child and adolescent 11.30 psychiatric or mental health nursing by a national nurse 11.31 certification organization or who has a master's degree in 11.32 nursing or one of the behavioral sciences or related fields from 11.33 an accredited college or university or its equivalent, with at 11.34 least 4,000 hours of post-master's supervised experience in the 11.35 delivery of clinical services in the treatment of mental 11.36 illness; 12.1 (2) for adults, in psychiatric nursing, a registered nurse 12.2 who is licensed under sections 148.171 to 148.285, and who is 12.3 certified as a clinical specialist in adult psychiatric and 12.4 mental health nursing by a national nurse certification 12.5 organization or who has a master's degree in nursing or one of 12.6 the behavioral sciences or related fields from an accredited 12.7 college or university or its equivalent, with at least 4,000 12.8 hours of post-master's supervised experience in the delivery of 12.9 clinical services in the treatment of mental illness; 12.10 (3) in clinical social work, a person licensed as an 12.11 independent clinical social worker under section 148B.21, 12.12 subdivision 6, or a person with a master's degree in social work 12.13 from an accredited college or university, with at least 4,000 12.14 hours of post-master's supervised experience in the delivery of 12.15 clinical services in the treatment of mental illness; 12.16 (4) in psychology, an individual licensed by the board of 12.17 psychology under sections 148.88 to 148.98, who has stated to 12.18 the board of psychology competencies in the diagnosis and 12.19 treatment of mental illness; 12.20 (5) in psychiatry, a physician licensed under chapter 147 12.21 and certified by the American Board of Psychiatry and Neurology 12.22 or eligible for board certification in psychiatry; and 12.23 (6) in marriage and family therapy, the mental health 12.24 professional must be a marriage and family therapist licensed 12.25 under sections 148B.29 to 148B.39, with at least two years of 12.26 post-master's supervised experience in the delivery of clinical 12.27 services in the treatment of mental illness. 12.28 Sec. 19. Minnesota Statutes 2002, section 256J.08, 12.29 subdivision 82, is amended to read: 12.30 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 12.31 family's assistance payment by a specified percentage of the 12.32 MFIP standard of need because: a nonexempt participant fails to 12.33 comply with the requirements of sections256J.52256J.515 to 12.34256J.55256J.57; a parental caregiver fails without good cause 12.35 to cooperate with the child support enforcement requirements; or 12.36 a participant fails to comply withthe insurance, tort13.1liability, orother requirements of this chapter. 13.2 Sec. 20. Minnesota Statutes 2002, section 256J.08, is 13.3 amended by adding a subdivision to read: 13.4 Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person 13.5 who receives at least $1 in SSI benefits, or who is not 13.6 receiving an SSI benefit due to recoupment or a one month 13.7 suspension by the Social Security Administration due to excess 13.8 income. 13.9 Sec. 21. Minnesota Statutes 2002, section 256J.08, 13.10 subdivision 85, is amended to read: 13.11 Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard" 13.12 means the basic standard for a familywith no other income or a13.13nonworking familywithout earned income and is a combination of 13.14 the cashassistance needsportion and foodassistance needs for13.15a family of that sizeportion as specified in section 256J.24, 13.16 subdivision 5. 13.17 Sec. 22. Minnesota Statutes 2002, section 256J.08, is 13.18 amended by adding a subdivision to read: 13.19 Subd. 90. [SEVERE FORMS OF TRAFFICKING IN 13.20 PERSONS.] "Severe forms of trafficking in persons" means: (1) 13.21 sex trafficking in which a commercial sex act is induced by 13.22 force, fraud, or coercion, or in which the person induced to 13.23 perform the act has not attained 18 years of age; or (2) the 13.24 recruitment, harboring, transportation, provision, or obtaining 13.25 of a person for labor or services through the use of force, 13.26 fraud, or coercion for the purposes of subjection to involuntary 13.27 servitude, peonage, debt bondage, or slavery. 13.28 Sec. 23. Minnesota Statutes 2002, section 256J.09, 13.29 subdivision 2, is amended to read: 13.30 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 13.31 INFORMATION.] When a person inquires about assistance, a county 13.32 agency must: 13.33 (1) explain the eligibility requirements of, and how to 13.34 apply for, diversionary assistance as provided in section13.35256J.47; emergency assistance as provided in section 256J.48;13.36MFIP as provided in section 256J.10; oranyotherassistance for 14.1 which the person may be eligible; and 14.2 (2) offer the person brochures developed or approved by the 14.3 commissioner that describe how to apply for assistance. 14.4 Sec. 24. Minnesota Statutes 2002, section 256J.09, 14.5 subdivision 3, is amended to read: 14.6 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 14.7 agency must offer, in person or by mail, the application forms 14.8 prescribed by the commissioner as soon as a person makes a 14.9 written or oral inquiry. At that time, the county agency must: 14.10 (1) inform the person that assistance begins with the date 14.11 the signed application is received by the county agency or the 14.12 date all eligibility criteria are met, whichever is later; 14.13 (2) inform the person that any delay in submitting the 14.14 application will reduce the amount of assistance paid for the 14.15 month of application; 14.16 (3) inform a person that the person may submit the 14.17 application before an interview; 14.18 (4) explain the information that will be verified during 14.19 the application process by the county agency as provided in 14.20 section 256J.32; 14.21 (5) inform a person about the county agency's average 14.22 application processing time and explain how the application will 14.23 be processed under subdivision 5; 14.24 (6) explain how to contact the county agency if a person's 14.25 application information changes and how to withdraw the 14.26 application; 14.27 (7) inform a person that the next step in the application 14.28 process is an interview and what a person must do if the 14.29 application is approved including, but not limited to, attending 14.30 orientation under section 256J.45 and complying with employment 14.31 and training services requirements in sections256J.52256J.515 14.32 to256J.55256J.57; 14.33 (8) explain the child care and transportation services that 14.34 are available under paragraph (c) to enable caregivers to attend 14.35 the interview, screening, and orientation; and 14.36 (9) identify any language barriers and arrange for 15.1 translation assistance during appointments, including, but not 15.2 limited to, screening under subdivision 3a, orientation under 15.3 section 256J.45, andthe initialassessment under section 15.4256J.52256J.521. 15.5 (b) Upon receipt of a signed application, the county agency 15.6 must stamp the date of receipt on the face of the application. 15.7 The county agency must process the application within the time 15.8 period required under subdivision 5. An applicant may withdraw 15.9 the application at any time by giving written or oral notice to 15.10 the county agency. The county agency must issue a written 15.11 notice confirming the withdrawal. The notice must inform the 15.12 applicant of the county agency's understanding that the 15.13 applicant has withdrawn the application and no longer wants to 15.14 pursue it. When, within ten days of the date of the agency's 15.15 notice, an applicant informs a county agency, in writing, that 15.16 the applicant does not wish to withdraw the application, the 15.17 county agency must reinstate the application and finish 15.18 processing the application. 15.19 (c) Upon a participant's request, the county agency must 15.20 arrange for transportation and child care or reimburse the 15.21 participant for transportation and child care expenses necessary 15.22 to enable participants to attend the screening under subdivision 15.23 3a and orientation under section 256J.45. 15.24 Sec. 25. Minnesota Statutes 2002, section 256J.09, 15.25 subdivision 3a, is amended to read: 15.26 Subd. 3a. [SCREENING.] The county agency, or at county 15.27 option, the county's employment and training service provider as 15.28 defined in section 256J.49, must screen each applicant to 15.29 determine immediate needs and to determine if the applicant may 15.30 be eligible for:15.31(1)another program that is not partially funded through 15.32 the federal temporary assistance to needy families block grant 15.33 under Title I of Public LawNumber104-193, including the 15.34 expedited issuance of food stamps under section 256J.28, 15.35 subdivision 1.If the applicant may be eligible for another15.36program, a county caseworker must provide the appropriate16.1referral to the program;16.2(2) the diversionary assistance program under section16.3256J.47; or16.4(3) the emergency assistance program under section16.5256J.48.If the applicant appears eligible for another program, 16.6 including any program funded by the MFIP consolidated fund, the 16.7 county must make a referral to the appropriate program. 16.8 Sec. 26. Minnesota Statutes 2002, section 256J.09, 16.9 subdivision 3b, is amended to read: 16.10 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 16.11 If the applicant is not diverted from applying for MFIP, and if 16.12 the applicant meets the MFIP eligibility requirements, then a 16.13 county agency must: 16.14 (1) identify an applicant who is under the age of 16.15 20 without a high school diploma or its equivalent and explain 16.16 to the applicant the assessment procedures and employment plan 16.17 requirementsfor minor parentsunder section 256J.54; 16.18 (2) explain to the applicant the eligibility criteria in 16.19 section 256J.545 foran exemption underthe family violence 16.20provisions in section 256J.52, subdivision 6waiver, andexplain16.21 what an applicant should do to develop analternativeemployment 16.22 plan; 16.23 (3) determine if an applicant qualifies for an exemption 16.24 under section 256J.56 from employment and training services 16.25 requirements, explain how a person should report to the county 16.26 agency any status changes, and explain that an applicant who is 16.27 exempt may volunteer to participate in employment and training 16.28 services; 16.29 (4) for applicants who are not exempt from the requirement 16.30 to attend orientation, arrange for an orientation under section 16.31 256J.45 and aninitialassessment under section256J.5216.32 256J.521; 16.33 (5) inform an applicant who is not exempt from the 16.34 requirement to attend orientation that failure to attend the 16.35 orientation is considered an occurrence of noncompliance with 16.36 program requirements and will result in an imposition of a 17.1 sanction under section 256J.46; and 17.2 (6) explain how to contact the county agency if an 17.3 applicant has questions about compliance with program 17.4 requirements. 17.5 Sec. 27. Minnesota Statutes 2002, section 256J.09, 17.6 subdivision 8, is amended to read: 17.7 Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency 17.8 issues notice of approval or denial, additional applications 17.9 submitted by an applicant are void. However, an application for 17.10 monthly assistance or other benefits funded under section 17.11 256J.626 and an application foremergency assistance or17.12 emergency general assistance may exist concurrently. More than 17.13 one application for monthly assistance, emergency assistance,or 17.14 emergency general assistance may exist concurrently when the 17.15 county agency decisions on one or more earlier applications have 17.16 been appealed to the commissioner, and the applicant asserts 17.17 that a change in circumstances has occurred that would allow 17.18 eligibility. A county agency must require additional 17.19 application forms or supplemental forms as prescribed by the 17.20 commissioner when a payee's name changes, or when a caregiver 17.21 requests the addition of another person to the assistance unit. 17.22 Sec. 28. Minnesota Statutes 2002, section 256J.09, 17.23 subdivision 10, is amended to read: 17.24 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 17.25 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 17.26 applicant is not eligible for MFIP or the diversionary work 17.27 program under section 256J.95 because the applicant does not 17.28 meet eligibility requirements, the county agency must determine 17.29 whether the applicant is eligible for food stamps, medical17.30assistance, diversionary assistance, or has a need for emergency17.31assistance when the applicant meets the eligibility requirements17.32for those programsor health care programs. The county must 17.33 also inform applicants about resources available through the 17.34 county or other agencies to meet short-term emergency needs. 17.35 Sec. 29. Minnesota Statutes 2002, section 256J.14, is 17.36 amended to read: 18.1 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 18.2 (a) The definitions in this paragraph only apply to this 18.3 subdivision. 18.4 (1) "Household of a parent, legal guardian, or other adult 18.5 relative" means the place of residence of: 18.6 (i) a natural or adoptive parent; 18.7 (ii) a legal guardian according to appointment or 18.8 acceptance under section 260C.325, 525.615, or 525.6165, and 18.9 related laws; 18.10 (iii) a caregiver as defined in section 256J.08, 18.11 subdivision 11; or 18.12 (iv) an appropriate adult relative designated by a county 18.13 agency. 18.14 (2) "Adult-supervised supportive living arrangement" means 18.15 a private family setting which assumes responsibility for the 18.16 care and control of the minor parent and minor child, or other 18.17 living arrangement, not including a public institution, licensed 18.18 by the commissioner of human services which ensures that the 18.19 minor parent receives adult supervision and supportive services, 18.20 such as counseling, guidance, independent living skills 18.21 training, or supervision. 18.22 (b) A minor parent and the minor child who is in the care 18.23 of the minor parent must reside in the household of a parent, 18.24 legal guardian, other adult relative, or in an adult-supervised 18.25 supportive living arrangement in order to receive MFIP unless: 18.26 (1) the minor parent has no living parent, other adult 18.27 relative, or legal guardian whose whereabouts is known; 18.28 (2) no living parent, other adult relative, or legal 18.29 guardian of the minor parent allows the minor parent to live in 18.30 the parent's, other adult relative's, or legal guardian's home; 18.31 (3) the minor parent lived apart from the minor parent's 18.32 own parent or legal guardian for a period of at least one year 18.33 before either the birth of the minor child or the minor parent's 18.34 application for MFIP; 18.35 (4) the physical or emotional health or safety of the minor 18.36 parent or minor child would be jeopardized if the minor parent 19.1 and the minor child resided in the same residence with the minor 19.2 parent's parent, other adult relative, or legal guardian; or 19.3 (5) an adult supervised supportive living arrangement is 19.4 not available for the minor parent and child in the county in 19.5 which the minor parent and child currently reside. If an adult 19.6 supervised supportive living arrangement becomes available 19.7 within the county, the minor parent and child must reside in 19.8 that arrangement. 19.9 (c) The county agency shall inform minor applicants both 19.10 orally and in writing about the eligibility requirements, their 19.11 rights and obligations under the MFIP program, and any other 19.12 applicable orientation information. The county must advise the 19.13 minor of the possible exemptions under section 256J.54, 19.14 subdivision 5, and specifically ask whether one or more of these 19.15 exemptions is applicable. If the minor alleges one or more of 19.16 these exemptions, then the county must assist the minor in 19.17 obtaining the necessary verifications to determine whether or 19.18 not these exemptions apply. 19.19 (d) If the county worker has reason to suspect that the 19.20 physical or emotional health or safety of the minor parent or 19.21 minor child would be jeopardized if they resided with the minor 19.22 parent's parent, other adult relative, or legal guardian, then 19.23 the county worker must make a referral to child protective 19.24 services to determine if paragraph (b), clause (4), applies. A 19.25 new determination by the county worker is not necessary if one 19.26 has been made within the last six months, unless there has been 19.27 a significant change in circumstances which justifies a new 19.28 referral and determination. 19.29 (e) If a minor parent is not living with a parent, legal 19.30 guardian, or other adult relative due to paragraph (b), clause 19.31 (1), (2), or (4), the minor parent must reside, when possible, 19.32 in a living arrangement that meets the standards of paragraph 19.33 (a), clause (2). 19.34 (f) Regardless of living arrangement, MFIP must be paid, 19.35 when possible, in the form of a protective payment on behalf of 19.36 the minor parent and minor child according to section 256J.39, 20.1 subdivisions 2 to 4. 20.2 Sec. 30. Minnesota Statutes 2002, section 256J.20, 20.3 subdivision 3, is amended to read: 20.4 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 20.5 MFIP, the equity value of all nonexcluded real and personal 20.6 property of the assistance unit must not exceed $2,000 for 20.7 applicants and $5,000 for ongoing participants. The value of 20.8 assets in clauses (1) to (19) must be excluded when determining 20.9 the equity value of real and personal property: 20.10 (1) a licensed vehicle up to a loan value of less than or 20.11 equal to $7,500. The county agency shall apply any excess loan 20.12 value as if it were equity value to the asset limit described in 20.13 this section. If the assistance unit owns more than one 20.14 licensed vehicle, the county agency shall determine the vehicle 20.15 with the highest loan value and count only the loan value over 20.16 $7,500, excluding: (i) the value of one vehicle per physically 20.17 disabled person when the vehicle is needed to transport the 20.18 disabled unit member; this exclusion does not apply to mentally 20.19 disabled people; (ii) the value of special equipment for a 20.20 handicapped member of the assistance unit; and (iii) any vehicle 20.21 used for long-distance travel, other than daily commuting, for 20.22 the employment of a unit member. 20.23 The county agency shall count the loan value of all other 20.24 vehicles and apply this amount as if it were equity value to the 20.25 asset limit described in this section. To establish the loan 20.26 value of vehicles, a county agency must use the N.A.D.A. 20.27 Official Used Car Guide, Midwest Edition, for newer model cars. 20.28 When a vehicle is not listed in the guidebook, or when the 20.29 applicant or participant disputes the loan value listed in the 20.30 guidebook as unreasonable given the condition of the particular 20.31 vehicle, the county agency may require the applicant or 20.32 participant document the loan value by securing a written 20.33 statement from a motor vehicle dealer licensed under section 20.34 168.27, stating the amount that the dealer would pay to purchase 20.35 the vehicle. The county agency shall reimburse the applicant or 20.36 participant for the cost of a written statement that documents a 21.1 lower loan value; 21.2 (2) the value of life insurance policies for members of the 21.3 assistance unit; 21.4 (3) one burial plot per member of an assistance unit; 21.5 (4) the value of personal property needed to produce earned 21.6 income, including tools, implements, farm animals, inventory, 21.7 business loans, business checking and savings accounts used at 21.8 least annually and used exclusively for the operation of a 21.9 self-employment business, and any motor vehicles if at least 50 21.10 percent of the vehicle's use is to produce income and if the 21.11 vehicles are essential for the self-employment business; 21.12 (5) the value of personal property not otherwise specified 21.13 which is commonly used by household members in day-to-day living 21.14 such as clothing, necessary household furniture, equipment, and 21.15 other basic maintenance items essential for daily living; 21.16 (6) the value of real and personal property owned by a 21.17 recipient of Supplemental Security Income or Minnesota 21.18 supplemental aid; 21.19 (7) the value of corrective payments, but only for the 21.20 month in which the payment is received and for the following 21.21 month; 21.22 (8) a mobile home or other vehicle used by an applicant or 21.23 participant as the applicant's or participant's home; 21.24 (9) money in a separate escrow account that is needed to 21.25 pay real estate taxes or insurance and that is used for this 21.26 purpose; 21.27 (10) money held in escrow to cover employee FICA, employee 21.28 tax withholding, sales tax withholding, employee worker 21.29 compensation, business insurance, property rental, property 21.30 taxes, and other costs that are paid at least annually, but less 21.31 often than monthly; 21.32 (11) monthly assistance, emergency assistance, and21.33diversionarypayments for the current month'sneedsor 21.34 short-term emergency needs under section 256J.626, subdivision 21.35 2; 21.36 (12) the value of school loans, grants, or scholarships for 22.1 the period they are intended to cover; 22.2 (13) payments listed in section 256J.21, subdivision 2, 22.3 clause (9), which are held in escrow for a period not to exceed 22.4 three months to replace or repair personal or real property; 22.5 (14) income received in a budget month through the end of 22.6 the payment month; 22.7 (15) savings from earned income of a minor child or a minor 22.8 parent that are set aside in a separate account designated 22.9 specifically for future education or employment costs; 22.10 (16) the federal earned income credit, Minnesota working 22.11 family credit, state and federal income tax refunds, state 22.12 homeowners and renters credits under chapter 290A, property tax 22.13 rebates and other federal or state tax rebates in the month 22.14 received and the following month; 22.15 (17) payments excluded under federal law as long as those 22.16 payments are held in a separate account from any nonexcluded 22.17 funds; 22.18 (18) the assets of children ineligible to receive MFIP 22.19 benefits because foster care or adoption assistance payments are 22.20 made on their behalf; and 22.21 (19) the assets of persons whose income is excluded under 22.22 section 256J.21, subdivision 2, clause (43). 22.23 Sec. 31. Minnesota Statutes 2002, section 256J.21, 22.24 subdivision 2, is amended to read: 22.25 Subd. 2. [INCOME EXCLUSIONS.] The following must be 22.26 excluded in determining a family's available income: 22.27 (1) payments for basic care, difficulty of care, and 22.28 clothing allowances received for providing family foster care to 22.29 children or adults under Minnesota Rules, parts 9545.0010 to 22.30 9545.0260 and 9555.5050 to 9555.6265, and payments received and 22.31 used for care and maintenance of a third-party beneficiary who 22.32 is not a household member; 22.33 (2) reimbursements for employment training received through 22.34 theJob Training PartnershipWorkforce Investment Act 1998, 22.35 United States Code, title2920, chapter1973,sections 150122.36to 1792bsection 9201; 23.1 (3) reimbursement for out-of-pocket expenses incurred while 23.2 performing volunteer services, jury duty, employment, or 23.3 informal carpooling arrangements directly related to employment; 23.4 (4) all educational assistance, except the county agency 23.5 must count graduate student teaching assistantships, 23.6 fellowships, and other similar paid work as earned income and, 23.7 after allowing deductions for any unmet and necessary 23.8 educational expenses, shall count scholarships or grants awarded 23.9 to graduate students that do not require teaching or research as 23.10 unearned income; 23.11 (5) loans, regardless of purpose, from public or private 23.12 lending institutions, governmental lending institutions, or 23.13 governmental agencies; 23.14 (6) loans from private individuals, regardless of purpose, 23.15 provided an applicant or participant documents that the lender 23.16 expects repayment; 23.17 (7)(i) state income tax refunds; and 23.18 (ii) federal income tax refunds; 23.19 (8)(i) federal earned income credits; 23.20 (ii) Minnesota working family credits; 23.21 (iii) state homeowners and renters credits under chapter 23.22 290A; and 23.23 (iv) federal or state tax rebates; 23.24 (9) funds received for reimbursement, replacement, or 23.25 rebate of personal or real property when these payments are made 23.26 by public agencies, awarded by a court, solicited through public 23.27 appeal, or made as a grant by a federal agency, state or local 23.28 government, or disaster assistance organizations, subsequent to 23.29 a presidential declaration of disaster; 23.30 (10) the portion of an insurance settlement that is used to 23.31 pay medical, funeral, and burial expenses, or to repair or 23.32 replace insured property; 23.33 (11) reimbursements for medical expenses that cannot be 23.34 paid by medical assistance; 23.35 (12) payments by a vocational rehabilitation program 23.36 administered by the state under chapter 268A, except those 24.1 payments that are for current living expenses; 24.2 (13) in-kind income, including any payments directly made 24.3 by a third party to a provider of goods and services; 24.4 (14) assistance payments to correct underpayments, but only 24.5 for the month in which the payment is received; 24.6 (15)emergency assistancepayments for short-term emergency 24.7 needs under section 256J.626, subdivision 2; 24.8 (16) funeral and cemetery payments as provided by section 24.9 256.935; 24.10 (17) nonrecurring cash gifts of $30 or less, not exceeding 24.11 $30 per participant in a calendar month; 24.12 (18) any form of energy assistance payment made through 24.13 Public LawNumber97-35, Low-Income Home Energy Assistance Act 24.14 of 1981, payments made directly to energy providers by other 24.15 public and private agencies, and any form of credit or rebate 24.16 payment issued by energy providers; 24.17 (19) Supplemental Security Income (SSI), including 24.18 retroactive SSI payments and other income of an SSI recipient, 24.19 except as described in section 256J.37, subdivision 3b; 24.20 (20) Minnesota supplemental aid, including retroactive 24.21 payments; 24.22 (21) proceeds from the sale of real or personal property; 24.23 (22) adoption assistance payments under section 259.67; 24.24 (23) state-funded family subsidy program payments made 24.25 under section 252.32 to help families care for children with 24.26 mental retardation or related conditions, consumer support grant 24.27 funds under section 256.476, and resources and services for a 24.28 disabled household member under one of the home and 24.29 community-based waiver services programs under chapter 256B; 24.30 (24) interest payments and dividends from property that is 24.31 not excluded from and that does not exceed the asset limit; 24.32 (25) rent rebates; 24.33 (26) income earned by a minor caregiver, minor child 24.34 through age 6, or a minor child who is at least a half-time 24.35 student in an approved elementary or secondary education 24.36 program; 25.1 (27) income earned by a caregiver under age 20 who is at 25.2 least a half-time student in an approved elementary or secondary 25.3 education program; 25.4 (28) MFIP child care payments under section 119B.05; 25.5 (29) all other payments made through MFIP to support a 25.6 caregiver's pursuit of greaterself-supporteconomic stability; 25.7 (30) income a participant receives related to shared living 25.8 expenses; 25.9 (31) reverse mortgages; 25.10 (32) benefits provided by the Child Nutrition Act of 1966, 25.11 United States Code, title 42, chapter 13A, sections 1771 to 25.12 1790; 25.13 (33) benefits provided by the women, infants, and children 25.14 (WIC) nutrition program, United States Code, title 42, chapter 25.15 13A, section 1786; 25.16 (34) benefits from the National School Lunch Act, United 25.17 States Code, title 42, chapter 13, sections 1751 to 1769e; 25.18 (35) relocation assistance for displaced persons under the 25.19 Uniform Relocation Assistance and Real Property Acquisition 25.20 Policies Act of 1970, United States Code, title 42, chapter 61, 25.21 subchapter II, section 4636, or the National Housing Act, United 25.22 States Code, title 12, chapter 13, sections 1701 to 1750jj; 25.23 (36) benefits from the Trade Act of 1974, United States 25.24 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 25.25 (37) war reparations payments to Japanese Americans and 25.26 Aleuts under United States Code, title 50, sections 1989 to 25.27 1989d; 25.28 (38) payments to veterans or their dependents as a result 25.29 of legal settlements regarding Agent Orange or other chemical 25.30 exposure under Public LawNumber101-239, section 10405, 25.31 paragraph (a)(2)(E); 25.32 (39) income that is otherwise specifically excluded from 25.33 MFIP consideration in federal law, state law, or federal 25.34 regulation; 25.35 (40) security and utility deposit refunds; 25.36 (41) American Indian tribal land settlements excluded under 26.1 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 26.2 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 26.3 and Mille Lacs reservations and payments to members of the White 26.4 Earth Band, under United States Code, title 25, chapter 9, 26.5 section 331, and chapter 16, section 1407; 26.6 (42) all income of the minor parent's parents and 26.7 stepparents when determining the grant for the minor parent in 26.8 households that include a minor parent living with parents or 26.9 stepparents on MFIP with other children; 26.10 (43) income of the minor parent's parents and stepparents 26.11 equal to 200 percent of the federal poverty guideline for a 26.12 family size not including the minor parent and the minor 26.13 parent's child in households that include a minor parent living 26.14 with parents or stepparents not on MFIP when determining the 26.15 grant for the minor parent. The remainder of income is deemed 26.16 as specified in section 256J.37, subdivision 1b; 26.17 (44) payments made to children eligible for relative 26.18 custody assistance under section 257.85; 26.19 (45) vendor payments for goods and services made on behalf 26.20 of a client unless the client has the option of receiving the 26.21 payment in cash; and 26.22 (46) the principal portion of a contract for deed payment. 26.23 Sec. 32. Minnesota Statutes 2002, section 256J.24, 26.24 subdivision 3, is amended to read: 26.25 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 26.26 ASSISTANCE UNIT.] (a) The following individuals who are part of 26.27 the assistance unit determined under subdivision 2 are 26.28 ineligible to receive MFIP: 26.29 (1) individualsreceivingwho are recipients of 26.30 Supplemental Security Income or Minnesota supplemental aid; 26.31 (2) individuals disqualified from the food stamp program or 26.32 MFIP, until the disqualification ends; 26.33 (3) children on whose behalf federal, state or local foster 26.34 care payments are made, except as provided in sections 256J.13, 26.35 subdivision 2, and 256J.74, subdivision 2; and 26.36 (4) children receiving ongoing monthly adoption assistance 27.1 payments under section 259.67. 27.2 (b) The exclusion of a person under this subdivision does 27.3 not alter the mandatory assistance unit composition. 27.4 Sec. 33. Minnesota Statutes 2002, section 256J.24, 27.5 subdivision 5, is amended to read: 27.6 Subd. 5. [MFIP TRANSITIONAL STANDARD.] Thefollowing table27.7represents theMFIP transitional standardtable when all members27.8ofis based on the number of persons in the assistance unitare27.9 eligible for both food and cash assistance unless the 27.10 restrictions in subdivision 6 on the birth of a child apply. 27.11 The following table represents the transitional standards 27.12 effective October 1, 2002. 27.13 Number of Transitional Cash Food 27.14 Eligible People Standard Portion Portion 27.15 1$351$370: $250 $120 27.16 2$609$658: $437 $221 27.17 3$763$844: $532 $312 27.18 4$903$998: $621 $377 27.19 5$1,025$1,135: $697 $438 27.20 6$1,165$1,296: $773 $523 27.21 7$1,273$1,414: $850 $564 27.22 8$1,403$1,558: $916 $642 27.23 9$1,530$1,700: $980 $720 27.24 10$1,653$1,836: $1,035 $801 27.25 over 10 add$121$136: $53 $83 27.26 per additional member. 27.27 The commissioner shall annually publish in the State 27.28 Register the transitional standard for an assistance unit sizes 27.29 1 to 10 including a breakdown of the cash and food portions. 27.30 Sec. 34. Minnesota Statutes 2002, section 256J.24, 27.31 subdivision 6, is amended to read: 27.32 Subd. 6. [APPLICATION OF ASSISTANCE STANDARDSFAMILY CAP.] 27.33The standards apply to the number of eligible persons in the27.34assistance unit.(a) MFIP assistance units shall not receive an 27.35 increase in the cash portion of the transitional standard as a 27.36 result of the birth of a child, unless one of the conditions 28.1 under paragraph (b) is met. The child shall be considered a 28.2 member of the assistance unit according to subdivisions 1 to 3, 28.3 but shall be excluded in determining family size for purposes of 28.4 determining the amount of the cash portion of the transitional 28.5 standard under subdivision 5. The child shall be included in 28.6 determining family size for purposes of determining the food 28.7 portion of the transitional standard. The transitional standard 28.8 under this subdivision shall be the total of the cash and food 28.9 portions as specified in this paragraph. The family wage level 28.10 under this subdivision shall be based on the family size used to 28.11 determine the food portion of the transitional standard. 28.12 (b) A child shall be included in determining family size 28.13 for purposes of determining the amount of the cash portion of 28.14 the MFIP transitional standard when at least one of the 28.15 following conditions is met: 28.16 (1) for families receiving MFIP assistance on July 1, 2003, 28.17 the child is born to the adult parent before May 1, 2004; 28.18 (2) for families who apply for the diversionary work 28.19 program under section 256J.95 or MFIP assistance on or after 28.20 July 1, 2003, the child is born to the adult parent within ten 28.21 months of the date the family is eligible for assistance; 28.22 (3) the child was conceived as a result of a sexual assault 28.23 or incest, provided that: 28.24 (i) the incident has been reported to a law enforcement 28.25 agency which determines that there is probable cause to believe 28.26 the crime occurred; and 28.27 (ii) a physician verifies that there is reason to believe 28.28 the pregnancy or birth resulted from the reported incident; 28.29 (4) the child's mother is a minor caregiver as defined in 28.30 section 256J.08, subdivision 59, and the child, or multiple 28.31 children, are the mother's first birth; or 28.32 (5) for reapplications after March 1, 2005, any child 28.33 previously excluded in determining family size under paragraph 28.34 (a) shall be included if the adult parent or parents have not 28.35 received benefits from the diversionary work program under 28.36 section 256J.95 or MFIP assistance in the previous ten months. 29.1 An adult parent or parents who reapply and have received 29.2 benefits from the diversionary work program or MFIP assistance 29.3 in the past ten months shall be under the ten-month grace period 29.4 of their previous application under clause (2). 29.5 (c) Income and resources of a child excluded under this 29.6 subdivision must be considered using the same policies as for 29.7 other children when determining the grant amount of the 29.8 assistance unit. 29.9 (d) The caregiver must assign support and cooperate with 29.10 the child support enforcement agency to establish paternity and 29.11 collect child support on behalf of the excluded child. Failure 29.12 to cooperate results in the sanction specified in section 29.13 256J.46, subdivisions 2 and 2a. Current support paid on behalf 29.14 of the excluded child shall be distributed according to section 29.15 256.741, subdivision 15, and counted to determine the grant 29.16 amount of the assistance unit. 29.17 (e) County agencies must inform applicants of the 29.18 provisions under this subdivision at the time of each 29.19 application and at recertification. 29.20 (f) Children excluded under this provision shall be deemed 29.21 MFIP recipients for purposes of child care under chapter 119B. 29.22 Sec. 35. Minnesota Statutes 2002, section 256J.24, 29.23 subdivision 7, is amended to read: 29.24 Subd. 7. [FAMILY WAGE LEVELSTANDARD.] The family wage 29.25 levelstandardis 110 percent of the transitional standard under 29.26 subdivision 5 or 6, when applicable, and is the standard used 29.27 when there is earned income in the assistance unit. As 29.28 specified in section 256J.21, earned income is subtracted from 29.29 the family wage level to determine the amount of the assistance 29.30 payment.Not includingThefamily wage level standard,29.31 assistancepaymentspayment may not exceed theMFIP standard of29.32needtransitional standard under subdivision 5 or 6, or the 29.33 shared household standard under subdivision 9, whichever is 29.34 applicable, for the assistance unit. 29.35 Sec. 36. Minnesota Statutes 2002, section 256J.24, 29.36 subdivision 10, is amended to read: 30.1 Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust 30.2 the MFIP earned income disregard to ensure that most 30.3 participants do not lose eligibility for MFIP until their income 30.4 reaches at least120115 percent of the federal poverty 30.5 guidelines in effect in October of each fiscal year. The 30.6 adjustment to the disregard shall be based on a household size 30.7 of three, and the resulting earned income disregard percentage 30.8 must be applied to all household sizes. The adjustment under 30.9 this subdivision must be implemented at the same time as the 30.10 October food stamp cost-of-living adjustment is reflected in the 30.11 food portion of MFIP transitional standard as required under 30.12 subdivision 5a. 30.13 Sec. 37. Minnesota Statutes 2002, section 256J.30, 30.14 subdivision 9, is amended to read: 30.15 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 30.16 report the changes or anticipated changes specified in clauses 30.17 (1) to(17)(16) within ten days of the date they occur, at the 30.18 time of the periodic recertification of eligibility under 30.19 section 256J.32, subdivision 6, or within eight calendar days of 30.20 a reporting period as in subdivision 5 or 6, whichever occurs 30.21 first. A caregiver must report other changes at the time of the 30.22 periodic recertification of eligibility under section 256J.32, 30.23 subdivision 6, or at the end of a reporting period under 30.24 subdivision 5 or 6, as applicable. A caregiver must make these 30.25 reports in writing to the county agency. When a county agency 30.26 could have reduced or terminated assistance for one or more 30.27 payment months if a delay in reporting a change specified under 30.28 clauses (1) to(16)(15) had not occurred, the county agency 30.29 must determine whether a timely notice under section 256J.31, 30.30 subdivision 4, could have been issued on the day that the change 30.31 occurred. When a timely notice could have been issued, each 30.32 month's overpayment subsequent to that notice must be considered 30.33 a client error overpayment under section 256J.38. Calculation 30.34 of overpayments for late reporting under clause(17)(16) is 30.35 specified in section 256J.09, subdivision 9. Changes in 30.36 circumstances which must be reported within ten days must also 31.1 be reported on the MFIP household report form for the reporting 31.2 period in which those changes occurred. Within ten days, a 31.3 caregiver must report: 31.4 (1) a change in initial employment; 31.5 (2) a change in initial receipt of unearned income; 31.6 (3) a recurring change in unearned income; 31.7 (4) a nonrecurring change of unearned income that exceeds 31.8 $30; 31.9 (5) the receipt of a lump sum; 31.10 (6) an increase in assets that may cause the assistance 31.11 unit to exceed asset limits; 31.12 (7) a change in the physical or mental status of an 31.13 incapacitated member of the assistance unit if the physical or 31.14 mental status is the basis of exemption from an MFIP employment 31.15 services program under section 256J.56 or for reducing the 31.16 hourly requirements under section 256J.55, subdivision 1, or the 31.17 type of activities included in an employment plan under section 31.18 256J.521, subdivision 2; 31.19 (8) a change in employment status; 31.20 (9) information affecting an exception under section 31.21 256J.24, subdivision 9; 31.22 (10)a change in health insurance coverage;31.23(11)the marriage or divorce of an assistance unit member; 31.24(12)(11) the death of a parent, minor child, or 31.25 financially responsible person; 31.26(13)(12) a change in address or living quarters of the 31.27 assistance unit; 31.28(14)(13) the sale, purchase, or other transfer of 31.29 property; 31.30(15)(14) a change in school attendance of acustodial31.31parentcaregiver under age 20 or an employed child; 31.32(16)(15) filing a lawsuit, a workers' compensation claim, 31.33 or a monetary claim against a third party; and 31.34(17)(16) a change in household composition, including 31.35 births, returns to and departures from the home of assistance 31.36 unit members and financially responsible persons, or a change in 32.1 the custody of a minor child. 32.2 Sec. 38. Minnesota Statutes 2002, section 256J.32, 32.3 subdivision 2, is amended to read: 32.4 Subd. 2. [DOCUMENTATION.] The applicant or participant 32.5 must document the information required under subdivisions 4 to 6 32.6 or authorize the county agency to verify the information. The 32.7 applicant or participant has the burden of providing documentary 32.8 evidence to verify eligibility. The county agency shall assist 32.9 the applicant or participant in obtaining required documents 32.10 when the applicant or participant is unable to do so.When an32.11applicant or participant and the county agency are unable to32.12obtain documents needed to verify information, the county agency32.13may accept an affidavit from an applicant or participant as32.14sufficient documentation.The county agency may accept an 32.15 affidavit only for factors specified under subdivision 8. 32.16 Sec. 39. Minnesota Statutes 2002, section 256J.32, 32.17 subdivision 4, is amended to read: 32.18 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 32.19 verify the following at application: 32.20 (1) identity of adults; 32.21 (2) presence of the minor child in the home, if 32.22 questionable; 32.23 (3) relationship of a minor child to caregivers in the 32.24 assistance unit; 32.25 (4) age, if necessary to determine MFIP eligibility; 32.26 (5) immigration status; 32.27 (6) social security number according to the requirements of 32.28 section 256J.30, subdivision 12; 32.29 (7) income; 32.30 (8) self-employment expenses used as a deduction; 32.31 (9) source and purpose of deposits and withdrawals from 32.32 business accounts; 32.33 (10) spousal support and child support payments made to 32.34 persons outside the household; 32.35 (11) real property; 32.36 (12) vehicles; 33.1 (13) checking and savings accounts; 33.2 (14) savings certificates, savings bonds, stocks, and 33.3 individual retirement accounts; 33.4 (15) pregnancy, if related to eligibility; 33.5 (16) inconsistent information, if related to eligibility; 33.6 (17)medical insurance;33.7(18)burial accounts; 33.8(19)(18) school attendance, if related to eligibility; 33.9(20)(19) residence; 33.10(21)(20) a claim of family violence if used as a basisfor33.11ato qualify for the family violence waiverfrom the 60-month33.12time limit in section 256J.42 and regular employment and33.13training services requirements in section 256J.56; 33.14(22)(21) disability if used as the basis for an exemption 33.15 from employment and training services requirements under section 33.16 256J.56 or as the basis for reducing the hourly participation 33.17 requirements under section 256J.55, subdivision 1, or the type 33.18 of activity included in an employment plan under section 33.19 256J.521, subdivision 2; and 33.20(23)(22) information needed to establish an exception 33.21 under section 256J.24, subdivision 9. 33.22 Sec. 40. Minnesota Statutes 2002, section 256J.32, 33.23 subdivision 5a, is amended to read: 33.24 Subd. 5a. [INCONSISTENT INFORMATION.] When the county 33.25 agency verifies inconsistent information under subdivision 4, 33.26 clause (16), or 6, clause(4)(5), the reason for verifying the 33.27 information must be documented in the financial case record. 33.28 Sec. 41. Minnesota Statutes 2002, section 256J.32, is 33.29 amended by adding a subdivision to read: 33.30 Subd. 8. [AFFIDAVIT.] The county agency may accept an 33.31 affidavit from the applicant or recipient as sufficient 33.32 documentation at the time of application or recertification only 33.33 for the following factors: 33.34 (1) a claim of family violence if used as a basis to 33.35 qualify for the family violence waiver; 33.36 (2) information needed to establish an exception under 34.1 section 256J.24, subdivision 9; 34.2 (3) relationship of a minor child to caregivers in the 34.3 assistance unit; and 34.4 (4) citizenship status from a noncitizen who reports to be, 34.5 or is identified as, a victim of severe forms of trafficking in 34.6 persons, if the noncitizen reports that the noncitizen's 34.7 immigration documents are being held by an individual or group 34.8 of individuals against the noncitizen's will. The noncitizen 34.9 must follow up with the Office of Refugee Resettlement (ORR) to 34.10 pursue certification. If verification that certification is 34.11 being pursued is not received within 30 days, the MFIP case must 34.12 be closed and the agency shall pursue overpayments. The ORR 34.13 documents certifying the noncitizen's status as a victim of 34.14 severe forms of trafficking in persons, or the reason for the 34.15 delay in processing, must be received within 90 days, or the 34.16 MFIP case must be closed and the agency shall pursue 34.17 overpayments. 34.18 Sec. 42. Minnesota Statutes 2002, section 256J.37, is 34.19 amended by adding a subdivision to read: 34.20 Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 34.21 Effective July 1, 2003, the county agency shall count $100 of 34.22 the value of public and assisted rental subsidies provided 34.23 through the Department of Housing and Urban Development (HUD) as 34.24 unearned income to the cash portion of the MFIP grant. The full 34.25 amount of the subsidy must be counted as unearned income when 34.26 the subsidy is less than $100. 34.27 (b) The provisions of this subdivision shall not apply to 34.28 an MFIP assistance unit which includes a participant who is: 34.29 (1) age 60 or older; 34.30 (2) a caregiver who is suffering from an illness, injury, 34.31 or incapacity that has been certified by a qualified 34.32 professional when the illness, injury, or incapacity is expected 34.33 to continue for more than 30 days and prevents the person from 34.34 obtaining or retaining employment; or 34.35 (3) a caregiver whose presence in the home is required due 34.36 to the illness or incapacity of another member in the assistance 35.1 unit, a relative in the household, or a foster child in the 35.2 household when the illness or incapacity and the need for the 35.3 participant's presence in the home has been certified by a 35.4 qualified professional and is expected to continue for more than 35.5 30 days. 35.6 (c) The provisions of this subdivision shall not apply to 35.7 an MFIP assistance unit where the parental caregiver is an SSI 35.8 recipient. 35.9 Sec. 43. Minnesota Statutes 2002, section 256J.37, is 35.10 amended by adding a subdivision to read: 35.11 Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY 35.12 INCOME.] Effective July 1, 2003, the county shall reduce the 35.13 cash portion of the MFIP grant by $175 per SSI recipient who 35.14 resides in the household, and who would otherwise be included in 35.15 the MFIP assistance unit under section 256J.24, subdivision 2, 35.16 but is excluded solely due to the supplemental security income 35.17 recipient status under section 256J.24, subdivision 3, paragraph 35.18 (a), clause (1). If the SSI recipient receives less than $175 35.19 of supplemental security income, only the amount received shall 35.20 be used in calculating the MFIP cash assistance payment. This 35.21 provision does not apply to relative caregivers who could elect 35.22 to be included in the MFIP assistance unit under section 35.23 256J.24, subdivision 4, unless the caregiver's children or 35.24 stepchildren are included in the MFIP assistance unit. 35.25 Sec. 44. Minnesota Statutes 2002, section 256J.37, 35.26 subdivision 9, is amended to read: 35.27 Subd. 9. [UNEARNED INCOME.](a)The county agency must 35.28 apply unearned income to the MFIP standard of need. When 35.29 determining the amount of unearned income, the county agency 35.30 must deduct the costs necessary to secure payments of unearned 35.31 income. These costs include legal fees, medical fees, and 35.32 mandatory deductions such as federal and state income taxes. 35.33(b) Effective July 1, 2003, the county agency shall count35.34$100 of the value of public and assisted rental subsidies35.35provided through the Department of Housing and Urban Development35.36(HUD) as unearned income. The full amount of the subsidy must36.1be counted as unearned income when the subsidy is less than $100.36.2(c) The provisions of paragraph (b) shall not apply to MFIP36.3participants who are exempt from the employment and training36.4services component because they are:36.5(i) individuals who are age 60 or older;36.6(ii) individuals who are suffering from a professionally36.7certified permanent or temporary illness, injury, or incapacity36.8which is expected to continue for more than 30 days and which36.9prevents the person from obtaining or retaining employment; or36.10(iii) caregivers whose presence in the home is required36.11because of the professionally certified illness or incapacity of36.12another member in the assistance unit, a relative in the36.13household, or a foster child in the household.36.14(d) The provisions of paragraph (b) shall not apply to an36.15MFIP assistance unit where the parental caregiver receives36.16supplemental security income.36.17 Sec. 45. Minnesota Statutes 2002, section 256J.38, 36.18 subdivision 3, is amended to read: 36.19 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER36.20PARTICIPANTS.] A county agency must initiate efforts to recover 36.21 overpayments paid to a former participant or caregiver.Adults36.22 Caregivers, both parental and nonparental, and minor caregivers 36.23 of an assistance unit at the time an overpayment occurs, whether 36.24 receiving assistance or not, are jointly and individually liable 36.25 for repayment of the overpayment. The county agency must 36.26 request repayment from the former participants and caregivers. 36.27 When an agreement for repayment is not completed within six 36.28 months of the date of discovery or when there is a default on an 36.29 agreement for repayment after six months, the county agency must 36.30 initiate recovery consistent with chapter 270A, or section 36.31 541.05. When a person has been convicted of fraud under section 36.32 256.98, recovery must be sought regardless of the amount of 36.33 overpayment. When an overpayment is less than $35, and is not 36.34 the result of a fraud conviction under section 256.98, the 36.35 county agency must not seek recovery under this subdivision. 36.36 The county agency must retain information about all overpayments 37.1 regardless of the amount. When an adult, adult caregiver, or 37.2 minor caregiver reapplies for assistance, the overpayment must 37.3 be recouped under subdivision 4. 37.4 Sec. 46. Minnesota Statutes 2002, section 256J.38, 37.5 subdivision 4, is amended to read: 37.6 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 37.7 participant may voluntarily repay, in part or in full, an 37.8 overpayment even if assistance is reduced under this 37.9 subdivision, until the total amount of the overpayment is 37.10 repaid. When an overpayment occurs due to fraud, the county 37.11 agency must recover from the overpaid assistance unit, including 37.12 child only cases, ten percent of the applicable standard or the 37.13 amount of the monthly assistance payment, whichever is less. 37.14 When a nonfraud overpayment occurs, the county agency must 37.15 recover from the overpaid assistance unit, including child only 37.16 cases, three percent of the MFIP standard of need or the amount 37.17 of the monthly assistance payment, whichever is less. 37.18 Sec. 47. Minnesota Statutes 2002, section 256J.42, 37.19 subdivision 4, is amended to read: 37.20 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 37.21 received by an assistance unit in a month when a caregiver 37.22 complied witha safetyan employment planor after October 1,37.232001, complied or is complying with an alternative employment37.24planunder section256J.49256J.521, subdivision1a3, does 37.25 not count toward the 60-month limitation on assistance. 37.26 Sec. 48. Minnesota Statutes 2002, section 256J.42, 37.27 subdivision 5, is amended to read: 37.28 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 37.29 assistance received by an assistance unit does not count toward 37.30 the 60-month limit on assistance during a month in which the 37.31 caregiver isin the category inage 60 or older, including 37.32 months during which the caregiver was exempt under section 37.33 256J.56, paragraph (a), clause (1). 37.34 (b) From July 1, 1997, until the date MFIP is operative in 37.35 the caregiver's county of financial responsibility, any cash 37.36 assistance received by a caregiver who is complying with 38.1 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 38.2 Minnesota Statutes 1998, section 256.736, if applicable, does 38.3 not count toward the 60-month limit on assistance. Thereafter, 38.4 any cash assistance received by a minor caregiver who is 38.5 complying with the requirements of sections 256J.14 and 256J.54, 38.6 if applicable, does not count towards the 60-month limit on 38.7 assistance. 38.8 (c) Any diversionary assistance or emergency assistance 38.9 received prior to July 1, 2003, does not count toward the 38.10 60-month limit. 38.11 (d) Any cash assistance received by an 18- or 19-year-old 38.12 caregiver who is complying withthe requirements ofan 38.13 employment plan that includes an education option under section 38.14 256J.54 does not count toward the 60-month limit. 38.15 (e) Payments provided to meet short-term emergency needs 38.16 under section 256J.626 and diversionary work program benefits 38.17 provided under section 256J.95 do not count toward the 60-month 38.18 time limit. 38.19 Sec. 49. Minnesota Statutes 2002, section 256J.42, 38.20 subdivision 6, is amended to read: 38.21 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 38.22 than 60 days, before the end of the participant's 60th month on 38.23 assistance, the county agency or job counselor must review the 38.24 participant's case to determine if the employment plan is still 38.25 appropriate or if the participant is exempt under section 38.26 256J.56 from the employment and training services component, and 38.27 attempt to meet with the participant face-to-face. 38.28 (b) During the face-to-face meeting, a county agency or the 38.29 job counselor must: 38.30 (1) inform the participant how many months of counted 38.31 assistance the participant has accrued and when the participant 38.32 is expected to reach the 60th month; 38.33 (2) explain the hardship extension criteria under section 38.34 256J.425 and what the participant should do if the participant 38.35 thinks a hardship extension applies; 38.36 (3) identify other resources that may be available to the 39.1 participant to meet the needs of the family; and 39.2 (4) inform the participant of the right to appeal the case 39.3 closure under section 256J.40. 39.4 (c) If a face-to-face meeting is not possible, the county 39.5 agency must send the participant a notice of adverse action as 39.6 provided in section 256J.31, subdivisions 4 and 5. 39.7 (d) Before a participant's case is closed under this 39.8 section, the county must ensure that: 39.9 (1) the case has been reviewed by the job counselor's 39.10 supervisor or the review team designatedinby thecounty's39.11approved local service unit plancounty to determine if the 39.12 criteria for a hardship extension, if requested, were applied 39.13 appropriately; and 39.14 (2) the county agency or the job counselor attempted to 39.15 meet with the participant face-to-face. 39.16 Sec. 50. Minnesota Statutes 2002, section 256J.425, 39.17 subdivision 1, is amended to read: 39.18 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 39.19 hardship extension, a participant in an assistance unit subject 39.20 to the time limit under section 256J.42, subdivision 1,in which39.21any participant has received 60 counted months of assistance,39.22 must be in compliance in the participant's 60th counted month 39.23the participant is applying for the extension. For purposes of 39.24 determining eligibility for a hardship extension, a participant 39.25 is in compliance in any month that the participant has not been 39.26 sanctioned. 39.27 (b) If one participant in a two-parent assistance unit is 39.28 determined to be ineligible for a hardship extension, the county 39.29 shall give the assistance unit the option of disqualifying the 39.30 ineligible participant from MFIP. In that case, the assistance 39.31 unit shall be treated as a one-parent assistance unit and the 39.32 assistance unit's MFIP grant shall be calculated using the 39.33 shared household standard under section 256J.08, subdivision 82a. 39.34 Sec. 51. Minnesota Statutes 2002, section 256J.425, 39.35 subdivision 1a, is amended to read: 39.36 Subd. 1a. [REVIEW.] If a county grants a hardship 40.1 extension under this section, a county agency shall review the 40.2 case every six or 12 months, whichever is appropriate based on 40.3 the participant's circumstances and the extension 40.4 category. More frequent reviews shall be required if 40.5 eligibility for an extension is based on a condition that is 40.6 subject to change in less than six months. 40.7 Sec. 52. Minnesota Statutes 2002, section 256J.425, 40.8 subdivision 2, is amended to read: 40.9 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 40.10 subject to the time limit in section 256J.42, subdivision 1,in40.11which any participant has received 60 counted months of40.12assistance,is eligible to receive months of assistance under a 40.13 hardship extension if the participant who reached the time limit 40.14 belongs to any of the following groups: 40.15 (1) participants who are suffering froma professionally40.16certifiedan illness, injury, or incapacity which has been 40.17 certified by a qualified professional when the illness, injury, 40.18 or incapacity is expected to continue for more than 30 days 40.19 andwhichprevents the person from obtaining or retaining 40.20 employmentand who are following. These participants must 40.21 follow the treatment recommendations of thehealth care provider40.22 qualified professional certifying the illness, injury, or 40.23 incapacity; 40.24 (2) participants whose presence in the home is required as 40.25 a caregiver because ofa professionally certifiedthe illness or 40.26 incapacity of another member in the assistance unit, a relative 40.27 in the household, or a foster child in the householdandwhen 40.28 the illness or incapacity and the need for the participant's 40.29 presence in the home has been certified by a qualified 40.30 professional and is expected to continue for more than 30 days; 40.31 or 40.32 (3) caregivers with a child or an adult in the household 40.33 who meets the disability or medical criteria for home care 40.34 services under section 256B.0627, subdivision 1, paragraph 40.35(c)(f), or a home and community-based waiver services program 40.36 under chapter 256B, or meets the criteria for severe emotional 41.1 disturbance under section 245.4871, subdivision 6, or for 41.2 serious and persistent mental illness under section 245.462, 41.3 subdivision 20, paragraph (c). Caregivers in this category are 41.4 presumed to be prevented from obtaining or retaining employment. 41.5 (b) An assistance unit receiving assistance under a 41.6 hardship extension under this subdivision may continue to 41.7 receive assistance as long as the participant meets the criteria 41.8 in paragraph (a), clause (1), (2), or (3). 41.9 Sec. 53. Minnesota Statutes 2002, section 256J.425, 41.10 subdivision 3, is amended to read: 41.11 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 41.12 subject to the time limit in section 256J.42, subdivision 1,in41.13which any participant has received 60 counted months of41.14assistance,is eligible to receive months of assistance under a 41.15 hardship extension if the participant who reached the time limit 41.16 belongs to any of the following groups: 41.17 (1) a person who is diagnosed by a licensed physician, 41.18 psychological practitioner, or other qualified professional, as 41.19 mentally retarded or mentally ill, and that condition prevents 41.20 the person from obtaining or retaining unsubsidized employment; 41.21 (2) a person who: 41.22 (i) has been assessed by a vocational specialist or the 41.23 county agency to be unemployable for purposes of this 41.24 subdivision; or 41.25 (ii) has an IQ below 80 who has been assessed by a 41.26 vocational specialist or a county agency to be employable, but 41.27 not at a level that makes the participant eligible for an 41.28 extension under subdivision 4or,. The determination of IQ 41.29 level must be made by a qualified professional. In the case of 41.30 a non-English-speaking personfor whom it is not possible to41.31provide a determination due to language barriers or absence of41.32culturally appropriate assessment tools, is determined by a41.33qualified professional to have an IQ below 80. A person is41.34considered employable if positions of employment in the local41.35labor market exist, regardless of the current availability of41.36openings for those positions, that the person is capable of42.1performing: (A) the determination must be made by a qualified 42.2 professional with experience conducting culturally appropriate 42.3 assessments, whenever possible; (B) the county may accept 42.4 reports that identify an IQ range as opposed to a specific 42.5 score; (C) these reports must include a statement of confidence 42.6 in the results; 42.7 (3) a person who is determined bythe county agencya 42.8 qualified professional to be learning disabledor, and the 42.9 disability severely limits the person's ability to obtain, 42.10 perform, or maintain suitable employment. For purposes of the 42.11 initial approval of a learning disability extension, the 42.12 determination must have been made or confirmed within the 42.13 previous 12 months. In the case of a non-English-speaking 42.14 personfor whom it is not possible to provide a medical42.15diagnosis due to language barriers or absence of culturally42.16appropriate assessment tools, is determined by a qualified42.17professional to have a learning disability. If a rehabilitation42.18plan for the person is developed or approved by the county42.19agency, the plan must be incorporated into the employment plan.42.20However, a rehabilitation plan does not replace the requirement42.21to develop and comply with an employment plan under section42.22256J.52. For purposes of this section, "learning disabled"42.23means the applicant or recipient has a disorder in one or more42.24of the psychological processes involved in perceiving,42.25understanding, or using concepts through verbal language or42.26nonverbal means. The disability must severely limit the42.27applicant or recipient in obtaining, performing, or maintaining42.28suitable employment. Learning disabled does not include42.29learning problems that are primarily the result of visual,42.30hearing, or motor handicaps; mental retardation; emotional42.31disturbance; or due to environmental, cultural, or economic42.32disadvantage: (i) the determination must be made by a qualified 42.33 professional with experience conducting culturally appropriate 42.34 assessments, whenever possible; and (ii) these reports must 42.35 include a statement of confidence in the results. If a 42.36 rehabilitation plan for a participant extended as learning 43.1 disabled is developed or approved by the county agency, the plan 43.2 must be incorporated into the employment plan. However, a 43.3 rehabilitation plan does not replace the requirement to develop 43.4 and comply with an employment plan under section 256J.521; or 43.5 (4) a person whois a victim ofhas been granted a family 43.6 violenceas defined in section 256J.49, subdivision 2waiver, 43.7 and who isparticipating incomplying with analternative43.8 employment plan under section256J.49256J.521, subdivision1a43.9 3. 43.10 Sec. 54. Minnesota Statutes 2002, section 256J.425, 43.11 subdivision 4, is amended to read: 43.12 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 43.13 subject to the time limit under section 256J.42, subdivision 1, 43.14in which any participant has received 60 months of assistance,43.15 is eligible to receive assistance under a hardship extension if 43.16 the participant who reached the time limit belongs to: 43.17 (1) a one-parent assistance unit in which the participant 43.18 is participating in work activities for at least 30 hours per 43.19 week, of which an average of at least 25 hours per week every 43.20 month are spent participating in employment; 43.21 (2) a two-parent assistance unit in which the participants 43.22 are participating in work activities for at least 55 hours per 43.23 week, of which an average of at least 45 hours per week every 43.24 month are spent participating in employment; or 43.25 (3) an assistance unit in which a participant is 43.26 participating in employment for fewer hours than those specified 43.27 in clause (1), and the participant submits verification from a 43.28health care providerqualified professional, in a form 43.29 acceptable to the commissioner, stating that the number of hours 43.30 the participant may work is limited due to illness or 43.31 disability, as long as the participant is participating in 43.32 employment for at least the number of hours specified by 43.33 thehealth care providerqualified professional. The 43.34 participant must be following the treatment recommendations of 43.35 thehealth care providerqualified professional providing the 43.36 verification. The commissioner shall develop a form to be 44.1 completed and signed by thehealth care providerqualified 44.2 professional, documenting the diagnosis and any additional 44.3 information necessary to document the functional limitations of 44.4 the participant that limit work hours. If the participant is 44.5 part of a two-parent assistance unit, the other parent must be 44.6 treated as a one-parent assistance unit for purposes of meeting 44.7 the work requirements under this subdivision. 44.8 (b) For purposes of this section, employment means: 44.9 (1) unsubsidized employment under section 256J.49, 44.10 subdivision 13, clause (1); 44.11 (2) subsidized employment under section 256J.49, 44.12 subdivision 13, clause (2); 44.13 (3) on-the-job training under section 256J.49, subdivision 44.14 13, clause(4)(2); 44.15 (4) an apprenticeship under section 256J.49, subdivision 44.16 13, clause(19)(1); 44.17 (5) supported work. For purposes of this section,44.18"supported work" means services supporting a participant on the44.19job which include, but are not limited to, supervision, job44.20coaching, and subsidized wagesunder section 256J.49, 44.21 subdivision 13, clause (2); 44.22 (6) a combination of clauses (1) to (5); or 44.23 (7) child care under section 256J.49, subdivision 13, 44.24 clause(25)(7), if it is in combination with paid employment. 44.25 (c) If a participant is complying with a child protection 44.26 plan under chapter 260C, the number of hours required under the 44.27 child protection plan count toward the number of hours required 44.28 under this subdivision. 44.29 (d) The county shall provide the opportunity for subsidized 44.30 employment to participants needing that type of employment 44.31 within available appropriations. 44.32 (e) To be eligible for a hardship extension for employed 44.33 participants under this subdivision, a participantin a44.34one-parent assistance unit or both parents in a two-parent44.35assistance unitmust be in compliance for at least ten out of 44.36 the 12 months immediately preceding the participant's 61st month 45.1 on assistance.If only one parent in a two-parent assistance45.2unit fails to be in compliance ten out of the 12 months45.3immediately preceding the participant's 61st month, the county45.4shall give the assistance unit the option of disqualifying the45.5noncompliant parent. If the noncompliant participant is45.6disqualified, the assistance unit must be treated as a45.7one-parent assistance unit for the purposes of meeting the work45.8requirements under this subdivision and the assistance unit's45.9MFIP grant shall be calculated using the shared household45.10standard under section 256J.08, subdivision 82a.45.11 (f) The employment plan developed under section256J.5245.12 256J.521, subdivision52, for participants under this 45.13 subdivision must contain the number of hours specified in 45.14 paragraph (a) related to employment and work activities. The 45.15 job counselor and the participant must sign the employment plan 45.16 to indicate agreement between the job counselor and the 45.17 participant on the contents of the plan. 45.18 (g) Participants who fail to meet the requirements in 45.19 paragraph (a), without good cause under section 256J.57, shall 45.20 be sanctioned or permanently disqualified under subdivision 6. 45.21 Good cause may only be granted for that portion of the month for 45.22 which the good cause reason applies. Participants must meet all 45.23 remaining requirements in the approved employment plan or be 45.24 subject to sanction or permanent disqualification. 45.25 (h) If the noncompliance with an employment plan is due to 45.26 the involuntary loss of employment, the participant is exempt 45.27 from the hourly employment requirement under this subdivision 45.28 for one month. Participants must meet all remaining 45.29 requirements in the approved employment plan or be subject to 45.30 sanction or permanent disqualification. This exemption is 45.31 available toone-parent assistance unitsa participant two times 45.32 in a 12-month period, and two-parent assistance units, two times45.33per parent in a 12-month period. 45.34(i) This subdivision expires on June 30, 2004.45.35 Sec. 55. Minnesota Statutes 2002, section 256J.425, 45.36 subdivision 6, is amended to read: 46.1 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 46.2 both participants in an assistance unit receiving assistance 46.3 under subdivision 3 or 4 are not in compliance with the 46.4 employment and training service requirements in sections256J.5246.5 256J.521 to256J.55256J.57, the sanctions under this 46.6 subdivision apply. For a first occurrence of noncompliance, an 46.7 assistance unit must be sanctioned under section 256J.46, 46.8 subdivision 1, paragraph(d)(c), clause (1). For a second or 46.9 third occurrence of noncompliance, the assistance unit must be 46.10 sanctioned under section 256J.46, subdivision 1, 46.11 paragraph(d)(c), clause (2). For a fourth occurrence of 46.12 noncompliance, the assistance unit is disqualified from MFIP. 46.13 If a participant is determined to be out of compliance, the 46.14 participant may claim a good cause exception under section 46.15 256J.57, however, the participant may not claim an exemption 46.16 under section 256J.56. 46.17 (b) If both participants in a two-parent assistance unit 46.18 are out of compliance at the same time, it is considered one 46.19 occurrence of noncompliance. 46.20 Sec. 56. Minnesota Statutes 2002, section 256J.425, 46.21 subdivision 7, is amended to read: 46.22 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 46.23 assistance unit that is disqualified under subdivision 6, 46.24 paragraph (a), may be approved for MFIP if the participant 46.25 complies with MFIP program requirements and demonstrates 46.26 compliance for up to one month. No assistance shall be paid 46.27 during this period. 46.28 (b) An assistance unit that is disqualified under 46.29 subdivision 6, paragraph (a), and that reapplies under paragraph 46.30 (a) is subject to sanction under section 256J.46, subdivision 1, 46.31 paragraph(d)(c), clause (1), for a first occurrence of 46.32 noncompliance. A subsequent occurrence of noncompliance results 46.33 in a permanent disqualification. 46.34 (c) If one participant in a two-parent assistance unit 46.35 receiving assistance under a hardship extension under 46.36 subdivision 3 or 4 is determined to be out of compliance with 47.1 the employment and training services requirements under sections 47.2256J.52256J.521 to256J.55256J.57, the county shall give the 47.3 assistance unit the option of disqualifying the noncompliant 47.4 participant from MFIP. In that case, the assistance unit shall 47.5 be treated as a one-parent assistance unit for the purposes of 47.6 meeting the work requirements under subdivision 4 and the 47.7 assistance unit's MFIP grant shall be calculated using the 47.8 shared household standard under section 256J.08, subdivision 47.9 82a. An applicant who is disqualified from receiving assistance 47.10 under this paragraph may reapply under paragraph (a). If a 47.11 participant is disqualified from MFIP under this subdivision a 47.12 second time, the participant is permanently disqualified from 47.13 MFIP. 47.14 (d) Prior to a disqualification under this subdivision, a 47.15 county agency must review the participant's case to determine if 47.16 the employment plan is still appropriate and attempt to meet 47.17 with the participant face-to-face. If a face-to-face meeting is 47.18 not conducted, the county agency must send the participant a 47.19 notice of adverse action as provided in section 256J.31. During 47.20 the face-to-face meeting, the county agency must: 47.21 (1) determine whether the continued noncompliance can be 47.22 explained and mitigated by providing a needed preemployment 47.23 activity, as defined in section 256J.49, subdivision 13, clause 47.24(16), or services under a local intervention grant for47.25self-sufficiency under section 256J.625(9); 47.26 (2) determine whether the participant qualifies for a good 47.27 cause exception under section 256J.57; 47.28 (3) inform the participant of the family violence waiver 47.29 provisions and make appropriate referrals if the waiver is 47.30 requested; 47.31 (4) inform the participant of the participant's sanction 47.32 status and explain the consequences of continuing noncompliance; 47.33(4)(5) identify other resources that may be available to 47.34 the participant to meet the needs of the family; and 47.35(5)(6) inform the participant of the right to appeal under 47.36 section 256J.40. 48.1 Sec. 57. Minnesota Statutes 2002, section 256J.45, 48.2 subdivision 2, is amended to read: 48.3 Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must 48.4 consist of a presentation that informs caregivers of: 48.5 (1) the necessity to obtain immediate employment; 48.6 (2) the work incentives under MFIP, including the 48.7 availability of the federal earned income tax credit and the 48.8 Minnesota working family tax credit; 48.9 (3) the requirement to comply with the employment plan and 48.10 other requirements of the employment and training services 48.11 component of MFIP, including a description of the range of work 48.12 and training activities that are allowable under MFIP to meet 48.13 the individual needs of participants; 48.14 (4) the consequences for failing to comply with the 48.15 employment plan and other program requirements, and that the 48.16 county agency may not impose a sanction when failure to comply 48.17 is due to the unavailability of child care or other 48.18 circumstances where the participant has good cause under 48.19 subdivision 3; 48.20 (5) the rights, responsibilities, and obligations of 48.21 participants; 48.22 (6) the types and locations of child care services 48.23 available through the county agency; 48.24 (7) the availability and the benefits of the early 48.25 childhood health and developmental screening under sections 48.26 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 48.27 (8) the caregiver's eligibility for transition year child 48.28 care assistance under section 119B.05; 48.29 (9)the caregiver's eligibility for extended medical48.30assistance when the caregiver loses eligibility for MFIP due to48.31increased earnings or increased child or spousal supportthe 48.32 availability of all health care programs, including transitional 48.33 medical assistance; 48.34 (10) the caregiver's option to choose an employment and 48.35 training provider and information about each provider, including 48.36 but not limited to, services offered, program components, job 49.1 placement rates, job placement wages, and job retention rates; 49.2 (11) the caregiver's option to request approval of an 49.3 education and training plan according to section256J.5249.4 256J.53; 49.5 (12) the work study programs available under the higher 49.6 education system; and 49.7 (13)effective October 1, 2001,information about the 49.8 60-month time limitexemption and waivers of regular employment49.9and training requirements for family violence victimsexemptions 49.10 under the family violence waiver and referral information about 49.11 shelters and programs for victims of family violence. 49.12 Sec. 58. Minnesota Statutes 2002, section 256J.46, 49.13 subdivision 1, is amended to read: 49.14 Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM 49.15 REQUIREMENTS.] (a) A participant who fails without good 49.16 cause under section 256J.57 to comply with the requirements of 49.17 this chapter, and who is not subject to a sanction under 49.18 subdivision 2, shall be subject to a sanction as provided in 49.19 this subdivision. Prior to the imposition of a sanction, a 49.20 county agency shall provide a notice of intent to sanction under 49.21 section 256J.57, subdivision 2, and, when applicable, a notice 49.22 of adverse action as provided in section 256J.31. 49.23 (b)A participant who fails to comply with an alternative49.24employment plan must have the plan reviewed by a person trained49.25in domestic violence and a job counselor or the county agency to49.26determine if components of the alternative employment plan are49.27still appropriate. If the activities are no longer appropriate,49.28the plan must be revised with a person trained in domestic49.29violence and approved by a job counselor or the county agency.49.30A participant who fails to comply with a plan that is determined49.31not to need revision will lose their exemption and be required49.32to comply with regular employment services activities.49.33(c)A sanction under this subdivision becomes effective the 49.34 month following the month in which a required notice is given. 49.35 A sanction must not be imposed when a participant comes into 49.36 compliance with the requirements for orientation under section 50.1 256J.45or third-party liability for medical services under50.2section 256J.30, subdivision 10,prior to the effective date of 50.3 the sanction. A sanction must not be imposed when a participant 50.4 comes into compliance with the requirements for employment and 50.5 training services under sections256J.49256J.515 to 50.6256J.55256J.57 ten days prior to the effective date of the 50.7 sanction. For purposes of this subdivision, each month that a 50.8 participant fails to comply with a requirement of this chapter 50.9 shall be considered a separate occurrence of noncompliance.A50.10participant who has had one or more sanctions imposed must50.11remain in compliance with the provisions of this chapter for six50.12months in order for a subsequent occurrence of noncompliance to50.13be considered a first occurrence.If both participants in a 50.14 two-parent assistance unit are out of compliance at the same 50.15 time, it is considered one occurrence of noncompliance. 50.16(d)(c) Sanctions for noncompliance shall be imposed as 50.17 follows: 50.18 (1) For the first occurrence of noncompliance by a 50.19 participant in an assistance unit, the assistance unit's grant 50.20 shall be reduced by ten percent of the MFIP standard of need for 50.21 an assistance unit of the same size with the residual grant paid 50.22 to the participant. The reduction in the grant amount must be 50.23 in effect for a minimum of one month and shall be removed in the 50.24 month following the month that the participant returns to 50.25 compliance. 50.26 (2) For a secondor subsequent, third, fourth, fifth, or 50.27 sixth occurrence of noncompliance by a participant in an 50.28 assistance unit,or when each of the participants in a50.29two-parent assistance unit have a first occurrence of50.30noncompliance at the same time,the assistance unit's shelter 50.31 costs shall be vendor paid up to the amount of the cash portion 50.32 of the MFIP grant for which the assistance unit is eligible. At 50.33 county option, the assistance unit's utilities may also be 50.34 vendor paid up to the amount of the cash portion of the MFIP 50.35 grant remaining after vendor payment of the assistance unit's 50.36 shelter costs. The residual amount of the grant after vendor 51.1 payment, if any, must be reduced by an amount equal to 30 51.2 percent of the MFIP standard of need for an assistance unit of 51.3 the same size before the residual grant is paid to the 51.4 assistance unit. The reduction in the grant amount must be in 51.5 effect for a minimum of one month and shall be removed in the 51.6 month following the month that the participant in a one-parent 51.7 assistance unit returns to compliance. In a two-parent 51.8 assistance unit, the grant reduction must be in effect for a 51.9 minimum of one month and shall be removed in the month following 51.10 the month both participants return to compliance. The vendor 51.11 payment of shelter costs and, if applicable, utilities shall be 51.12 removed six months after the month in which the participant or 51.13 participants return to compliance. If an assistance unit is 51.14 sanctioned under this clause, the participant's case file must 51.15 be reviewedas required under paragraph (e)to determine if the 51.16 employment plan is still appropriate. 51.17(e) When a sanction under paragraph (d), clause (2), is in51.18effect(d) For a seventh occurrence of noncompliance by a 51.19 participant in an assistance unit, or when the participants in a 51.20 two-parent assistance unit have a total of seven occurrences of 51.21 noncompliance, the county agency shall close the MFIP assistance 51.22 unit's financial assistance case, both the cash and food 51.23 portions. The case must remain closed for a minimum of one full 51.24 month. Closure under this paragraph does not make a participant 51.25 automatically ineligible for food support, if otherwise eligible. 51.26 Before the case is closed, the county agency must review the 51.27 participant's case to determine if the employment plan is still 51.28 appropriate and attempt to meet with the participant 51.29 face-to-face. The participant may bring an advocate to the 51.30 face-to-face meeting. If a face-to-face meeting is not 51.31 conducted, the county agency must send the participant a written 51.32 notice that includes the information required under clause (1). 51.33 (1) During the face-to-face meeting, the county agency must: 51.34 (i) determine whether the continued noncompliance can be 51.35 explained and mitigated by providing a needed preemployment 51.36 activity, as defined in section 256J.49, subdivision 13, clause 52.1(16), or services under a local intervention grant for52.2self-sufficiency under section 256J.625(9); 52.3 (ii) determine whether the participant qualifies for a good 52.4 cause exception under section 256J.57, or if the sanction is for 52.5 noncooperation with child support requirements, determine if the 52.6 participant qualifies for a good cause exemption under section 52.7 256.741, subdivision 10; 52.8 (iii) determine whether the participant qualifies for an 52.9 exemption under section 256J.56 or the work activities in the 52.10 employment plan are appropriate based on the criteria in section 52.11 256J.521, subdivision 2 or 3; 52.12 (iv)determine whether the participant qualifies for an52.13exemption from regular employment services requirements for52.14victims of family violence under section 256J.52, subdivision52.156determine whether the participant qualifies for the family 52.16 violence waiver; 52.17 (v) inform the participant of the participant's sanction 52.18 status and explain the consequences of continuing noncompliance; 52.19 (vi) identify other resources that may be available to the 52.20 participant to meet the needs of the family; and 52.21 (vii) inform the participant of the right to appeal under 52.22 section 256J.40. 52.23 (2) If the lack of an identified activity or service can 52.24 explain the noncompliance, the county must work with the 52.25 participant to provide the identified activity, and the county52.26must restore the participant's grant amount to the full amount52.27for which the assistance unit is eligible. The grant must be52.28restored retroactively to the first day of the month in which52.29the participant was found to lack preemployment activities or to52.30qualify for an exemption under section 256J.56, a good cause52.31exception under section 256J.57, or an exemption for victims of52.32family violence under section 256J.52, subdivision 6. 52.33 (3)If the participant is found to qualify for a good cause52.34exception or an exemption, the county must restore the52.35participant's grant to the full amount for which the assistance52.36unit is eligible.The grant must be restored to the full amount 53.1 for which the assistance unit is eligible retroactively to the 53.2 first day of the month in which the participant was found to 53.3 lack preemployment activities or to qualify for an exemption 53.4 under section 256J.56, a family violence waiver, or for a good 53.5 cause exemption under section 256.741, subdivision 10, or 53.6 256J.57. 53.7 (e) For the purpose of applying sanctions under this 53.8 section, only occurrences of noncompliance that occur after the 53.9 effective date of this section shall be considered. If the 53.10 participant is in 30 percent sanction in the month this section 53.11 takes effect, that month counts as the first occurrence for 53.12 purposes of applying the sanctions under this section, but the 53.13 sanction shall remain at 30 percent for that month. 53.14 (f) An assistance unit whose case is closed under paragraph 53.15 (d) or (g), or under an approved county option sanction plan 53.16 under section 256J.462 in effect June 30, 2003, or a county 53.17 pilot project under Laws 2000, chapter 488, article 10, section 53.18 29, in effect June 30, 2003, may reapply for MFIP and shall be 53.19 eligible if the participant complies with MFIP program 53.20 requirements and demonstrates compliance for up to one month. 53.21 No assistance shall be paid during this period. 53.22 (g) An assistance unit whose case has been closed for 53.23 noncompliance, that reapplies under paragraph (f) is subject to 53.24 sanction under paragraph (c), clause (2), for a first occurrence 53.25 of noncompliance. Any subsequent occurrence of noncompliance 53.26 shall result in case closure under paragraph (d). 53.27 Sec. 59. Minnesota Statutes 2002, section 256J.46, 53.28 subdivision 2, is amended to read: 53.29 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 53.30 REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 53.31 cooperate, as determined by the child support enforcement 53.32 agency, with support requirements under section 256.741, shall 53.33 be subject to sanction as specified in this subdivision and 53.34 subdivision 1. For a first occurrence of noncooperation, the 53.35 assistance unit's grant must be reduced by 25 percent of the 53.36 applicable MFIP standard of need. Subsequent occurrences of 54.1 noncooperation shall be subject to sanction under subdivision 1, 54.2 paragraphs (c) and (d), except that the sanction shall remain at 54.3 25 percent of the applicable MFIP standard of need and the case 54.4 shall not be subject to vendoring. The residual amount of the 54.5 grant, if any, must be paid to the caregiver. A sanction under 54.6 this subdivision becomes effective the first month following the 54.7 month in which a required notice is given. A sanction must not 54.8 be imposed when a caregiver comes into compliance with the 54.9 requirements under section 256.741 prior to the effective date 54.10 of the sanction. The sanction shall be removed in the month 54.11 following the month that the caregiver cooperates with the 54.12 support requirements. Each month that an MFIP caregiver fails 54.13 to comply with the requirements of section 256.741 must be 54.14 considered a separate occurrence of noncompliance for the 54.15 purpose of applying sanctions under subdivision 1, paragraphs 54.16 (c) and (d).An MFIP caregiver who has had one or more54.17sanctions imposed must remain in compliance with the54.18requirements of section 256.741 for six months in order for a54.19subsequent sanction to be considered a first occurrence.54.20 Sec. 60. Minnesota Statutes 2002, section 256J.46, 54.21 subdivision 2a, is amended to read: 54.22 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 54.23 provisions of subdivisions 1 and 2, for a participant subject to 54.24 a sanction for refusal to comply with child support requirements 54.25 under subdivision 2 and subject to a concurrent sanction for 54.26 refusal to cooperate with other program requirements under 54.27 subdivision 1, sanctions shall be imposed in the manner 54.28 prescribed in this subdivision. 54.29A participant who has had one or more sanctions imposed54.30under this subdivision must remain in compliance with the54.31provisions of this chapter for six months in order for a54.32subsequent occurrence of noncompliance to be considered a first54.33occurrence.Any vendor payment of shelter costs or utilities 54.34 under this subdivision must remain in effect for six months 54.35 after the month in which the participant is no longer subject to 54.36 sanction under subdivision 1. 55.1 (b) If the participant was subject to sanction for: 55.2 (i) noncompliance under subdivision 1 before being subject 55.3 to sanction for noncooperation under subdivision 2; or 55.4 (ii) noncooperation under subdivision 2 before being 55.5 subject to sanction for noncompliance under subdivision 1, the 55.6 participant is considered to have a second occurrence of 55.7 noncompliance and shall be sanctioned as provided in subdivision 55.8 1, paragraph(d)(c), clause (2). Each subsequent occurrence of 55.9 noncompliance shall be considered one additional occurrence and 55.10 shall be subject to the applicable level of sanction under 55.11 subdivision 1, paragraph (d), or section 256J.462. The 55.12 requirement that the county conduct a review as specified in 55.13 subdivision 1, paragraph(e)(d), remains in effect. 55.14 (c) A participant who first becomes subject to sanction 55.15 under both subdivisions 1 and 2 in the same month is subject to 55.16 sanction as follows: 55.17 (i) in the first month of noncompliance and noncooperation, 55.18 the participant's grant must be reduced by 25 percent of the 55.19 applicable MFIP standard of need, with any residual amount paid 55.20 to the participant; 55.21 (ii) in the second and subsequent months of noncompliance 55.22 and noncooperation, the participant shall be subject to the 55.23 applicable level of sanction under subdivision 1, paragraph (d),55.24or section 256J.462. 55.25 The requirement that the county conduct a review as 55.26 specified in subdivision 1, paragraph(e)(d), remains in effect. 55.27 (d) A participant remains subject to sanction under 55.28 subdivision 2 if the participant: 55.29 (i) returns to compliance and is no longer subject to 55.30 sanctionunder subdivision 1 or section 256J.462for 55.31 noncompliance with section 256J.45 or sections 256J.515 to 55.32 256J.57; or 55.33 (ii) has the sanctionunder subdivision 1, paragraph (d),55.34or section 256J.462for noncompliance with section 256J.45 or 55.35 sections 256J.515 to 256J.57 removed upon completion of the 55.36 review under subdivision 1, paragraph (e). 56.1 A participant remains subject to the applicable level of 56.2 sanction under subdivision 1, paragraph (d), or section 256J.46256.3 if the participant cooperates and is no longer subject to 56.4 sanction under subdivision 2. 56.5 Sec. 61. Minnesota Statutes 2002, section 256J.49, 56.6 subdivision 4, is amended to read: 56.7 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 56.8 "Employment and training service provider" means: 56.9 (1) a public, private, or nonprofit employment and training 56.10 agency certified by the commissioner of economic security under 56.11 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 56.12 is approved under section 256J.51 and is included in the county 56.13planservice agreement submitted under section256J.50256J.626, 56.14 subdivision74; 56.15 (2) a public, private, or nonprofit agency that is not 56.16 certified by the commissioner under clause (1), but with which a 56.17 county has contracted to provide employment and training 56.18 services and which is included in the county'splanservice 56.19 agreement submitted under section256J.50256J.626, 56.20 subdivision74; or 56.21 (3) a county agency, if the county has opted to provide 56.22 employment and training services and the county has indicated 56.23 that fact in theplanservice agreement submitted under section 56.24256J.50256J.626, subdivision74. 56.25 Notwithstanding section 268.871, an employment and training 56.26 services provider meeting this definition may deliver employment 56.27 and training services under this chapter. 56.28 Sec. 62. Minnesota Statutes 2002, section 256J.49, 56.29 subdivision 5, is amended to read: 56.30 Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan 56.31 developed by the job counselor and the participant which 56.32 identifies the participant's most direct path to unsubsidized 56.33 employment, lists the specific steps that the caregiver will 56.34 take on that path, and includes a timetable for the completion 56.35 of each step. The plan should also identify any subsequent 56.36 steps that support long-term economic stability. For 57.1 participants who request and qualify for a family violence 57.2 waiver, an employment plan must be developed by the job 57.3 counselor, the participant, and a person trained in domestic 57.4 violence and follow the employment plan provisions in section 57.5 256J.521, subdivision 3. 57.6 Sec. 63. Minnesota Statutes 2002, section 256J.49, is 57.7 amended by adding a subdivision to read: 57.8 Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work 57.9 literacy" means an intensive English as a second language 57.10 program that is work focused and offers at least 20 hours of 57.11 class time per week. 57.12 Sec. 64. Minnesota Statutes 2002, section 256J.49, 57.13 subdivision 9, is amended to read: 57.14 Subd. 9. [PARTICIPANT.] "Participant" means a recipient of 57.15 MFIP assistance who participates or is required to participate 57.16 in employment and training services under sections 256J.515 to 57.17 256J.57 and 256J.95. 57.18 Sec. 65. Minnesota Statutes 2002, section 256J.49, 57.19 subdivision 13, is amended to read: 57.20 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 57.21 activity in a participant's approved employment plan thatis57.22tied to the participant'sleads to employmentgoal. For 57.23 purposes of the MFIP program,any activity that is included in a57.24participant's approved employment plan meetsthis includes 57.25 activities that meet the definition of work activityas counted57.26 under thefederalparticipationstandardsrequirements of TANF. 57.27 Work activity includes, but is not limited to: 57.28 (1) unsubsidized employment, including work study and paid 57.29 apprenticeships or internships; 57.30 (2) subsidized private sector or public sector employment, 57.31 including grant diversion as specified in section 256J.69, 57.32 on-the-job training as specified in section 256J.66, the 57.33 self-employment investment demonstration program (SEID) as 57.34 specified in section 256J.65, paid work experience, and 57.35 supported work when a wage subsidy is provided; 57.36 (3) unpaid work experience, includingCWEPcommunity 58.1 service, volunteer work, the community work experience program 58.2 as specified in section 256J.67, unpaid apprenticeships or 58.3 internships, andincluding work associated with the refurbishing58.4of publicly assisted housing if sufficient private sector58.5employment is not availablesupported work when a wage subsidy 58.6 is not provided; 58.7 (4)on-the-job training as specified in section 256J.66job 58.8 search including job readiness assistance, job clubs, job 58.9 placement, job-related counseling, and job retention services; 58.10(5) job search, either supervised or unsupervised;58.11(6) job readiness assistance;58.12(7) job clubs, including job search workshops;58.13(8) job placement;58.14(9) job development;58.15(10) job-related counseling;58.16(11) job coaching;58.17(12) job retention services;58.18(13) job-specific training or education;58.19(14) job skills training directly related to employment;58.20(15) the self-employment investment demonstration (SEID),58.21as specified in section 256J.65;58.22(16) preemployment activities, based on availability and58.23resources, such as volunteer work, literacy programs and related58.24activities, citizenship classes, English as a second language58.25(ESL) classes as limited by the provisions of section 256J.52,58.26subdivisions 3, paragraph (d), and 5, paragraph (c), or58.27participation in dislocated worker services, chemical dependency58.28treatment, mental health services, peer group networks,58.29displaced homemaker programs, strength-based resiliency58.30training, parenting education, or other programs designed to58.31help families reach their employment goals and enhance their58.32ability to care for their children;58.33(17) community service programs;58.34(18) vocational educational training or educational58.35programs that can reasonably be expected to lead to employment,58.36as limited by the provisions of section 256J.53;59.1(19) apprenticeships;59.2(20) satisfactory attendance in general educational59.3development diploma classes or an adult diploma program;59.4(21) satisfactory attendance at secondary school, if the59.5participant has not received a high school diploma;59.6(22) adult basic education classes;59.7(23) internships;59.8(24) bilingual employment and training services;59.9(25) providing child care services to a participant who is59.10working in a community service program; and59.11(26) activities included in an alternative employment plan59.12that is developed under section 256J.52, subdivision 6.59.13 (5) job readiness education, including English as a second 59.14 language (ESL) or functional work literacy classes as limited by 59.15 the provisions of section 256J.531, subdivision 2, general 59.16 educational development (GED) course work, high school 59.17 completion, and adult basic education as limited by the 59.18 provisions of section 256J.531, subdivision 1; 59.19 (6) job skills training directly related to employment, 59.20 including education and training that can reasonably be expected 59.21 to lead to employment, as limited by the provisions of section 59.22 256J.53; 59.23 (7) providing child care services to a participant who is 59.24 working in a community service program; 59.25 (8) activities included in the employment plan that is 59.26 developed under section 256J.521, subdivision 3; and 59.27 (9) preemployment activities including chemical and mental 59.28 health assessments, treatment, and services; learning 59.29 disabilities services; child protective services; family 59.30 stabilization services; or other programs designed to enhance 59.31 employability. 59.32 Sec. 66. Minnesota Statutes 2002, section 256J.49, is 59.33 amended by adding a subdivision to read: 59.34 Subd. 14. [SUPPORTED WORK.] "Supported work" means a 59.35 subsidized or unsubsidized work experience placement with a 59.36 public or private sector employer, which may include services 60.1 such as individual supervision and job coaching to support the 60.2 participant on the job. 60.3 Sec. 67. Minnesota Statutes 2002, section 256J.50, 60.4 subdivision 1, is amended to read: 60.5 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 60.6 OF MFIP.] (a)By January 1, 1998,Each county must develop and 60.7implementprovide an employment and training services component 60.8of MFIPwhich is designed to put participants on the most direct 60.9 path to unsubsidized employment. Participation in these 60.10 services is mandatory for all MFIP caregivers, unless the 60.11 caregiver is exempt under section 256J.56. 60.12 (b) A county must provide employment and training services 60.13 under sections 256J.515 to 256J.74 within 30 days after 60.14 thecaregiver's participation becomes mandatory under60.15subdivision 5 or within 30 days of receipt of a request for60.16services from a caregiver who under section 256J.42 is no longer60.17eligible to receive MFIP but whose income is below 120 percent60.18of the federal poverty guidelines for a family of the same60.19size. The request must be made within 12 months of the date the60.20caregivers' MFIP case was closedcaregiver is determined 60.21 eligible for MFIP, or within five days when the caregiver 60.22 participated in the diversionary work program under section 60.23 256J.95 within the past 12 months. 60.24 Sec. 68. Minnesota Statutes 2002, section 256J.50, 60.25 subdivision 8, is amended to read: 60.26 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 60.27 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 60.28 working cooperatively, shall make available to participants the 60.29 choice of at least two employment and training service providers 60.30 as defined under section 256J.49, subdivision 4, except in 60.31 counties utilizing workforce centers that use multiple 60.32 employment and training services, offer multiple services 60.33 options under a collaborative effort and can document that 60.34 participants have choice among employment and training services 60.35 designed to meet specialized needs. The requirements of this 60.36 subdivision do not apply to the diversionary work program under 61.1 section 256J.95. 61.2 Sec. 69. Minnesota Statutes 2002, section 256J.50, 61.3 subdivision 9, is amended to read: 61.4 Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 61.5 subdivision 8, a county that explains in theplanservice 61.6 agreement required under section 256J.626, subdivision74, that 61.7 the provision of alternative employment and training service 61.8 providers would result in financial hardship for the county is 61.9 not required to make available more than one employment and 61.10 training provider. 61.11 Sec. 70. Minnesota Statutes 2002, section 256J.50, 61.12 subdivision 10, is amended to read: 61.13 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 61.14 VIOLENCE.] (a) County agencies and their contractors must 61.15 provide universal notification to all applicants and recipients 61.16 of MFIP that: 61.17 (1) referrals to counseling and supportive services are 61.18 available for victims of family violence; 61.19 (2) nonpermanent resident battered individuals married to 61.20 United States citizens or permanent residents may be eligible to 61.21 petition for permanent residency under the federal Violence 61.22 Against Women Act, and that referrals to appropriate legal 61.23 services are available; 61.24 (3) victims of family violence are exempt from the 60-month 61.25 limit on assistancewhile the individual isif they are 61.26 complying with anapproved safety plan or, after October 1,61.272001, an alternativeemployment plan, as defined inunder 61.28 section256J.49256J.521, subdivision1a3; and 61.29 (4) victims of family violence may choose to have regular 61.30 work requirements waived while the individual is complying with 61.31 analternativeemployment planas defined inunder section 61.32256J.49256J.521, subdivision1a3. 61.33 (b) If analternativeemployment plan under section 61.34 256J.521, subdivision 3, is denied, the county or a job 61.35 counselor must provide reasons why the plan is not approved and 61.36 document how the denial of the plan does not interfere with the 62.1 safety of the participant or children. 62.2 Notification must be in writing and orally at the time of 62.3 application and recertification, when the individual is referred 62.4 to the title IV-D child support agency, and at the beginning of 62.5 any job training or work placement assistance program. 62.6 Sec. 71. Minnesota Statutes 2002, section 256J.51, 62.7 subdivision 1, is amended to read: 62.8 Subdivision 1. [PROVIDER APPLICATION.] An employment and 62.9 training service provider that is not included in a county's 62.10planservice agreement under section256J.50256J.626, 62.11 subdivision74, because the county has demonstrated financial 62.12 hardship under section 256J.50, subdivision9 of that section5, 62.13 may appeal its exclusion to the commissioner of economic 62.14 security under this section. 62.15 Sec. 72. Minnesota Statutes 2002, section 256J.51, 62.16 subdivision 2, is amended to read: 62.17 Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment 62.18 and training service provider that is not included by a county 62.19 agency in theplanservice agreement under section 62.20256J.50256J.626, subdivision74, and that meets the criteria 62.21 in paragraph (b), may appeal its exclusion to the commissioner 62.22 of economic security, and may request alternative approval by 62.23 the commissioner of economic security to provide services in the 62.24 county. 62.25 (b) An employment and training services provider that is 62.26 requesting alternative approval must demonstrate to the 62.27 commissioner that the provider meets the standards specified in 62.28 section 268.871, subdivision 1, paragraph (b), except that the 62.29 provider's past experience may be in services and programs 62.30 similar to those specified in section 268.871, subdivision 1, 62.31 paragraph (b). 62.32 Sec. 73. Minnesota Statutes 2002, section 256J.51, 62.33 subdivision 3, is amended to read: 62.34 Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner 62.35 must act on a request for alternative approval under this 62.36 section within 30 days of the receipt of the request. If after 63.1 reviewing the provider's request, and the county'splanservice 63.2 agreement submitted under section256J.50256J.626, 63.3 subdivision74, the commissioner determines that the provider 63.4 meets the criteria under subdivision 2, paragraph (b), and that 63.5 approval of the provider would not cause financial hardship to 63.6 the county, the county must submit a revisedplanservice 63.7 agreement under subdivision 4 that includes the approved 63.8 provider. 63.9 (b) If the commissioner determines that the approval of the 63.10 provider would cause financial hardship to the county, the 63.11 commissioner must notify the provider and the county of this 63.12 determination. The alternate approval process under this 63.13 section shall be closed to other requests for alternate approval 63.14 to provide employment and training services in the county for up 63.15 to 12 months from the date that the commissioner makes a 63.16 determination under this paragraph. 63.17 Sec. 74. Minnesota Statutes 2002, section 256J.51, 63.18 subdivision 4, is amended to read: 63.19 Subd. 4. [REVISEDPLANSERVICE AGREEMENT REQUIRED.] The 63.20 commissioner of economic security must notify the county agency 63.21 when the commissioner grants an alternative approval to an 63.22 employment and training service provider under subdivision 2. 63.23 Upon receipt of the notice, the county agency must submit a 63.24 revisedplanservice agreement under section256J.50256J.626, 63.25 subdivision74, that includes the approved provider. The 63.26 county has 90 days from the receipt of the commissioner's notice 63.27 to submit the revisedplanservice agreement. 63.28 Sec. 75. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 63.29 Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP 63.30 employment services, assessment is a continuing process of 63.31 gathering information related to employability for the purpose 63.32 of identifying both participant's strengths and strategies for 63.33 coping with issues that interfere with employment. The job 63.34 counselor must use information from the assessment process to 63.35 develop and update the employment plan under subdivision 2. 63.36 (b) The scope of assessment must cover at least the 64.1 following areas: 64.2 (1) basic information about the participant's ability to 64.3 obtain and retain employment, including: a review of the 64.4 participant's education level; interests, skills, and abilities; 64.5 prior employment or work experience; transferable work skills; 64.6 child care and transportation needs; 64.7 (2) identification of personal and family circumstances 64.8 that impact the participant's ability to obtain and retain 64.9 employment, including: any special needs of the children, the 64.10 level of English proficiency, and any involvement with social 64.11 services or the legal system; 64.12 (3) the results of a mental and chemical health screening 64.13 tool designed by the commissioner and results of the brief 64.14 screening tool for special learning needs. Screening for mental 64.15 and chemical health and special learning needs must be completed 64.16 by participants who are unable to find suitable employment after 64.17 six weeks of job search under subdivision 2, paragraph (b), and 64.18 participants who are determined to have barriers to employment 64.19 under subdivision 2, paragraph (d). Failure to complete the 64.20 screens will result in sanction under section 256J.46; and 64.21 (4) a comprehensive review of participation and progress 64.22 for participants who have received MFIP assistance and have not 64.23 worked in unsubsidized employment during the past 12 months. 64.24 The purpose of the review is to determine the need for 64.25 additional services and supports, including placement in 64.26 subsidized employment or unpaid work experience under section 64.27 256J.49, subdivision 13. 64.28 (c) Information gathered during a caregiver's participation 64.29 in the diversionary work program under section 256J.95 must be 64.30 incorporated into the assessment process. 64.31 (d) The job counselor may require the participant to 64.32 complete a professional chemical use assessment to be performed 64.33 according to the rules adopted under section 254A.03, 64.34 subdivision 3, including provisions in the administrative rules 64.35 which recognize the cultural background of the participant, or a 64.36 professional psychological assessment as a component of the 65.1 assessment process, when the job counselor has a reasonable 65.2 belief, based on objective evidence, that a participant's 65.3 ability to obtain and retain suitable employment is impaired by 65.4 a medical condition. The job counselor may assist the 65.5 participant with arranging services, including child care 65.6 assistance and transportation, necessary to meet needs 65.7 identified by the assessment. Data gathered as part of a 65.8 professional assessment must be classified and disclosed 65.9 according to the provisions in section 13.46. 65.10 Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 65.11 assessment under subdivision 1, the job counselor and the 65.12 participant must develop an employment plan that includes 65.13 participation in activities and hours that meet the requirements 65.14 of section 256J.55, subdivision 1. The purpose of the 65.15 employment plan is to identify for each participant the most 65.16 direct path to unsubsidized employment and any subsequent steps 65.17 that support long-term economic stability. The employment plan 65.18 should be developed using the highest level of activity 65.19 appropriate for the participant. Activities must be chosen from 65.20 clauses (1) to (6), which are listed in order of preference. 65.21 The employment plan must also list the specific steps the 65.22 participant will take to obtain employment, including steps 65.23 necessary for the participant to progress from one level of 65.24 activity to another, and a timetable for completion of each 65.25 step. Levels of activity include: 65.26 (1) unsubsidized employment; 65.27 (2) job search; 65.28 (3) subsidized employment or unpaid work experience; 65.29 (4) unsubsidized employment and job readiness education or 65.30 job skills training; 65.31 (5) unsubsidized employment or unpaid work experience, and 65.32 activities related to a family violence waiver or preemployment 65.33 needs; and 65.34 (6) activities related to a family violence waiver or 65.35 preemployment needs. 65.36 (b) Participants who are determined able to work in 66.1 unsubsidized employment must job search at least 30 hours per 66.2 week for up to six weeks, and accept any offer of suitable 66.3 employment. The remaining hours necessary to meet the 66.4 requirements of section 256J.55, subdivision 1, may be met 66.5 through participation in other work activities under section 66.6 256J.49, subdivision 13. The participant's employment plan must 66.7 specify, at a minimum: (1) whether the job search is supervised 66.8 or unsupervised; (2) support services that will be provided; and 66.9 (3) how frequently the participant must report to the job 66.10 counselor. Participants who are unable to find suitable 66.11 employment after six weeks must meet with the job counselor to 66.12 determine whether other activities in paragraph (a) should be 66.13 incorporated into the employment plan. Job search activities 66.14 which are continued after six weeks must be structured and 66.15 supervised. 66.16 (c) Beginning July 1, 2004, activities and hourly 66.17 requirements in the employment plan may be adjusted as necessary 66.18 to accommodate the personal and family circumstances of 66.19 participants identified under section 256J.561, subdivision 1, 66.20 paragraph (d). Participants who no longer meet the provisions 66.21 of section 256J.561, subdivision 1, paragraph (d), must meet 66.22 with the job counselor within ten days of the determination to 66.23 revise the employment plan. 66.24 (d) Participants who are determined to have barriers that 66.25 will not be overcome during six weeks of job search under 66.26 paragraph (b) must work with the job counselor to develop an 66.27 employment plan that addresses those barriers by incorporating 66.28 appropriate activities from paragraph (a), clauses (1) to (6). 66.29 The employment plan must include enough hours to meet the 66.30 participation requirements in section 256J.55, subdivision 1, 66.31 unless a compelling reason to require fewer hours is noted in 66.32 the participant's file. 66.33 (e) The job counselor and the participant must sign the 66.34 employment plan to indicate agreement on the contents. Failure 66.35 to develop or comply with activities in the plan, or voluntarily 66.36 quitting suitable employment without good cause, will result in 67.1 the imposition of a sanction under section 256J.46. 67.2 (f) Employment plans must be reviewed at least every three 67.3 months to determine whether activities and hourly requirements 67.4 should be revised. 67.5 Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 67.6 participant who requests and qualifies for a family violence 67.7 waiver shall develop or revise the employment plan as specified 67.8 in this subdivision with a job counselor or county, and a person 67.9 trained in domestic violence. The revised or new employment 67.10 plan must be approved by the county or the job counselor. The 67.11 plan may address safety, legal, or emotional issues, and other 67.12 demands on the family as a result of the family violence. 67.13 Information in section 256J.515, clauses (1) to (8), must be 67.14 included as part of the development of the plan. 67.15 (b) The primary goal of an employment plan developed under 67.16 this subdivision is to ensure the safety of the caregiver and 67.17 children. To the extent it is consistent with ensuring safety, 67.18 the plan shall also include activities that are designed to lead 67.19 to economic stability. An activity is inconsistent with 67.20 ensuring safety if, in the opinion of a person trained in 67.21 domestic violence, the activity would endanger the safety of the 67.22 participant or children. A plan under this subdivision may not 67.23 automatically include a provision that requires a participant to 67.24 obtain an order for protection or to attend counseling. 67.25 (c) If at any time there is a disagreement over whether the 67.26 activities in the plan are appropriate or the participant is not 67.27 complying with activities in the plan under this subdivision, 67.28 the participant must receive the assistance of a person trained 67.29 in domestic violence to help resolve the disagreement or 67.30 noncompliance with the county or job counselor. If the person 67.31 trained in domestic violence recommends that the activities are 67.32 still appropriate, the county or a job counselor must approve 67.33 the activities in the plan or provide written reasons why 67.34 activities in the plan are not approved and document how denial 67.35 of the activities do not endanger the safety of the participant 67.36 or children. 68.1 Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities 68.2 may be included in an employment plan contingent on the 68.3 development of a business plan which establishes a timetable and 68.4 earning goals that will result in the participant exiting MFIP 68.5 assistance. Business plans must be developed with assistance 68.6 from an individual or organization with expertise in small 68.7 business as approved by the job counselor. 68.8 (b) Participants with an approved plan that includes 68.9 self-employment must meet the participation requirements in 68.10 section 256J.55, subdivision 1. Only hours where the 68.11 participant earns at least minimum wage shall be counted toward 68.12 the requirement. Additional activities and hours necessary to 68.13 meet the participation requirements in section 256J.55, 68.14 subdivision 1, must be included in the employment plan. 68.15 (c) Employment plans which include self-employment 68.16 activities must be reviewed every three months. Participants 68.17 who fail, without good cause, to make satisfactory progress as 68.18 established in the business plan must revise the employment plan 68.19 to replace the self-employment with other approved work 68.20 activities. 68.21 (d) The requirements of this subdivision may be waived for 68.22 participants who are enrolled in the self-employment investment 68.23 demonstration program (SEID) under section 256J.65, and who make 68.24 satisfactory progress as determined by the job counselor and the 68.25 SEID provider. 68.26 Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK 68.27 PROGRAM.] Participants who become eligible for MFIP assistance 68.28 after completing the diversionary work program under section 68.29 256J.95 must comply with all requirements of subdivisions 1 and 68.30 2. Participants who become eligible for MFIP assistance after 68.31 being determined unable to benefit from the diversionary work 68.32 program must comply with the requirements of subdivisions 1 and 68.33 2, with the exception of subdivision 2, paragraph (b). 68.34 Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid 68.35 off, quit with good cause, or are terminated from employment 68.36 through no fault of their own must meet with the job counselor 69.1 within ten working days to ascertain the reason for the job loss 69.2 and to revise the employment plan as necessary to address the 69.3 problem. 69.4 Sec. 76. Minnesota Statutes 2002, section 256J.53, 69.5 subdivision 1, is amended to read: 69.6 Subdivision 1. [LENGTH OF PROGRAM.] (a) In order for a 69.7 post-secondary education or training program to be an approved 69.8 work activity as defined in section 256J.49, subdivision 13, 69.9 clause(18)(6), it must be a program lasting2412 months or 69.10 less, and the participant must meet the requirements of 69.11 subdivisions 2and, 3, and 5. 69.12 (b) The 12 months of allowable postsecondary education or 69.13 training may be used to complete the final 12 months of a longer 69.14 program, provided the program does not exceed the undergraduate 69.15 level. 69.16 (c) All course work must be completed within 18 months of 69.17 enrollment in the program. 69.18 Sec. 77. Minnesota Statutes 2002, section 256J.53, 69.19 subdivision 2, is amended to read: 69.20 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAMAPPROVAL OF 69.21 POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 69.22 post-secondary education or training program to be an approved 69.23 activity ina participant'san employment plan, the participant 69.24or the employment and training service providermustprovide69.25documentation that:be working in unsubsidized employment at 69.26 least 25 hours per week. 69.27 (b) Participants seeking approval of a postsecondary 69.28 education or training plan must provide documentation that: 69.29 (1) theparticipant'semploymentplan identifies specific69.30goals thatgoal can only be met with the additional education or 69.31 training; 69.32 (2) there are suitable employment opportunities that 69.33 require the specific education or training in the area in which 69.34 the participant resides or is willing to reside; 69.35 (3) the education or training will result in significantly 69.36 higher wages for the participant than the participant could earn 70.1 without the education or training; 70.2 (4) the participant can meet the requirements for admission 70.3 into the program; and 70.4 (5) there is a reasonable expectation that the participant 70.5 will complete the training program based on such factors as the 70.6 participant's MFIP assessment, previous education, training, and 70.7 work history; current motivation; and changes in previous 70.8 circumstances. 70.9 (c) The hourly unsubsidized employment requirement may be 70.10 reduced for intensive education or training programs lasting 12 70.11 weeks or less when full-time attendance is required. 70.12 (d) Participants with an approved employment plan in place 70.13 on July 1, 2003, which includes more than 12 months of 70.14 postsecondary education or training shall be allowed to complete 70.15 that plan provided that participation requirements in section 70.16 256J.55, subdivision 1, and conditions specified in paragraph 70.17 (b), and subdivisions 3 and 5 are met. 70.18 Sec. 78. Minnesota Statutes 2002, section 256J.53, 70.19 subdivision 5, is amended to read: 70.20 Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY70.21 REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.]If a70.22participant's employment plan includes a post-secondary70.23educational or training program, the plan must include an70.24anticipated completion date for those activities. At the time70.25the education or training is completed, the participant must70.26participate in job search. If, after three months of job70.27search, the participant does not find a job that is consistent70.28with the participant's employment goal, the participant must70.29accept any offer of suitable employment.Upon completion of an 70.30 approved education or training program, a participant who does 70.31 not meet the participation requirements in section 256J.55, 70.32 subdivision 1, through unsubsidized employment must participate 70.33 in job search. If, after six weeks of job search, the 70.34 participant does not find a full-time job consistent with the 70.35 employment goal, the participant must accept any offer of 70.36 full-time suitable employment, or meet with the job counselor to 71.1 revise the employment plan to include additional work activities 71.2 necessary to meet hourly requirements. 71.3 Sec. 79. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 71.4 LANGUAGE.] 71.5 Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With 71.6 the exception of classes related to obtaining a general 71.7 equivalency development credential, a participant must have 71.8 reading or mathematics proficiency below a ninth grade level in 71.9 order for adult basic education classes to be an approved work 71.10 activity. The employment plan must also specify that the 71.11 participant fulfill no more than one-half of the participation 71.12 requirements in section 256J.55, subdivision 1, through 71.13 attending adult basic education or general education development 71.14 classes. 71.15 Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 71.16 order for English as a second language (ESL) classes to be an 71.17 approved work activity in an employment plan, a participant must 71.18 be below a spoken language proficiency level of SPL6 or its 71.19 equivalent, as measured by a nationally recognized test. In 71.20 approving ESL as a work activity, the job counselor must give 71.21 preference to enrollment in a functional work literacy program, 71.22 if one is available, over a regular ESL program. A participant 71.23 may not be approved for more than a combined total of 24 months 71.24 of ESL classes while participating in the diversionary work 71.25 program and the employment and training services component of 71.26 MFIP. The employment plan must also specify that the 71.27 participant fulfill no more than one-half of the participation 71.28 requirements in section 256J.55, subdivision 1, through 71.29 attending ESL classes. 71.30 Sec. 80. Minnesota Statutes 2002, section 256J.54, 71.31 subdivision 1, is amended to read: 71.32 Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND 71.33 NEEDS.] (a) The county agency must document the educational 71.34 level of each MFIP caregiver who is under the age of 20 and 71.35 determine if the caregiver has obtained a high school diploma or 71.36 its equivalent. If the caregiver has not obtained a high school 72.1 diploma or its equivalent,and is not exempt from the72.2requirement to attend school under subdivision 5,the county 72.3 agency must complete an individual assessment for the 72.4 caregiver unless the caregiver is exempt from the requirement to 72.5 attend school under subdivision 5 or has chosen to have an 72.6 employment plan under section 256J.521, subdivision 2, as 72.7 allowed in paragraph (b). The assessment must be performed as 72.8 soon as possible but within 30 days of determining MFIP 72.9 eligibility for the caregiver. The assessment must provide an 72.10 initial examination of the caregiver's educational progress and 72.11 needs, literacy level, child care and supportive service needs, 72.12 family circumstances, skills, and work experience. In the case 72.13 of a caregiver under the age of 18, the assessment must also 72.14 consider the results of either the caregiver's or the 72.15 caregiver's minor child's child and teen checkup under Minnesota 72.16 Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 72.17 and the effect of a child's development and educational needs on 72.18 the caregiver's ability to participate in the program. The 72.19 county agency must advise the caregiver that the caregiver's 72.20 first goal must be to complete an appropriateeducational72.21 education option if one is identified for the caregiver through 72.22 the assessment and, in consultation with educational agencies, 72.23 must review the various school completion options with the 72.24 caregiver and assist in selecting the most appropriate option. 72.25 (b) The county agency must give a caregiver, who is age 18 72.26 or 19 and has not obtained a high school diploma or its 72.27 equivalent, the option to choose an employment plan with an 72.28 education option under subdivision 3 or an employment plan under 72.29 section 256J.521, subdivision 2. 72.30 Sec. 81. Minnesota Statutes 2002, section 256J.54, 72.31 subdivision 2, is amended to read: 72.32 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 72.33 PLAN.] For caregivers who are under age 18 without a high school 72.34 diploma or its equivalent, the assessment under subdivision 1 72.35 and the employment plan under subdivision 3 must be completed by 72.36 the social services agency under section 257.33. For caregivers 73.1 who are age 18 or 19 without a high school diploma or its 73.2 equivalent who choose to have an employment plan with an 73.3 education option under subdivision 3, the assessment under 73.4 subdivision 1 and the employment plan under subdivision 3 must 73.5 be completed by the job counselor or, at county option, by the 73.6 social services agency under section 257.33. Upon reaching age 73.7 18 or 19 a caregiver who received social services under section 73.8 257.33 and is without a high school diploma or its equivalent 73.9 has the option to choose whether to continue receiving services 73.10 under the caregiver's plan from the social services agency or to 73.11 utilize an MFIP employment and training service provider. The 73.12 social services agency or the job counselor shall consult with 73.13 representatives of educational agencies that are required to 73.14 assist in developing educational plans under section 124D.331. 73.15 Sec. 82. Minnesota Statutes 2002, section 256J.54, 73.16 subdivision 3, is amended to read: 73.17 Subd. 3. [EDUCATIONALEDUCATION OPTION DEVELOPED.] If the 73.18 job counselor or county social services agency identifies an 73.19 appropriateeducationaleducation option for a minor caregiver 73.20under the age of 20without a high school diploma or its 73.21 equivalent, or a caregiver age 18 or 19 without a high school 73.22 diploma or its equivalent who chooses an employment plan with an 73.23 education option, the job counselor or agency must develop an 73.24 employment plan which reflects the identified option. The plan 73.25 must specify that participation in an educational activity is 73.26 required, what school or educational program is most 73.27 appropriate, the services that will be provided, the activities 73.28 the caregiver will take part in, including child care and 73.29 supportive services, the consequences to the caregiver for 73.30 failing to participate or comply with the specified 73.31 requirements, and the right to appeal any adverse action. The 73.32 employment plan must, to the extent possible, reflect the 73.33 preferences of the caregiver. 73.34 Sec. 83. Minnesota Statutes 2002, section 256J.54, 73.35 subdivision 5, is amended to read: 73.36 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 74.1 the provisions of section 256J.56, minor parents, or 18- or 74.2 19-year-old parents without a high school diploma or its 74.3 equivalent who chooses an employment plan with an education 74.4 option must attend school unless: 74.5 (1) transportation services needed to enable the caregiver 74.6 to attend school are not available; 74.7 (2) appropriate child care services needed to enable the 74.8 caregiver to attend school are not available; 74.9 (3) the caregiver is ill or incapacitated seriously enough 74.10 to prevent attendance at school; or 74.11 (4) the caregiver is needed in the home because of the 74.12 illness or incapacity of another member of the household. This 74.13 includes a caregiver of a child who is younger than six weeks of 74.14 age. 74.15 (b) The caregiver must be enrolled in a secondary school 74.16 and meeting the school's attendance requirements. The county, 74.17 social service agency, or job counselor must verify at least 74.18 once per quarter that the caregiver is meeting the school's 74.19 attendance requirements. An enrolled caregiver is considered to 74.20 be meeting the attendance requirements when the school is not in 74.21 regular session, including during holiday and summer breaks. 74.22 Sec. 84. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 74.23 (a) In order to qualify for a family violence waiver, an 74.24 individual must provide documentation of past or current family 74.25 violence which may prevent the individual from participating in 74.26 certain employment activities. A claim of family violence must 74.27 be documented by the applicant or participant providing a sworn 74.28 statement which is supported by collateral documentation. 74.29 (b) Collateral documentation may consist of: 74.30 (1) police, government agency, or court records; 74.31 (2) a statement from a battered women's shelter staff with 74.32 knowledge of the circumstances or credible evidence that 74.33 supports the sworn statement; 74.34 (3) a statement from a sexual assault or domestic violence 74.35 advocate with knowledge of the circumstances or credible 74.36 evidence that supports the sworn statement; 75.1 (4) a statement from professionals from whom the applicant 75.2 or recipient has sought assistance for the abuse; or 75.3 (5) a sworn statement from any other individual with 75.4 knowledge of circumstances or credible evidence that supports 75.5 the sworn statement. 75.6 Sec. 85. Minnesota Statutes 2002, section 256J.55, 75.7 subdivision 1, is amended to read: 75.8 Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT75.9PLAN; SUITABLE EMPLOYMENTPARTICIPATION REQUIREMENTS.](a) Each75.10MFIP participant must comply with the terms of the participant's75.11job search support plan or employment plan. When the75.12participant has completed the steps listed in the employment75.13plan, the participant must comply with section 256J.53,75.14subdivision 5, if applicable, and then the participant must not75.15refuse any offer of suitable employment. The participant may75.16choose to accept an offer of suitable employment before the75.17participant has completed the steps of the employment plan.75.18(b) For a participant under the age of 20 who is without a75.19high school diploma or general educational development diploma,75.20the requirement to comply with the terms of the employment plan75.21means the participant must meet the requirements of section75.22256J.54.75.23(c) Failure to develop or comply with a job search support75.24plan or an employment plan, or quitting suitable employment75.25without good cause, shall result in the imposition of a sanction75.26as specified in sections 256J.46 and 256J.57.75.27 (a) All caregivers must participate in employment services 75.28 under sections 256J.515 to 256J.57 concurrent with receipt of 75.29 MFIP assistance. 75.30 (b) Until July 1, 2004, participants who meet the 75.31 requirements of section 256J.56 are exempt from participation 75.32 requirements. 75.33 (c) Participants under paragraph (a) must develop and 75.34 comply with an employment plan under section 256J.521, or 75.35 section 256J.54 in the case of a participant under the age of 20 75.36 who has not obtained a high school diploma or its equivalent. 76.1 (d) With the exception of participants under the age of 20 76.2 who must meet the education requirements of section 256J.54, all 76.3 participants must meet the hourly participation requirements of 76.4 TANF or the hourly requirements listed in clauses (1) to (3), 76.5 whichever is higher. 76.6 (1) In single-parent families with no children under six 76.7 years of age, the job counselor and the caregiver must develop 76.8 an employment plan that includes 30 to 35 hours per week of work 76.9 activities. 76.10 (2) In single-parent families with a child under six years 76.11 of age, the job counselor and the caregiver must develop an 76.12 employment plan that includes 20 to 35 hours per week of work 76.13 activities. 76.14 (3) In two-parent families, the job counselor and the 76.15 caregivers must develop employment plans which result in a 76.16 combined total of at least 55 hours per week of work activities. 76.17 (e) Failure to participate in employment services, 76.18 including the requirement to develop and comply with an 76.19 employment plan, including hourly requirements, without good 76.20 cause under section 256J.57, shall result in the imposition of a 76.21 sanction under section 256J.46. 76.22 Sec. 86. Minnesota Statutes 2002, section 256J.55, 76.23 subdivision 2, is amended to read: 76.24 Subd. 2. [DUTY TO REPORT.] The participant must inform the 76.25 job counselor withinthreeten working days regarding any 76.26 changes related to the participant's employment status. 76.27 Sec. 87. Minnesota Statutes 2002, section 256J.56, is 76.28 amended to read: 76.29 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 76.30 EXEMPTIONS.] 76.31 (a) An MFIP participant is exempt from the requirements of 76.32 sections256J.52256J.515 to256J.55256J.57 if the participant 76.33 belongs to any of the following groups: 76.34 (1) participants who are age 60 or older; 76.35 (2) participants who are suffering from aprofessionally76.36certifiedpermanent or temporary illness, injury, or incapacity 77.1 which has been certified by a qualified professional when the 77.2 illness, injury, or incapacity is expected to continue for more 77.3 than 30 days andwhichprevents the person from obtaining or 77.4 retaining employment. Persons in this category with a temporary 77.5 illness, injury, or incapacity must be reevaluated at least 77.6 quarterly; 77.7 (3) participants whose presence in the home is required as 77.8 a caregiver because ofa professionally certifiedthe illness or 77.9 incapacity of another member in the assistance unit, a relative 77.10 in the household, or a foster child in the householdandwhen 77.11 the illness or incapacity and the need for the participant's 77.12 presence in the home has been certified by a qualified 77.13 professional and is expected to continue for more than 30 days; 77.14 (4) women who are pregnant, if the pregnancy has resulted 77.15 ina professionally certifiedan incapacity that prevents the 77.16 woman from obtaining or retaining employment, and the incapacity 77.17 has been certified by a qualified professional; 77.18 (5) caregivers of a child under the age of one year who 77.19 personally provide full-time care for the child. This exemption 77.20 may be used for only 12 months in a lifetime. In two-parent 77.21 households, only one parent or other relative may qualify for 77.22 this exemption; 77.23 (6) participants experiencing a personal or family crisis 77.24 that makes them incapable of participating in the program, as 77.25 determined by the county agency. If the participant does not 77.26 agree with the county agency's determination, the participant 77.27 may seekprofessionalcertification from a qualified 77.28 professional, as defined in section 256J.08, that the 77.29 participant is incapable of participating in the program. 77.30 Persons in this exemption category must be reevaluated 77.31 every 60 days. A personal or family crisis related to family 77.32 violence, as determined by the county or a job counselor with 77.33 the assistance of a person trained in domestic violence, should 77.34 not result in an exemption, but should be addressed through the 77.35 development or revision of analternativeemployment plan under 77.36 section256J.52256J.521, subdivision63; or 78.1 (7) caregivers with a child or an adult in the household 78.2 who meets the disability or medical criteria for home care 78.3 services under section 256B.0627, subdivision 1, 78.4 paragraph(c)(f), or a home and community-based waiver services 78.5 program under chapter 256B, or meets the criteria for severe 78.6 emotional disturbance under section 245.4871, subdivision 6, or 78.7 for serious and persistent mental illness under section 245.462, 78.8 subdivision 20, paragraph (c). Caregivers in this exemption 78.9 category are presumed to be prevented from obtaining or 78.10 retaining employment. 78.11 A caregiver who is exempt under clause (5) must enroll in 78.12 and attend an early childhood and family education class, a 78.13 parenting class, or some similar activity, if available, during 78.14 the period of time the caregiver is exempt under this section. 78.15 Notwithstanding section 256J.46, failure to attend the required 78.16 activity shall not result in the imposition of a sanction. 78.17 (b) The county agency must provide employment and training 78.18 services to MFIP participants who are exempt under this section, 78.19 but who volunteer to participate. Exempt volunteers may request 78.20 approval for any work activity under section 256J.49, 78.21 subdivision 13. The hourly participation requirements for 78.22 nonexempt participants under section256J.50256J.55, 78.23 subdivision51, do not apply to exempt participants who 78.24 volunteer to participate. 78.25 (c) This section expires on June 30, 2004. 78.26 Sec. 88. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 78.27 Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 78.28 REQUIREMENTS.] (a) All caregivers whose applications were 78.29 received July 1, 2004, or after, are immediately subject to the 78.30 requirements in subdivision 2. 78.31 (b) For all MFIP participants who were exempt from 78.32 participating in employment services under section 256J.56 as of 78.33 June 30, 2004, between July 1, 2004, and June 30, 2005, the 78.34 county, as part of the participant's recertification under 78.35 section 256J.32, subdivision 6, shall determine whether a new 78.36 employment plan is required to meet the requirements in 79.1 subdivision 2. Counties shall notify each participant who is in 79.2 need of an employment plan that the participant must meet with a 79.3 job counselor within ten days to develop an employment plan. 79.4 Until a participant's employment plan is developed, the 79.5 participant shall be considered in compliance with the 79.6 participation requirements in this section if the participant 79.7 continues to meet the criteria for an exemption under section 79.8 256J.56 as in effect on June 30, 2004, and is cooperating in the 79.9 development of the new plan. 79.10 Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP 79.11 caregivers, except caregivers who meet the criteria in 79.12 subdivision 3, must participate in employment services. Except 79.13 as specified in paragraphs (b) to (d), the employment plan must 79.14 meet the requirements of section 256J.521, subdivision 2, 79.15 contain allowable work activities, as defined in section 79.16 256J.49, subdivision 13, and, include at a minimum, the number 79.17 of participation hours required under section 256J.55, 79.18 subdivision 1. 79.19 (b) Minor caregivers and caregivers who are less than age 79.20 20 who have not completed high school or obtained a GED are 79.21 required to comply with section 256J.54. 79.22 (c) A participant who has a family violence waiver shall 79.23 develop and comply with an employment plan under section 79.24 256J.521, subdivision 3. 79.25 (d) As specified in section 256J.521, subdivision 2, 79.26 paragraph (c), a participant who meets any one of the following 79.27 criteria may work with the job counselor to develop an 79.28 employment plan that contains less than the number of 79.29 participation hours under section 256J.55, subdivision 1. 79.30 Employment plans for participants covered under this paragraph 79.31 must be tailored to recognize the special circumstances of 79.32 caregivers and families including limitations due to illness or 79.33 disability and caregiving needs: 79.34 (1) a participant who is age 60 or older; 79.35 (2) a participant who has been diagnosed by a qualified 79.36 professional as suffering from an illness or incapacity that is 80.1 expected to last for 30 days or more, including a pregnant 80.2 participant who is determined to be unable to obtain or retain 80.3 employment due to the pregnancy; or 80.4 (3) a participant who is determined by a qualified 80.5 professional as being needed in the home to care for an ill or 80.6 incapacitated family member, including caregivers with a child 80.7 or an adult in the household who meets the disability or medical 80.8 criteria for home care services under section 256B.0627, 80.9 subdivision 1, paragraph (f), or a home and community-based 80.10 waiver services program under chapter 256B, or meets the 80.11 criteria for severe emotional disturbance under section 80.12 245.4871, subdivision 6, or for serious and persistent mental 80.13 illness under section 245.462, subdivision 20, paragraph (c). 80.14 (e) For participants covered under paragraphs (c) and (d), 80.15 the county shall review the participant's employment services 80.16 status every three months to determine whether conditions have 80.17 changed. When it is determined that the participant's status is 80.18 no longer covered under paragraph (c) or (d), the county shall 80.19 notify the participant that a new or revised employment plan is 80.20 needed. The participant and job counselor shall meet within ten 80.21 days of the determination to revise the employment plan. 80.22 Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 80.23 who has a natural born child who is less than 12 weeks of age 80.24 who meets the criteria in clauses (1) and (2) is not required to 80.25 participate in employment services until the child reaches 12 80.26 weeks of age. To be eligible for this provision, the following 80.27 conditions must be met: 80.28 (1) the child must have been born within ten months of the 80.29 caregiver's application for the diversionary work program or 80.30 MFIP; and 80.31 (2) the assistance unit must not have already used this 80.32 provision or the previously allowed child under age one 80.33 exemption. However, an assistance unit that has an approved 80.34 child under age one exemption at the time this provision becomes 80.35 effective may continue to use that exemption until the child 80.36 reaches one year of age. 81.1 (b) The provision in paragraph (a) ends the first full 81.2 month after the child reaches 12 weeks of age. This provision 81.3 is available only once in a caregiver's lifetime. In a 81.4 two-parent household, only one parent shall be allowed to use 81.5 this provision. The participant and job counselor must meet 81.6 within ten days after the child reaches 12 weeks of age to 81.7 revise the participant's employment plan. 81.8 [EFFECTIVE DATE.] This section is effective July 1, 2004. 81.9 Sec. 89. Minnesota Statutes 2002, section 256J.57, is 81.10 amended to read: 81.11 256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 81.12 CONCILIATION CONFERENCE.] 81.13 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 81.14 county agency shall not impose the sanction under section 81.15 256J.46 if it determines that the participant has good cause for 81.16 failing to comply with the requirements of sections256J.5281.17 256J.515 to256J.55256J.57. Good cause exists when: 81.18 (1) appropriate child care is not available; 81.19 (2) the job does not meet the definition of suitable 81.20 employment; 81.21 (3) the participant is ill or injured; 81.22 (4) a member of the assistance unit, a relative in the 81.23 household, or a foster child in the household is ill and needs 81.24 care by the participant that prevents the participant from 81.25 complying with thejob search support plan oremployment plan; 81.26 (5) the parental caregiver is unable to secure necessary 81.27 transportation; 81.28 (6) the parental caregiver is in an emergency situation 81.29 that prevents compliance with thejob search support plan or81.30 employment plan; 81.31 (7) the schedule of compliance with thejob search support81.32plan oremployment plan conflicts with judicial proceedings; 81.33 (8) a mandatory MFIP meeting is scheduled during a time 81.34 that conflicts with a judicial proceeding or a meeting related 81.35 to a juvenile court matter, or a participant's work schedule; 81.36 (9) the parental caregiver is already participating in 82.1 acceptable work activities; 82.2 (10) the employment plan requires an educational program 82.3 for a caregiver under age 20, but the educational program is not 82.4 available; 82.5 (11) activities identified in thejob search support plan82.6oremployment plan are not available; 82.7 (12) the parental caregiver is willing to accept suitable 82.8 employment, but suitable employment is not available; or 82.9 (13) the parental caregiver documents other verifiable 82.10 impediments to compliance with thejob search support plan or82.11 employment plan beyond the parental caregiver's control. 82.12 The job counselor shall work with the participant to 82.13 reschedule mandatory meetings for individuals who fall under 82.14 clauses (1), (3), (4), (5), (6), (7), and (8). 82.15 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 82.16 participant fails without good cause to comply with the 82.17 requirements of sections256J.52256J.515 to256J.55256J.57, 82.18 the job counselor or the county agency must provide a notice of 82.19 intent to sanction to the participant specifying the program 82.20 requirements that were not complied with, informing the 82.21 participant that the county agency will impose the sanctions 82.22 specified in section 256J.46, and informing the participant of 82.23 the opportunity to request a conciliation conference as 82.24 specified in paragraph (b). The notice must also state that the 82.25 participant's continuing noncompliance with the specified 82.26 requirements will result in additional sanctions under section 82.27 256J.46, without the need for additional notices or conciliation 82.28 conferences under this subdivision. The notice, written in 82.29 English, must include the department of human services language 82.30 block, and must be sent to every applicable participant. If the 82.31 participant does not request a conciliation conference within 82.32 ten calendar days of the mailing of the notice of intent to 82.33 sanction, the job counselor must notify the county agency that 82.34 the assistance payment should be reduced. The county must then 82.35 send a notice of adverse action to the participant informing the 82.36 participant of the sanction that will be imposed, the reasons 83.1 for the sanction, the effective date of the sanction, and the 83.2 participant's right to have a fair hearing under section 256J.40. 83.3 (b) The participant may request a conciliation conference 83.4 by sending a written request, by making a telephone request, or 83.5 by making an in-person request. The request must be received 83.6 within ten calendar days of the date the county agency mailed 83.7 the ten-day notice of intent to sanction. If a timely request 83.8 for a conciliation is received, the county agency's service 83.9 provider must conduct the conference within five days of the 83.10 request. The job counselor's supervisor, or a designee of the 83.11 supervisor, must review the outcome of the conciliation 83.12 conference. If the conciliation conference resolves the 83.13 noncompliance, the job counselor must promptly inform the county 83.14 agency and request withdrawal of the sanction notice. 83.15 (c) Upon receiving a sanction notice, the participant may 83.16 request a fair hearing under section 256J.40, without exercising 83.17 the option of a conciliation conference. In such cases, the 83.18 county agency shall not require the participant to engage in a 83.19 conciliation conference prior to the fair hearing. 83.20 (d) If the participant requests a fair hearing or a 83.21 conciliation conference, sanctions will not be imposed until 83.22 there is a determination of noncompliance. Sanctions must be 83.23 imposed as provided in section 256J.46. 83.24 Sec. 90. Minnesota Statutes 2002, section 256J.62, 83.25 subdivision 9, is amended to read: 83.26 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if 83.27 services were approved as part of an employment plan prior to 83.28 June 30, 2003, at the request of the participant, the county may 83.29 continue to provide case management, counseling, or other 83.30 support services to a participant: 83.31(a)(1) who has achieved the employment goal; or 83.32(b)(2) who under section 256J.42 is no longer eligible to 83.33 receive MFIP but whose income is below 115 percent of the 83.34 federal poverty guidelines for a family of the same size. 83.35 These services may be provided for up to 12 months 83.36 following termination of the participant's eligibility for MFIP. 84.1 Sec. 91. [256J.626] [MFIP CONSOLIDATED FUND.] 84.2 Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund 84.3 is established to support counties and tribes in meeting their 84.4 duties under this chapter. Counties and tribes must use funds 84.5 from the consolidated fund to develop programs and services that 84.6 are designed to improve participant outcomes as measured in 84.7 section 256J.751, subdivision 2. Counties may use the funds for 84.8 any allowable expenditures under subdivision 2. Tribes may use 84.9 the funds for any allowable expenditures under subdivision 2, 84.10 except those in clauses (1) and (6). 84.11 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 84.12 must restrict expenditures under the consolidated fund to 84.13 benefits and services allowed under title IV-A of the federal 84.14 Social Security Act. Allowable expenditures under the 84.15 consolidated fund may include, but are not limited to: 84.16 (1) short-term, nonrecurring shelter and utility needs that 84.17 are excluded from the definition of assistance under Code of 84.18 Federal Regulations, title 45, section 260.31, for families who 84.19 meet the residency requirement in section 256J.12, subdivisions 84.20 1 and 1a. Payments under this subdivision are not considered 84.21 TANF cash assistance and are not counted towards the 60-month 84.22 time limit; 84.23 (2) transportation needed to obtain or retain employment or 84.24 to participate in other approved work activities; 84.25 (3) direct and administrative costs of staff to deliver 84.26 employment services for MFIP or the diversionary work program, 84.27 to administer financial assistance, and to provide specialized 84.28 services intended to assist hard-to-employ participants to 84.29 transition to work; 84.30 (4) costs of education and training including functional 84.31 work literacy and English as a second language; 84.32 (5) cost of work supports including tools, clothing, boots, 84.33 and other work-related expenses; 84.34 (6) county administrative expenses as defined in Code of 84.35 Federal Regulations, title 45, section 260(b); 84.36 (7) services to parenting and pregnant teens; 85.1 (8) supported work; 85.2 (9) wage subsidies; 85.3 (10) child care needed for MFIP or diversionary work 85.4 program participants to participate in social services; 85.5 (11) child care to ensure that families leaving MFIP or 85.6 diversionary work program will continue to receive child care 85.7 assistance from the time the family no longer qualifies for 85.8 transition year child care until an opening occurs under the 85.9 basic sliding fee child care program; and 85.10 (12) services to help noncustodial parents of minor 85.11 children receiving MFIP or DWP assistance who live in Minnesota, 85.12 but do not live in the same household as the child, obtain or 85.13 retain employment. 85.14 (b) Administrative costs that are not matched with county 85.15 funds as provided in subdivision 8 may not exceed 7.5 percent of 85.16 a county's or tribe's reimbursement under this section. The 85.17 commissioner shall define administrative costs for purposes of 85.18 this subdivision. 85.19 Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor 85.20 child, as defined in section 256J.08, or a noncustodial parent 85.21 of a minor child receiving assistance, with incomes below 200 85.22 percent of the federal poverty guideline for a family of the 85.23 applicable size, are eligible for services funded under the 85.24 consolidated fund. Counties and tribes must give priority to 85.25 families currently receiving MFIP or diversionary work program, 85.26 and families at risk of receiving MFIP or diversionary work 85.27 program. 85.28 Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE 85.29 AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 85.30 period thereafter, each county and tribe must submit to the 85.31 commissioner a biennial service agreement related to the 85.32 services and programs in this chapter. Counties may submit 85.33 multicounty, multitribal, or regional service agreements. 85.34 (b) The service agreements will be completed in a form 85.35 prescribed by the commissioner. The agreement must include: 85.36 (1) a statement of the needs of the service population and 86.1 strengths and resources in the community; 86.2 (2) numerical goals for participant outcomes measures to be 86.3 accomplished during the biennial period. The commissioner may 86.4 identify outcomes from section 256J.751, subdivision 2, as core 86.5 outcomes for all counties and tribes; 86.6 (3) strategies the county or tribe will pursue to achieve 86.7 the outcome targets. Strategies must include specification of 86.8 how funds under this section will be used and may include 86.9 community partnerships that will be established or strengthened; 86.10 and 86.11 (4) other items prescribed by the commissioner in 86.12 consultation with counties and tribes. 86.13 (c) The commissioner shall provide each county and tribe 86.14 with information needed to complete an agreement, including: 86.15 (1) information on MFIP cases in the county or tribe; (2) 86.16 comparisons with the rest of the state; (3) baseline performance 86.17 on outcome measures; and (4) promising program practices. 86.18 (d) The service agreement must be submitted to the 86.19 commissioner by October 15, 2003, and October 15 of each second 86.20 year thereafter. The county or tribe must allow a period of not 86.21 less than 30 days prior to the submission of the agreement to 86.22 solicit comments from the public on the contents of the 86.23 agreement. 86.24 (e) The commissioner must, within 60 days of receiving each 86.25 county or tribal service agreement, inform the county or tribe 86.26 if the service agreement is approved. If the service agreement 86.27 is not approved, the commissioner must inform the county or 86.28 tribe of any revisions needed prior to approval. 86.29 (f) The service agreement in this subdivision supersedes 86.30 the plan requirements of section 268.88. 86.31 Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005, 86.32 no more than $3,000,000 of the funds annually appropriated to 86.33 the commissioner for use in the consolidated fund shall be 86.34 available to the commissioner for projects testing innovative 86.35 approaches to improving outcomes for MFIP participants, and 86.36 persons at risk of receiving MFIP as detailed in subdivision 3. 87.1 Projects shall be targeted to geographic areas with poor 87.2 outcomes as specified in section 256J.751, subdivision 5, or to 87.3 subgroups within the MFIP case load who are experiencing poor 87.4 outcomes. 87.5 Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 87.6 purposes of this section, the following terms have the meanings 87.7 given them: 87.8 (1) "2002 historic spending base" means the commissioner's 87.9 determination of the sum of the reimbursement related to fiscal 87.10 year 2002 of county or tribal agency expenditures for the base 87.11 programs listed in clause (4), items (i) to (iv), and earnings 87.12 related to calendar year 2002 in the base program listed in 87.13 clause (4), item (v), and the amount of spending in fiscal year 87.14 2002 in the base program listed in clause (4), item (vi), issued 87.15 to or on behalf of persons residing in the county or tribal 87.16 service delivery area. 87.17 (2) "Initial allocation" means the amount potentially 87.18 available to each county or tribe based on the formula in 87.19 paragraphs (b) to (d). 87.20 (3) "Final allocation" means the amount available to each 87.21 county or tribe based on the formula in paragraphs (b) to (d), 87.22 after adjustment by subdivision 7. 87.23 (4) "Base programs" means the: 87.24 (i) MFIP employment and training services under section 87.25 256J.62, subdivision 1, in effect June 30, 2002; 87.26 (ii) bilingual employment and training services to refugees 87.27 under section 256J.62, subdivision 6, in effect June 30, 2002; 87.28 (iii) work literacy language programs under section 87.29 256J.62, subdivision 7, in effect June 30, 2002; 87.30 (iv) supported work program authorized in Laws 2001, First 87.31 Special Session chapter 9, article 17, section 2, in effect June 87.32 30, 2002; 87.33 (v) administrative aid program under section 256J.76 in 87.34 effect December 31, 2002; and 87.35 (vi) emergency assistance program under section 256J.48 in 87.36 effect June 30, 2002. 88.1 (b)(1) Beginning July 1, 2003, the commissioner shall 88.2 determine the initial allocation of funds available under this 88.3 section according to clause (2). 88.4 (2)(i) Ninety percent of the funds available for the period 88.5 beginning July 1, 2003, and ending December 31, 2004, shall be 88.6 allocated to each county or tribe in proportion to the county's 88.7 or tribe's share of the statewide 2002 historic spending base; 88.8 (ii) the remaining funds for the period beginning July 1, 88.9 2003, and ending December 31, 2004, shall be allocated to each 88.10 county or tribe in proportion to the average number of MFIP 88.11 cases: 88.12 (A) the average number of cases must be based upon counts 88.13 of MFIP or tribal TANF cases as of March 31, June 30, September 88.14 30, and December 31 using the most recent available data, less 88.15 the number of child only cases. Two-parent cases, with the 88.16 exception of those with a caregiver age 60 or over, will be 88.17 multiplied by a factor of two; 88.18 (B) the MFIP or tribal TANF case count for each eligible 88.19 tribal provider shall be based upon the number of MFIP or tribal 88.20 TANF cases with participating adults who are enrolled in, or are 88.21 eligible for enrollment in, the tribe; and to be counted, the 88.22 case must be an active MFIP case, and the case members must 88.23 reside within the tribal program's service delivery area; and 88.24 (C) to prevent duplicate counts, MFIP or tribal TANF cases 88.25 counted for determining allocations to tribal providers shall be 88.26 removed from the case counts of the respective counties where 88.27 they reside. 88.28 (c)(1) Beginning January 1, 2005, the commissioner shall 88.29 determine the initial allocation of funds to be made available 88.30 under this section according to clause (2). 88.31 (2)(i) Seventy percent of the funds available for the 88.32 calendar year shall be allocated to each county or tribe in 88.33 proportion to the county's or tribe's share of the statewide 88.34 2002 historic spending base; 88.35 (ii) the remaining funds shall be allocated to each county 88.36 or tribe in proportion to the sum of the average number of MFIP 89.1 cases and the average monthly count of diversionary work program 89.2 cases. The commissioner shall determine the count of MFIP and 89.3 diversionary work program cases according to subitems (A) to (C): 89.4 (A) the average number of cases must be based upon counts 89.5 of MFIP, tribal TANF, or diversionary work program cases as of 89.6 March 31, June 30, September 30, and December 31 using the most 89.7 recent available data, less the number of child only cases. 89.8 Two-parent cases, with the exception of those with a caregiver 89.9 age 60 or over, will be multiplied by a factor of two; 89.10 (B) the case count for each eligible tribal provider shall 89.11 be based upon the number of MFIP, tribal TANF, or diversionary 89.12 work program cases with participating adults who are enrolled 89.13 in, or are eligible for enrollment in, the tribe; and to be 89.14 counted, the case must be an active MFIP or diversionary work 89.15 program case, and the case members must reside within the tribal 89.16 program's service delivery area; and 89.17 (C) to prevent duplicate counts, MFIP, tribal TANF, or 89.18 diversionary work program cases counted for determining 89.19 allocations to tribal providers shall be removed from the case 89.20 counts of the respective counties where they reside. 89.21 (d)(1) Beginning January 1, 2006, and effective January 1 89.22 of each subsequent year, the commissioner shall determine the 89.23 initial allocation of funds available under this section 89.24 according to clause (2). 89.25 (2)(i) Fifty percent of the funds available for the 89.26 calendar year shall be allocated to each county or tribe in 89.27 proportion to the county's or tribe's share of the statewide 89.28 2002 historic spending base; 89.29 (ii) the remaining funds shall be allocated to each county 89.30 or tribe in proportion to the sum of the average number of MFIP 89.31 cases and the average monthly count of diversionary work program 89.32 cases. The commissioner shall determine the count of MFIP and 89.33 diversionary work program cases according to subitems (A) to (C): 89.34 (A) the average number of cases must be based upon counts 89.35 of MFIP, tribal TANF, or diversionary work program cases as of 89.36 March 31, June 30, September 30, and December 31 using the most 90.1 recent available data, less the number of child only cases. 90.2 Two-parent cases, with the exception of those with a caregiver 90.3 age 60 or over, will be multiplied by a factor of two; 90.4 (B) the case count for each eligible tribal provider shall 90.5 be based upon the number of MFIP, tribal TANF, or diversionary 90.6 work program cases with participating adults who are enrolled 90.7 in, or are eligible for, enrollment in the tribe; and to be 90.8 counted, the case must be an active MFIP or diversionary work 90.9 program case, and the case members must reside within the tribal 90.10 program's service delivery area; and 90.11 (C) to prevent duplicate counts, MFIP, tribal TANF, or 90.12 diversionary work program cases counted for determining 90.13 allocations to tribal providers shall be removed from the case 90.14 counts of the respective counties where they reside. 90.15 (e) Before November 30, 2003, a county or tribe may ask for 90.16 a review of the commissioner's determination of the historic 90.17 base spending when the county or tribe believes the 2002 90.18 information was inaccurate or incomplete. By January 1, 2004, 90.19 the commissioner must adjust that county's or tribe's base when 90.20 the commissioner has determined that inaccurate or incomplete 90.21 information was used to develop that base. The commissioner 90.22 shall adjust each county's or tribe's initial allocation under 90.23 paragraph (c) and final allocation under subdivision 7 to 90.24 reflect the base change. 90.25 (f) Effective January 1, 2005, and effective January 1 of 90.26 each succeeding year, counties and tribes will have their final 90.27 allocations adjusted based on the performance provisions of 90.28 subdivision 7. 90.29 Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Beginning with 90.30 allocations for calendar year 2005, each county and tribe will 90.31 be allocated 95 percent of their initial allocation. Counties 90.32 and tribes will be allocated additional funds based on 90.33 performance as follows: 90.34 (1) a county or tribe that achieves a 50 percent rate or 90.35 higher on the MFIP participation rate under section 256J.751, 90.36 subdivision 2, clause (8), as averaged across the four quarterly 91.1 measurements in the preceding year, will receive an additional 91.2 allocation equal to 2.5 percent of its initial allocation; and 91.3 (2) a county or tribe that performs above the top of its 91.4 range of expected performance on the three-year self-support 91.5 index under section 256J.751, subdivision 2, clause (7), in both 91.6 measurements in the preceding year will receive an additional 91.7 allocation equal to five percent of its initial allocation; or 91.8 (3) a county or tribe that performs within its range of 91.9 expected performance on the three-year self-support index under 91.10 section 256J.751, subdivision 2, clause (7), in both 91.11 measurements in the preceding year, or above the top of its 91.12 range of expected performance in one measurement and within its 91.13 expected range of performance in the other measurement, will 91.14 receive an additional allocation equal to 2.5 percent of its 91.15 initial allocation. 91.16 (b) Funds remaining unallocated after the performance-based 91.17 allocations in paragraph (a) are available to the commissioner 91.18 for innovation projects under subdivision 5. 91.19 (c)(1) If available funds are insufficient to meet county 91.20 and tribal allocations under paragraph (a), the commissioner may 91.21 make available for allocation funds that are unobligated and 91.22 available from the innovation projects through the end of the 91.23 current biennium. 91.24 (2) If after the application of clause (1) funds remain 91.25 insufficient to meet county and tribal allocations under 91.26 paragraph (a), the commissioner must proportionally reduce the 91.27 allocation of each county and tribe with respect to their 91.28 maximum allocation available under paragraph (a). 91.29 Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 91.30 The commissioner shall specify requirements for reporting 91.31 according to section 256.01, subdivision 2, clause (17). Each 91.32 county or tribe shall be reimbursed for eligible expenditures up 91.33 to the limit of its allocation and subject to availability of 91.34 funds. 91.35 (b) Reimbursements for county administrative-related 91.36 expenditures determined through the income maintenance random 92.1 moment time study shall be reimbursed at a rate of 50 percent of 92.2 eligible expenditures. 92.3 (c) The commissioner of human services shall review county 92.4 and tribal agency expenditures of the MFIP consolidated fund as 92.5 appropriate and may reallocate unencumbered or unexpended money 92.6 appropriated under this section to those county and tribal 92.7 agencies that can demonstrate a need for additional money. 92.8 Subd. 9. [REPORT.] By January 1, 2004, the commissioner 92.9 shall, in consultation with counties and tribes: 92.10 (1) determine how performance-based allocations under 92.11 subdivision 7, paragraph (a), clauses (2) and (3), will be 92.12 allocated to groupings of counties and tribes when groupings are 92.13 used to measure expected performance ranges for the self-support 92.14 index under section 256J.751, subdivision 2, clause (7); and 92.15 (2) determine how performance-based allocations under 92.16 subdivision 7, paragraph (a), clauses (2) and (3), will be 92.17 allocated to tribes. 92.18 Sec. 92. Minnesota Statutes 2002, section 256J.645, 92.19 subdivision 3, is amended to read: 92.20 Subd. 3. [FUNDING.] If the commissioner and an Indian 92.21 tribe are parties to an agreement under this subdivision, the 92.22 agreement shall annually provide to the Indian tribe the funding 92.23 allocated in section256J.62, subdivisions 1 and 2a256J.626. 92.24 Sec. 93. Minnesota Statutes 2002, section 256J.66, 92.25 subdivision 2, is amended to read: 92.26 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 92.27 shall limit the length of training based on the complexity of 92.28 the job and the caregiver's previous experience and training. 92.29 Placement in an on-the-job training position with an employer is 92.30 for the purpose of training and employment with the same 92.31 employer who has agreed to retain the person upon satisfactory 92.32 completion of training. 92.33 (b) Placement of any participant in an on-the-job training 92.34 position must be compatible with the participant's assessment 92.35 and employment plan under section256J.52256J.521. 92.36 Sec. 94. Minnesota Statutes 2002, section 256J.67, 93.1 subdivision 1, is amended to read: 93.2 Subdivision 1. [ESTABLISHING THE COMMUNITY WORK EXPERIENCE 93.3 PROGRAM.] To the extent of available resources, each county 93.4 agency may establish and operate a work experience component for 93.5 MFIP caregivers who are participating in employment and training 93.6 services. This option for county agencies supersedes the 93.7 requirement in section 402(a)(1)(B)(iv) of the Social Security 93.8 Act that caregivers who have received assistance for two months 93.9 and who are not exempt from work requirements must participate 93.10 in a work experience program. The purpose of the work 93.11 experience component is to enhance the caregiver's employability 93.12 and self-sufficiency and to provide meaningful, productive work 93.13 activities. The county shall use this program for an individual 93.14 after exhausting all other unsubsidized employment 93.15 opportunities.The county agency shall not require a caregiver93.16to participate in the community work experience program unless93.17the caregiver has been given an opportunity to participate in93.18other work activities.93.19 Sec. 95. Minnesota Statutes 2002, section 256J.67, 93.20 subdivision 3, is amended to read: 93.21 Subd. 3. [EMPLOYMENT OPTIONS.] (a) Work sites developed 93.22 under this section are limited to projects that serve a useful 93.23 public service such as: health, social service, environmental 93.24 protection, education, urban and rural development and 93.25 redevelopment, welfare, recreation, public facilities, public 93.26 safety, community service, services to aged or disabled 93.27 citizens, and child care. To the extent possible, the prior 93.28 training, skills, and experience of a caregiver must be 93.29 considered in making appropriate work experience assignments. 93.30 (b) Structured, supervised volunteer work with an agency or 93.31 organization, which is monitored by the county service provider, 93.32 may, with the approval of the county agency, be used as a work 93.33 experience placement. 93.34 (c) As a condition of placing a caregiver in a program 93.35 under this section, the county agency shall first provide the 93.36 caregiver the opportunity:94.1(1)for placement in suitablesubsidized orunsubsidized 94.2 employment through participation in a job search; or94.3(2) for placement in suitable employment through94.4participation in on-the-job training, if such employment is94.5available. 94.6 Sec. 96. Minnesota Statutes 2002, section 256J.69, 94.7 subdivision 2, is amended to read: 94.8 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 94.9 shall limit the length of training to nine months. Placement in 94.10 a grant diversion training position with an employer is for the 94.11 purpose of training and employment with the same employer who 94.12 has agreed to retain the person upon satisfactory completion of 94.13 training. 94.14 (b) Placement of any participant in a grant diversion 94.15 subsidized training position must be compatible with the 94.16 assessment and employment plan or employability development plan 94.17 established for the recipient under section256J.52 or 256K.03,94.18subdivision 8256J.521. 94.19 Sec. 97. Minnesota Statutes 2002, section 256J.75, 94.20 subdivision 3, is amended to read: 94.21 Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE 94.22 PAYMENTS.] A county of residence, when different from the county 94.23 of financial responsibility, will be charged by the commissioner 94.24 for the value of incorrect assistance paymentsand medical94.25assistancepaid to or on behalf of a person who was not eligible 94.26 to receive that amount. Incorrect payments include payments to 94.27 an ineligible person or family resulting from decisions, 94.28 failures to act, miscalculations, or overdue recertification. 94.29 However, financial responsibility does not accrue for a county 94.30 when the recertification is overdue at the time the referral is 94.31 received by the county of residence or when the county of 94.32 financial responsibility does not act on the recommendation of 94.33 the county of residence.When federal or state law requires94.34that medical assistance continue after assistance ends, this94.35subdivision also governs financial responsibility for the94.36extended medical assistance.95.1 Sec. 98. Minnesota Statutes 2002, section 256J.751, 95.2 subdivision 1, is amended to read: 95.3 Subdivision 1. [QUARTERLYMONTHLY COUNTY CASELOAD REPORT.] 95.4 The commissioner shall reportquarterlymonthly to each county 95.5onthecounty's performance on the following measuresfollowing 95.6 caseload information: 95.7(1) number of cases receiving only the food portion of95.8assistance;95.9(2) number of child-only cases;95.10(3) number of minor caregivers;95.11(4) number of cases that are exempt from the 60-month time95.12limit by the exemption category under section 256J.42;95.13(5) number of participants who are exempt from employment95.14and training services requirements by the exemption category95.15under section 256J.56;95.16(6) number of assistance units receiving assistance under a95.17hardship extension under section 256J.425;95.18(7) number of participants and number of months spent in95.19each level of sanction under section 256J.46, subdivision 1;95.20(8) number of MFIP cases that have left assistance;95.21(9) federal participation requirements as specified in95.22title 1 of Public Law Number 104-193;95.23(10) median placement wage rate; and95.24(11) of each county's total MFIP caseload less the number95.25of cases in clauses (1) to (6):95.26(i) number of one-parent cases;95.27(ii) number of two-parent cases;95.28(iii) percent of one-parent cases that are working more95.29than 20 hours per week;95.30(iv) percent of two-parent cases that are working more than95.3120 hours per week; and95.32(v) percent of cases that have received more than 36 months95.33of assistance.95.34 (1) total number of cases receiving MFIP, and subtotals of 95.35 cases with one eligible parent, two eligible parents, and an 95.36 eligible caregiver who is not a parent; 96.1 (2) total number of child only assistance cases; 96.2 (3) total number of eligible adults and children receiving 96.3 an MFIP grant, and subtotals for cases with one eligible parent, 96.4 two eligible parents, an eligible caregiver who is not a parent, 96.5 and child only cases; 96.6 (4) number of cases with an exemption from the 60-month 96.7 time limit based on a family violence waiver; 96.8 (5) number of MFIP cases with work hours, and subtotals for 96.9 cases with one eligible parent, two eligible parents, and an 96.10 eligible caregiver who is not a parent; 96.11 (6) number of employed MFIP cases, and subtotals for cases 96.12 with one eligible parent, two eligible parents, and an eligible 96.13 caregiver who is not a parent; 96.14 (7) average monthly gross earnings, and averages for 96.15 subgroups of cases with one eligible parent, two eligible 96.16 parents, and an eligible caregiver who is not a parent; 96.17 (8) number of employed cases receiving only the food 96.18 portion of assistance; 96.19 (9) number of parents or caregivers exempt from work 96.20 activity requirements, with subtotals for each exemption type; 96.21 and 96.22 (10) number of cases with a sanction, with subtotals by 96.23 level of sanction for cases with one eligible parent, two 96.24 eligible parents, and an eligible caregiver who is not a parent. 96.25 Sec. 99. Minnesota Statutes 2002, section 256J.751, 96.26 subdivision 2, is amended to read: 96.27 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 96.28 shall report quarterly to all counties on each county's 96.29 performance on the following measures: 96.30 (1) percent of MFIP caseload working in paid employment; 96.31 (2) percent of MFIP caseload receiving only the food 96.32 portion of assistance; 96.33 (3) number of MFIP cases that have left assistance; 96.34 (4) federal participation requirements as specified in 96.35 Title 1 of Public LawNumber104-193; 96.36 (5) median placement wage rate;and97.1 (6) caseload by months of TANF assistance; 97.2 (7) percent of MFIP cases off cash assistance or working 30 97.3 or more hours per week at one-year, two-year, and three-year 97.4 follow-up points from a base line quarter. This measure is 97.5 called the self-support index. Twice annually, the commissioner 97.6 shall report an expected range of performance for each county, 97.7 county grouping, and tribe on the self-support index. The 97.8 expected range shall be derived by a statistical methodology 97.9 developed by the commissioner in consultation with the counties 97.10 and tribes. The statistical methodology shall control 97.11 differences across counties in economic conditions and 97.12 demographics of the MFIP case load; and 97.13 (8) the MFIP work participation rate, defined as the 97.14 participation requirements specified in title 1 of Public Law 97.15 104-193 applied to all MFIP cases. 97.16 Sec. 100. Minnesota Statutes 2002, section 256J.751, 97.17 subdivision 5, is amended to read: 97.18 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 97.19 (a) If sanctions occur for failure to meet the performance 97.20 standards specified in title 1 of Public LawNumber104-193 of 97.21 the Personal Responsibility and Work Opportunity Act of 1996, 97.22 the state shall pay 88 percent of the sanction. The remaining 97.23 12 percent of the sanction will be paid by the counties. The 97.24 county portion of the sanction will be distributed across all 97.25 counties in proportion to each county's percentage of the MFIP 97.26 average monthly caseload during the period for which the 97.27 sanction was applied. 97.28 (b) If a county fails to meet the performance standards 97.29 specified in title 1 of Public LawNumber104-193 of the 97.30 Personal Responsibility and Work Opportunity Act of 1996 for any 97.31 year, the commissioner shall work with counties to organize a 97.32 joint state-county technical assistance team to work with the 97.33 county. The commissioner shall coordinate any technical 97.34 assistance with other departments and agencies including the 97.35 departments of economic security and children, families, and 97.36 learning as necessary to achieve the purpose of this paragraph. 98.1 (c) For state performance measures, a low-performing county 98.2 is one that: 98.3 (1) performs below the bottom of their expected range for 98.4 the measure in subdivision 2, clause (7), in both measurements 98.5 during the year; or 98.6 (2) performs below 40 percent for the measure in 98.7 subdivision 2, clause (8), as averaged across the four quarterly 98.8 measurements for the year, or the ten counties with the lowest 98.9 rates if more than ten are below 40 percent. 98.10 (d) Low-performing counties under paragraph (c) must engage 98.11 in corrective action planning as defined by the commissioner. 98.12 The commissioner may coordinate technical assistance as 98.13 specified in paragraph (b) for low-performing counties under 98.14 paragraph (c). 98.15 Sec. 101. [256J.95] [DIVERSIONARY WORK PROGRAM.] 98.16 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 98.17 (DWP).] (a) The Personal Responsibility and Work Opportunity 98.18 Reconciliation Act of 1996, Public Law 104-193, establishes 98.19 block grants to states for temporary assistance for needy 98.20 families (TANF). TANF provisions allow states to use TANF 98.21 dollars for nonrecurrent, short-term diversionary benefits. The 98.22 diversionary work program established on July 1, 2003, is 98.23 Minnesota's TANF program to provide short-term diversionary 98.24 benefits to eligible recipients of the diversionary work program. 98.25 (b) The goal of the diversionary work program is to provide 98.26 short-term, necessary services and supports to families which 98.27 will lead to unsubsidized employment and economic stability and 98.28 reduce the risk of those families needing longer term 98.29 assistance, under the Minnesota family investment program (MFIP). 98.30 (c) When a family unit meets the eligibility criteria in 98.31 this section, the family must receive a diversionary work 98.32 program grant and is not eligible for MFIP. 98.33 (d) A family unit is eligible for the diversionary work 98.34 program for a maximum of four months only once in a 12-month 98.35 period. The 12-month period begins at the date of application 98.36 or the date eligibility is met, whichever is later. During the 99.1 four-month period, family maintenance needs as defined in 99.2 subdivision 2, shall be vendor paid, up to the cash portion of 99.3 the MFIP standard of need for the same size household. To the 99.4 extent there is a balance available between the amount paid for 99.5 family maintenance needs and the cash portion of the 99.6 transitional standard, a personal needs allowance of up to $70 99.7 per DWP recipient in the family unit shall be issued. The 99.8 personal needs allowance payment plus the family maintenance 99.9 needs shall not exceed the cash portion of the MFIP standard of 99.10 need. Counties may provide supportive and other allowable 99.11 services funded by the MFIP consolidated fund under section 99.12 256J.626 to eligible participants during the four-month 99.13 diversionary period. 99.14 Subd. 2. [DEFINITIONS.] The terms used in this section 99.15 have the following meanings. 99.16 (a) "Diversionary Work Program (DWP)" means the program 99.17 established under this section. 99.18 (b) "Employment plan" means a plan developed by the job 99.19 counselor and the participant which identifies the participant's 99.20 most direct path to unsubsidized employment, lists the specific 99.21 steps that the caregiver will take on that path, and includes a 99.22 timetable for the completion of each step. For participants who 99.23 request and qualify for a family violence waiver in section 99.24 256J.521, subdivision 3, an employment plan must be developed by 99.25 the job counselor, the participant and a person trained in 99.26 domestic violence and follow the employment plan provisions in 99.27 section 256J.521, subdivision 3. Employment plans under this 99.28 section shall be written for a period of time not to exceed four 99.29 months. 99.30 (c) "Employment services" means programs, activities, and 99.31 services in this section that are designed to assist 99.32 participants in obtaining and retaining employment. 99.33 (d) "Family maintenance needs" means current housing costs 99.34 including rent, manufactured home lot rental costs, or monthly 99.35 principal, interest, insurance premiums, and property taxes due 99.36 for mortgages or contracts for deed, association fees required 100.1 for homeownership, utility costs for current month expenses of 100.2 gas and electric, garbage, water and sewer, and a flat rate of 100.3 $35 for a telephone. 100.4 (e) "Family unit" means a group of people applying for or 100.5 receiving DWP benefits together. For the purposes of 100.6 determining eligibility for this program, the unit includes the 100.7 relationships in section 256J.08, subdivision 34. 100.8 (f) "Minnesota family investment program (MFIP)" means the 100.9 assistance program as defined in section 256J.08, subdivision 57. 100.10 (g) "Personal needs allowance" means an allowance of up to 100.11 $70 per month per DWP unit member to pay for expenses such as 100.12 household products and personal products. 100.13 (h) "Work activities" means allowable work activities as 100.14 defined in section 256J.49, subdivision 13. 100.15 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK 100.16 PROGRAM.] Except for the categories of family units listed 100.17 below, all family units who apply for cash benefits and who meet 100.18 MFIP eligibility as required in section 256J.10, are eligible 100.19 and must participate in the diversionary work program. Family 100.20 units that are not eligible for the diversionary work program 100.21 include: 100.22 (1) child only cases; 100.23 (2) a single-parent family unit that includes a child under 100.24 12 weeks of age. A parent is eligible for this exception once 100.25 in a parent's lifetime and is not eligible if the parent has 100.26 already used the previously allowed child under age one 100.27 exemption from MFIP employment services; 100.28 (3) minor parent cases. In a two-parent family unit, each 100.29 parent must be under age 18; 100.30 (4) family units with a caregiver who is less than 20 years 100.31 of age who has not completed high school or a GED. In the case 100.32 of a two-parent family unit, each parent must be under age 20 100.33 and have not completed high school or obtained a GED; 100.34 (5) family units with a caregiver age 60 or over. In a 100.35 two-parent family unit, each parent must be age 60 or older; 100.36 (6) family units with a parent who received DWP benefits 101.1 within a 12-month period as defined in subdivision 1, paragraph 101.2 (d); and 101.3 (7) family units with a parent who received MFIP within the 101.4 past 12 months. 101.5 Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 101.6 be eligible for DWP, an applicant must comply with the 101.7 requirements of paragraphs (b) to (d). 101.8 (b) Applicants and participants must cooperate with the 101.9 requirements of the child support enforcement program, but will 101.10 not be charged a fee under section 518.551, subdivision 7. 101.11 (c) The applicant must provide each member of the family 101.12 unit's social security number to the county agency. This 101.13 requirement is satisfied when each member of the family unit 101.14 cooperates with the procedures for verification of numbers, 101.15 issuance of duplicate cards, and issuance of new numbers which 101.16 have been established jointly between the Social Security 101.17 Administration and the commissioner. 101.18 (d) Before DWP benefits can be issued to a family unit, the 101.19 caregiver must, in conjunction with a job counselor, develop and 101.20 sign an employment plan. In two-parent family units, both 101.21 parents must develop and sign employment plans before benefits 101.22 can be issued. Food support and health care benefits are not 101.23 contingent on the requirement for a signed employment plan. 101.24 Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility 101.25 date for the diversionary work program begins with the date the 101.26 signed combined application form (CAF) is received by the county 101.27 agency or the date diversionary work program eligibility 101.28 criteria are met, whichever is later. The county agency must 101.29 inform the applicant that any delay in submitting the 101.30 application will reduce the amount of assistance paid for the 101.31 month of application. The county agency must inform a person 101.32 that an application may be submitted before the person has an 101.33 interview appointment. Upon receipt of a signed application, 101.34 the county agency must stamp the date of receipt on the face of 101.35 the application. The applicant may withdraw the application at 101.36 any time prior to approval by giving written or oral notice to 102.1 the county agency. The county agency must follow the notice 102.2 requirements in section 256J.09, subdivision 3, when issuing a 102.3 notice confirming the withdrawal. 102.4 Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 102.5 of the application, the county agency must determine if the 102.6 applicant may be eligible for other benefits as required in 102.7 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 102.8 and 5. The county must also follow the provisions in section 102.9 256J.09, subdivision 3b, clause (2). 102.10 Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The 102.11 interview to determine financial eligibility for the 102.12 diversionary work program must be conducted within five working 102.13 days of the receipt of the cash application form. During the 102.14 intake interview the financial worker must discuss: 102.15 (1) the goals, requirements, and services of the 102.16 diversionary work program; 102.17 (2) the availability of child care assistance. If child 102.18 care is needed, the worker must obtain a completed application 102.19 for child care from the applicant before the interview is 102.20 terminated. The same day the application for child care is 102.21 received, the application must be forwarded to the appropriate 102.22 child care worker. For purposes of eligibility for child care 102.23 assistance under chapter 119B, DWP participants shall be 102.24 eligible for the same benefits as MFIP recipients; and 102.25 (3) if the applicant has not requested food support and 102.26 health care assistance on the application, the county agency 102.27 shall, during the interview process, talk with the applicant 102.28 about the availability of these benefits. 102.29 (b) The county shall follow section 256J.74, subdivision 2, 102.30 paragraph (b), clauses (1) and (2), when an applicant or a 102.31 recipient of DWP has a person who is a member of more than one 102.32 assistance unit in a given payment month. 102.33 (c) If within 30 days the county agency cannot determine 102.34 eligibility for the diversionary work program, the county must 102.35 deny the application and inform the applicant of the decision 102.36 according to the notice provisions in section 256J.31. A family 103.1 unit is eligible for a fair hearing under section 256J.40. 103.2 Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency 103.3 must only require verification of information necessary to 103.4 determine DWP eligibility and the amount of the payment. The 103.5 applicant or participant must document the information required 103.6 or authorize the county agency to verify the information. The 103.7 applicant or participant has the burden of providing documentary 103.8 evidence to verify eligibility. The county agency shall assist 103.9 the applicant or participant in obtaining required documents 103.10 when the applicant or participant is unable to do so. 103.11 (b) A county agency must not request information about an 103.12 applicant or participant that is not a matter of public record 103.13 from a source other than county agencies, the department of 103.14 human services, or the United States Department of Health and 103.15 Human Services without the person's prior written consent. An 103.16 applicant's signature on an application form constitutes consent 103.17 for contact with the sources specified on the application. A 103.18 county agency may use a single consent form to contact a group 103.19 of similar sources, but the sources to be contacted must be 103.20 identified by the county agency prior to requesting an 103.21 applicant's consent. 103.22 (c) Factors to be verified shall follow section 256J.32, 103.23 subdivision 4, except for clause (20). Except for personal 103.24 needs, family maintenance needs must be verified before the 103.25 expense can be allowed in the calculation of the DWP grant. 103.26 Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset 103.27 limits and exclusions in section 256J.20, apply to applicants 103.28 and recipients of DWP. All payments, unless excluded in section 103.29 256J.21, must be counted as income to determine eligibility for 103.30 the diversionary work program. The county shall treat income as 103.31 outlined in section 256J.37, except for subdivision 3a. The 103.32 initial income test and the disregards in section 256J.21, 103.33 subdivision 3, shall be followed for determining eligibility for 103.34 the diversionary work program. 103.35 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 103.36 amount of cash benefits that a family unit is eligible for under 104.1 the diversionary work program is based on the number of persons 104.2 in the family unit, the family maintenance needs, personal needs 104.3 allowance, and countable income. The county agency shall 104.4 evaluate the income of the family unit that is requesting 104.5 payments under the diversionary work program. Countable income 104.6 means gross earned and unearned income not excluded or 104.7 disregarded under MFIP. The same disregards for earned income 104.8 that are allowed under MFIP are allowed for the diversionary 104.9 work program. 104.10 (b) The DWP grant is based on the family maintenance needs 104.11 for which the DWP family unit is responsible plus a personal 104.12 needs allowance. Housing and utilities shall be vendor paid. 104.13 Unless otherwise stated in this section, actual housing and 104.14 utility expenses shall be used when determining the amount of 104.15 the DWP grant. 104.16 (c) The maximum monthly benefit amount available under the 104.17 diversionary work program is the difference between the family 104.18 unit's family maintenance needs under paragraph (b) and the 104.19 family unit's countable income not to exceed the cash portion of 104.20 the MFIP standard of need as defined in section 256J.08, 104.21 subdivision 55a, for the family unit's size. The family wage 104.22 level as defined in section 256J.08, subdivision 35, shall be 104.23 used when determining the amount of countable income for working 104.24 members. 104.25 (d) Once the county has determined a grant amount, the DWP 104.26 grant amount will not be decreased if the determination is based 104.27 on the best information available at the time of approval and 104.28 shall not be decreased because of any additional income to the 104.29 family unit. The grant can be increased if a participant later 104.30 verifies an increase in family maintenance needs or family unit 104.31 size. The minimum cash benefit amount, if income and asset 104.32 tests are met, is $10. Benefits of $10 shall not be vendor paid. 104.33 (e) When all criteria are met, including the development of 104.34 an employment plan as described in subdivision 14 and 104.35 eligibility exists for the month of application, the amount of 104.36 benefits for the diversionary work program retroactive to the 105.1 date of application is as specified in section 256J.35, 105.2 paragraph (a). 105.3 (f) Any month during the four-month DWP period that a 105.4 person receives a DWP benefit directly or through a vendor 105.5 payment made on the person's behalf, that person is ineligible 105.6 for MFIP or any other TANF cash program. 105.7 If during the four-month period a family unit that receives 105.8 DWP benefits moves to a county that has not established a 105.9 diversionary work program, the family unit may be eligible for 105.10 MFIP the month following the last month of the issuance of the 105.11 DWP benefit. 105.12 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 105.13 caregivers, except caregivers who meet the criteria in paragraph 105.14 (e), are required to participate in DWP employment services. 105.15 Except for paragraphs (b) to (d), employment plans under DWP 105.16 must, at a minimum, meet the requirements in section 256J.55, 105.17 subdivision 1. 105.18 (b) The following DWP caregivers may be allowed to develop 105.19 employment plans under section 256J.521, subdivision 2, 105.20 paragraph (c), that may contain alternate activities and reduced 105.21 hours when approved by the job counselor: 105.22 (1) a caregiver who is 60 years of age or older but is 105.23 required to participate in DWP because the caregiver is in a 105.24 two-parent family unit and the second caregiver is less than 60 105.25 years of age; and 105.26 (2) a caregiver, in a two-parent DWP family unit, who meets 105.27 one of the criteria in subdivision 12, paragraph (b), clauses 105.28 (1) to (5), when only one of the two caregivers in the family 105.29 unit meets these criteria. 105.30 (c) A caregiver who is under the age of 20, who has not 105.31 completed high school or its equivalent, and who is a member of 105.32 a two-parent family unit that is required to participate in DWP 105.33 is required to comply with section 256J.54. 105.34 (d) A participant who has a family violence waiver shall be 105.35 allowed to develop an employment plan under section 256J.521, 105.36 subdivision 3. 106.1 (e) One parent in a two-parent family unit that has a 106.2 natural born child under 12 weeks of age is not required to have 106.3 an employment plan until the child reaches 12 weeks of age 106.4 unless the family unit has already used the exclusion under 106.5 section 256J.561, subdivision 2, or the previously allowed child 106.6 under age one exemption under section 256J.56, paragraph (a), 106.7 clause (5). 106.8 (f) The provision in paragraph (e) ends the first full 106.9 month after the child reaches 12 weeks of age. This provision 106.10 is allowable only once in a caregiver's lifetime. In a 106.11 two-parent household, only one parent shall be allowed to use 106.12 this category. 106.13 (g) The participant and job counselor must meet within ten 106.14 days after the child reaches 12 weeks of age to revise the 106.15 participant's employment plan. The employment plan for a family 106.16 unit that has a child under 12 weeks of age that has already 106.17 used the exclusion in section 256J.561 or the previously allowed 106.18 child under age one exemption under section 256J.56, paragraph 106.19 (a), clause (5), must be tailored to recognize the caregiving 106.20 needs of the parent. 106.21 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 106.22 time during the DWP application process or during the four-month 106.23 DWP eligibility period, it is determined that a participant is 106.24 unlikely to benefit from the diversionary work program, the 106.25 county shall convert or refer the participant to MFIP as 106.26 specified in paragraph (d). Participants who are determined to 106.27 be unlikely to benefit from the diversionary work program must 106.28 still develop and sign an employment plan. Participants are 106.29 determined to be unlikely to benefit from the DWP program for 106.30 any one of the reasons listed in paragraph (b), provided the 106.31 necessary documentation is available to support the 106.32 determination. 106.33 (b)(1) a participant who has been determined by a qualified 106.34 professional as being unable to obtain or retain employment due 106.35 to an illness, injury, or incapacity that is expected to last at 106.36 least 60 days; 107.1 (2) a participant who is determined by a qualified 107.2 professional as being needed in the home to care for a family 107.3 member due to an illness, injury, or incapacity that is expected 107.4 to last at least 60 days; 107.5 (3) a participant who is determined by a qualified 107.6 professional as being needed in the home to care for a child 107.7 meeting the special medical criteria in section 256J.425, 107.8 subdivision 2, clause (3); 107.9 (4) a pregnant participant who is determined by a qualified 107.10 professional as being unable to obtain or retain employment due 107.11 to the pregnancy; and 107.12 (5) a participant who has applied for SSI or RSDI. 107.13 (c) In a two-parent family unit, both parents must be 107.14 determined to be unlikely to benefit from the diversionary work 107.15 program before the family unit can be converted or referred to 107.16 MFIP. 107.17 (d) A participant who is determined to be unlikely to 107.18 benefit from the diversionary work program shall be converted to 107.19 MFIP and, if the determination was made within 30 days of the 107.20 initial application for benefits, a new combined application 107.21 form will not be required. A participant who is determined to 107.22 be unlikely to benefit from the diversionary work program shall 107.23 be referred to MFIP and, if the determination is made more than 107.24 30 days after the initial application, the participant must 107.25 submit a new combined application form. The county agency shall 107.26 process the combined application form by the first of the 107.27 following month to ensure that no gap in benefits is due to 107.28 delayed action by the county agency. 107.29 Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 107.30 Within one working day of determination that the applicant is 107.31 eligible for the diversionary work program, but before cash 107.32 assistance is issued to or on behalf of the family unit, the 107.33 county shall refer all caregivers to employment services. The 107.34 referral to the DWP employment services must be in writing and 107.35 must contain the following information: 107.36 (1) notification that, as part of the application process, 108.1 applicants are required to develop an employment plan or the DWP 108.2 application will be denied; 108.3 (2) the employment services provider name and phone number; 108.4 (3) the date, time, and location of the scheduled 108.5 employment services interview; 108.6 (4) the immediate availability of supportive services, 108.7 including, but not limited to, child care, transportation, and 108.8 other work-related aid; and 108.9 (5) the rights, responsibilities, and obligations of 108.10 participants in the program, including, but not limited to, the 108.11 grounds for good cause, the consequences of refusing or failing 108.12 to participate fully with program requirements, and the appeal 108.13 process. 108.14 Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] Within five 108.15 working days of being notified that a participant is eligible 108.16 for the diversionary work program, the employment services 108.17 provider and participant shall meet to develop an employment 108.18 plan. Once the employment plan has been developed and signed by 108.19 the participant and the job counselor, the employment services 108.20 provider shall notify the county within one working day that the 108.21 employment plan has been signed. The county shall issue DWP 108.22 benefits within one working day after receiving notice that the 108.23 employment plan has been signed. 108.24 Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 108.25 Except as specified in paragraphs (b) to (d), employment 108.26 activities listed in section 256J.49, subdivision 13, are 108.27 allowable under the diversionary work program. 108.28 (b) Work activities under section 256J.49, subdivision 13, 108.29 clause (5), shall be allowable only when in combination with 108.30 approved work activities under section 256J.49, subdivision 13, 108.31 clauses (1) to (4), and shall be limited to no more than 108.32 one-half of the hours required in the employment plan. 108.33 (c) In order for an English as a second language (ESL) 108.34 class to be an approved work activity, a participant must: 108.35 (1) be below a spoken language proficiency level of SPL6 or 108.36 its equivalent, as measured by a nationally recognized test; and 109.1 (2) not have been enrolled in ESL for more than 24 months 109.2 while previously participating in MFIP or DWP. A participant 109.3 who has been enrolled in ESL for 20 or more months may be 109.4 approved for ESL until the participant has received 24 total 109.5 months. 109.6 (d) Work activities under section 256J.49, subdivision 13, 109.7 clause (6), shall be allowable only when the training or 109.8 education program will be completed within the four-month DWP 109.9 period. Training or education programs that will not be 109.10 completed within the four-month DWP period shall not be approved. 109.11 Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 109.12 unit that includes a participant who fails to comply with DWP 109.13 employment service or child support enforcement requirements, 109.14 without good cause as defined in sections 256.741 and 256J.57, 109.15 shall be disqualified from the diversionary work program. The 109.16 county shall provide written notice as specified in section 109.17 256J.31 to the participant prior to disqualifying the family 109.18 unit due to noncompliance with employment service or child 109.19 support. The disqualification does not apply to food support or 109.20 health care benefits. 109.21 Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH 109.22 REQUIREMENTS.] A participant who fails to comply with the 109.23 requirements of the diversionary work program may claim good 109.24 cause for reasons listed in sections 256.741 and 256J.57, 109.25 subdivision 1, clauses (1) to (13). The county shall not impose 109.26 a disqualification if good cause exists. 109.27 Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 109.28 participant who has been disqualified from the diversionary work 109.29 program due to noncompliance with employment services may regain 109.30 eligibility for the diversionary work program by complying with 109.31 program requirements. A participant who has been disqualified 109.32 from the diversionary work program due to noncooperation with 109.33 child support enforcement requirements may regain eligibility by 109.34 complying with child support requirements under section 109.35 256J.741. Once a participant has been reinstated, the county 109.36 shall issue prorated benefits for the remaining portion of the 110.1 month. A family unit that has been disqualified from the 110.2 diversionary work program due to noncompliance shall not be 110.3 eligible for MFIP or any other TANF cash program during the 110.4 period of time the participant remains noncompliant. In a 110.5 two-parent family, both parents must be in compliance before the 110.6 family unit can regain eligibility for benefits. 110.7 Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment 110.8 due to client error or an ATM error is determined, the 110.9 overpayment shall be recouped or recovered as specified in 110.10 section 256J.38, subdivisions 2 to 5. 110.11 Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish 110.12 a diversionary work program according to this section any time 110.13 on or after July 1, 2003. Prior to establishing a diversionary 110.14 work program, the county must notify the commissioner. All 110.15 counties must implement the provisions of this section no later 110.16 than July 1, 2004. 110.17 Sec. 102. Minnesota Statutes 2002, section 261.063, is 110.18 amended to read: 110.19 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 110.20 PENALTY.] 110.21 (a) The board of county commissioners of each county shall 110.22 annually levy taxes and fix a rate sufficient to produce the 110.23 full amount required for poor relief, general assistance, 110.24 Minnesota family investment program, diversionary work program, 110.25 county share of county and state supplemental aid to 110.26 supplemental security income applicants or recipients, and any 110.27 other social security measures wherein there is now or may 110.28 hereafter be county participation, sufficient to produce the 110.29 full amount necessary for each such item, including 110.30 administrative expenses, for the ensuing year, within the time 110.31 fixed by law in addition to all other tax levies and tax rates, 110.32 however fixed or determined, and any commissioner who shall fail 110.33 to comply herewith shall be guilty of a gross misdemeanor and 110.34 shall be immediately removed from office by the governor. For 110.35 the purposes of this paragraph, "poor relief" means county 110.36 services provided under sections 261.035, 261.04,and 261.21 to 111.1 261.231. 111.2 (b) Nothing within the provisions of this section shall be 111.3 construed as requiring a county agency to provide income support 111.4 or cash assistance to needy persons when they are no longer 111.5 eligible for assistance under general assistance,the Minnesota111.6family investment programchapter 256J, or Minnesota 111.7 supplemental aid. 111.8 Sec. 103. Minnesota Statutes 2002, section 393.07, 111.9 subdivision 10, is amended to read: 111.10 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 111.11 CHILD NUTRITION ACT.] (a) The local social services agency shall 111.12 establish and administer the food stamp or support program 111.13 according to rules of the commissioner of human services, the 111.14 supervision of the commissioner as specified in section 256.01, 111.15 and all federal laws and regulations. The commissioner of human 111.16 services shall monitor food stamp or support program delivery on 111.17 an ongoing basis to ensure that each county complies with 111.18 federal laws and regulations. Program requirements to be 111.19 monitored include, but are not limited to, number of 111.20 applications, number of approvals, number of cases pending, 111.21 length of time required to process each application and deliver 111.22 benefits, number of applicants eligible for expedited issuance, 111.23 length of time required to process and deliver expedited 111.24 issuance, number of terminations and reasons for terminations, 111.25 client profiles by age, household composition and income level 111.26 and sources, and the use of phone certification and home 111.27 visits. The commissioner shall determine the county-by-county 111.28 and statewide participation rate. 111.29 (b) On July 1 of each year, the commissioner of human 111.30 services shall determine a statewide and county-by-county food 111.31 stamp program participation rate. The commissioner may 111.32 designate a different agency to administer the food stamp 111.33 program in a county if the agency administering the program 111.34 fails to increase the food stamp program participation rate 111.35 among families or eligible individuals, or comply with all 111.36 federal laws and regulations governing the food stamp program. 112.1 The commissioner shall review agency performance annually to 112.2 determine compliance with this paragraph. 112.3 (c) A person who commits any of the following acts has 112.4 violated section 256.98 or 609.821, or both, and is subject to 112.5 both the criminal and civil penalties provided under those 112.6 sections: 112.7 (1) obtains or attempts to obtain, or aids or abets any 112.8 person to obtain by means of a willful statement or 112.9 misrepresentation, or intentional concealment of a material 112.10 fact, food stamps or vouchers issued according to sections 112.11 145.891 to 145.897 to which the person is not entitled or in an 112.12 amount greater than that to which that person is entitled or 112.13 which specify nutritional supplements to which that person is 112.14 not entitled; or 112.15 (2) presents or causes to be presented, coupons or vouchers 112.16 issued according to sections 145.891 to 145.897 for payment or 112.17 redemption knowing them to have been received, transferred or 112.18 used in a manner contrary to existing state or federal law; or 112.19 (3) willfully uses, possesses, or transfers food stamp 112.20 coupons, authorization to purchase cards or vouchers issued 112.21 according to sections 145.891 to 145.897 in any manner contrary 112.22 to existing state or federal law, rules, or regulations; or 112.23 (4) buys or sells food stamp coupons, authorization to 112.24 purchase cards, other assistance transaction devices, vouchers 112.25 issued according to sections 145.891 to 145.897, or any food 112.26 obtained through the redemption of vouchers issued according to 112.27 sections 145.891 to 145.897 for cash or consideration other than 112.28 eligible food. 112.29 (d) A peace officer or welfare fraud investigator may 112.30 confiscate food stamps, authorization to purchase cards, or 112.31 other assistance transaction devices found in the possession of 112.32 any person who is neither a recipient of the food stamp program 112.33 nor otherwise authorized to possess and use such materials. 112.34 Confiscated property shall be disposed of as the commissioner 112.35 may direct and consistent with state and federal food stamp 112.36 law. The confiscated property must be retained for a period of 113.1 not less than 30 days to allow any affected person to appeal the 113.2 confiscation under section 256.045. 113.3 (e) Food stamp overpayment claims which are due in whole or 113.4 in part to client error shall be established by the county 113.5 agency for a period of six years from the date of any resultant 113.6 overpayment. 113.7 (f) With regard to the federal tax revenue offset program 113.8 only, recovery incentives authorized by the federal food and 113.9 consumer service shall be retained at the rate of 50 percent by 113.10 the state agency and 50 percent by the certifying county agency. 113.11 (g) A peace officer, welfare fraud investigator, federal 113.12 law enforcement official, or the commissioner of health may 113.13 confiscate vouchers found in the possession of any person who is 113.14 neither issued vouchers under sections 145.891 to 145.897, nor 113.15 otherwise authorized to possess and use such vouchers. 113.16 Confiscated property shall be disposed of as the commissioner of 113.17 health may direct and consistent with state and federal law. 113.18 The confiscated property must be retained for a period of not 113.19 less than 30 days. 113.20 (h) The commissioner of human services shall seek a waiver 113.21 from the United States Department of Agriculture to allow the 113.22 state to specify foods that may and may not be purchased in 113.23 Minnesota with benefits funded by the federal Food Stamp Program. 113.24 Sec. 104. Laws 1997, chapter 203, article 9, section 21, 113.25 as amended by Laws 1998, chapter 407, article 6, section 111, 113.26 Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 113.27 First Special Session chapter 9, article 10, section 62, is 113.28 amended to read: 113.29 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 113.30 (a) Effective on the date specified, the following persons 113.31 will be ineligible for general assistance and general assistance 113.32 medical care under Minnesota Statutes, chapter 256D, group 113.33 residential housing under Minnesota Statutes, chapter 256I, and 113.34 MFIP assistance under Minnesota Statutes, chapter 256J, funded 113.35 with state money: 113.36 (1) Beginning July 1, 2002, persons who are terminated from 114.1 or denied Supplemental Security Income due to the 1996 changes 114.2 in the federal law making persons whose alcohol or drug 114.3 addiction is a material factor contributing to the person's 114.4 disability ineligible for Supplemental Security Income, and are 114.5 eligible for general assistance under Minnesota Statutes, 114.6 section 256D.05, subdivision 1, paragraph (a), clause (15), 114.7 general assistance medical care under Minnesota Statutes, 114.8 chapter 256D, or group residential housing under Minnesota 114.9 Statutes, chapter 256I; and 114.10 (2) Beginning July 1, 2002, legal noncitizens who are 114.11 ineligible for Supplemental Security Income due to the 1996 114.12 changes in federal law making certain noncitizens ineligible for 114.13 these programs due to their noncitizen status; and. 114.14(3) Beginning July 1, 2003, legal noncitizens who are114.15eligible for MFIP assistance, either the cash assistance portion114.16or the food assistance portion, funded entirely with state money.114.17 (b) State money that remains unspent due to changes in 114.18 federal law enacted after May 12, 1997, that reduce state 114.19 spending for legal noncitizens or for persons whose alcohol or 114.20 drug addiction is a material factor contributing to the person's 114.21 disability, or enacted after February 1, 1998, that reduce state 114.22 spending for food benefits for legal noncitizens shall not 114.23 cancel and shall be deposited in the TANF reserve account. 114.24 Sec. 105. [REVISOR'S INSTRUCTION.] 114.25 (a) In the next publication of Minnesota Statutes, the 114.26 revisor of statutes shall codify section 104 of this act. 114.27 (b) Wherever "food stamp" or "food stamps" appears in 114.28 Minnesota Statutes and Rules, the revisor of statutes shall 114.29 insert "food support" or "or food support" except for instances 114.30 where federal code or federal law is referenced. 114.31 (c) For sections in Minnesota Statutes and Minnesota Rules 114.32 affected by the repealed sections in this article, the revisor 114.33 shall delete internal cross-references where appropriate and 114.34 make changes necessary to correct the punctuation, grammar, or 114.35 structure of the remaining text and preserve its meaning. 114.36 Sec. 106. [REPEALER.] 115.1 (a) Minnesota Statutes 2002, sections 256J.02, subdivision 115.2 3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 115.3 256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 115.4 subdivisions 1a, 6, and 7; 256J.49, subdivision 2; 256J.50, 115.5 subdivisions 2, 3, 3a, 5, and 7; 256J.52, subdivisions 1, 2, 3, 115.6 4, 5, 5a, 6, 7, 8, and 9; 256J.55, subdivision 5; 256J.62, 115.7 subdivisions 1, 2a, 3a, 4, 6, 7, and 8; 256J.625; 256J.655; 115.8 256J.74, subdivision 3; 256J.751, subdivisions 3 and 4; 256J.76; 115.9 and 256K.30, are repealed. 115.10 (b) Laws 2000, chapter 488, article 10, section 29, is 115.11 repealed. 115.12 ARTICLE 2 115.13 HEALTH CARE 115.14 Section 1. Minnesota Statutes 2002, section 16A.724, is 115.15 amended to read: 115.16 16A.724 [HEALTH CARE ACCESS FUND.] 115.17 A health care access fund is created in the state 115.18 treasury. The fund is a direct appropriated special revenue 115.19 fund. The commissioner shall deposit to the credit of the fund 115.20 money made available to the fund. Notwithstanding section 115.21 11A.20, after June 30, 1997, all investment income and all 115.22 investment losses attributable to the investment of the health 115.23 care access fund not currently needed shall be credited to the 115.24 health care access fund. The health care access fund shall 115.25 sunset on June 30, 2005, and all remaining funds shall be 115.26 deposited in the general fund. Beginning July 1, 2005, all 115.27 activities which would otherwise receive funding from the health 115.28 care access fund shall be funded out of the general fund. 115.29 Sec. 2. Minnesota Statutes 2002, section 256.01, 115.30 subdivision 2, is amended to read: 115.31 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 115.32 section 241.021, subdivision 2, the commissioner of human 115.33 services shall: 115.34 (1) Administer and supervise all forms of public assistance 115.35 provided for by state law and other welfare activities or 115.36 services as are vested in the commissioner. Administration and 116.1 supervision of human services activities or services includes, 116.2 but is not limited to, assuring timely and accurate distribution 116.3 of benefits, completeness of service, and quality program 116.4 management. In addition to administering and supervising human 116.5 services activities vested by law in the department, the 116.6 commissioner shall have the authority to: 116.7 (a) require county agency participation in training and 116.8 technical assistance programs to promote compliance with 116.9 statutes, rules, federal laws, regulations, and policies 116.10 governing human services; 116.11 (b) monitor, on an ongoing basis, the performance of county 116.12 agencies in the operation and administration of human services, 116.13 enforce compliance with statutes, rules, federal laws, 116.14 regulations, and policies governing welfare services and promote 116.15 excellence of administration and program operation; 116.16 (c) develop a quality control program or other monitoring 116.17 program to review county performance and accuracy of benefit 116.18 determinations; 116.19 (d) require county agencies to make an adjustment to the 116.20 public assistance benefits issued to any individual consistent 116.21 with federal law and regulation and state law and rule and to 116.22 issue or recover benefits as appropriate; 116.23 (e) delay or deny payment of all or part of the state and 116.24 federal share of benefits and administrative reimbursement 116.25 according to the procedures set forth in section 256.017; 116.26 (f) make contracts with and grants to public and private 116.27 agencies and organizations, both profit and nonprofit, and 116.28 individuals, using appropriated funds; and 116.29 (g) enter into contractual agreements with federally 116.30 recognized Indian tribes with a reservation in Minnesota to the 116.31 extent necessary for the tribe to operate a federally approved 116.32 family assistance program or any other program under the 116.33 supervision of the commissioner. The commissioner shall consult 116.34 with the affected county or counties in the contractual 116.35 agreement negotiations, if the county or counties wish to be 116.36 included, in order to avoid the duplication of county and tribal 117.1 assistance program services. The commissioner may establish 117.2 necessary accounts for the purposes of receiving and disbursing 117.3 funds as necessary for the operation of the programs. 117.4 (2) Inform county agencies, on a timely basis, of changes 117.5 in statute, rule, federal law, regulation, and policy necessary 117.6 to county agency administration of the programs. 117.7 (3) Administer and supervise all child welfare activities; 117.8 promote the enforcement of laws protecting handicapped, 117.9 dependent, neglected and delinquent children, and children born 117.10 to mothers who were not married to the children's fathers at the 117.11 times of the conception nor at the births of the children; 117.12 license and supervise child-caring and child-placing agencies 117.13 and institutions; supervise the care of children in boarding and 117.14 foster homes or in private institutions; and generally perform 117.15 all functions relating to the field of child welfare now vested 117.16 in the state board of control. 117.17 (4) Administer and supervise all noninstitutional service 117.18 to handicapped persons, including those who are visually 117.19 impaired, hearing impaired, or physically impaired or otherwise 117.20 handicapped. The commissioner may provide and contract for the 117.21 care and treatment of qualified indigent children in facilities 117.22 other than those located and available at state hospitals when 117.23 it is not feasible to provide the service in state hospitals. 117.24 (5) Assist and actively cooperate with other departments, 117.25 agencies and institutions, local, state, and federal, by 117.26 performing services in conformity with the purposes of Laws 117.27 1939, chapter 431. 117.28 (6) Act as the agent of and cooperate with the federal 117.29 government in matters of mutual concern relative to and in 117.30 conformity with the provisions of Laws 1939, chapter 431, 117.31 including the administration of any federal funds granted to the 117.32 state to aid in the performance of any functions of the 117.33 commissioner as specified in Laws 1939, chapter 431, and 117.34 including the promulgation of rules making uniformly available 117.35 medical care benefits to all recipients of public assistance, at 117.36 such times as the federal government increases its participation 118.1 in assistance expenditures for medical care to recipients of 118.2 public assistance, the cost thereof to be borne in the same 118.3 proportion as are grants of aid to said recipients. 118.4 (7) Establish and maintain any administrative units 118.5 reasonably necessary for the performance of administrative 118.6 functions common to all divisions of the department. 118.7 (8) Act as designated guardian of both the estate and the 118.8 person of all the wards of the state of Minnesota, whether by 118.9 operation of law or by an order of court, without any further 118.10 act or proceeding whatever, except as to persons committed as 118.11 mentally retarded. For children under the guardianship of the 118.12 commissioner whose interests would be best served by adoptive 118.13 placement, the commissioner may contract with a licensed 118.14 child-placing agency or a Minnesota tribal social services 118.15 agency to provide adoption services. A contract with a licensed 118.16 child-placing agency must be designed to supplement existing 118.17 county efforts and may not replace existing county programs, 118.18 unless the replacement is agreed to by the county board and the 118.19 appropriate exclusive bargaining representative or the 118.20 commissioner has evidence that child placements of the county 118.21 continue to be substantially below that of other counties. 118.22 Funds encumbered and obligated under an agreement for a specific 118.23 child shall remain available until the terms of the agreement 118.24 are fulfilled or the agreement is terminated. 118.25 (9) Act as coordinating referral and informational center 118.26 on requests for service for newly arrived immigrants coming to 118.27 Minnesota. 118.28 (10) The specific enumeration of powers and duties as 118.29 hereinabove set forth shall in no way be construed to be a 118.30 limitation upon the general transfer of powers herein contained. 118.31 (11) Establish county, regional, or statewide schedules of 118.32 maximum fees and charges which may be paid by county agencies 118.33 for medical, dental, surgical, hospital, nursing and nursing 118.34 home care and medicine and medical supplies under all programs 118.35 of medical care provided by the state and for congregate living 118.36 care under the income maintenance programs. 119.1 (12) Have the authority to conduct and administer 119.2 experimental projects to test methods and procedures of 119.3 administering assistance and services to recipients or potential 119.4 recipients of public welfare. To carry out such experimental 119.5 projects, it is further provided that the commissioner of human 119.6 services is authorized to waive the enforcement of existing 119.7 specific statutory program requirements, rules, and standards in 119.8 one or more counties. The order establishing the waiver shall 119.9 provide alternative methods and procedures of administration, 119.10 shall not be in conflict with the basic purposes, coverage, or 119.11 benefits provided by law, and in no event shall the duration of 119.12 a project exceed four years. It is further provided that no 119.13 order establishing an experimental project as authorized by the 119.14 provisions of this section shall become effective until the 119.15 following conditions have been met: 119.16 (a) The secretary of health and human services of the 119.17 United States has agreed, for the same project, to waive state 119.18 plan requirements relative to statewide uniformity. 119.19 (b) A comprehensive plan, including estimated project 119.20 costs, shall be approved by the legislative advisory commission 119.21 and filed with the commissioner of administration. 119.22 (13) According to federal requirements, establish 119.23 procedures to be followed by local welfare boards in creating 119.24 citizen advisory committees, including procedures for selection 119.25 of committee members. 119.26 (14) Allocate federal fiscal disallowances or sanctions 119.27 which are based on quality control error rates for the aid to 119.28 families with dependent children program formerly codified in 119.29 sections 256.72 to 256.87, medical assistance, or food stamp 119.30 program in the following manner: 119.31 (a) One-half of the total amount of the disallowance shall 119.32 be borne by the county boards responsible for administering the 119.33 programs. For the medical assistance and the AFDC program 119.34 formerly codified in sections 256.72 to 256.87, disallowances 119.35 shall be shared by each county board in the same proportion as 119.36 that county's expenditures for the sanctioned program are to the 120.1 total of all counties' expenditures for the AFDC program 120.2 formerly codified in sections 256.72 to 256.87, and medical 120.3 assistance programs. For the food stamp program, sanctions 120.4 shall be shared by each county board, with 50 percent of the 120.5 sanction being distributed to each county in the same proportion 120.6 as that county's administrative costs for food stamps are to the 120.7 total of all food stamp administrative costs for all counties, 120.8 and 50 percent of the sanctions being distributed to each county 120.9 in the same proportion as that county's value of food stamp 120.10 benefits issued are to the total of all benefits issued for all 120.11 counties. Each county shall pay its share of the disallowance 120.12 to the state of Minnesota. When a county fails to pay the 120.13 amount due hereunder, the commissioner may deduct the amount 120.14 from reimbursement otherwise due the county, or the attorney 120.15 general, upon the request of the commissioner, may institute 120.16 civil action to recover the amount due. 120.17 (b) Notwithstanding the provisions of paragraph (a), if the 120.18 disallowance results from knowing noncompliance by one or more 120.19 counties with a specific program instruction, and that knowing 120.20 noncompliance is a matter of official county board record, the 120.21 commissioner may require payment or recover from the county or 120.22 counties, in the manner prescribed in paragraph (a), an amount 120.23 equal to the portion of the total disallowance which resulted 120.24 from the noncompliance, and may distribute the balance of the 120.25 disallowance according to paragraph (a). 120.26 (15) Develop and implement special projects that maximize 120.27 reimbursements and result in the recovery of money to the 120.28 state. For the purpose of recovering state money, the 120.29 commissioner may enter into contracts with third parties. Any 120.30 recoveries that result from projects or contracts entered into 120.31 under this paragraph shall be deposited in the state treasury 120.32 and credited to a special account until the balance in the 120.33 account reaches $1,000,000. When the balance in the account 120.34 exceeds $1,000,000, the excess shall be transferred and credited 120.35 to the general fund. All money in the account is appropriated 120.36 to the commissioner for the purposes of this paragraph. 121.1 (16) Have the authority to make direct payments to 121.2 facilities providing shelter to women and their children 121.3 according to section 256D.05, subdivision 3. Upon the written 121.4 request of a shelter facility that has been denied payments 121.5 under section 256D.05, subdivision 3, the commissioner shall 121.6 review all relevant evidence and make a determination within 30 121.7 days of the request for review regarding issuance of direct 121.8 payments to the shelter facility. Failure to act within 30 days 121.9 shall be considered a determination not to issue direct payments. 121.10 (17) Have the authority to establish and enforce the 121.11 following county reporting requirements: 121.12 (a) The commissioner shall establish fiscal and statistical 121.13 reporting requirements necessary to account for the expenditure 121.14 of funds allocated to counties for human services programs. 121.15 When establishing financial and statistical reporting 121.16 requirements, the commissioner shall evaluate all reports, in 121.17 consultation with the counties, to determine if the reports can 121.18 be simplified or the number of reports can be reduced. 121.19 (b) The county board shall submit monthly or quarterly 121.20 reports to the department as required by the commissioner. 121.21 Monthly reports are due no later than 15 working days after the 121.22 end of the month. Quarterly reports are due no later than 30 121.23 calendar days after the end of the quarter, unless the 121.24 commissioner determines that the deadline must be shortened to 121.25 20 calendar days to avoid jeopardizing compliance with federal 121.26 deadlines or risking a loss of federal funding. Only reports 121.27 that are complete, legible, and in the required format shall be 121.28 accepted by the commissioner. 121.29 (c) If the required reports are not received by the 121.30 deadlines established in clause (b), the commissioner may delay 121.31 payments and withhold funds from the county board until the next 121.32 reporting period. When the report is needed to account for the 121.33 use of federal funds and the late report results in a reduction 121.34 in federal funding, the commissioner shall withhold from the 121.35 county boards with late reports an amount equal to the reduction 121.36 in federal funding until full federal funding is received. 122.1 (d) A county board that submits reports that are late, 122.2 illegible, incomplete, or not in the required format for two out 122.3 of three consecutive reporting periods is considered 122.4 noncompliant. When a county board is found to be noncompliant, 122.5 the commissioner shall notify the county board of the reason the 122.6 county board is considered noncompliant and request that the 122.7 county board develop a corrective action plan stating how the 122.8 county board plans to correct the problem. The corrective 122.9 action plan must be submitted to the commissioner within 45 days 122.10 after the date the county board received notice of noncompliance. 122.11 (e) The final deadline for fiscal reports or amendments to 122.12 fiscal reports is one year after the date the report was 122.13 originally due. If the commissioner does not receive a report 122.14 by the final deadline, the county board forfeits the funding 122.15 associated with the report for that reporting period and the 122.16 county board must repay any funds associated with the report 122.17 received for that reporting period. 122.18 (f) The commissioner may not delay payments, withhold 122.19 funds, or require repayment under paragraph (c) or (e) if the 122.20 county demonstrates that the commissioner failed to provide 122.21 appropriate forms, guidelines, and technical assistance to 122.22 enable the county to comply with the requirements. If the 122.23 county board disagrees with an action taken by the commissioner 122.24 under paragraph (c) or (e), the county board may appeal the 122.25 action according to sections 14.57 to 14.69. 122.26 (g) Counties subject to withholding of funds under 122.27 paragraph (c) or forfeiture or repayment of funds under 122.28 paragraph (e) shall not reduce or withhold benefits or services 122.29 to clients to cover costs incurred due to actions taken by the 122.30 commissioner under paragraph (c) or (e). 122.31 (18) Allocate federal fiscal disallowances or sanctions for 122.32 audit exceptions when federal fiscal disallowances or sanctions 122.33 are based on a statewide random sample for the foster care 122.34 program under title IV-E of the Social Security Act, United 122.35 States Code, title 42, in direct proportion to each county's 122.36 title IV-E foster care maintenance claim for that period. 123.1 (19) Be responsible for ensuring the detection, prevention, 123.2 investigation, and resolution of fraudulent activities or 123.3 behavior by applicants, recipients, and other participants in 123.4 the human services programs administered by the department. 123.5 (20) Require county agencies to identify overpayments, 123.6 establish claims, and utilize all available and cost-beneficial 123.7 methodologies to collect and recover these overpayments in the 123.8 human services programs administered by the department. 123.9 (21) Have the authority to administer a drug rebate program 123.10 for drugs purchased pursuant to the prescription drug program 123.11 established under section 256.955 after the beneficiary's 123.12 satisfaction of any deductible established in the program. The 123.13 commissioner shall require a rebate agreement from all 123.14 manufacturers of covered drugs as defined in section 256B.0625, 123.15 subdivision 13. Rebate agreements for prescription drugs 123.16 delivered on or after July 1, 2002, must include rebates for 123.17 individuals covered under the prescription drug program who are 123.18 under 65 years of age. For each drug, the amount of the rebate 123.19 shall be equal to thebasicrebate as defined for purposes of 123.20 the federal rebate program in United States Code, title 42, 123.21 section 1396r-8(c)(1).This basic rebate shall be applied to123.22single-source and multiple-source drugs.The manufacturers must 123.23 provide full payment within 30 days of receipt of the state 123.24 invoice for the rebate within the terms and conditions used for 123.25 the federal rebate program established pursuant to section 1927 123.26 of title XIX of the Social Security Act. The manufacturers must 123.27 provide the commissioner with any information necessary to 123.28 verify the rebate determined per drug. The rebate program shall 123.29 utilize the terms and conditions used for the federal rebate 123.30 program established pursuant to section 1927 of title XIX of the 123.31 Social Security Act. 123.32 (22) Have the authority to administer the federal drug 123.33 rebate program for drugs purchased under the medical assistance 123.34 program as allowed by section 1927 of title XIX of the Social 123.35 Security Act and according to the terms and conditions of 123.36 section 1927. Rebates shall be collected for all drugs that 124.1 have been dispensed or administered in an outpatient setting and 124.2 that are from manufacturers who have signed a rebate agreement 124.3 with the United States Department of Health and Human Services. 124.4 (23) Have the authority to administer a supplemental drug 124.5 rebate program for drugs purchased under the medical assistance 124.6 program. The commissioner may enter into supplemental rebate 124.7 contracts with pharmaceutical manufacturers and may require 124.8 prior authorization for drugs that are from manufacturers that 124.9 have not signed a supplemental rebate contract. Prior 124.10 authorization of drugs shall be subject to the provisions of 124.11 section 256B.0625, subdivision 13. 124.12 (24) Operate the department's communication systems account 124.13 established in Laws 1993, First Special Session chapter 1, 124.14 article 1, section 2, subdivision 2, to manage shared 124.15 communication costs necessary for the operation of the programs 124.16 the commissioner supervises. A communications account may also 124.17 be established for each regional treatment center which operates 124.18 communications systems. Each account must be used to manage 124.19 shared communication costs necessary for the operations of the 124.20 programs the commissioner supervises. The commissioner may 124.21 distribute the costs of operating and maintaining communication 124.22 systems to participants in a manner that reflects actual usage. 124.23 Costs may include acquisition, licensing, insurance, 124.24 maintenance, repair, staff time and other costs as determined by 124.25 the commissioner. Nonprofit organizations and state, county, 124.26 and local government agencies involved in the operation of 124.27 programs the commissioner supervises may participate in the use 124.28 of the department's communications technology and share in the 124.29 cost of operation. The commissioner may accept on behalf of the 124.30 state any gift, bequest, devise or personal property of any 124.31 kind, or money tendered to the state for any lawful purpose 124.32 pertaining to the communication activities of the department. 124.33 Any money received for this purpose must be deposited in the 124.34 department's communication systems accounts. Money collected by 124.35 the commissioner for the use of communication systems must be 124.36 deposited in the state communication systems account and is 125.1 appropriated to the commissioner for purposes of this section. 125.2 (25) Receive any federal matching money that is made 125.3 available through the medical assistance program for the 125.4 consumer satisfaction survey. Any federal money received for 125.5 the survey is appropriated to the commissioner for this 125.6 purpose. The commissioner may expend the federal money received 125.7 for the consumer satisfaction survey in either year of the 125.8 biennium. 125.9 (26) Incorporate cost reimbursement claims from First Call 125.10 Minnesota and Greater Twin Cities United Way into the federal 125.11 cost reimbursement claiming processes of the department 125.12 according to federal law, rule, and regulations. Any 125.13 reimbursement received is appropriated to the commissioner and 125.14 shall be disbursed to First Call Minnesota and Greater Twin 125.15 Cities United Way according to normal department payment 125.16 schedules. 125.17 (27) Develop recommended standards for foster care homes 125.18 that address the components of specialized therapeutic services 125.19 to be provided by foster care homes with those services. 125.20 Sec. 3. Minnesota Statutes 2002, section 256.955, 125.21 subdivision 2a, is amended to read: 125.22 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 125.23 following requirements and the requirements described in 125.24 subdivision 2, paragraph (d), is eligible for the prescription 125.25 drug program: 125.26 (1) is at least 65 years of age or older; and 125.27 (2) is eligible as a qualified Medicare beneficiary 125.28 according to section 256B.057, subdivision 3,or 3a,or 3b,125.29clause (1),or is eligible under section 256B.057, subdivision 125.30 3,or 3a,or 3b, clause (1),and is also eligible for medical 125.31 assistance or general assistance medical care with a spenddown 125.32 as defined in section 256B.056, subdivision 5. 125.33 Sec. 4. Minnesota Statutes 2002, section 256.969, 125.34 subdivision 2b, is amended to read: 125.35 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 125.36 operating payment rates for admissions occurring on or after the 126.1 rate year beginning January 1, 1991, and every two years after, 126.2 or more frequently as determined by the commissioner, the 126.3 commissioner shall obtain operating data from an updated base 126.4 year and establish operating payment rates per admission for 126.5 each hospital based on the cost-finding methods and allowable 126.6 costs of the Medicare program in effect during the base year. 126.7 Rates under the general assistance medical care, medical 126.8 assistance, and MinnesotaCare programs shall not be rebased to 126.9 more current data on January 1, 1997, and January 1, 2005. The 126.10 base year operating payment rate per admission is standardized 126.11 by the case mix index and adjusted by the hospital cost index, 126.12 relative values, and disproportionate population adjustment. 126.13 The cost and charge data used to establish operating rates shall 126.14 only reflect inpatient services covered by medical assistance 126.15 and shall not include property cost information and costs 126.16 recognized in outlier payments. 126.17 Sec. 5. Minnesota Statutes 2002, section 256.969, 126.18 subdivision 3a, is amended to read: 126.19 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 126.20 under the medical assistance program must not be submitted until 126.21 the recipient is discharged. However, the commissioner shall 126.22 establish monthly interim payments for inpatient hospitals that 126.23 have individual patient lengths of stay over 30 days regardless 126.24 of diagnostic category. Except as provided in section 256.9693, 126.25 medical assistance reimbursement for treatment of mental illness 126.26 shall be reimbursed based on diagnostic classifications. 126.27 Individual hospital payments established under this section and 126.28 sections 256.9685, 256.9686, and 256.9695, in addition to third 126.29 party and recipient liability, for discharges occurring during 126.30 the rate year shall not exceed, in aggregate, the charges for 126.31 the medical assistance covered inpatient services paid for the 126.32 same period of time to the hospital. This payment limitation 126.33 shall be calculated separately for medical assistance and 126.34 general assistance medical care services. The limitation on 126.35 general assistance medical care shall be effective for 126.36 admissions occurring on or after July 1, 1991. Services that 127.1 have rates established under subdivision 11 or 12, must be 127.2 limited separately from other services. After consulting with 127.3 the affected hospitals, the commissioner may consider related 127.4 hospitals one entity and may merge the payment rates while 127.5 maintaining separate provider numbers. The operating and 127.6 property base rates per admission or per day shall be derived 127.7 from the best Medicare and claims data available when rates are 127.8 established. The commissioner shall determine the best Medicare 127.9 and claims data, taking into consideration variables of recency 127.10 of the data, audit disposition, settlement status, and the 127.11 ability to set rates in a timely manner. The commissioner shall 127.12 notify hospitals of payment rates by December 1 of the year 127.13 preceding the rate year. The rate setting data must reflect the 127.14 admissions data used to establish relative values. Base year 127.15 changes from 1981 to the base year established for the rate year 127.16 beginning January 1, 1991, and for subsequent rate years, shall 127.17 not be limited to the limits ending June 30, 1987, on the 127.18 maximum rate of increase under subdivision 1. The commissioner 127.19 may adjust base year cost, relative value, and case mix index 127.20 data to exclude the costs of services that have been 127.21 discontinued by the October 1 of the year preceding the rate 127.22 year or that are paid separately from inpatient services. 127.23 Inpatient stays that encompass portions of two or more rate 127.24 years shall have payments established based on payment rates in 127.25 effect at the time of admission unless the date of admission 127.26 preceded the rate year in effect by six months or more. In this 127.27 case, operating payment rates for services rendered during the 127.28 rate year in effect and established based on the date of 127.29 admission shall be adjusted to the rate year in effect by the 127.30 hospital cost index. 127.31 (b) For fee-for-service admissions occurring on or after 127.32 July 1, 2002, the total payment, before third-party liability 127.33 and spenddown, made to hospitals for inpatient services is 127.34 reduced by .5 percent from the current statutory rates. 127.35 (c) In addition to the reduction in paragraph (b), the 127.36 total payment for fee-for-service admissions occurring on or 128.1 after July 1, 2003, made to hospitals for inpatient services 128.2 before third-party liability and spenddown, is reduced five 128.3 percent from the current statutory rates. Mental health 128.4 services within diagnosis related groups 424 to 432, and 128.5 facilities defined under subdivision 16 are excluded from this 128.6 paragraph. 128.7 Sec. 6. Minnesota Statutes 2002, section 256B.055, is 128.8 amended by adding a subdivision to read: 128.9 Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 128.10 Beginning October 1, 2003, persons who would be eligible for 128.11 medical assistance under chapter 256B but for residing in a 128.12 facility that is determined by the commissioner or the federal 128.13 Centers for Medicare and Medicaid Services to be an institution 128.14 for mental diseases are eligible for medical assistance without 128.15 federal financial participation. 128.16 Sec. 7. Minnesota Statutes 2002, section 256B.056, 128.17 subdivision 1a, is amended to read: 128.18 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 128.19 specifically required by state law or rule or federal law or 128.20 regulation, the methodologies used in counting income and assets 128.21 to determine eligibility for medical assistance for persons 128.22 whose eligibility category is based on blindness, disability, or 128.23 age of 65 or more years, the methodologies for the supplemental 128.24 security income program shall be used. Increases in benefits 128.25 under title II of the Social Security Act shall not be counted 128.26 as income for purposes of this subdivision until July 1 of each 128.27 year. Effective upon federal approval, for children eligible 128.28 under section 256B.055, subdivision 12, or for home and 128.29 community-based waiver services whose eligibility for medical 128.30 assistance is determined without regard to parental income, 128.31 child support payments, including any payments made by an 128.32 obligor in satisfaction of or in addition to a temporary or 128.33 permanent order for child support, and social security payments 128.34 are not counted as income. For families and children, which 128.35 includes all other eligibility categories, the methodologies 128.36 under the state's AFDC plan in effect as of July 16, 1996, as 129.1 required by the Personal Responsibility and Work Opportunity 129.2 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 129.3 shall be used, except that effectiveJuly 1, 2002, the $90 and129.4$30 and one-third earned income disregards shall not apply and129.5the disregard specified in subdivision 1c shall applyOctober 1, 129.6 2003, the earned income disregards and deductions are limited to 129.7 those in subdivision 1c. For these purposes, a "methodology" 129.8 does not include an asset or income standard, or accounting 129.9 method, or method of determining effective dates. 129.10 Sec. 8. Minnesota Statutes 2002, section 256B.056, 129.11 subdivision 1c, is amended to read: 129.12 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] (a) 129.13 For children ages oneto fivethrough 18 whose eligibility is 129.14 determined under section 256B.057, subdivision 2,21 percent of129.15countable earned income shall be disregarded for up to four129.16monthsthe following deductions shall be applied to income 129.17 counted toward the child's eligibility as allowed under the 129.18 state's AFDC plan in effect as of July 16, 1996: $90 work 129.19 expense, dependent care, and child support paid under court 129.20 order. 129.21 (b) For families with children whose eligibility is 129.22 determined using the standard specified in section 256B.056, 129.23 subdivision 4, paragraph (c), 17 percent of countable earned 129.24 income shall be disregarded for up to four months and the 129.25 following deductions shall be applied to each individual's 129.26 income counted toward eligibility as allowed under the state's 129.27 AFDC plan in effect as of July 16, 1996: dependent care and 129.28 child support paid under court order. 129.29 (c) If the four month disregard in paragraph (b) has been 129.30 applied to the wage earner's income for four months, the 129.31 disregard shall not be applied again until the wage earner's 129.32 income has not been considered in determining medical assistance 129.33 eligibility for 12 consecutive months. 129.34 Sec. 9. Minnesota Statutes 2002, section 256B.057, 129.35 subdivision 1, is amended to read: 129.36 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a) An infant 130.1 less than one year of ageor a pregnant woman who has written130.2verification of a positive pregnancy test from a physician or130.3licensed registered nurse,is eligible for medical assistance if 130.4 countable family income is equal to or less than 275 percent of 130.5 the federal poverty guideline for the same family size. A 130.6 pregnant woman who has written verification of a positive 130.7 pregnancy test from a physician or licensed registered nurse is 130.8 eligible for medical assistance if countable family income is 130.9 equal to or less than 200 percent of the federal poverty 130.10 guideline for the same family size. For purposes of this 130.11 subdivision, "countable family income" means the amount of 130.12 income considered available using the methodology of the AFDC 130.13 program under the state's AFDC plan as of July 16, 1996, as 130.14 required by the Personal Responsibility and Work Opportunity 130.15 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 130.16 except for the earned income disregard and employment deductions. 130.17 (b) An amount equal to the amount of earned income 130.18 exceeding 275 percent of the federal poverty guideline, up to a 130.19 maximum of the amount by which the combined total of 185 percent 130.20 of the federal poverty guideline plus the earned income 130.21 disregards and deductions of the AFDC program under the state's 130.22 AFDC plan as of July 16, 1996, as required by the Personal 130.23 Responsibility and Work Opportunity Reconciliation Act of 1996 130.24 (PRWORA), Public LawNumber104-193, exceeds 275 percent of the 130.25 federal poverty guideline will be deducted for pregnant women 130.26 and infants less than one year of age. This paragraph expires 130.27 July 1, 2003. 130.28 (c) Dependent care and child support paid under court order 130.29 shall be deducted from the countable income of pregnant women. 130.30(b)(d) An infant born on or after January 1, 1991, to a 130.31 woman who was eligible for and receiving medical assistance on 130.32 the date of the child's birth shall continue to be eligible for 130.33 medical assistance without redetermination until the child's 130.34 first birthday, as long as the child remains in the woman's 130.35 household. 130.36 [EFFECTIVE DATE.] This section is effective February 1, 131.1 2004, except where a different date is specified in the text. 131.2 Sec. 10. Minnesota Statutes 2002, section 256B.057, 131.3 subdivision 1b, is amended to read: 131.4 Subd. 1b. [PREGNANT WOMEN AND INFANTS; EXPANSION.] (a) 131.5 This subdivision supersedes subdivision 1 as long as the 131.6 Minnesota health care reform waiver remains in effect. When the 131.7 waiver expires, the commissioner of human services shall publish 131.8 a notice in the State Register and notify the revisor of 131.9 statutes. An infant less than two years of age or a pregnant 131.10 woman who has written verification of a positive pregnancy test 131.11 from a physician or licensed registered nurse, is eligible for 131.12 medical assistance if countable family income is equal to or 131.13 less than 275 percent of the federal poverty guideline for the 131.14 same family size. For purposes of this subdivision, "countable 131.15 family income" means the amount of income considered available 131.16 using the methodology of the AFDC program under the state's AFDC 131.17 plan as of July 16, 1996, as required by the Personal 131.18 Responsibility and Work Opportunity Reconciliation Act of 1996 131.19 (PRWORA), Public LawNumber104-193, except for the earned 131.20 income disregard and employment deductions.An amount equal to131.21the amount of earned income exceeding 275 percent of the federal131.22poverty guideline, up to a maximum of the amount by which the131.23combined total of 185 percent of the federal poverty guideline131.24plus the earned income disregards and deductions of the AFDC131.25program under the state's AFDC plan as of July 16, 1996, as131.26required by the Personal Responsibility and Work Opportunity131.27Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193,131.28exceeds 275 percent of the federal poverty guideline will be131.29deducted for pregnant women and infants less than two years of131.30age.131.31 (b) An infant born on or after January 1, 1991, to a woman 131.32 who was eligible for and receiving medical assistance on the 131.33 date of the child's birth shall continue to be eligible for 131.34 medical assistance without redetermination until the child's 131.35 second birthday, as long as the child remains in the woman's 131.36 household. 132.1 [EFFECTIVE DATE.] This section is effective July 1, 2003. 132.2 Sec. 11. Minnesota Statutes 2002, section 256B.057, 132.3 subdivision 2, is amended to read: 132.4 Subd. 2. [CHILDREN.] Except as specified in subdivision 132.5 1b, effectiveJuly 1, 2002October 1, 2003, a child one through 132.6 18 years of age in a family whose countable income is no greater 132.7 than170150 percent of the federal poverty guidelines for the 132.8 same family size, is eligible for medical assistance. 132.9 Sec. 12. Minnesota Statutes 2002, section 256B.057, 132.10 subdivision 3b, is amended to read: 132.11 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 132.12 1998,to the extent of the federal allocation to Minnesota132.13 contingent upon federal funding, a person who would otherwise be 132.14 eligible as a qualified Medicare beneficiary under subdivision 132.15 3, except that the person's income is in excess of the limit, is 132.16 eligible as a qualifying individual according to the following 132.17 criteria: 132.18 (1) if the person's income is greater than 120 percent, but 132.19 less than 135 percent of the official federal poverty guidelines 132.20 for the applicable family size, the person is eligible for 132.21 medical assistance reimbursement of Medicare Part B premiums; or 132.22 (2) if the person's income is equal to or greater than 135 132.23 percent but less than 175 percent of the official federal 132.24 poverty guidelines for the applicable family size, the person is 132.25 eligible for medical assistance reimbursement of that portion of 132.26 the Medicare Part B premium attributable to an increase in Part 132.27 B expenditures which resulted from the shift of home care 132.28 services from Medicare Part A to Medicare Part B under Public 132.29 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 132.30 The commissioner shall limit enrollment of qualifying 132.31 individuals under this subdivision according to the requirements 132.32 of Public LawNumber105-33, section 4732. 132.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 132.34 Sec. 13. Minnesota Statutes 2002, section 256B.057, 132.35 subdivision 9, is amended to read: 132.36 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 133.1 assistance may be paid for a person who is employed and who: 133.2 (1) meets the definition of disabled under the supplemental 133.3 security income program; 133.4 (2) is at least 16 but less than 65 years of age; 133.5 (3) meets the asset limits in paragraph (b); and 133.6 (4) effective November 1, 2003, pays a premium, if133.7required,and other obligations under paragraph(c)(d). 133.8 Any spousal income or assets shall be disregarded for purposes 133.9 of eligibility and premium determinations. 133.10 After the month of enrollment, a person enrolled in medical 133.11 assistance under this subdivision who: 133.12 (1) is temporarily unable to work and without receipt of 133.13 earned income due to a medical condition, as verified by a 133.14 physician, may retain eligibility for up to four calendar 133.15 months; or 133.16 (2) effective January 1, 2004, loses employment for reasons 133.17 not attributable to the enrollee, may retain eligibility for up 133.18 to four consecutive months after the month of job loss. To 133.19 receive a four-month extension, enrollees must verify the 133.20 medical condition or provide notification of job loss. All 133.21 other eligibility requirements must be met and the enrollee must 133.22 pay all calculated premium costs for continued eligibility. 133.23 (b) For purposes of determining eligibility under this 133.24 subdivision, a person's assets must not exceed $20,000, 133.25 excluding: 133.26 (1) all assets excluded under section 256B.056; 133.27 (2) retirement accounts, including individual accounts, 133.28 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 133.29 (3) medical expense accounts set up through the person's 133.30 employer. 133.31 (c)(1) Effective January 1, 2004, for purposes of 133.32 eligibility, there will be a $65 earned income disregard. To be 133.33 eligible, a person applying for medical assistance under this 133.34 subdivision must have earned income above the disregard level. 133.35 (2) Effective January 1, 2004, to be considered earned 133.36 income, Medicare, social security, and applicable state and 134.1 federal income taxes must be withheld. To be eligible, a person 134.2 must document earned income tax withholding. 134.3 (d)(1) A person whose earned and unearned income is equal 134.4 to or greater than 100 percent of federal poverty guidelines for 134.5 the applicable family size must pay a premium to be eligible for 134.6 medical assistance under this subdivision. The premium shall be 134.7 based on the person's gross earned and unearned income and the 134.8 applicable family size using a sliding fee scale established by 134.9 the commissioner, which begins at one percent of income at 100 134.10 percent of the federal poverty guidelines and increases to 7.5 134.11 percent of income for those with incomes at or above 300 percent 134.12 of the federal poverty guidelines. Annual adjustments in the 134.13 premium schedule based upon changes in the federal poverty 134.14 guidelines shall be effective for premiums due in July of each 134.15 year. 134.16 (2) Effective January 1, 2004, all enrollees must pay a 134.17 premium to be eligible for medical assistance under this 134.18 subdivision. An enrollee shall pay the greater of a $35 premium 134.19 or the premium calculated in clause (1). 134.20 (3) Effective November 1, 2003, all enrollees who receive 134.21 unearned income must pay five percent of unearned income in 134.22 addition to the premium amount. 134.23 (4) Effective November 1, 2003, for enrollees with income 134.24 equal to or more than the limit under subdivision 3a who are 134.25 also enrolled in Medicare the commissioner must reduce 134.26 reimbursement to the enrollee for Medicare Part B premiums under 134.27 section 256B.0625, subdivision 15, paragraph (a), based on a 134.28 sliding fee scale established by the commissioner. The scale is 134.29 based on the person's gross earned and unearned income. The 134.30 obligation of the enrollee shall begin at a dollar amount 134.31 determined by the commissioner for incomes equal to the limit 134.32 under subdivision 3a and increase to the full amount of the 134.33 Medicare Part B premium cost for incomes equal to or greater 134.34 than 300 percent of the federal poverty guidelines. 134.35(d)(e) A person's eligibility and premium shall be 134.36 determined by the local county agency. Premiums must be paid to 135.1 the commissioner. All premiums are dedicated to the 135.2 commissioner. 135.3(e)(f) Any required premium shall be determined at 135.4 application and redeterminedannually at recertificationat the 135.5 enrollee's six-month income review or when a change in income or 135.6familyhousehold sizeoccursis reported. Enrollees must report 135.7 any change in income or household size within ten days of when 135.8 the change occurs. A decreased premium resulting from a 135.9 reported change in income or household size shall be effective 135.10 the first day of the next available billing month after the 135.11 change is reported. Except for changes occurring from annual 135.12 cost-of-living increases or verification of income under section 135.13 256B.061, paragraph (b), a change resulting in an increased 135.14 premium shall not affect the premium amount until the next 135.15 six-month review. 135.16(f)(g) Premium payment is due upon notification from the 135.17 commissioner of the premium amount required. Premiums may be 135.18 paid in installments at the discretion of the commissioner. 135.19(g)(h) Nonpayment of the premium shall result in denial or 135.20 termination of medical assistance unless the person demonstrates 135.21 good cause for nonpayment. Good cause exists if the 135.22 requirements specified in Minnesota Rules, part 9506.0040, 135.23 subpart 7, items B to D, are met. Except when an installment 135.24 agreement is accepted by the commissioner, all persons 135.25 disenrolled for nonpayment of a premium must pay any past due 135.26 premiums as well as current premiums due prior to being 135.27 reenrolled. Nonpayment shall include payment with a returned, 135.28 refused, or dishonored instrument. The commissioner may require 135.29 a guaranteed form of payment as the only means to replace a 135.30 returned, refused, or dishonored instrument. 135.31 [EFFECTIVE DATE.] This section is effective November 1, 135.32 2003, except the amendments to Minnesota Statutes 2002, section 135.33 256B.057, subdivision 9, paragraphs (e) and (g), are effective 135.34 July 1, 2003. 135.35 Sec. 14. Minnesota Statutes 2002, section 256B.0595, 135.36 subdivision 1, is amended to read: 136.1 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 136.2 of assets made on or before August 10, 1993, if a person or the 136.3 person's spouse has given away, sold, or disposed of, for less 136.4 than fair market value, any asset or interest therein, except 136.5 assets other than the homestead that are excluded under the 136.6 supplemental security program, within 30 months before or any 136.7 time after the date of institutionalization if the person has 136.8 been determined eligible for medical assistance, or within 30 136.9 months before or any time after the date of the first approved 136.10 application for medical assistance if the person has not yet 136.11 been determined eligible for medical assistance, the person is 136.12 ineligible for long-term care services for the period of time 136.13 determined under subdivision 2. 136.14 (b) Effective for transfers made after August 10, 1993, a 136.15 person, a person's spouse, or any person, court, or 136.16 administrative body with legal authority to act in place of, on 136.17 behalf of, at the direction of, or upon the request of the 136.18 person or person's spouse, may not give away, sell, or dispose 136.19 of, for less than fair market value, any asset or interest 136.20 therein, except assets other than the homestead that are 136.21 excluded under the supplemental security income program, for the 136.22 purpose of establishing or maintaining medical assistance 136.23 eligibility. This applies to all transfers, including those 136.24 made by a community spouse after the month in which the 136.25 institutionalized spouse is determined eligible for medical 136.26 assistance. For purposes of determining eligibility for 136.27 long-term care services, any transfer of such assets within 36 136.28 months before or any time after an institutionalized person 136.29 applies for medical assistance, or 36 months before or any time 136.30 after a medical assistance recipient becomes institutionalized, 136.31 for less than fair market value may be considered. Any such 136.32 transfer is presumed to have been made for the purpose of 136.33 establishing or maintaining medical assistance eligibility and 136.34 the person is ineligible for long-term care services for the 136.35 period of time determined under subdivision 2, unless the person 136.36 furnishes convincing evidence to establish that the transaction 137.1 was exclusively for another purpose, or unless the transfer is 137.2 permitted under subdivision 3 or 4. Notwithstanding the 137.3 provisions of this paragraph, in the case of payments from a 137.4 trust or portions of a trust that are considered transfers of 137.5 assets under federal law, any transfers made within 60 months 137.6 before or any time after an institutionalized person applies for 137.7 medical assistance and within 60 months before or any time after 137.8 a medical assistance recipient becomes institutionalized, may be 137.9 considered. 137.10 Effective July 1, 2003, or upon receipt of federal 137.11 approval, whichever is later, the 36-month period for transfers 137.12 of assets shall be extended by another 36 months, and the 137.13 60-month period for transfers to trusts shall be extended by 137.14 another 12 months for purposes of transfers under this paragraph 137.15 and paragraphs (c) through (f). 137.16 (c) This section applies to transfers, for less than fair 137.17 market value, of income or assets, including assets that are 137.18 considered income in the month received, such as inheritances, 137.19 court settlements, and retroactive benefit payments or income to 137.20 which the person or the person's spouse is entitled but does not 137.21 receive due to action by the person, the person's spouse, or any 137.22 person, court, or administrative body with legal authority to 137.23 act in place of, on behalf of, at the direction of, or upon the 137.24 request of the person or the person's spouse. 137.25 (d) This section applies to payments for care or personal 137.26 services provided by a relative, unless the compensation was 137.27 stipulated in a notarized, written agreement which was in 137.28 existence when the service was performed, the care or services 137.29 directly benefited the person, and the payments made represented 137.30 reasonable compensation for the care or services provided. A 137.31 notarized written agreement is not required if payment for the 137.32 services was made within 60 days after the service was provided. 137.33 (e) This section applies to the portion of any asset or 137.34 interest that a person, a person's spouse, or any person, court, 137.35 or administrative body with legal authority to act in place of, 137.36 on behalf of, at the direction of, or upon the request of the 138.1 person or the person's spouse, transfers to any annuity that 138.2 exceeds the value of the benefit likely to be returned to the 138.3 person or spouse while alive, based on estimated life expectancy 138.4 using the life expectancy tables employed by the supplemental 138.5 security income program to determine the value of an agreement 138.6 for services for life. The commissioner may adopt rules 138.7 reducing life expectancies based on the need for long-term 138.8 care. This section applies to an annuity described in this 138.9 paragraph purchased on or after March 1, 2002, that: 138.10 (1) is not purchased from an insurance company or financial 138.11 institution that is subject to licensing or regulation by the 138.12 Minnesota department of commerce or a similar regulatory agency 138.13 of another state; 138.14 (2) does not pay out principal and interest in equal 138.15 monthly installments; or 138.16 (3) does not begin payment at the earliest possible date 138.17 after annuitization. 138.18 (f) For purposes of this section, long-term care services 138.19 include services in a nursing facility, services that are 138.20 eligible for payment according to section 256B.0625, subdivision 138.21 2, because they are provided in a swing bed, intermediate care 138.22 facility for persons with mental retardation, and home and 138.23 community-based services provided pursuant to sections 138.24 256B.0915, 256B.092, and 256B.49. For purposes of this 138.25 subdivision and subdivisions 2, 3, and 4, "institutionalized 138.26 person" includes a person who is an inpatient in a nursing 138.27 facility or in a swing bed, or intermediate care facility for 138.28 persons with mental retardation or who is receiving home and 138.29 community-based services under sections 256B.0915, 256B.092, and 138.30 256B.49. 138.31 (g) The commissioner shall seek federal approval to extend 138.32 the period for evaluating transfers of assets or interests for 138.33 less than fair market value in subdivision 1, paragraphs (b) 138.34 through (f), to a total of 72 months. 138.35 [EFFECTIVE DATE.] This section is effective July 1, 2003. 138.36 If the amendments to this section are not effective because of 139.1 prohibitions in federal law, the commissioner shall seek a 139.2 waiver of those prohibitions or other federal authority, and 139.3 each provision shall become effective upon receipt of federal 139.4 approval, notification to the revisor of statutes, and 139.5 publication of a notice in the State Register. 139.6 Sec. 15. Minnesota Statutes 2002, section 256B.0595, 139.7 subdivision 2, is amended to read: 139.8 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 139.9 uncompensated transfer occurring on or before August 10, 1993, 139.10 the number of months of ineligibility for long-term care 139.11 services shall be the lesser of 30 months, or the uncompensated 139.12 transfer amount divided by the average medical assistance rate 139.13 for nursing facility services in the state in effect on the date 139.14 of application. The amount used to calculate the average 139.15 medical assistance payment rate shall be adjusted each July 1 to 139.16 reflect payment rates for the previous calendar year. The 139.17 period of ineligibility begins with the month in which the 139.18 assets were transferred. If the transfer was not reported to 139.19 the local agency at the time of application, and the applicant 139.20 received long-term care services during what would have been the 139.21 period of ineligibility if the transfer had been reported, a 139.22 cause of action exists against the transferee for the cost of 139.23 long-term care services provided during the period of 139.24 ineligibility, or for the uncompensated amount of the transfer, 139.25 whichever is less. The action may be brought by the state or 139.26 the local agency responsible for providing medical assistance 139.27 under chapter 256G. The uncompensated transfer amount is the 139.28 fair market value of the asset at the time it was given away, 139.29 sold, or disposed of, less the amount of compensation received. 139.30 (b) For uncompensated transfers made after August 10, 1993, 139.31 the number of months of ineligibility for long-term care 139.32 services shall be the total uncompensated value of the resources 139.33 transferred divided by the average medical assistance rate for 139.34 nursing facility services in the state in effect on the date of 139.35 application. The amount used to calculate the average medical 139.36 assistance payment rate shall be adjusted each July 1 to reflect 140.1 payment rates for the previous calendar year. The period of 140.2 ineligibility begins with the first day of the month after the 140.3 month in which the assets were transferred except that if one or 140.4 more uncompensated transfers are made during a period of 140.5 ineligibility, the total assets transferred during the 140.6 ineligibility period shall be combined and a penalty period 140.7 calculated to begininon the first day of the month after the 140.8 month in which the first uncompensated transfer was 140.9 made. Effective upon federal approval, the period of 140.10 ineligibility for uncompensated transfers begins on the first 140.11 day of the month in which an applicant would otherwise be 140.12 eligible for long-term care services, or in the case of a 140.13 transfer affecting a person receiving long-term care services, 140.14 on the first day of the month after the month the local agency 140.15 learns of the uncompensated transfer. If the transfer was not 140.16 reported to the local agencyat the time of application, and the 140.17 applicant received medical assistance services during what would 140.18 have been the period of ineligibility if the transfer had been 140.19 reported, a cause of action exists against the transferee for 140.20 the cost of medical assistance services provided during the 140.21 period of ineligibility, or for the uncompensated amount of the 140.22 transfer, whichever is less. The action may be brought by the 140.23 state or the local agency responsible for providing medical 140.24 assistance under chapter 256G. The uncompensated transfer 140.25 amount is the fair market value of the asset at the time it was 140.26 given away, sold, or disposed of, less the amount of 140.27 compensation received. Effective for transfers made on or after 140.28 March 1, 1996, involving persons who apply for medical 140.29 assistance on or after April 13, 1996, no cause of action exists 140.30 for a transfer unless: 140.31 (1) the transferee knew or should have known that the 140.32 transfer was being made by a person who was a resident of a 140.33 long-term care facility or was receiving that level of care in 140.34 the community at the time of the transfer; 140.35 (2) the transferee knew or should have known that the 140.36 transfer was being made to assist the person to qualify for or 141.1 retain medical assistance eligibility; or 141.2 (3) the transferee actively solicited the transfer with 141.3 intent to assist the person to qualify for or retain eligibility 141.4 for medical assistance. 141.5 (c) If a calculation of a penalty period results in a 141.6 partial month, payments for long-term care services shall be 141.7 reduced in an amount equal to the fraction, except that in 141.8 calculating the value of uncompensated transfers, if the total 141.9 value of all uncompensated transfers made in a month not 141.10 included in an existing penalty period does not exceed $200, 141.11 then such transfers shall be disregarded for each month prior to 141.12 the month of application for or during receipt of medical 141.13 assistance. 141.14 (d) The commissioner shall seek federal approval for 141.15 purposes of establishing that the period of ineligibility 141.16 determined under paragraphs (b) and (c) shall begin on the first 141.17 day of the month in which the applicant would otherwise be 141.18 eligible for long-term care services, or in the case of a 141.19 transfer affecting a recipient of long-term care services, the 141.20 first day of the month after the month in which the local agency 141.21 learns of the uncompensated transfer. 141.22 [EFFECTIVE DATE.] Paragraph (b) of this section is 141.23 effective July 1, 2003. If the amendments to this section are 141.24 not effective because of prohibitions in federal law, the 141.25 commissioner shall seek a waiver of those prohibitions or other 141.26 federal authority, and each provision shall become effective 141.27 upon receipt of federal approval, notification to the revisor of 141.28 statutes, and publication of a notice in the State Register to 141.29 that effect. 141.30 Sec. 16. Minnesota Statutes 2002, section 256B.06, 141.31 subdivision 4, is amended to read: 141.32 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 141.33 medical assistance is limited to citizens of the United States, 141.34 qualified noncitizens as defined in this subdivision, and other 141.35 persons residing lawfully in the United States. 141.36 (b) "Qualified noncitizen" means a person who meets one of 142.1 the following immigration criteria: 142.2 (1) admitted for lawful permanent residence according to 142.3 United States Code, title 8; 142.4 (2) admitted to the United States as a refugee according to 142.5 United States Code, title 8, section 1157; 142.6 (3) granted asylum according to United States Code, title 142.7 8, section 1158; 142.8 (4) granted withholding of deportation according to United 142.9 States Code, title 8, section 1253(h); 142.10 (5) paroled for a period of at least one year according to 142.11 United States Code, title 8, section 1182(d)(5); 142.12 (6) granted conditional entrant status according to United 142.13 States Code, title 8, section 1153(a)(7); 142.14 (7) determined to be a battered noncitizen by the United 142.15 States Attorney General according to the Illegal Immigration 142.16 Reform and Immigrant Responsibility Act of 1996, title V of the 142.17 Omnibus Consolidated Appropriations Bill, Public Law Number 142.18 104-200; 142.19 (8) is a child of a noncitizen determined to be a battered 142.20 noncitizen by the United States Attorney General according to 142.21 the Illegal Immigration Reform and Immigrant Responsibility Act 142.22 of 1996, title V, of the Omnibus Consolidated Appropriations 142.23 Bill, Public Law Number 104-200; or 142.24 (9) determined to be a Cuban or Haitian entrant as defined 142.25 in section 501(e) of Public Law Number 96-422, the Refugee 142.26 Education Assistance Act of 1980. 142.27 (c) All qualified noncitizens who were residing in the 142.28 United States before August 22, 1996, who otherwise meet the 142.29 eligibility requirements of chapter 256B, are eligible for 142.30 medical assistance with federal financial participation. 142.31 (d) All qualified noncitizens who entered the United States 142.32 on or after August 22, 1996, and who otherwise meet the 142.33 eligibility requirements of chapter 256B, are eligible for 142.34 medical assistance with federal financial participation through 142.35 November 30, 1996. 142.36 Beginning December 1, 1996, qualified noncitizens who 143.1 entered the United States on or after August 22, 1996, and who 143.2 otherwise meet the eligibility requirements of chapter 256B are 143.3 eligible for medical assistance with federal participation for 143.4 five years if they meet one of the following criteria: 143.5 (i) refugees admitted to the United States according to 143.6 United States Code, title 8, section 1157; 143.7 (ii) persons granted asylum according to United States 143.8 Code, title 8, section 1158; 143.9 (iii) persons granted withholding of deportation according 143.10 to United States Code, title 8, section 1253(h); 143.11 (iv) veterans of the United States Armed Forces with an 143.12 honorable discharge for a reason other than noncitizen status, 143.13 their spouses and unmarried minor dependent children; or 143.14 (v) persons on active duty in the United States Armed 143.15 Forces, other than for training, their spouses and unmarried 143.16 minor dependent children. 143.17 Beginning December 1, 1996, qualified noncitizens who do 143.18 not meet one of the criteria in items (i) to (v) are eligible 143.19 for medical assistance without federal financial participation 143.20 as described in paragraph(j)(i). 143.21 (e) Noncitizens who are not qualified noncitizens as 143.22 defined in paragraph (b), who are lawfully residing in the 143.23 United States and who otherwise meet the eligibility 143.24 requirements of chapter 256B, are eligible for medical 143.25 assistance under clauses (1) to (3). These individuals must 143.26 cooperate with the Immigration and Naturalization Service to 143.27 pursue any applicable immigration status, including citizenship, 143.28 that would qualify them for medical assistance with federal 143.29 financial participation. 143.30 (1) Persons who were medical assistance recipients on 143.31 August 22, 1996, are eligible for medical assistance with 143.32 federal financial participation through December 31, 1996. 143.33 (2) Beginning January 1, 1997, persons described in clause 143.34 (1) are eligible for medical assistance without federal 143.35 financial participation as described in paragraph(j)(i). 143.36 (3) Beginning December 1, 1996, persons residing in the 144.1 United States prior to August 22, 1996, who were not receiving 144.2 medical assistance and persons who arrived on or after August 144.3 22, 1996, are eligible for medical assistance without federal 144.4 financial participation as described in paragraph(j)(i). 144.5 (f) Nonimmigrants who otherwise meet the eligibility 144.6 requirements of chapter 256B are eligible for the benefits as 144.7 provided in paragraphs (g)to (i)and (h). For purposes of this 144.8 subdivision, a "nonimmigrant" is a person in one of the classes 144.9 listed in United States Code, title 8, section 1101(a)(15). 144.10 (g) Payment shall also be made for care and services that 144.11 are furnished to noncitizens, regardless of immigration status, 144.12 who otherwise meet the eligibility requirements of chapter 256B, 144.13 if such care and services are necessary for the treatment of an 144.14 emergency medical condition, except for organ transplants and 144.15 related care and services and routine prenatal care. 144.16 (h) For purposes of this subdivision, the term "emergency 144.17 medical condition" means a medical condition that meets the 144.18 requirements of United States Code, title 42, section 1396b(v). 144.19 (i)Pregnant noncitizens who are undocumented or144.20nonimmigrants, who otherwise meet the eligibility requirements144.21of chapter 256B, are eligible for medical assistance payment144.22without federal financial participation for care and services144.23through the period of pregnancy, and 60 days postpartum, except144.24for labor and delivery.144.25(j)Qualified noncitizens as described in paragraph (d), 144.26 and all other noncitizens lawfully residing in the United States 144.27 as described in paragraph (e), who are ineligible for medical 144.28 assistance with federal financial participation and who 144.29 otherwise meet the eligibility requirements of chapter 256B and 144.30 of this paragraph, are eligible for medical assistance without 144.31 federal financial participation. Qualified noncitizens as 144.32 described in paragraph (d) are only eligible for medical 144.33 assistance without federal financial participation for five 144.34 years from their date of entry into the United States. 144.35(k) The commissioner shall submit to the legislature by144.36December 31, 1998, a report on the number of recipients and cost145.1of coverage of care and services made according to paragraphs145.2(i) and (j).145.3 (j) Beginning October 1, 2003, persons who are receiving 145.4 care and rehabilitation services from a nonprofit center 145.5 established to serve victims of torture and are otherwise 145.6 ineligible for medical assistance under chapter 256B or general 145.7 assistance medical care under section 256D.03 are eligible for 145.8 medical assistance without federal financial participation. 145.9 These individuals are eligible only for the period during which 145.10 they are receiving services from the center. Individuals 145.11 eligible under this clause shall not be required to participate 145.12 in prepaid medical assistance. 145.13 [EFFECTIVE DATE.] This section is effective July 1, 2003, 145.14 except where a different date is specified in the text. 145.15 Sec. 17. Minnesota Statutes 2002, section 256B.061, is 145.16 amended to read: 145.17 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 145.18(a)If any individual has been determined to be eligible 145.19 for medical assistance, it will be made available for care and 145.20 services included under the plan and furnished in or after the 145.21 third month before the month in which the individual made 145.22 application for such assistance, if such individual was, or upon 145.23 application would have been, eligible for medical assistance at 145.24 the time the care and services were furnished. The commissioner 145.25 may limit, restrict, or suspend the eligibility of an individual 145.26 for up to one year upon that individual's conviction of a 145.27 criminal offense related to application for or receipt of 145.28 medical assistance benefits. 145.29(b) On the basis of information provided on the completed145.30application, an applicant who meets the following criteria shall145.31be determined eligible beginning in the month of application:145.32(1) whose gross income is less than 90 percent of the145.33applicable income standard;145.34(2) whose total liquid assets are less than 90 percent of145.35the asset limit;145.36(3) does not reside in a long-term care facility; and146.1(4) meets all other eligibility requirements.146.2The applicant must provide all required verifications within 30146.3days' notice of the eligibility determination or eligibility146.4shall be terminated.146.5 [EFFECTIVE DATE.] This section is repealed April 1, 2005, 146.6 if the HealthMatch system is operational. If the HealthMatch 146.7 system is not operational, this section is effective July 1, 146.8 2005. 146.9 Sec. 18. Minnesota Statutes 2002, section 256B.0625, 146.10 subdivision 13, is amended to read: 146.11 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 146.12 except for fertility drugs when specifically used to enhance 146.13 fertility, if prescribed by a licensed practitioner and 146.14 dispensed by a licensed pharmacist, by a physician enrolled in 146.15 the medical assistance program as a dispensing physician, or by 146.16 a physician or a nurse practitioner employed by or under 146.17 contract with a community health board as defined in section 146.18 145A.02, subdivision 5, for the purposes of communicable disease 146.19 control. The commissioner, after receiving recommendations from 146.20 professional medical associations and professional pharmacist 146.21 associations, shall designate a formulary committee to advise 146.22 the commissioner on the names of drugs for which payment is 146.23 made, recommend a system for reimbursing providers on a set fee 146.24 or charge basis rather than the present system, and develop 146.25 methods encouraging use of generic drugs when they are less 146.26 expensive and equally effective as trademark drugs. The 146.27 formulary committee shall consist of nine members, four of whom 146.28 shall be physicians who are not employed by the department of 146.29 human services, and a majority of whose practice is for persons 146.30 paying privately or through health insurance, three of whom 146.31 shall be pharmacists who are not employed by the department of 146.32 human services, and a majority of whose practice is for persons 146.33 paying privately or through health insurance, a consumer 146.34 representative, and a nursing home representative. Committee 146.35 members shall serve three-year terms and shall serve without 146.36 compensation. Members may be reappointed once. 147.1 (b) The commissioner shall establish a drug formulary. Its 147.2 establishment and publication shall not be subject to the 147.3 requirements of the Administrative Procedure Act, but the 147.4 formulary committee shall review and comment on the formulary 147.5 contents. 147.6 The formulary shall not include: 147.7 (i) drugs or products for which there is no federal 147.8 funding; 147.9 (ii) over-the-counter drugs, except for antacids, 147.10 acetaminophen, family planning products, aspirin, insulin, 147.11 products for the treatment of lice, vitamins for adults with 147.12 documented vitamin deficiencies, vitamins for children under the 147.13 age of seven and pregnant or nursing women, and any other 147.14 over-the-counter drug identified by the commissioner, in 147.15 consultation with the drug formulary committee, as necessary, 147.16 appropriate, and cost-effective for the treatment of certain 147.17 specified chronic diseases, conditions or disorders, and this 147.18 determination shall not be subject to the requirements of 147.19 chapter 14; 147.20 (iii)anorectics, except that medically necessary147.21anorectics shall be covered for a recipient previously diagnosed147.22as having pickwickian syndrome and currently diagnosed as having147.23diabetes and being morbidly obesedrugs used for weight loss; 147.24 (iv) drugs for which medical value has not been 147.25 established; and 147.26 (v) drugs from manufacturers who have not signed a rebate 147.27 agreement with the Department of Health and Human Services 147.28 pursuant to section 1927 of title XIX of the Social Security Act. 147.29 The commissioner shall publish conditions for prohibiting 147.30 payment for specific drugs after considering the formulary 147.31 committee's recommendations.An honorarium of $100 per meeting147.32and reimbursement for mileage shall be paid to each committee147.33member in attendance.147.34 (c) The dispensed quantity of a prescribed drug must not 147.35 exceed a 30-day supply. The basis for determining the amount of 147.36 payment shall be the lower of the actual acquisition costs of 148.1 the drugs plus a fixed dispensing fee; the maximum allowable 148.2 cost set by the federal government or by the commissioner plus 148.3 the fixed dispensing fee; or the usual and customary price 148.4 charged to the public. The amount of payment basis must be 148.5 reduced to reflect all discount amounts applied to the charge by 148.6 any provider/insurer agreement or contract for submitted charges 148.7 to medical assistance programs. The net submitted charge may 148.8 not be greater than the patient liability for the service. The 148.9 pharmacy dispensing fee shall be $3.65, except that the 148.10 dispensing fee for intravenous solutions which must be 148.11 compounded by the pharmacist shall be $8 per bag, $14 per bag 148.12 for cancer chemotherapy products, and $30 per bag for total 148.13 parenteral nutritional products dispensed in one liter 148.14 quantities, or $44 per bag for total parenteral nutritional 148.15 products dispensed in quantities greater than one liter. Actual 148.16 acquisition cost includes quantity and other special discounts 148.17 except time and cash discounts. The actual acquisition cost of 148.18 a drug shall be estimated by the commissioner, at average 148.19 wholesale price minusnine14 percent, except that where a drug 148.20 has had its wholesale price reduced as a result of the actions 148.21 of the National Association of Medicaid Fraud Control Units, the 148.22 estimated actual acquisition cost shall be the reduced average 148.23 wholesale price, without thenine14 percent deduction. The 148.24 maximum allowable cost of a multisource drug may be set by the 148.25 commissioner and it shall be comparable to, but no higher than, 148.26 the maximum amount paid by other third-party payors in this 148.27 state who have maximum allowable cost programs.The148.28commissioner shall set maximum allowable costs for multisource148.29drugs that are not on the federal upper limit list as described148.30in United States Code, title 42, chapter 7, section 1396r-8(e),148.31the Social Security Act, and Code of Federal Regulations, title148.3242, part 447, section 447.332.Establishment of the amount of 148.33 payment for drugs shall not be subject to the requirements of 148.34 the Administrative Procedure Act. An additional dispensing fee 148.35 of $.30 may be added to the dispensing fee paid to pharmacists 148.36 for legend drug prescriptions dispensed to residents of 149.1 long-term care facilities when a unit dose blister card system, 149.2 approved by the department, is used. Under this type of 149.3 dispensing system, the pharmacist must dispense a 30-day supply 149.4 of drug. The National Drug Code (NDC) from the drug container 149.5 used to fill the blister card must be identified on the claim to 149.6 the department. The unit dose blister card containing the drug 149.7 must meet the packaging standards set forth in Minnesota Rules, 149.8 part 6800.2700, that govern the return of unused drugs to the 149.9 pharmacy for reuse. The pharmacy provider will be required to 149.10 credit the department for the actual acquisition cost of all 149.11 unused drugs that are eligible for reuse. Over-the-counter 149.12 medications must be dispensed in the manufacturer's unopened 149.13 package. The commissioner may permit the drug clozapine to be 149.14 dispensed in a quantity that is less than a 30-day supply. 149.15 Whenever a generically equivalent product is available, payment 149.16 shall be on the basis of the actual acquisition cost of the 149.17 generic drug,unless the prescriber specifically indicates149.18"dispense as written - brand necessary" on the prescription as149.19required by section 151.21, subdivision 2.or on the maximum 149.20 allowable cost established by the commissioner. The 149.21 commissioner may require prior authorization for brand-name 149.22 drugs whenever a generically equivalent product is available 149.23 even if the prescriber specifically indicates "dispense as 149.24 written - brand necessary" on the prescription as required by 149.25 section 151.21, subdivision 2. The formulary committee shall 149.26 establish general criteria to be used for the prior 149.27 authorization of brand-name drugs for which generically 149.28 equivalent drugs are available, but formulary committee review 149.29 of each brand-name drug for which a generically equivalent drug 149.30 is available shall not be required. 149.31 (d)For purposes of this subdivision, "multisource drugs"149.32means covered outpatient drugs, excluding innovator multisource149.33drugs for which there are two or more drug products, which:149.34(1) are related as therapeutically equivalent under the149.35Food and Drug Administration's most recent publication of149.36"Approved Drug Products with Therapeutic Equivalence150.1Evaluations";150.2(2) are pharmaceutically equivalent and bioequivalent as150.3determined by the Food and Drug Administration; and150.4(3) are sold or marketed in Minnesota.150.5"Innovator multisource drug" means a multisource drug that was150.6originally marketed under an original new drug application150.7approved by the Food and Drug Administration.150.8(e)The formulary committee shall review and recommend 150.9 drugs which require prior authorization. The formulary 150.10 committee may recommend drugs for prior authorization directly 150.11 to the commissioner, as long as opportunity for public input is 150.12 provided. Prior authorization may be requested by the 150.13 commissioner based on medical and clinical criteria and on cost 150.14 before certain drugs are eligible for payment. Before a drug 150.15 may be considered for prior authorization at the request of the 150.16 commissioner: 150.17 (1) the drug formulary committee must develop criteria to 150.18 be used for identifying drugs; the development of these criteria 150.19 is not subject to the requirements of chapter 14, but the 150.20 formulary committee shall provide opportunity for public input 150.21 in developing criteria; 150.22 (2) the drug formulary committee must hold a public forum 150.23 and receive public comment for an additional 15 days; 150.24 (3) the drug formulary committee must consider data from 150.25 the state Medicaid program if such data is available; and 150.26 (4) the commissioner must provide information to the 150.27 formulary committee on the impact that placing the drug on prior 150.28 authorization will have on the quality of patient care and on 150.29 program costs, and information regarding whether the drug is 150.30 subject to clinical abuse or misuse. 150.31 Prior authorization may be required by the commissioner 150.32 before certain formulary drugs are eligible for payment. If 150.33 prior authorization of a drug is required by the commissioner, 150.34 the commissioner must provide a 30-day notice period before 150.35 implementing the prior authorization. If a prior authorization 150.36 request is denied by the department, the recipient may appeal 151.1 the denial in accordance with section 256.045. If an appeal is 151.2 filed, the drug must be provided without prior authorization 151.3 until a decision is made on the appeal. 151.4(f)(e) The basis for determining the amount of payment for 151.5 drugs administered in an outpatient setting shall be the lower 151.6 of the usual and customary cost submitted by the provider; the 151.7 average wholesale price minus five percent; or the maximum 151.8 allowable cost set by the federal government under United States 151.9 Code, title 42, chapter 7, section 1396r-8(e), and Code of 151.10 Federal Regulations, title 42, section 447.332, or by the 151.11 commissioner under paragraph (c). 151.12(g)(f) Prior authorization shall not be required or 151.13 utilized for any antipsychotic drug prescribed for the treatment 151.14 of mental illness where there is no generically equivalent drug 151.15 available unless the commissioner determines that prior 151.16 authorization is necessary for patient safety. This paragraph 151.17 applies to any supplemental drug rebate program established or 151.18 administered by the commissioner. 151.19(h)(g) Prior authorization shall not be required or 151.20 utilized for any antihemophilic factor drug prescribed for the 151.21 treatment of hemophilia and blood disorders where there is no 151.22 generically equivalent drug available unless the commissioner 151.23 determines that prior authorization is necessary for patient 151.24 safety. This paragraph applies to any supplemental drug rebate 151.25 program established or administered by the commissioner. This 151.26 paragraph expires July 1, 2003. 151.27 Sec. 19. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 151.28 Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in 151.29 subdivision 2, the medical assistance benefit plan shall include 151.30 the following co-payments for all recipients, effective for 151.31 services provided on or after October 1, 2003: 151.32 (1) $3 per nonpreventive visit. For purposes of this 151.33 subdivision, a visit means an episode of service which is 151.34 required because of a recipient's symptoms, diagnosis, or 151.35 established illness, and which is delivered in an ambulatory 151.36 setting by a physician or physician ancillary, dentist, 152.1 chiropractor, podiatrist, nurse midwife, mental health 152.2 professional, advanced practice nurse, physical therapist, 152.3 occupational therapist, speech therapist, audiologist, optician, 152.4 or optometrist; 152.5 (2) $3 for eyeglasses; 152.6 (3) $6 for nonemergency visits to a hospital-based 152.7 emergency room; and 152.8 (4) $3 per brand-name drug prescription and $1 per generic 152.9 drug prescription. 152.10 (b) Recipients of medical assistance are responsible for 152.11 all co-payments in this subdivision. 152.12 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 152.13 following exceptions: 152.14 (1) children under the age of 21; 152.15 (2) pregnant women for services that relate to the 152.16 pregnancy or any other medical condition that may complicate the 152.17 pregnancy; 152.18 (3) recipients expected to reside for at least 30 days in a 152.19 hospital, nursing home, or intermediate care facility for the 152.20 mentally retarded; 152.21 (4) recipients receiving hospice care; 152.22 (5) 100 percent federally funded services provided by an 152.23 Indian health service; 152.24 (6) emergency services; 152.25 (7) family planning services; 152.26 (8) services that are paid by Medicare, resulting in the 152.27 medical assistance program paying for the coinsurance and 152.28 deductible; and 152.29 (9) co-payments that exceed one per day per provider for 152.30 nonpreventive visits, eyeglasses, and nonemergency visits to a 152.31 hospital-based emergency room. 152.32 Subd. 3. [COLLECTION.] The medical assistance 152.33 reimbursement to the provider shall be reduced by the amount of 152.34 the co-payment. The provider collects the co-payment from the 152.35 recipient. Providers may not deny services to individuals who 152.36 are unable to pay the co-payment. Providers must accept an 153.1 assertion from the recipient that they are unable to pay. 153.2 Sec. 20. Minnesota Statutes 2002, section 256B.0635, 153.3 subdivision 1, is amended to read: 153.4 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 153.5 2002, medical assistance may be paid for persons who received 153.6 MFIP or medical assistance for families and children in at least 153.7 three of six months preceding the month in which the person 153.8 became ineligible for MFIP or medical assistance, if the 153.9 ineligibility was due to an increase in hours of employment or 153.10 employment income or due to the loss of an earned income 153.11 disregard. In addition, to receive continued assistance under 153.12 this section, persons who received medical assistance for 153.13 families and children but did not receive MFIP must have had 153.14 income less than or equal to the assistance standard for their 153.15 family size under the state's AFDC plan in effect as of July 16, 153.16 1996, increased by three percent effective July 1, 2000, at the 153.17 time medical assistance eligibility began. A person who is 153.18 eligible for extended medical assistance is entitled to six 153.19 months of assistance without reapplication, unless the 153.20 assistance unit ceases to include a dependent child. For a 153.21 person under 21 years of age, medical assistance may not be 153.22 discontinued within the six-month period of extended eligibility 153.23 until it has been determined that the person is not otherwise 153.24 eligible for medical assistance. Medical assistance may be 153.25 continued for an additional six months if the person meets all 153.26 requirements for the additional six months, according to title 153.27 XIX of the Social Security Act, as amended by section 303 of the 153.28 Family Support Act of 1988, Public LawNumber100-485. 153.29 (b) Beginning July 1, 2002, contingent upon federal 153.30 funding, medical assistance for families and children may be 153.31 paid for persons who were eligible under section 256B.055, 153.32 subdivision 3a, in at least three of six months preceding the 153.33 month in which the person became ineligible under that section 153.34 if the ineligibility was due to an increase in hours of 153.35 employment or employment income or due to the loss of an earned 153.36 income disregard. A person who is eligible for extended medical 154.1 assistance is entitled to six months of assistance without 154.2 reapplication, unless the assistance unit ceases to include a 154.3 dependent child, except medical assistance may not be 154.4 discontinued for that dependent child under 21 years of age 154.5 within the six-month period of extended eligibility until it has 154.6 been determined that the person is not otherwise eligible for 154.7 medical assistance. Medical assistance may be continued for an 154.8 additional six months if the person meets all requirements for 154.9 the additional six months, according to title XIX of the Social 154.10 Security Act, as amended by section 303 of the Family Support 154.11 Act of 1988, Public LawNumber100-485. 154.12 [EFFECTIVE DATE.] This section is effective July 1, 2003. 154.13 Sec. 21. Minnesota Statutes 2002, section 256B.0635, 154.14 subdivision 2, is amended to read: 154.15 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 154.16 June 30, 2002, medical assistance may be paid for persons who 154.17 received MFIP or medical assistance for families and children in 154.18 at least three of the six months preceding the month in which 154.19 the person became ineligible for MFIP or medical assistance, if 154.20 the ineligibility was the result of the collection of child or 154.21 spousal support under part D of title IV of the Social Security 154.22 Act. In addition, to receive continued assistance under this 154.23 section, persons who received medical assistance for families 154.24 and children but did not receive MFIP must have had income less 154.25 than or equal to the assistance standard for their family size 154.26 under the state's AFDC plan in effect as of July 16, 1996, 154.27 increased by three percent effective July 1, 2000, at the time 154.28 medical assistance eligibility began. A person who is eligible 154.29 for extended medical assistance under this subdivision is 154.30 entitled to four months of assistance without reapplication, 154.31 unless the assistance unit ceases to include a dependent child, 154.32 except medical assistance may not be discontinued for that 154.33 dependent child under 21 years of age within the four-month 154.34 period of extended eligibility until it has been determined that 154.35 the person is not otherwise eligible for medical assistance. 154.36 (b) Beginning July 1, 2002, contingent upon federal 155.1 funding, medical assistance for families and children may be 155.2 paid for persons who were eligible under section 256B.055, 155.3 subdivision 3a, in at least three of the six months preceding 155.4 the month in which the person became ineligible under that 155.5 section if the ineligibility was the result of the collection of 155.6 child or spousal support under part D of title IV of the Social 155.7 Security Act. A person who is eligible for extended medical 155.8 assistance under this subdivision is entitled to four months of 155.9 assistance without reapplication, unless the assistance unit 155.10 ceases to include a dependent child, except medical assistance 155.11 may not be discontinued for that dependent child under 21 years 155.12 of age within the four-month period of extended eligibility 155.13 until it has been determined that the person is not otherwise 155.14 eligible for medical assistance. 155.15 [EFFECTIVE DATE.] This section is effective July 1, 2003. 155.16 Sec. 22. Minnesota Statutes 2002, section 256B.15, 155.17 subdivision 1, is amended to read: 155.18 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 155.19 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 155.20 that individuals or couples, either or both of whom participate 155.21 in the medical assistance program, use their own assets to pay 155.22 their share of the total cost of their care during or after 155.23 their enrollment in the program according to applicable federal 155.24 law and the laws of this state. The following provisions apply: 155.25 (1) subdivisions 1c to 1k shall not apply to claims arising 155.26 under this section which are presented under section 525.313; 155.27 (2) the provisions of subdivisions 1c to 1k expanding the 155.28 interests included in an estate for purposes of recovery under 155.29 this section give effect to the provisions of United States 155.30 Code, title 42, section 1396p, governing recoveries, but do not 155.31 give rise to any express or implied liens in favor of any other 155.32 parties not named in these provisions; 155.33 (3) the continuation of a recipient's life estate or joint 155.34 tenancy interest in real property after the recipient's death 155.35 for the purpose of recovering medical assistance under this 155.36 section modifies common law principles holding that these 156.1 interests terminate on the death of the holder; and 156.2 (4) all laws, rules, and regulations governing or involved 156.3 with a recovery of medical assistance shall be liberally 156.4 construed to accomplish their intended purposes. 156.5 (b) For purposes of this section, "medical assistance" 156.6 includes the medical assistance program under this chapter and 156.7 the general assistance medical care program under chapter 256D, 156.8 but does not include the alternative care program for nonmedical 156.9 assistance recipients under section 256B.0913, subdivision 4. 156.10 [EFFECTIVE DATE.] This section is effective August 1, 2003, 156.11 and applies to estates of decedents who die on or after that 156.12 date. 156.13 Sec. 23. Minnesota Statutes 2002, section 256B.15, 156.14 subdivision 1a, is amended to read: 156.15 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 156.16 receives any medical assistance hereunder, on the person's 156.17 death, if single, or on the death of the survivor of a married 156.18 couple, either or both of whom received medical assistance, or 156.19 as otherwise provided for in this section, the total amount paid 156.20 for medical assistance rendered for the person and spouse shall 156.21 be filed as a claim against the estate of the person or the 156.22 estate of the surviving spouse in the court having jurisdiction 156.23 to probate the estate or to issue a decree of descent according 156.24 to sections 525.31 to 525.313. 156.25 A claim shall be filed if medical assistance was rendered 156.26 for either or both persons under one of the following 156.27 circumstances: 156.28 (a) the person was over 55 years of age, and received 156.29 services under this chapter, excluding alternative care; 156.30 (b) the person resided in a medical institution for six 156.31 months or longer, received services under this chapter excluding 156.32 alternative care, and, at the time of institutionalization or 156.33 application for medical assistance, whichever is later, the 156.34 person could not have reasonably been expected to be discharged 156.35 and returned home, as certified in writing by the person's 156.36 treating physician. For purposes of this section only, a 157.1 "medical institution" means a skilled nursing facility, 157.2 intermediate care facility, intermediate care facility for 157.3 persons with mental retardation, nursing facility, or inpatient 157.4 hospital; or 157.5 (c) the person received general assistance medical care 157.6 services under chapter 256D. 157.7 The claim shall be considered an expense of the last 157.8 illness of the decedent for the purpose of section 524.3-805. 157.9 Any statute of limitations that purports to limit any county 157.10 agency or the state agency, or both, to recover for medical 157.11 assistance granted hereunder shall not apply to any claim made 157.12 hereunder for reimbursement for any medical assistance granted 157.13 hereunder. Notice of the claim shall be given to all heirs and 157.14 devisees of the decedent whose identity can be ascertained with 157.15 reasonable diligence. The notice must include procedures and 157.16 instructions for making an application for a hardship waiver 157.17 under subdivision 5; time frames for submitting an application 157.18 and determination; and information regarding appeal rights and 157.19 procedures. Counties are entitled to one-half of the nonfederal 157.20 share of medical assistance collections from estates that are 157.21 directly attributable to county effort. 157.22 [EFFECTIVE DATE.] This section is effective August 1, 2003, 157.23 and applies to the estates of decedents who die on and after 157.24 that date. 157.25 Sec. 24. Minnesota Statutes 2002, section 256B.15, is 157.26 amended by adding a subdivision to read: 157.27 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 157.28 with a claim or potential claim under this section may file a 157.29 notice of potential claim under this subdivision anytime before 157.30 or after a medical assistance recipient dies. The claimant 157.31 shall be the state agency. A notice filed prior to the 157.32 recipient's death shall not take effect and shall not be 157.33 effective as notice until the recipient dies. A notice filed 157.34 after a recipient dies shall be effective from the time of 157.35 filing. 157.36 (b) The notice of claim shall be filed or recorded in the 158.1 real estate records in the office of the county recorder or 158.2 registrar of titles for each county in which any part of the 158.3 property is located. The recorder shall accept the notice for 158.4 recording or filing. The registrar of titles shall accept the 158.5 notice for filing if the recipient has a recorded interest in 158.6 the property. The notice must be filed within one year after 158.7 the date of the recipient's death. The registrar of titles 158.8 shall not carry forward to a new certificate of title any notice 158.9 filed more than one year from the date of the recipient's death. 158.10 (c) The notice must be dated, state the name of the 158.11 claimant, the medical assistance recipient's name and social 158.12 security number if filed before their death and their date of 158.13 death if filed after they die, the name and date of death of any 158.14 predeceased spouse of the medical assistance recipient for whom 158.15 a claim may exist, a statement that the claimant may have a 158.16 claim arising under this section, generally identify the 158.17 recipient's interest in the property, contain a legal 158.18 description for the property and whether it is abstract or 158.19 registered property, a statement of when the notice becomes 158.20 effective and the effect of the notice, be signed by an 158.21 authorized representative of the state agency, and may include 158.22 such other contents as the state or county agency may deem 158.23 appropriate. 158.24 Sec. 25. Minnesota Statutes 2002, section 256B.15, is 158.25 amended by adding a subdivision to read: 158.26 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 158.27 effect, the notice shall be notice to remaindermen, joint 158.28 tenants, or to anyone else owning or acquiring an interest in or 158.29 encumbrance against the property described in the notice that 158.30 the medical assistance recipient's life estate, joint tenancy, 158.31 or other interests in the real estate described in the notice: 158.32 (1) shall, in the case of life estate and joint tenancy 158.33 interests, continue to exist for purposes of this section, and 158.34 be subject to liens and claims as provided in this section; 158.35 (2) shall be subject to a lien in favor of the claimant 158.36 effective upon the death of the recipient and dealt with as 159.1 provided in this section; 159.2 (3) may be included in the recipient's estate, as defined 159.3 in this section; and 159.4 (4) may be subject to administration and all other 159.5 provisions of chapter 524 and may be sold, assigned, 159.6 transferred, or encumbered free and clear of their interest or 159.7 encumbrance to satisfy claims under this section. 159.8 Sec. 26. Minnesota Statutes 2002, section 256B.15, is 159.9 amended by adding a subdivision to read: 159.10 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 159.11 claimant may fully or partially release the notice and the lien 159.12 arising out of the notice of record in the real estate records 159.13 where the notice is filed or recorded at any time. The claimant 159.14 may give a full or partial release to extinguish any life 159.15 estates or joint tenancy interests which are or may be continued 159.16 under this section or whose existence or nonexistence may create 159.17 a cloud on the title to real property at any time whether or not 159.18 a notice has been filed. The recorder or registrar of titles 159.19 shall accept the release for recording or filing. If the 159.20 release is a partial release, it must include a legal 159.21 description of the property being released. 159.22 (b) At any time, the claimant may, at the claimant's 159.23 discretion, wholly or partially release, subordinate, modify, or 159.24 amend the recorded notice and the lien arising out of the notice. 159.25 Sec. 27. Minnesota Statutes 2002, section 256B.15, is 159.26 amended by adding a subdivision to read: 159.27 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 159.28 lien in favor of the department of human services against the 159.29 recipient's interests in the real estate it describes for a 159.30 period of 20 years from the date of filing or the date of the 159.31 recipient's death, whichever is later. Notwithstanding any law 159.32 or rule to the contrary, a recipient's life estate and joint 159.33 tenancy interests shall not end upon the recipient's death but 159.34 shall continue according to subdivisions 1h and 1i. The amount 159.35 of the lien shall be equal to the total amount of the claims 159.36 that could be presented in the recipient's estate under this 160.1 section. 160.2 (b) If no estate has been opened for the deceased 160.3 recipient, any holder of an interest in the property may apply 160.4 to the lien holder for a statement of the amount of the lien or 160.5 for a full or partial release of the lien. The application 160.6 shall include the applicant's name, current mailing address, 160.7 current home and work telephone numbers, and a description of 160.8 their interest in the property, a legal description of the 160.9 recipient's interest in the property, and the deceased 160.10 recipient's name, date of birth, and social security number. 160.11 The lien holder shall send the applicant by certified mail, 160.12 return receipt requested, a written statement showing the amount 160.13 of the lien, whether the lien holder is willing to release the 160.14 lien and under what conditions, and inform them of the right to 160.15 a hearing under section 256.045. The lien holder shall have the 160.16 discretion to compromise and settle the lien upon any terms and 160.17 conditions the lien holder deems appropriate. 160.18 (c) Any holder of an interest in property subject to the 160.19 lien has a right to request a hearing under section 256.045 to 160.20 determine the validity, extent, or amount of the lien. The 160.21 request must be in writing, and must include the names, current 160.22 addresses, and home and business telephone numbers for all other 160.23 parties holding an interest in the property. A request for a 160.24 hearing by any holder of an interest in the property shall be 160.25 deemed to be a request for a hearing by all parties owning 160.26 interests in the property. Notice of the hearing shall be given 160.27 to the lien holder, the party filing the appeal, and all of the 160.28 other holders of interests in the property at the addresses 160.29 listed in the appeal by certified mail, return receipt 160.30 requested, or by ordinary mail. Any owner of an interest in the 160.31 property to whom notice of the hearing is mailed shall be deemed 160.32 to have waived any and all claims or defenses in respect to the 160.33 lien unless they appear and assert any claims or defenses at the 160.34 hearing. 160.35 (d) If the claim the lien secures could be filed under 160.36 subdivision 1h, the lien holder may collect, compromise, settle, 161.1 or release the lien upon any terms and conditions it deems 161.2 appropriate. If the claim the lien secures could be filed under 161.3 subdivision 1i, the lien may be adjusted or enforced to the same 161.4 extent had it been filed under subdivision 1i, and the 161.5 provisions of subdivisions 1i, clause (f), and lj, clause (d), 161.6 shall apply to voluntary payment, settlement, or satisfaction of 161.7 the lien. 161.8 (e) If no probate proceedings have been commenced for the 161.9 recipient as of the date the lien holder executes a release of 161.10 the lien on a recipient's life estate or joint tenancy interest, 161.11 created for purposes of this section, the release shall 161.12 terminate the life estate or joint tenancy interest created 161.13 under this section as of the date it is recorded or filed to the 161.14 extent of the release. If the claimant executes a release for 161.15 purposes of extinguishing a life estate or a joint tenancy 161.16 interest created under this section to remove a cloud on title 161.17 to real property, the release shall have the effect of 161.18 extinguishing any life estate or joint tenancy interests in the 161.19 property it describes which may have been continued by reason of 161.20 this section retroactive to the date of death of the deceased 161.21 life tenant or joint tenant except as provided for in section 161.22 514.981, subdivision 6. 161.23 (f) If the deceased recipient's estate is probated, a claim 161.24 shall be filed under this section. The amount of the lien shall 161.25 be limited to the amount of the claim as finally allowed. If 161.26 the claim the lien secures is filed under subdivision 1h, the 161.27 lien may be released in full after any allowance of the claim 161.28 becomes final or according to any agreement to settle and 161.29 satisfy the claim. The release shall release the lien but shall 161.30 not extinguish or terminate the interest being released. If the 161.31 claim the lien secures is filed under subdivision 1i, the lien 161.32 shall be released after the lien under subdivision 1i is filed 161.33 or recorded, or settled according to any agreement to settle and 161.34 satisfy the claim. The release shall not extinguish or 161.35 terminate the interest being released. If the claim is finally 161.36 disallowed in full, the claimant shall release the claimant's 162.1 lien at the claimant's expense. 162.2 [EFFECTIVE DATE.] This section takes effect on August 1, 162.3 2003, and applies to the estates of decedents who die on or 162.4 after that date. 162.5 Sec. 28. Minnesota Statutes 2002, section 256B.15, is 162.6 amended by adding a subdivision to read: 162.7 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 162.8 rule to the contrary, if a claim is presented under this 162.9 section, interests or the proceeds of interests in real property 162.10 a decedent owned as a life tenant or a joint tenant with a right 162.11 of survivorship shall be part of the decedent's estate, subject 162.12 to administration, and shall be dealt with as provided in this 162.13 section. 162.14 [EFFECTIVE DATE.] This section takes effect on August 1, 162.15 2003, and applies to the estates of decedents who die on or 162.16 after that date. 162.17 Sec. 29. Minnesota Statutes 2002, section 256B.15, is 162.18 amended by adding a subdivision to read: 162.19 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 162.20 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 162.21 (k) apply if a person received medical assistance for which a 162.22 claim may be filed under this section and died single, or the 162.23 surviving spouse of the couple and was not survived by any of 162.24 the persons described in subdivisions 3 and 4. 162.25 (b) For purposes of this section, the person's estate 162.26 consists of: (1) their probate estate; (2) all of the person's 162.27 interests or proceeds of those interests in real property the 162.28 person owned as a life tenant or as a joint tenant with a right 162.29 of survivorship at the time of the person's death; (3) all of 162.30 the person's interests or proceeds of those interests in 162.31 securities the person owned in beneficiary form as provided 162.32 under sections 524.6-301 to 524.6-311 at the time of the 162.33 person's death, to the extent they become part of the probate 162.34 estate under section 524.6-307; and (4) all of the person's 162.35 interests in joint accounts, multiple party accounts, and pay on 162.36 death accounts, or the proceeds of those accounts, as provided 163.1 under sections 524.6-201 to 524.6-214 at the time of the 163.2 person's death to the extent they become part of the probate 163.3 estate under section 524.6-207. Notwithstanding any law or rule 163.4 to the contrary, a state or county agency with a claim under 163.5 this section shall be a creditor under section 524.6-307. 163.6 (c) Notwithstanding any law or rule to the contrary, the 163.7 person's life estate or joint tenancy interest in real property 163.8 not subject to a medical assistance lien under sections 514.980 163.9 to 514.985 on the date of the person's death shall not end upon 163.10 the person's death and shall continue as provided in this 163.11 subdivision. The life estate in the person's estate shall be 163.12 that portion of the interest in the real property subject to the 163.13 life estate which is equal to the percentage factor for the life 163.14 estate of the person and the medical assistance recipient's age 163.15 on the date of the person's death as listed in the Life Estate 163.16 Mortality Table of the health care program's manual. The joint 163.17 tenancy interest in real property in the estate shall be equal 163.18 to the fractional interest the person would have owned in the 163.19 jointly held interest in the property had they and the other 163.20 owners held title to the property as tenants in common on the 163.21 date the person died. 163.22 (d) The court upon its own motion, or upon motion by the 163.23 personal representative or any interested party, may enter an 163.24 order directing the remaindermen or surviving joint tenants and 163.25 their spouses, if any, to sign all documents, take all actions, 163.26 and otherwise fully cooperate with the personal representative 163.27 and the court to liquidate the decedent's life estate or joint 163.28 tenancy interests in the estate and deliver the cash or the 163.29 proceeds of those interests to the personal representative and 163.30 provide for any legal and equitable sanctions as the court deems 163.31 appropriate to enforce and carry out the order, including an 163.32 award of reasonable attorney fees. 163.33 (e) The personal representative may make, execute, and 163.34 deliver any conveyances or other documents necessary to convey 163.35 the decedent's life estate or joint tenancy interest in the 163.36 estate that are necessary to liquidate and reduce to cash the 164.1 decedent's interest or for any other purposes. 164.2 (f) Subject to administration, all costs, including 164.3 reasonable attorney fees, directly and immediately related to 164.4 liquidating the decedent's life estate or joint tenancy interest 164.5 in the decedent's estate, shall be paid from the gross proceeds 164.6 of the liquidation and the net proceeds shall be turned over to 164.7 the personal representative and applied to payment of the claim 164.8 presented under this section. 164.9 (g) The personal representative shall bring a motion in the 164.10 district court in which the estate is being probated to compel 164.11 the remaindermen or surviving joint tenants to account for and 164.12 deliver to the personal representative all or any part of the 164.13 proceeds of any sale, mortgage, transfer, conveyance, or any 164.14 disposition of real property allocable to the decedent's life 164.15 estate or joint tenancy interest in the decedent's estate, and 164.16 do everything necessary to liquidate and reduce to cash the 164.17 decedent's interest and turn the proceeds of the sale or other 164.18 disposition over to the personal representative. The court may 164.19 grant any legal or equitable relief including, but not limited 164.20 to, ordering a partition of real estate under chapter 558 164.21 necessary to make the value of the decedent's life estate or 164.22 joint tenancy interest available to the estate for payment of a 164.23 claim under this section. 164.24 (h) Subject to administration, the personal representative 164.25 shall use all of the cash or proceeds of interests to pay an 164.26 allowable claim under this section. The remaindermen or 164.27 surviving joint tenants and their spouses, if any, may enter 164.28 into a written agreement with the personal representative or the 164.29 claimant to settle and satisfy obligations imposed at any time 164.30 before or after a claim is filed. 164.31 (i) The personal representative may provide any or all of 164.32 the other owners, remaindermen, or surviving joint tenants with 164.33 an affidavit terminating the decedent's estate's interest in 164.34 real property the decedent owned as a life tenant or as a joint 164.35 tenant with others, if the personal representative determines 164.36 that neither the decedent nor any of the decedent's predeceased 165.1 spouses received any medical assistance for which a claim could 165.2 be filed under this section, or if the personal representative 165.3 has filed an affidavit with the court that the estate has other 165.4 assets sufficient to pay a claim, as presented, or if there is a 165.5 written agreement under paragraph (h), or if the claim, as 165.6 allowed, has been paid in full or to the full extent of the 165.7 assets the estate has available to pay it. The affidavit may be 165.8 recorded in the office of the county recorder or filed in the 165.9 office of the registrar of titles for the county in which the 165.10 real property is located. Except as provided in section 165.11 514.981, subdivision 6, when recorded or filed, the affidavit 165.12 shall terminate the decedent's interest in real estate the 165.13 decedent owned as a life tenant or a joint tenant with others. 165.14 The affidavit shall: (1) be signed by the personal 165.15 representative; (2) identify the decedent and the interest being 165.16 terminated; (3) give recording information sufficient to 165.17 identify the instrument that created the interest in real 165.18 property being terminated; (4) legally describe the affected 165.19 real property; (5) state that the personal representative has 165.20 determined that neither the decedent nor any of the decedent's 165.21 predeceased spouses received any medical assistance for which a 165.22 claim could be filed under this section; (6) state that the 165.23 decedent's estate has other assets sufficient to pay the claim, 165.24 as presented, or that there is a written agreement between the 165.25 personal representative and the claimant and the other owners or 165.26 remaindermen or other joint tenants to satisfy the obligations 165.27 imposed under this subdivision; and (7) state that the affidavit 165.28 is being given to terminate the estate's interest under this 165.29 subdivision, and any other contents as may be appropriate. 165.30 The recorder or registrar of titles shall accept the affidavit 165.31 for recording or filing. The affidavit shall be effective as 165.32 provided in this section and shall constitute notice even if it 165.33 does not include recording information sufficient to identify 165.34 the instrument creating the interest it terminates. The 165.35 affidavit shall be conclusive evidence of the stated facts. 165.36 (j) The holder of a lien arising under subdivision 1c shall 166.1 release the lien at the holder's expense against an interest 166.2 terminated under paragraph (h) to the extent of the termination. 166.3 (k) If a lien arising under subdivision 1c is not released 166.4 under paragraph (j), prior to closing the estate, the personal 166.5 representative shall deed the interest subject to the lien to 166.6 the remaindermen or surviving joint tenants as their interests 166.7 may appear. Upon recording or filing, the deed shall work a 166.8 merger of the recipient's life estate or joint tenancy interest, 166.9 subject to the lien, into the remainder interest or interest the 166.10 decedent and others owned jointly. The lien shall attach to and 166.11 run with the property to the extent of the decedent's interest 166.12 at the time of the decedent's death. 166.13 [EFFECTIVE DATE.] This section takes effect on August 1, 166.14 2003, and applies to the estates of decedents who die on or 166.15 after that date. 166.16 Sec. 30. Minnesota Statutes 2002, section 256B.15, is 166.17 amended by adding a subdivision to read: 166.18 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 166.19 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 166.20 the person's estate consists of the person's probate estate and 166.21 all of the person's interests in real property the person owned 166.22 as a life tenant or a joint tenant at the time of the person's 166.23 death. 166.24 (b) Notwithstanding any law or rule to the contrary, this 166.25 subdivision applies if a person received medical assistance for 166.26 which a claim could be filed under this section but for the fact 166.27 the person was survived by a spouse or by a person listed in 166.28 subdivision 3, or if subdivision 4 applies to a claim arising 166.29 under this section. 166.30 (c) The person's life estate or joint tenancy interests in 166.31 real property not subject to a medical assistance lien under 166.32 sections 514.980 to 514.985 on the date of the person's death 166.33 shall not end upon death and shall continue as provided in this 166.34 subdivision. The life estate in the estate shall be the portion 166.35 of the interest in the property subject to the life estate that 166.36 is equal to the percentage factor for the life estate of the 167.1 medical assistance recipient's age on the date of the person's 167.2 death as listed in the Life Estate Mortality Table in the health 167.3 care program's manual. The joint tenancy interest in the estate 167.4 shall be equal to the fractional interest the medical assistance 167.5 recipient would have owned in the jointly held interest in the 167.6 property had they and the other owners held title to the 167.7 property as tenants in common on the date the medical assistance 167.8 recipient died. 167.9 (d) The county agency shall file a claim in the estate 167.10 under this section on behalf of the claimant who shall be the 167.11 commissioner of human services, notwithstanding that the 167.12 decedent is survived by a spouse or a person listed in 167.13 subdivision 3. The claim, as allowed, shall not be paid by the 167.14 estate and shall be disposed of as provided in this paragraph. 167.15 The personal representative or the court shall make, execute, 167.16 and deliver a lien in favor of the claimant on the decedent's 167.17 interest in real property in the estate in the amount of the 167.18 allowed claim on forms provided by the commissioner to the 167.19 county agency filing the lien. The lien shall bear interest as 167.20 provided under section 524.3-806, shall attach to the property 167.21 it describes upon filing or recording, and shall remain a lien 167.22 on the real property it describes for a period of 20 years from 167.23 the date it is filed or recorded. The lien shall be a 167.24 disposition of the claim sufficient to permit the estate to 167.25 close. 167.26 (e) The state or county agency shall file or record the 167.27 lien in the office of the county recorder or registrar of titles 167.28 for each county in which any of the real property is located. 167.29 The recorder or registrar of titles shall accept the lien for 167.30 filing or recording. All recording or filing fees shall be paid 167.31 by the department of human services. The recorder or registrar 167.32 of titles shall mail the recorded lien to the department of 167.33 human services. The lien need not be attested, certified, or 167.34 acknowledged as a condition of recording or filing. Upon 167.35 recording or filing of a lien against a life estate or a joint 167.36 tenancy interest, the interest subject to the lien shall merge 168.1 into the remainder interest or the interest the recipient and 168.2 others owned jointly. The lien shall attach to and run with the 168.3 property to the extent of the decedent's interest in the 168.4 property at the time of the decedent's death as determined under 168.5 this section. 168.6 (f) The department shall make no adjustment or recovery 168.7 under the lien until after the decedent's spouse, if any, has 168.8 died, and only at a time when the decedent has no surviving 168.9 child described in subdivision 3. The estate, any owner of an 168.10 interest in the property which is or may be subject to the lien, 168.11 or any other interested party, may voluntarily pay off, settle, 168.12 or otherwise satisfy the claim secured or to be secured by the 168.13 lien at any time before or after the lien is filed or recorded. 168.14 Such payoffs, settlements, and satisfactions shall be deemed to 168.15 be voluntary repayments of past medical assistance payments for 168.16 the benefit of the deceased recipient, and neither the process 168.17 of settling the claim, the payment of the claim, or the 168.18 acceptance of a payment shall constitute an adjustment or 168.19 recovery that is prohibited under this subdivision. 168.20 (g) The lien under this subdivision may be enforced or 168.21 foreclosed in the manner provided by law for the enforcement of 168.22 judgment liens against real estate or by a foreclosure by action 168.23 under chapter 581. When the lien is paid, satisfied, or 168.24 otherwise discharged, the state or county agency shall prepare 168.25 and file a release of lien at its own expense. No action to 168.26 foreclose the lien shall be commenced unless the lien holder has 168.27 first given 30 days' prior written notice to pay the lien to the 168.28 owners and parties in possession of the property subject to the 168.29 lien. The notice shall: (1) include the name, address, and 168.30 telephone number of the lien holder; (2) describe the lien; (3) 168.31 give the amount of the lien; (4) inform the owner or party in 168.32 possession that payment of the lien in full must be made to the 168.33 lien holder within 30 days after service of the notice or the 168.34 lien holder may begin proceedings to foreclose the lien; and (5) 168.35 be served by personal service, certified mail, return receipt 168.36 requested, ordinary first class mail, or by publishing it once 169.1 in a newspaper of general circulation in the county in which any 169.2 part of the property is located. Service of the notice shall be 169.3 complete upon mailing or publication. 169.4 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 169.5 and applies to estates of decedents who die on and after that 169.6 date. 169.7 Sec. 31. Minnesota Statutes 2002, section 256B.15, is 169.8 amended by adding a subdivision to read: 169.9 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 169.10 OTHER SURVIVORS.] For purposes of this subdivision, the 169.11 provisions in subdivision 1i, paragraphs (a) to (c) apply. 169.12 (a) If payment of a claim filed under this section is 169.13 limited as provided in subdivision 4, and if the estate does not 169.14 have other assets sufficient to pay the claim in full, as 169.15 allowed, the personal representative or the court shall make, 169.16 execute, and deliver a lien on the property in the estate that 169.17 is exempt from the claim under subdivision 4 in favor of the 169.18 commissioner of human services on forms provided by the 169.19 commissioner to the county agency filing the claim. If the 169.20 estate pays a claim filed under this section in full from other 169.21 assets of the estate, no lien shall be filed against the 169.22 property described in subdivision 4. 169.23 (b) The lien shall be in an amount equal to the unpaid 169.24 balance of the allowed claim under this section remaining after 169.25 the estate has applied all other available assets of the estate 169.26 to pay the claim. The property exempt under subdivision 4 shall 169.27 not be sold, assigned, transferred, conveyed, encumbered, or 169.28 distributed until after the personal representative has 169.29 determined the estate has other assets sufficient to pay the 169.30 allowed claim in full, or until after the lien has been filed or 169.31 recorded. The lien shall bear interest as provided under 169.32 section 524.3-806, shall attach to the property it describes 169.33 upon filing or recording, and shall remain a lien on the real 169.34 property it describes for a period of 20 years from the date it 169.35 is filed or recorded. The lien shall be a disposition of the 169.36 claim sufficient to permit the estate to close. 170.1 (c) The state or county agency shall file or record the 170.2 lien in the office of the county recorder or registrar of titles 170.3 in each county in which any of the real property is located. 170.4 The department shall pay the filing fees. The lien need not be 170.5 attested, certified, or acknowledged as a condition of recording 170.6 or filing. The recorder or registrar of titles shall accept the 170.7 lien for filing or recording. 170.8 (d) The commissioner shall make no adjustment or recovery 170.9 under the lien until none of the persons listed in subdivision 4 170.10 are residing on the property or until the property is sold or 170.11 transferred. The estate or any owner of an interest in the 170.12 property that is or may be subject to the lien, or any other 170.13 interested party, may voluntarily pay off, settle, or otherwise 170.14 satisfy the claim secured or to be secured by the lien at any 170.15 time before or after the lien is filed or recorded. The 170.16 payoffs, settlements, and satisfactions shall be deemed to be 170.17 voluntary repayments of past medical assistance payments for the 170.18 benefit of the deceased recipient and neither the process of 170.19 settling the claim, the payment of the claim, or acceptance of a 170.20 payment shall constitute an adjustment or recovery that is 170.21 prohibited under this subdivision. 170.22 (e) A lien under this subdivision may be enforced or 170.23 foreclosed in the manner provided for by law for the enforcement 170.24 of judgment liens against real estate or by a foreclosure by 170.25 action under chapter 581. When the lien has been paid, 170.26 satisfied, or otherwise discharged, the claimant shall prepare 170.27 and file a release of lien at the claimant's expense. No action 170.28 to foreclose the lien shall be commenced unless the lien holder 170.29 has first given 30 days prior written notice to pay the lien to 170.30 the record owners of the property and the parties in possession 170.31 of the property subject to the lien. The notice shall: (1) 170.32 include the name, address, and telephone number of the lien 170.33 holder; (2) describe the lien; (3) give the amount of the lien; 170.34 (4) inform the owner or party in possession that payment of the 170.35 lien in full must be made to the lien holder within 30 days 170.36 after service of the notice or the lien holder may begin 171.1 proceedings to foreclose the lien; and (5) be served by personal 171.2 service, certified mail, return receipt requested, ordinary 171.3 first class mail, or by publishing it once in a newspaper of 171.4 general circulation in the county in which any part of the 171.5 property is located. Service shall be complete upon mailing or 171.6 publication. 171.7 (f) Upon filing or recording of a lien against a life 171.8 estate or joint tenancy interest under this subdivision, the 171.9 interest subject to the lien shall merge into the remainder 171.10 interest or the interest the decedent and others owned jointly, 171.11 effective on the date of recording and filing. The lien shall 171.12 attach to and run with the property to the extent of the 171.13 decedent's interest in the property at the time of the 171.14 decedent's death as determined under this section. 171.15 (g)(1) An affidavit may be provided by a personal 171.16 representative stating the personal representative has 171.17 determined in good faith that a decedent survived by a spouse or 171.18 a person listed in subdivision 3, or by a person listed in 171.19 subdivision 4, or the decedent's predeceased spouse did not 171.20 receive any medical assistance giving rise to a claim under this 171.21 section, or that the real property described in subdivision 4 is 171.22 not needed to pay in full a claim arising under this section. 171.23 (2) The affidavit shall: (i) describe the property and the 171.24 interest being extinguished; (ii) name the decedent and give the 171.25 date of death; (iii) state the facts listed in clause (1); (iv) 171.26 state that the affidavit is being filed to terminate the life 171.27 estate or joint tenancy interest created under this subdivision; 171.28 (v) be signed by the personal representative; and (vi) contain 171.29 any other information that the affiant deems appropriate. 171.30 (3) Except as provided in section 514.981, subdivision 6, 171.31 when the affidavit is filed or recorded, the life estate or 171.32 joint tenancy interest in real property that the affidavit 171.33 describes shall be terminated effective as of the date of filing 171.34 or recording. The termination shall be final and may not be set 171.35 aside for any reason. 171.36 [EFFECTIVE DATE.] This section takes effect on August 1, 172.1 2003, and applies to the estates of decedents who die on or 172.2 after that date. 172.3 Sec. 32. Minnesota Statutes 2002, section 256B.15, is 172.4 amended by adding a subdivision to read: 172.5 Subd. 1k. [FILING.] Any notice, lien, release, or other 172.6 document filed under subdivisions 1c to 1l, and any lien, 172.7 release of lien, or other documents relating to a lien filed 172.8 under subdivisions 1h and 1i must be filed or recorded in the 172.9 office of the county recorder or registrar of titles, as 172.10 appropriate, in the county where the affected real property is 172.11 located. Notwithstanding section 386.77, the state or county 172.12 agency shall pay any applicable filing fee. An attestation, 172.13 certification, or acknowledgment is not required as a condition 172.14 of filing. If the property described in the filing is 172.15 registered property, the registrar of titles shall record the 172.16 filing on the certificate of title for each parcel of property 172.17 described in the filing. If the property described in the 172.18 filing is abstract property, the recorder shall file and index 172.19 the property in the county's grantor-grantee indexes and any 172.20 tract indexes the county maintains for each parcel of property 172.21 described in the filing. The recorder or registrar of titles 172.22 shall return the filed document to the party filing it at no 172.23 cost. If the party making the filing provides a duplicate copy 172.24 of the filing, the recorder or registrar of titles shall show 172.25 the recording or filing data on the copy and return it to the 172.26 party at no extra cost. 172.27 [EFFECTIVE DATE.] This section takes effect on August 1, 172.28 2003, and applies to the estates of decedents who die on or 172.29 after that date. 172.30 Sec. 33. Minnesota Statutes 2002, section 256B.15, 172.31 subdivision 3, is amended to read: 172.32 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 172.33 CHILDREN.] If a decedentwhois survived by a spouse, or was 172.34 single,orwho wasthe surviving spouse of a married couple,and 172.35 is survived by a child who is under age 21 or blind or 172.36 permanently and totally disabled according to the supplemental 173.1 security income program criteria,noa claim shall be filed 173.2 against the estate according to this section. 173.3 [EFFECTIVE DATE.] This section is effective August 1, 2003, 173.4 and applies to decedents who die on or after that date. 173.5 Sec. 34. Minnesota Statutes 2002, section 256B.15, 173.6 subdivision 4, is amended to read: 173.7 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 173.8 or the surviving spouse of a married couple is survived by one 173.9 of the following persons, a claim exists against the estate in 173.10 an amount not to exceed the value of the nonhomestead property 173.11 included in the estate and the personal representative shall 173.12 make, execute, and deliver to the county agency a lien against 173.13 the homestead property in the estate for any unpaid balance of 173.14 the claim to the claimant as provided under this section: 173.15 (a) a sibling who resided in the decedent medical 173.16 assistance recipient's home at least one year before the 173.17 decedent's institutionalization and continuously since the date 173.18 of institutionalization; or 173.19 (b) a son or daughter or a grandchild who resided in the 173.20 decedent medical assistance recipient's home for at least two 173.21 years immediately before the parent's or grandparent's 173.22 institutionalization and continuously since the date of 173.23 institutionalization, and who establishes by a preponderance of 173.24 the evidence having provided care to the parent or grandparent 173.25 who received medical assistance, that the care was provided 173.26 before institutionalization, and that the care permitted the 173.27 parent or grandparent to reside at home rather than in an 173.28 institution. 173.29 [EFFECTIVE DATE.] This section is effective August 1, 2003, 173.30 and applies to decedents who die on or after that date. 173.31 Sec. 35. Minnesota Statutes 2002, section 256B.195, 173.32 subdivision 4, is amended to read: 173.33 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 173.34 adjust the intergovernmental transfers under subdivision 2 and 173.35 the payments under subdivision 3,and payments and transfers173.36under subdivision 5,based on the commissioner's determination 174.1 of Medicare upper payment limits, hospital-specific charge 174.2 limits, and hospital-specific limitations on disproportionate 174.3 share payments. Any adjustments must be made on a proportional 174.4 basis. If participation by a particular hospital under this 174.5 section is limited, the commissioner shall adjust the payments 174.6 that relate to that hospital under subdivisions 2,and 3, and 5174.7 on a proportional basis in order to allow the hospital to 174.8 participate under this section to the fullest extent possible 174.9 and shall increase other payments under subdivisions 2,and 3,174.10and 5to the extent allowable to maintain the overall level of 174.11 payments under this section. The commissioner may make 174.12 adjustments under this subdivision only after consultation with 174.13 the counties and hospitals identified in subdivisions 2 and 3,174.14and, if subdivision 5 receives federal approval, with the174.15hospital and educational institution identified in subdivision 5. 174.16 (b) The ratio of medical assistance payments specified in 174.17 subdivision 3 to the intergovernmental transfers specified in 174.18 subdivision 2 shall not be reduced except as provided under 174.19 paragraph (a). 174.20 (c) The increase in intergovernmental transfers and 174.21 payments that result from section 256.969, subdivision 3a, 174.22 paragraph (c), shall be paid to the general fund. 174.23 Sec. 36. Minnesota Statutes 2002, section 256B.32, 174.24 subdivision 1, is amended to read: 174.25 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 174.26 commissioner shall establish a facility fee payment mechanism 174.27 that will pay a facility fee to all enrolled outpatient 174.28 hospitals for each emergency room or outpatient clinic visit 174.29 provided on or after July 1, 1989. This payment mechanism may 174.30 not result in an overall increase in outpatient payment rates. 174.31 This section does not apply to federally mandated maximum 174.32 payment limits, department approved program packages, or 174.33 services billed using a nonoutpatient hospital provider number. 174.34 (b) For fee-for-service services provided on or after July 174.35 1, 2002, the total payment, before third-party liability and 174.36 spenddown, made to hospitals for outpatient hospital facility 175.1 services is reduced by .5 percent from the current statutory 175.2 rates. 175.3 (c) In addition to the reduction in paragraph (b), the 175.4 total payment for fee-for-service services provided on or after 175.5 July 1, 2003, made to hospitals for outpatient hospital facility 175.6 services before third-party liability and spenddown, is reduced 175.7 five percent from the current statutory rates. Facilities 175.8 defined under section 256.969, subdivision 16, are excluded from 175.9 this paragraph. 175.10 Sec. 37. Minnesota Statutes 2002, section 256B.69, 175.11 subdivision 2, is amended to read: 175.12 Subd. 2. [DEFINITIONS.] For the purposes of this section, 175.13 the following terms have the meanings given. 175.14 (a) "Commissioner" means the commissioner of human services. 175.15 For the remainder of this section, the commissioner's 175.16 responsibilities for methods and policies for implementing the 175.17 project will be proposed by the project advisory committees and 175.18 approved by the commissioner. 175.19 (b) "Demonstration provider" means a health maintenance 175.20 organization, community integrated service network, or 175.21 accountable provider network authorized and operating under 175.22 chapter 62D, 62N, or 62T that participates in the demonstration 175.23 project according to criteria, standards, methods, and other 175.24 requirements established for the project and approved by the 175.25 commissioner. For purposes of this section, a county board, or 175.26 group of county boards operating under a joint powers agreement, 175.27 is considered a demonstration provider if the county or group of 175.28 county boards meets the requirements of section 256B.692. 175.29 Notwithstanding the above, Itasca county may continue to 175.30 participate as a demonstration provider until July 1, 2004. 175.31 (c) "Eligible individuals" means those persons eligible for 175.32 medical assistance benefits as defined in sections 256B.055, 175.33 256B.056, and 256B.06. 175.34 (d) "Limitation of choice" means suspending freedom of 175.35 choice while allowing eligible individuals to choose among the 175.36 demonstration providers. 176.1(e) This paragraph supersedes paragraph (c) as long as the176.2Minnesota health care reform waiver remains in effect. When the176.3waiver expires, this paragraph expires and the commissioner of176.4human services shall publish a notice in the State Register and176.5notify the revisor of statutes. "Eligible individuals" means176.6those persons eligible for medical assistance benefits as176.7defined in sections 256B.055, 256B.056, and 256B.06.176.8Notwithstanding sections 256B.055, 256B.056, and 256B.06, an176.9individual who becomes ineligible for the program because of176.10failure to submit income reports or recertification forms in a176.11timely manner, shall remain enrolled in the prepaid health plan176.12and shall remain eligible to receive medical assistance coverage176.13through the last day of the month following the month in which176.14the enrollee became ineligible for the medical assistance176.15program.176.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 176.17 Sec. 38. Minnesota Statutes 2002, section 256B.69, 176.18 subdivision 4, is amended to read: 176.19 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 176.20 shall develop criteria to determine when limitation of choice 176.21 may be implemented in the experimental counties. The criteria 176.22 shall ensure that all eligible individuals in the county have 176.23 continuing access to the full range of medical assistance 176.24 services as specified in subdivision 6. 176.25 (b) The commissioner shall exempt the following persons 176.26 from participation in the project, in addition to those who do 176.27 not meet the criteria for limitation of choice: 176.28 (1) persons eligible for medical assistance according to 176.29 section 256B.055, subdivision 1; 176.30 (2) persons eligible for medical assistance due to 176.31 blindness or disability as determined by the social security 176.32 administration or the state medical review team, unless: 176.33 (i) they are 65 years of age or older; or 176.34 (ii) they reside in Itasca county or they reside in a 176.35 county in which the commissioner conducts a pilot project under 176.36 a waiver granted pursuant to section 1115 of the Social Security 177.1 Act; 177.2 (3) recipients who currently have private coverage through 177.3 a health maintenance organization; 177.4 (4) recipients who are eligible for medical assistance by 177.5 spending down excess income for medical expenses other than the 177.6 nursing facility per diem expense; 177.7 (5) recipients who receive benefits under the Refugee 177.8 Assistance Program, established under United States Code, title 177.9 8, section 1522(e); 177.10 (6) children who are both determined to be severely 177.11 emotionally disturbed and receiving case management services 177.12 according to section 256B.0625, subdivision 20; 177.13 (7) adults who are both determined to be seriously and 177.14 persistently mentally ill and received case management services 177.15 according to section 256B.0625, subdivision 20;and177.16 (8) persons eligible for medical assistance according to 177.17 section 256B.057, subdivision 10; and 177.18 (9) persons with access to cost-effective 177.19 employer-sponsored private health insurance or persons enrolled 177.20 in an individual health plan determined to be cost-effective 177.21 according to section 256B.0625, subdivision 15. 177.22 Children under age 21 who are in foster placement may enroll in 177.23 the project on an elective basis. Individuals excluded under 177.24 clauses (6) and (7) may choose to enroll on an elective basis. 177.25 (c) The commissioner may allow persons with a one-month 177.26 spenddown who are otherwise eligible to enroll to voluntarily 177.27 enroll or remain enrolled, if they elect to prepay their monthly 177.28 spenddown to the state. 177.29 (d) The commissioner may require those individuals to 177.30 enroll in the prepaid medical assistance program who otherwise 177.31 would have been excluded under paragraph (b), clauses (1), (3), 177.32 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 177.33 items H, K, and L. 177.34 (e) Before limitation of choice is implemented, eligible 177.35 individuals shall be notified and after notification, shall be 177.36 allowed to choose only among demonstration providers. The 178.1 commissioner may assign an individual with private coverage 178.2 through a health maintenance organization, to the same health 178.3 maintenance organization for medical assistance coverage, if the 178.4 health maintenance organization is under contract for medical 178.5 assistance in the individual's county of residence. After 178.6 initially choosing a provider, the recipient is allowed to 178.7 change that choice only at specified times as allowed by the 178.8 commissioner. If a demonstration provider ends participation in 178.9 the project for any reason, a recipient enrolled with that 178.10 provider must select a new provider but may change providers 178.11 without cause once more within the first 60 days after 178.12 enrollment with the second provider. 178.13 Sec. 39. Minnesota Statutes 2002, section 256B.69, 178.14 subdivision 5c, is amended to read: 178.15 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 178.16 commissioner of human services shall transfer each year to the 178.17 medical education and research fund established under section 178.18 62J.692, the following: 178.19 (1) an amount equal to the reduction in the prepaid medical 178.20 assistance and prepaid general assistance medical care payments 178.21 as specified in this clause. Until January 1, 2002, the county 178.22 medical assistance and general assistance medical care 178.23 capitation base rate prior to plan specific adjustments and 178.24 after the regional rate adjustments under section 256B.69, 178.25 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 178.26 percent for the remaining metropolitan counties, and no 178.27 reduction for nonmetropolitan Minnesota counties; and after 178.28 January 1, 2002, the county medical assistance and general 178.29 assistance medical care capitation base rate prior to plan 178.30 specific adjustments is reduced 6.3 percent for Hennepin county, 178.31 two percent for the remaining metropolitan counties, and 1.6 178.32 percent for nonmetropolitan Minnesota counties. Nursing 178.33 facility and elderly waiver payments and demonstration project 178.34 payments operating under subdivision 23 are excluded from this 178.35 reduction. The amount calculated under this clause shall not be 178.36 adjusted for periods already paid due to subsequent changes to 179.1 the capitation payments; 179.2 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 179.3 from the capitation rates paid under this section plus any 179.4 federal matching funds on this amount; 179.5 (3) beginning July 1, 2002, an additional $12,700,000 from 179.6 the capitation rates paid under this section; and 179.7 (4) beginning July 1, 2003, an additional $4,700,000 from 179.8 the capitation rates paid under this section. 179.9 (b) This subdivision shall be effective upon approval of a 179.10 federal waiver which allows federal financial participation in 179.11 the medical education and research fund. 179.12 (c) Effective July 1, 2003, the amount from general 179.13 assistance medical care under paragraph (a), clause (1), shall 179.14 be transferred to the general fund. 179.15 Sec. 40. Minnesota Statutes 2002, section 256B.69, is 179.16 amended by adding a subdivision to read: 179.17 Subd. 5h. [PAYMENT REDUCTION.] In addition to the 179.18 reduction in subdivision 5g, the total payment made to managed 179.19 care plans under the medical assistance program is reduced one 179.20 percent for services provided on or after October 1, 2003, and 179.21 an additional one percent for services provided on or after 179.22 January 1, 2004. This provision excludes payments for nursing 179.23 home services, home and community-based waivers, and payments to 179.24 demonstration projects for persons with disabilities. 179.25 Sec. 41. Minnesota Statutes 2002, section 256B.75, is 179.26 amended to read: 179.27 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 179.28 (a) For outpatient hospital facility fee payments for 179.29 services rendered on or after October 1, 1992, the commissioner 179.30 of human services shall pay the lower of (1) submitted charge, 179.31 or (2) 32 percent above the rate in effect on June 30, 1992, 179.32 except for those services for which there is a federal maximum 179.33 allowable payment. Effective for services rendered on or after 179.34 January 1, 2000, payment rates for nonsurgical outpatient 179.35 hospital facility fees and emergency room facility fees shall be 179.36 increased by eight percent over the rates in effect on December 180.1 31, 1999, except for those services for which there is a federal 180.2 maximum allowable payment. Services for which there is a 180.3 federal maximum allowable payment shall be paid at the lower of 180.4 (1) submitted charge, or (2) the federal maximum allowable 180.5 payment. Total aggregate payment for outpatient hospital 180.6 facility fee services shall not exceed the Medicare upper 180.7 limit. If it is determined that a provision of this section 180.8 conflicts with existing or future requirements of the United 180.9 States government with respect to federal financial 180.10 participation in medical assistance, the federal requirements 180.11 prevail. The commissioner may, in the aggregate, prospectively 180.12 reduce payment rates to avoid reduced federal financial 180.13 participation resulting from rates that are in excess of the 180.14 Medicare upper limitations. 180.15 (b) Notwithstanding paragraph (a), payment for outpatient, 180.16 emergency, and ambulatory surgery hospital facility fee services 180.17 for critical access hospitals designated under section 144.1483, 180.18 clause (11), shall be paid on a cost-based payment system that 180.19 is based on the cost-finding methods and allowable costs of the 180.20 Medicare program. 180.21 (c) Effective for services provided on or after July 1, 180.22 2003, rates that are based on the Medicare outpatient 180.23 prospective payment system shall be replaced by a budget neutral 180.24 prospective payment system that is derived using medical 180.25 assistance data. The commissioner shall provide a proposal to 180.26 the 2003 legislature to define and implement this provision. 180.27 (d) For fee-for-service services provided on or after July 180.28 1, 2002, the total payment, before third-party liability and 180.29 spenddown, made to hospitals for outpatient hospital facility 180.30 services is reduced by .5 percent from the current statutory 180.31 rate. 180.32 (e) In addition to the reduction in paragraph (d), the 180.33 total payment for fee-for-service services provided on or after 180.34 July 1, 2003, made to hospitals for outpatient hospital facility 180.35 services before third-party liability and spenddown, is reduced 180.36 five percent from the current statutory rates. Facilities 181.1 defined under section 256.969, subdivision 16, are excluded from 181.2 this paragraph. 181.3 Sec. 42. Minnesota Statutes 2002, section 256B.76, is 181.4 amended to read: 181.5 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 181.6 (a) Effective for services rendered on or after October 1, 181.7 1992, the commissioner shall make payments for physician 181.8 services as follows: 181.9 (1) payment for level one Centers for Medicare and Medicaid 181.10 Services' common procedural coding system codes titled "office 181.11 and other outpatient services," "preventive medicine new and 181.12 established patient," "delivery, antepartum, and postpartum 181.13 care," "critical care," cesarean delivery and pharmacologic 181.14 management provided to psychiatric patients, and level three 181.15 codes for enhanced services for prenatal high risk, shall be 181.16 paid at the lower of (i) submitted charges, or (ii) 25 percent 181.17 above the rate in effect on June 30, 1992. If the rate on any 181.18 procedure code within these categories is different than the 181.19 rate that would have been paid under the methodology in section 181.20 256B.74, subdivision 2, then the larger rate shall be paid; 181.21 (2) payments for all other services shall be paid at the 181.22 lower of (i) submitted charges, or (ii) 15.4 percent above the 181.23 rate in effect on June 30, 1992; 181.24 (3) all physician rates shall be converted from the 50th 181.25 percentile of 1982 to the 50th percentile of 1989, less the 181.26 percent in aggregate necessary to equal the above increases 181.27 except that payment rates for home health agency services shall 181.28 be the rates in effect on September 30, 1992; 181.29 (4) effective for services rendered on or after January 1, 181.30 2000, payment rates for physician and professional services 181.31 shall be increased by three percent over the rates in effect on 181.32 December 31, 1999, except for home health agency and family 181.33 planning agency services; and 181.34 (5) the increases in clause (4) shall be implemented 181.35 January 1, 2000, for managed care. 181.36 (b) Effective for services rendered on or after October 1, 182.1 1992, the commissioner shall make payments for dental services 182.2 as follows: 182.3 (1) dental services shall be paid at the lower of (i) 182.4 submitted charges, or (ii) 25 percent above the rate in effect 182.5 on June 30, 1992; 182.6 (2) dental rates shall be converted from the 50th 182.7 percentile of 1982 to the 50th percentile of 1989, less the 182.8 percent in aggregate necessary to equal the above increases; 182.9 (3) effective for services rendered on or after January 1, 182.10 2000, payment rates for dental services shall be increased by 182.11 three percent over the rates in effect on December 31, 1999; 182.12 (4) the commissioner shall award grants to community 182.13 clinics or other nonprofit community organizations, political 182.14 subdivisions, professional associations, or other organizations 182.15 that demonstrate the ability to provide dental services 182.16 effectively to public program recipients. Grants may be used to 182.17 fund the costs related to coordinating access for recipients, 182.18 developing and implementing patient care criteria, upgrading or 182.19 establishing new facilities, acquiring furnishings or equipment, 182.20 recruiting new providers, or other development costs that will 182.21 improve access to dental care in a region. In awarding grants, 182.22 the commissioner shall give priority to applicants that plan to 182.23 serve areas of the state in which the number of dental providers 182.24 is not currently sufficient to meet the needs of recipients of 182.25 public programs or uninsured individuals. The commissioner 182.26 shall consider the following in awarding the grants: 182.27 (i) potential to successfully increase access to an 182.28 underserved population; 182.29 (ii) the ability to raise matching funds; 182.30 (iii) the long-term viability of the project to improve 182.31 access beyond the period of initial funding; 182.32 (iv) the efficiency in the use of the funding; and 182.33 (v) the experience of the proposers in providing services 182.34 to the target population. 182.35 The commissioner shall monitor the grants and may terminate 182.36 a grant if the grantee does not increase dental access for 183.1 public program recipients. The commissioner shall consider 183.2 grants for the following: 183.3 (i) implementation of new programs or continued expansion 183.4 of current access programs that have demonstrated success in 183.5 providing dental services in underserved areas; 183.6 (ii) a pilot program for utilizing hygienists outside of a 183.7 traditional dental office to provide dental hygiene services; 183.8 and 183.9 (iii) a program that organizes a network of volunteer 183.10 dentists, establishes a system to refer eligible individuals to 183.11 volunteer dentists, and through that network provides donated 183.12 dental care services to public program recipients or uninsured 183.13 individuals; 183.14 (5) beginning October 1, 1999, the payment for tooth 183.15 sealants and fluoride treatments shall be the lower of (i) 183.16 submitted charge, or (ii) 80 percent of median 1997 charges; 183.17 (6) the increases listed in clauses (3) and (5) shall be 183.18 implemented January 1, 2000, for managed care; and 183.19 (7) effective for services provided on or after January 1, 183.20 2002, payment for diagnostic examinations and dental x-rays 183.21 provided to children under age 21 shall be the lower of (i) the 183.22 submitted charge, or (ii) 85 percent of median 1999 charges. 183.23 (c) Effective for dental services rendered on or after 183.24 January 1, 2002, the commissioner may, within the limits of 183.25 available appropriation, increase reimbursements to dentists and 183.26 dental clinics deemed by the commissioner to be critical access 183.27 dental providers. Reimbursement to a critical access dental 183.28 provider may be increased by not more than 50 percent above the 183.29 reimbursement rate that would otherwise be paid to the 183.30 provider. Payments to health plan companies shall be adjusted 183.31 to reflect increased reimbursements to critical access dental 183.32 providers as approved by the commissioner. In determining which 183.33 dentists and dental clinics shall be deemed critical access 183.34 dental providers, the commissioner shall review: 183.35 (1) the utilization rate in the service area in which the 183.36 dentist or dental clinic operates for dental services to 184.1 patients covered by medical assistance, general assistance 184.2 medical care, or MinnesotaCare as their primary source of 184.3 coverage; 184.4 (2) the level of services provided by the dentist or dental 184.5 clinic to patients covered by medical assistance, general 184.6 assistance medical care, or MinnesotaCare as their primary 184.7 source of coverage; and 184.8 (3) whether the level of services provided by the dentist 184.9 or dental clinic is critical to maintaining adequate levels of 184.10 patient access within the service area. 184.11 In the absence of a critical access dental provider in a service 184.12 area, the commissioner may designate a dentist or dental clinic 184.13 as a critical access dental provider if the dentist or dental 184.14 clinic is willing to provide care to patients covered by medical 184.15 assistance, general assistance medical care, or MinnesotaCare at 184.16 a level which significantly increases access to dental care in 184.17 the service area. 184.18 (d) Effective July 1, 2001, the medical assistance rates 184.19 for outpatient mental health services provided by an entity that 184.20 operates: 184.21 (1) a Medicare-certified comprehensive outpatient 184.22 rehabilitation facility; and 184.23 (2) a facility that was certified prior to January 1, 1993, 184.24 with at least 33 percent of the clients receiving rehabilitation 184.25 services in the most recent calendar year who are medical 184.26 assistance recipients, will be increased by 38 percent, when 184.27 those services are provided within the comprehensive outpatient 184.28 rehabilitation facility and provided to residents of nursing 184.29 facilities owned by the entity. 184.30 (e) An entity that operates both a Medicare certified 184.31 comprehensive outpatient rehabilitation facility and a facility 184.32 which was certified prior to January 1, 1993, that is licensed 184.33 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 184.34 whom at least 33 percent of the clients receiving rehabilitation 184.35 services in the most recent calendar year are medical assistance 184.36 recipients, shall be reimbursed by the commissioner for 185.1 rehabilitation services at rates that are 38 percent greater 185.2 than the maximum reimbursement rate allowed under paragraph (a), 185.3 clause (2), when those services are (1) provided within the 185.4 comprehensive outpatient rehabilitation facility and (2) 185.5 provided to residents of nursing facilities owned by the entity. 185.6 (f) Effective for services rendered on or after January 1, 185.7 2007, the commissioner shall make payments for physician and 185.8 professional services based on the Medicare relative value units 185.9 (RVUs). This change shall be budget neutral and the cost of 185.10 implementing RVUs will be incorporated in the established 185.11 conversion factor. 185.12 Sec. 43. Minnesota Statutes 2002, section 256D.03, 185.13 subdivision 3, is amended to read: 185.14 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 185.15 (a) General assistance medical care may be paid for any person 185.16 who is not eligible for medical assistance under chapter 256B, 185.17 including eligibility for medical assistance based on a 185.18 spenddown of excess income according to section 256B.056, 185.19 subdivision 5, or MinnesotaCare as defined in paragraph (b), 185.20 except as provided in paragraph (c);, and: 185.21 (1)who is receiving assistance under section 256D.05,185.22except for families with children who are eligible under185.23Minnesota family investment program (MFIP), who is having a185.24payment made on the person's behalf under sections 256I.01 to185.25256I.06, or who resides in group residential housing as defined185.26in chapter 256I and can meet a spenddown using the cost of185.27remedial services received through group residential housing; or185.28(2)(i)who is a resident of Minnesota; and whose equity in 185.29 assets is not in excess of$1,000 per assistance unitthe limits 185.30 in section 256B.056, subdivision 3c. Exempt assets, the185.31reduction of excess assets, and the waiver of excess assets must185.32conform to the medical assistance program in chapter 256B, with185.33the following exception: the maximum amount of undistributed185.34funds in a trust that could be distributed to or on behalf of185.35the beneficiary by the trustee, assuming the full exercise of185.36the trustee's discretion under the terms of the trust, must be186.1applied toward the asset maximum; and 186.2(ii)(2) who has gross countable income not in excess of 186.3the assistance standards established in section 256B.056,186.4subdivision 5c, paragraph (b), or whose excess income is spent186.5down to that standard using a six-month budget period. The186.6method for calculating earned income disregards and deductions186.7for a person who resides with a dependent child under age 21186.8shall follow the AFDC income disregard and deductions in effect186.9under the July 16, 1996, AFDC state plan. The earned income and186.10work expense deductions for a person who does not reside with a186.11dependent child under age 21 shall be the same as the method186.12used to determine eligibility for a person under section186.13256D.06, subdivision 1, except the disregard of the first $50 of186.14earned income is not allowed;186.15(3) who would be eligible for medical assistance except186.16that the person resides in a facility that is determined by the186.17commissioner or the federal Centers for Medicare and Medicaid186.18Services to be an institution for mental diseases; or186.19(4) who is ineligible for medical assistance under chapter186.20256B or general assistance medical care under any other186.21provision of this section, and is receiving care and186.22rehabilitation services from a nonprofit center established to186.23serve victims of torture. These individuals are eligible for186.24general assistance medical care only for the period during which186.25they are receiving services from the center. During this period186.26of eligibility, individuals eligible under this clause shall not186.27be required to participate in prepaid general assistance medical186.28care75 percent of the federal poverty guidelines for the family 186.29 size in effect on October 1, 2003. 186.30 (b) Beginning January 1, 2000, applicants or recipients who 186.31 meet all eligibility requirements of MinnesotaCare as defined in 186.32 sections 256L.01 to 256L.16, and are: 186.33 (i) adults with dependent children under 21 whose gross 186.34 family income is equal to or less than 275 percent of the 186.35 federal poverty guidelines; or 186.36 (ii) adults without children with earned income and whose 187.1 family gross income isbetweenequal to or less than 75 percent 187.2 of the federal poverty guidelinesand the amount set by section187.3256L.04, subdivision 7in effect on October 1, 2003, shall be 187.4 terminated from general assistance medical care upon enrollment 187.5 in MinnesotaCare. Earned income is deemed available to family 187.6 members as defined in section 256D.02, subdivision 8. 187.7 (c) Forservices rendered on or after July 1, 1997,187.8eligibility is limited to one month prior to application if the187.9person is determined eligible in the prior monthapplications 187.10 received on or after October 1, 2003, eligibility may begin no 187.11 earlier than the date of application. A redetermination of 187.12 eligibility must occur every 12 months. Beginning January 1, 187.13 2000, Minnesota health care program applications completed by 187.14 recipients and applicants who are persons described in paragraph 187.15 (b), may be returned to the county agency to be forwarded to the 187.16 department of human services or sent directly to the department 187.17 of human services for enrollment in MinnesotaCare. If all other 187.18 eligibility requirements of this subdivision are met, 187.19 eligibility for general assistance medical care shall be 187.20 available in any month during which a MinnesotaCare eligibility 187.21 determination and enrollment are pending. Upon notification of 187.22 eligibility for MinnesotaCare, notice of termination for 187.23 eligibility for general assistance medical care shall be sent to 187.24 an applicant or recipient. If all other eligibility 187.25 requirements of this subdivision are met, eligibility for 187.26 general assistance medical care shall be available until 187.27 enrollment in MinnesotaCare subject to the provisions of 187.28 paragraph (e). 187.29 (d) The date of an initial Minnesota health care program 187.30 application necessary to begin a determination of eligibility 187.31 shall be the date the applicant has provided a name, address, 187.32 and social security number, signed and dated, to the county 187.33 agency or the department of human services. If the applicant is 187.34 unable to provide an initial application when health care is 187.35 delivered due to a medical condition or disability, a health 187.36 care provider may act on the person's behalf to complete the 188.1 initial application. The applicant must complete the remainder 188.2 of the application and provide necessary verification before 188.3 eligibility can be determined. The county agency must assist 188.4 the applicant in obtaining verification if necessary.On the188.5basis of information provided on the completed application, an188.6applicant who meets the following criteria shall be determined188.7eligible beginning in the month of application:188.8(1) has gross income less than 90 percent of the applicable188.9income standard;188.10(2) has liquid assets that total within $300 of the asset188.11standard;188.12(3) does not reside in a long-term care facility; and188.13(4) meets all other eligibility requirements.188.14The applicant must provide all required verifications within 30188.15days' notice of the eligibility determination or eligibility188.16shall be terminated.188.17 (e) County agencies are authorized to use all automated 188.18 databases containing information regarding recipients' or 188.19 applicants' income in order to determine eligibility for general 188.20 assistance medical care or MinnesotaCare. Such use shall be 188.21 considered sufficient in order to determine eligibility and 188.22 premium payments by the county agency. 188.23 (f) General assistance medical care is not available for a 188.24 person in a correctional facility unless the person is detained 188.25 by law for less than one year in a county correctional or 188.26 detention facility as a person accused or convicted of a crime, 188.27 or admitted as an inpatient to a hospital on a criminal hold 188.28 order, and the person is a recipient of general assistance 188.29 medical care at the time the person is detained by law or 188.30 admitted on a criminal hold order and as long as the person 188.31 continues to meet other eligibility requirements of this 188.32 subdivision. 188.33 (g) General assistance medical care is not available for 188.34 applicants or recipients who do not cooperate with the county 188.35 agency to meet the requirements of medical assistance.General188.36assistance medical care is limited to payment of emergency189.1services only for applicants or recipients as described in189.2paragraph (b), whose MinnesotaCare coverage is denied or189.3terminated for nonpayment of premiums as required by sections189.4256L.06 and 256L.07.189.5 (h) In determining the amount of assets of an individual, 189.6 there shall be included any asset or interest in an asset, 189.7 including an asset excluded under paragraph (a), that was given 189.8 away, sold, or disposed of for less than fair market value 189.9 within the 60 months preceding application for general 189.10 assistance medical care or during the period of eligibility. 189.11 Any transfer described in this paragraph shall be presumed to 189.12 have been for the purpose of establishing eligibility for 189.13 general assistance medical care, unless the individual furnishes 189.14 convincing evidence to establish that the transaction was 189.15 exclusively for another purpose. For purposes of this 189.16 paragraph, the value of the asset or interest shall be the fair 189.17 market value at the time it was given away, sold, or disposed 189.18 of, less the amount of compensation received. For any 189.19 uncompensated transfer, the number of months of ineligibility, 189.20 including partial months, shall be calculated by dividing the 189.21 uncompensated transfer amount by the average monthly per person 189.22 payment made by the medical assistance program to skilled 189.23 nursing facilities for the previous calendar year. The 189.24 individual shall remain ineligible until this fixed period has 189.25 expired. The period of ineligibility may exceed 30 months, and 189.26 a reapplication for benefits after 30 months from the date of 189.27 the transfer shall not result in eligibility unless and until 189.28 the period of ineligibility has expired. The period of 189.29 ineligibility begins in the month the transfer was reported to 189.30 the county agency, or if the transfer was not reported, the 189.31 month in which the county agency discovered the transfer, 189.32 whichever comes first. For applicants, the period of 189.33 ineligibility begins on the date of the first approved 189.34 application. 189.35 (i) When determining eligibility for any state benefits 189.36 under this subdivision, the income and resources of all 190.1 noncitizens shall be deemed to include their sponsor's income 190.2 and resources as defined in the Personal Responsibility and Work 190.3 Opportunity Reconciliation Act of 1996, title IV, Public Law 190.4 Number 104-193, sections 421 and 422, and subsequently set out 190.5 in federal rules. 190.6 (j)(1) AnUndocumentednoncitizen or a nonimmigrant190.7isnoncitizens and nonimmigrants are ineligible for general 190.8 assistance medical careother than emergency services, except 190.9 for an individual eligible under paragraph (a), clause (2). For 190.10 purposes of this subdivision, a nonimmigrant is an individual in 190.11 one or more of the classes listed in United States Code, title 190.12 8, section 1101(a)(15), and an undocumented noncitizen is an 190.13 individual who resides in the United States without the approval 190.14 or acquiescence of the Immigration and Naturalization Service. 190.15(2) This paragraph does not apply to a child under age 18,190.16to a Cuban or Haitian entrant as defined in Public Law Number190.1796-422, section 501(e)(1) or (2)(a), or to a noncitizen who is190.18aged, blind, or disabled as defined in Code of Federal190.19Regulations, title 42, sections 435.520, 435.530, 435.531,190.20435.540, and 435.541, or effective October 1, 1998, to an190.21individual eligible for general assistance medical care under190.22paragraph (a), clause (4), who cooperates with the Immigration190.23and Naturalization Service to pursue any applicable immigration190.24status, including citizenship, that would qualify the individual190.25for medical assistance with federal financial participation.190.26 (k)For purposes of paragraphs (g) and (j), "emergency190.27services" has the meaning given in Code of Federal Regulations,190.28title 42, section 440.255(b)(1), except that it also means190.29services rendered because of suspected or actual pesticide190.30poisoning.190.31 (l) Notwithstanding any other provision of law, a 190.32 noncitizen who is ineligible for medical assistance due to the 190.33 deeming of a sponsor's income and resources, is ineligible for 190.34 general assistance medical care. 190.35 (m) Effective July 1, 2003, general assistance medical care 190.36 emergency services end. Effective October 1, 2004, the general 191.1 assistance medical care program ends. Persons enrolled in 191.2 general assistance medical care as of September 30, 2004, will 191.3 be converted to MinnesotaCare if they meet all the requirements 191.4 of chapter 256L. 191.5 [EFFECTIVE DATE.] (a) The amendments to paragraphs (a), 191.6 clauses (1) to (4), and (b) and (c), are effective October 1, 191.7 2003. 191.8 (b) The amendments to paragraphs (d), (g), and (k) are 191.9 effective April 1, 2005, if the HealthMatch system is 191.10 operational. If the HealthMatch system is not operational on 191.11 April 1, 2005, then the amendment to paragraph (d) is effective 191.12 July 1, 2005. 191.13 (c) The amendments to paragraphs (j), (g), and (k), are 191.14 effective July 1, 2003. 191.15 Sec. 44. Minnesota Statutes 2002, section 256D.03, 191.16 subdivision 4, is amended to read: 191.17 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 191.18 For a person who is eligible under subdivision 3, paragraph (a), 191.19 clause (3), general assistance medical care covers, except as 191.20 provided in paragraph (c): 191.21 (1) inpatient hospital services; 191.22 (2) outpatient hospital services; 191.23 (3) services provided by Medicare certified rehabilitation 191.24 agencies; 191.25 (4) prescription drugs and other products recommended 191.26 through the process established in section 256B.0625, 191.27 subdivision 13; 191.28 (5) equipment necessary to administer insulin and 191.29 diagnostic supplies and equipment for diabetics to monitor blood 191.30 sugar level; 191.31 (6) eyeglasses and eye examinations provided by a physician 191.32 or optometrist; 191.33 (7) hearing aids; 191.34 (8) prosthetic devices; 191.35 (9) laboratory and X-ray services; 191.36 (10) physician's services; 192.1 (11) medical transportation; 192.2 (12) chiropractic services as covered under the medical 192.3 assistance program; 192.4 (13) podiatric services; 192.5 (14) dental services; 192.6 (15) outpatient services provided by a mental health center 192.7 or clinic that is under contract with the county board and is 192.8 established under section 245.62; 192.9 (16) day treatment services for mental illness provided 192.10 under contract with the county board; 192.11 (17) prescribed medications for persons who have been 192.12 diagnosed as mentally ill as necessary to prevent more 192.13 restrictive institutionalization; 192.14 (18) psychological services, medical supplies and 192.15 equipment, and Medicare premiums, coinsurance and deductible 192.16 payments; 192.17 (19) medical equipment not specifically listed in this 192.18 paragraph when the use of the equipment will prevent the need 192.19 for costlier services that are reimbursable under this 192.20 subdivision; 192.21 (20) services performed by a certified pediatric nurse 192.22 practitioner, a certified family nurse practitioner, a certified 192.23 adult nurse practitioner, a certified obstetric/gynecological 192.24 nurse practitioner, a certified neonatal nurse practitioner, or 192.25 a certified geriatric nurse practitioner in independent 192.26 practice, if (1) the service is otherwise covered under this 192.27 chapter as a physician service, (2) the service provided on an 192.28 inpatient basis is not included as part of the cost for 192.29 inpatient services included in the operating payment rate, and 192.30 (3) the service is within the scope of practice of the nurse 192.31 practitioner's license as a registered nurse, as defined in 192.32 section 148.171; 192.33 (21) services of a certified public health nurse or a 192.34 registered nurse practicing in a public health nursing clinic 192.35 that is a department of, or that operates under the direct 192.36 authority of, a unit of government, if the service is within the 193.1 scope of practice of the public health nurse's license as a 193.2 registered nurse, as defined in section 148.171; and 193.3 (22) telemedicine consultations, to the extent they are 193.4 covered under section 256B.0625, subdivision 3b. 193.5 (b) Except as provided in paragraph (c), for a recipient 193.6 who is eligible under subdivision 3, paragraph (a), clause (1) 193.7 or (2), general assistance medical care covers the services 193.8 listed in paragraph (a) with the exception of special 193.9 transportation services. 193.10 (c) Gender reassignment surgery and related services are 193.11 not covered services under this subdivision unless the 193.12 individual began receiving gender reassignment services prior to 193.13 July 1, 1995. 193.14 (d) In order to contain costs, the commissioner of human 193.15 services shall select vendors of medical care who can provide 193.16 the most economical care consistent with high medical standards 193.17 and shall where possible contract with organizations on a 193.18 prepaid capitation basis to provide these services. The 193.19 commissioner shall consider proposals by counties and vendors 193.20 for prepaid health plans, competitive bidding programs, block 193.21 grants, or other vendor payment mechanisms designed to provide 193.22 services in an economical manner or to control utilization, with 193.23 safeguards to ensure that necessary services are provided. 193.24 Before implementing prepaid programs in counties with a county 193.25 operated or affiliated public teaching hospital or a hospital or 193.26 clinic operated by the University of Minnesota, the commissioner 193.27 shall consider the risks the prepaid program creates for the 193.28 hospital and allow the county or hospital the opportunity to 193.29 participate in the program in a manner that reflects the risk of 193.30 adverse selection and the nature of the patients served by the 193.31 hospital, provided the terms of participation in the program are 193.32 competitive with the terms of other participants considering the 193.33 nature of the population served. Payment for services provided 193.34 pursuant to this subdivision shall be as provided to medical 193.35 assistance vendors of these services under sections 256B.02, 193.36 subdivision 8, and 256B.0625. For payments made during fiscal 194.1 year 1990 and later years, the commissioner shall consult with 194.2 an independent actuary in establishing prepayment rates, but 194.3 shall retain final control over the rate methodology. 194.4Notwithstanding the provisions of subdivision 3, an individual194.5who becomes ineligible for general assistance medical care194.6because of failure to submit income reports or recertification194.7forms in a timely manner, shall remain enrolled in the prepaid194.8health plan and shall remain eligible for general assistance194.9medical care coverage through the last day of the month in which194.10the enrollee became ineligible for general assistance medical194.11care.194.12 (e)There shall be no copayment required of any recipient194.13of benefits for any services provided under this subdivision.A 194.14 hospital receiving a reduced payment as a result of this section 194.15 may apply the unpaid balance toward satisfaction of the 194.16 hospital's bad debts. 194.17 (f) Any county may, from its own resources, provide medical 194.18 payments for which state payments are not made. 194.19 (g) Chemical dependency services that are reimbursed under 194.20 chapter 254B must not be reimbursed under general assistance 194.21 medical care. 194.22 (h) The maximum payment for new vendors enrolled in the 194.23 general assistance medical care program after the base year 194.24 shall be determined from the average usual and customary charge 194.25 of the same vendor type enrolled in the base year. 194.26 (i) The conditions of payment for services under this 194.27 subdivision are the same as the conditions specified in rules 194.28 adopted under chapter 256B governing the medical assistance 194.29 program, unless otherwise provided by statute or rule. 194.30 Sec. 45. [256D.031] [GAMC CO-PAYMENTS AND COINSURANCE.] 194.31 Subdivision 1. [CO-PAYMENTS AND COINSURANCE.] (a) Except 194.32 as provided in subdivision 2, the general assistance medical 194.33 care benefit plan under section 256D.03, subdivision 3, shall 194.34 include the following co-payments for all recipients effective 194.35 for services provided on or after October 1, 2003: 194.36 (1) $3 per nonpreventive visit. For purposes of this 195.1 subdivision, a visit means an episode of service which is 195.2 required because of a recipient's symptoms, diagnosis, or 195.3 established illness, and which is delivered in an ambulatory 195.4 setting by a physician or physician ancillary, dentist, 195.5 chiropractor, podiatrist, nurse midwife, mental health 195.6 professional, advanced practice nurse, physical therapist, 195.7 occupational therapist, speech therapist, audiologist, optician, 195.8 or optometrist; 195.9 (2) $3 for eyeglasses; 195.10 (3) $6 for nonemergency visits to a hospital-based 195.11 emergency room; and 195.12 (4) $3 per brand-name drug prescription and $1 per generic 195.13 drug prescription. 195.14 (b) Recipients of general assistance medical care are 195.15 responsible for all co-payments in this subdivision. 195.16 Subd. 2. [INPATIENT HOSPITAL SERVICES.] Inpatient hospital 195.17 services provided on or after October 1, 2003, are subject to a 195.18 $10,000 annual benefit limit. 195.19 Subd. 3. [EXCEPTIONS.] Co-payments shall be subject to the 195.20 following exceptions: 195.21 (1) children under the age of 21; 195.22 (2) pregnant women for services that relate to the 195.23 pregnancy or any other medical condition that may complicate the 195.24 pregnancy; 195.25 (3) recipients expected to reside for at least 30 days in a 195.26 hospital, nursing home, or intermediate care facility for the 195.27 mentally retarded; 195.28 (4) recipients receiving hospice care; 195.29 (5) 100 percent federally funded services provided by an 195.30 Indian health service; 195.31 (6) emergency services; 195.32 (7) family planning services; 195.33 (8) services that are paid by Medicare, resulting in the 195.34 medical assistance program paying for the coinsurance and 195.35 deductible; and 195.36 (9) co-payments that exceed one per day per provider for 196.1 nonpreventive office visits, eyeglasses, and nonemergency visits 196.2 to a hospital-based emergency room. 196.3 Subd. 4. [COLLECTION.] The general assistance medical care 196.4 reimbursement to the provider shall be reduced by the amount of 196.5 the co-payment. The provider collects the co-payment from the 196.6 recipient. Providers may not deny services to individuals who 196.7 are unable to pay the co-payment. Providers must accept an 196.8 assertion from the recipient that they are unable to pay. 196.9 Sec. 46. Minnesota Statutes 2002, section 256G.05, 196.10 subdivision 2, is amended to read: 196.11 Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not 196.12 required for receiving emergency assistance in the Minnesota 196.13 supplemental aid program. The receipt of emergency assistance 196.14 must not be used as a factor in determining county or state 196.15 residence.Non-Minnesota residents are not eligible for196.16emergency general assistance medical care, except emergency196.17hospital services, and professional services incident to the196.18hospital services, for the treatment of acute trauma resulting196.19from an accident occurring in Minnesota. To be eligible under196.20this subdivision a non-Minnesota resident must verify that they196.21are not eligible for coverage under any other health care196.22program, including coverage from a program in their state of196.23residence.196.24 [EFFECTIVE DATE.] This section is effective July 1, 2003. 196.25 Sec. 47. Minnesota Statutes 2002, section 256L.02, is 196.26 amended by adding a subdivision to read: 196.27 Subd. 3a. [FUNDING SOURCE.] Beginning July 1, 2005, all 196.28 MinnesotaCare obligations shall be funded out of the general 196.29 fund. 196.30 Sec. 48. Minnesota Statutes 2002, section 256L.03, 196.31 subdivision 5, is amended to read: 196.32 Subd. 5. [COPAYMENTS AND COINSURANCE.] (a) Except as 196.33 provided in paragraphs (b) and (c), the MinnesotaCare benefit 196.34 plan shall include the following copayments and coinsurance 196.35 requirements for all enrollees effective for services provided 196.36 on or after October 1, 2003: 197.1 (1) ten percent of the paid charges for inpatient hospital 197.2 services for adult enrollees, subject to an annual inpatient 197.3 out-of-pocket maximum of $1,000 per individual and $3,000 per 197.4 family; 197.5 (2) $3 perprescription for adult enrolleesnonpreventive 197.6 visit. For purposes of this subdivision, a visit means an 197.7 episode of service which is required because of a recipient's 197.8 symptoms, diagnosis, or established illness, and which is 197.9 delivered in an ambulatory setting by a physician or physician 197.10 ancillary, dentist, chiropractor, podiatrist, nurse, midwife, 197.11 mental health professional, advanced practice nurse, physical 197.12 therapist, occupational therapist, speech therapist, 197.13 audiologist, optician, or optometrist; 197.14 (3) $25 for eyeglassesfor adult enrollees;and197.15 (4) $6 for nonemergency visits to a hospital-based 197.16 emergency room; 197.17 (5) $3 per prescription; and 197.18 (6) 50 percent of the fee-for-service rate for adult dental 197.19 care services other than preventive care services for persons 197.20 eligible under section256L.04256L.05, subdivisions 1 to 7, 197.21 with income equal to or less than 175 percent of the federal 197.22 poverty guidelines. 197.23 (b) Paragraph (a), clause (1), does not apply to parents 197.24 and relative caretakers of children under the age of 21 in 197.25 households with family income equal to or less than 175 percent 197.26 of the federal poverty guidelines. Paragraph (a), clause (1), 197.27 does not apply to parents and relative caretakers of children 197.28 under the age of 21 in households with family income greater 197.29 than 175 percent of the federal poverty guidelines for inpatient 197.30 hospital admissions occurring on or after January 1, 2001. 197.31 (c) Paragraph (a), clauses (1) to(4)(6), do not apply to 197.32pregnant women and children under the age of 21.: 197.33 (1) children under the age of 21; 197.34 (2) pregnant women for services that relate to the 197.35 pregnancy or any other medical condition that may complicate the 197.36 pregnancy; 198.1 (3) enrollees expected to reside for at least 30 days in a 198.2 hospital, nursing home, or intermediate care facility for the 198.3 mentally retarded; 198.4 (4) enrollees receiving hospice care; 198.5 (5) 100 percent federally funded services provided by an 198.6 Indian Health Service; 198.7 (6) emergency services; 198.8 (7) family planning services; 198.9 (8) services that are paid by Medicare, resulting in the 198.10 medical assistance program paying for the coinsurance and 198.11 deductible; and 198.12 (9) co-payments that exceed one per day per provider for 198.13 nonpreventive office visits, eyeglasses, and nonemergency visits 198.14 to a hospital emergency room. 198.15 (d) Adult enrollees with family gross income that exceeds 198.16 175 percent of the federal poverty guidelines and who are not 198.17 pregnant shall be financially responsible for the coinsurance 198.18 amount, if applicable, and amounts which exceed the $10,000 198.19 inpatient hospital benefit limit. 198.20 (e) When a MinnesotaCare enrollee becomes a member of a 198.21 prepaid health plan, or changes from one prepaid health plan to 198.22 another during a calendar year, any charges submitted towards 198.23 the $10,000 annual inpatient benefit limit, and any 198.24 out-of-pocket expenses incurred by the enrollee for inpatient 198.25 services, that were submitted or incurred prior to enrollment, 198.26 or prior to the change in health plans, shall be disregarded. 198.27 (f) Enrollees are responsible for all co-payments and 198.28 coinsurance in this subdivision. 198.29 (g) The MinnesotaCare reimbursement to the provider shall 198.30 be reduced by the amount of the co-payment. The provider 198.31 collects the co-payment from the recipient. Providers may not 198.32 deny services to individuals who are unable to pay the 198.33 co-payment. Providers must accept an assertion from the 198.34 recipient that they are unable to pay. 198.35 Sec. 49. Minnesota Statutes 2002, section 256L.04, 198.36 subdivision 1, is amended to read: 199.1 Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with 199.2 children with family income equal to or less than 275 percent of 199.3 the federal poverty guidelines for the applicable family size 199.4 shall be eligible for MinnesotaCare according to this section. 199.5 All other provisions of sections 256L.01 to 256L.18, including 199.6 the insurance-related barriers to enrollment under section 199.7 256L.07, shall apply unless otherwise specified. 199.8 (b) Parents who enroll in the MinnesotaCare program must 199.9 also enroll their childrenand dependent siblings, if the 199.10 childrenand their dependent siblingsare eligible. Children 199.11and dependent siblingsmay be enrolled separately without 199.12 enrollment by parents. However, if one parent in the household 199.13 enrolls, both parents must enroll, unless other insurance is 199.14 available. If one child from a family is enrolled, all children 199.15 must be enrolled, unless other insurance is available. If one 199.16 spouse in a household enrolls, the other spouse in the household 199.17 must also enroll, unless other insurance is available. Families 199.18 cannot choose to enroll only certain uninsured members. 199.19 (c) Beginning February 1, 2004, the dependent sibling 199.20 definition no longer applies to the MinnesotaCare program. 199.21 These persons are no longer counted in the parental household 199.22 and may apply as a separate household. 199.23 [EFFECTIVE DATE.] This section is effective February 1, 199.24 2004. 199.25 Sec. 50. Minnesota Statutes 2002, section 256L.05, 199.26 subdivision 3, is amended to read: 199.27 Subd. 3. [EFFECTIVE DATE OF COVERAGE.] (a) The effective 199.28 date of coverage is the first day of the month following the 199.29 month in which eligibility is approved and the first premium 199.30 payment has been received. As provided in section 256B.057, 199.31 coverage for newborns is automatic from the date of birth and 199.32 must be coordinated with other health coverage. The effective 199.33 date of coverage for eligible newly adoptive children added to a 199.34 family receiving covered health services is the date of entry 199.35 into the family. The effective date of coverage for other new 199.36 recipients added to the family receiving covered health services 200.1 is the first day of the month following the month in which 200.2 eligibility is approved or at renewal, whichever the family 200.3 receiving covered health services prefers. All eligibility 200.4 criteria must be met by the family at the time the new family 200.5 member is added. The income of the new family member is 200.6 included with the family's gross income and the adjusted premium 200.7 begins in the month the new family member is added. 200.8 (b) The initial premium must be received by the last 200.9 working day of the month for coverage to begin the first day of 200.10 the following month. 200.11 (c) Benefits are not available until the day following 200.12 discharge if an enrollee is hospitalized on the first day of 200.13 coverage. 200.14 (d) Notwithstanding any other law to the contrary, benefits 200.15 under sections 256L.01 to 256L.18 are secondary to a plan of 200.16 insurance or benefit program under which an eligible person may 200.17 have coverage and the commissioner shall use cost avoidance 200.18 techniques to ensure coordination of any other health coverage 200.19 for eligible persons. The commissioner shall identify eligible 200.20 persons who may have coverage or benefits under other plans of 200.21 insurance or who become eligible for medical assistance. 200.22 (e) Notwithstanding paragraphs (a) and (b), effective 200.23 October 1, 2004, coverage begins for single adults and 200.24 households without children with gross family income at or below 200.25 75 percent of the federal poverty guidelines the day of 200.26 application, or the first day they meet all eligibility 200.27 requirements, whichever is later. 200.28 (f) Effective October 1, 2004, the date of an initial 200.29 application necessary to begin a determination of eligibility 200.30 for single adults and households without children with gross 200.31 family income at or below 75 percent of the federal poverty 200.32 guidelines shall be the date the applicant has provided a name, 200.33 address, and social security number, signed and dated, to the 200.34 county agency or the department of human services. If the 200.35 applicant is unable to provide an initial application when 200.36 health care is delivered due to a medical condition or 201.1 disability, a health care provider may act on the person's 201.2 behalf to complete the initial application. The applicant must 201.3 complete the remainder of the application and provide necessary 201.4 verification before eligibility can be determined. The county 201.5 agency must assist the applicant in obtaining verification if 201.6 necessary. 201.7 Sec. 51. Minnesota Statutes 2002, section 256L.05, 201.8 subdivision 3a, is amended to read: 201.9 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 201.10 1, 1999, an enrollee's eligibility must be renewed every 12 201.11 months. The 12-month period begins in the month after the month 201.12 the application is approved. 201.13 (b) Beginning October 1, 2004, an enrollee's eligibility 201.14 must be renewed every six months. The first six-month period of 201.15 eligibility begins in the month after the month the application 201.16 is approved. Each new period of eligibility must take into 201.17 account any changes in circumstances that impact eligibility and 201.18 premium amount. An enrollee must provide all the information 201.19 needed to redetermine eligibility by the first day of the month 201.20 that ends the eligibility period. The premium for the new 201.21 period of eligibility must be received as provided in section 201.22 256L.06 in order for eligibility to continue. 201.23 Sec. 52. Minnesota Statutes 2002, section 256L.05, 201.24 subdivision 3c, is amended to read: 201.25 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 201.26 subdivision 3, the effective date of coverage shall be the first 201.27 day of the month following termination from medical assistance 201.28or general assistance medical carefor families and individuals 201.29 who are eligible for MinnesotaCare and who submitted a written 201.30 request for retroactive MinnesotaCare coverage with a completed 201.31 application within 30 days of the mailing of notification of 201.32 termination from medical assistanceor general assistance201.33medical care. The applicant must provide all required 201.34 verifications within 30 days of the written request for 201.35 verification. For retroactive coverage, premiums must be paid 201.36 in full for any retroactive month, current month, and next month 202.1 within 30 days of the premium billing. 202.2 [EFFECTIVE DATE.] This section is effective November 1, 202.3 2004. 202.4 Sec. 53. Minnesota Statutes 2002, section 256L.05, 202.5 subdivision 4, is amended to read: 202.6 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 202.7 human services shall determine an applicant's eligibility for 202.8 MinnesotaCare no more than 30 days from the date that the 202.9 application is received by the department of human services. 202.10 Beginning January 1, 2000, this requirement also applies to 202.11 local county human services agencies that determine eligibility 202.12 for MinnesotaCare.Once annually at application or202.13reenrollment, to prevent processing delays, applicants or202.14enrollees who, from the information provided on the application,202.15appear to meet eligibility requirements shall be enrolled upon202.16timely payment of premiums. The enrollee must provide all202.17required verifications within 30 days of notification of the202.18eligibility determination or coverage from the program shall be202.19terminated. Enrollees who are determined to be ineligible when202.20verifications are provided shall be disenrolled from the program.202.21 [EFFECTIVE DATE.] This section is effective April 1, 2005, 202.22 if the HealthMatch system is operational. If the HealthMatch 202.23 system is not operational on April 1, 2005, then this section is 202.24 effective July 1, 2005. 202.25 Sec. 54. Minnesota Statutes 2002, section 256L.06, 202.26 subdivision 3, is amended to read: 202.27 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 202.28 are dedicated to the commissioner for MinnesotaCare. 202.29 (b) The commissioner shall develop and implement procedures 202.30 to: (1) require enrollees to report changes in income; (2) 202.31 adjust sliding scale premium payments, based upon changes in 202.32 enrollee income; and (3) disenroll enrollees from MinnesotaCare 202.33 for failure to pay required premiums. Failure to pay includes 202.34 payment with a dishonored check, a returned automatic bank 202.35 withdrawal, or a refused credit card or debit card payment. The 202.36 commissioner may demand a guaranteed form of payment, including 203.1 a cashier's check or a money order, as the only means to replace 203.2 a dishonored, returned, or refused payment. 203.3 (c) Premiums are calculated on a calendar month basis and 203.4 may be paid on a monthly, quarterly, orannualsemiannual basis, 203.5 with the first payment due upon notice from the commissioner of 203.6 the premium amount required. The commissioner shall inform 203.7 applicants and enrollees of these premium payment options. 203.8 Premium payment is required before enrollment is complete and to 203.9 maintain eligibility in MinnesotaCare. Premium payments 203.10 received before noon are credited the same day. Premium 203.11 payments received after noon are credited on the next working 203.12 day. 203.13 (d) Nonpayment of the premium will result in disenrollment 203.14 from the plan effective for the calendar month for which the 203.15 premium was due. Persons disenrolled for nonpayment or who 203.16 voluntarily terminate coverage from the program may not reenroll 203.17 until four calendar months have elapsed. Persons disenrolled 203.18 for nonpayment who pay all past due premiums as well as current 203.19 premiums due, including premiums due for the period of 203.20 disenrollment, within 20 days of disenrollment, shall be 203.21 reenrolled retroactively to the first day of disenrollment. 203.22 Persons disenrolled for nonpayment or who voluntarily terminate 203.23 coverage from the program may not reenroll for four calendar 203.24 months unless the person demonstrates good cause for 203.25 nonpayment. Good cause does not exist if a person chooses to 203.26 pay other family expenses instead of the premium. The 203.27 commissioner shall define good cause in rule. 203.28 [EFFECTIVE DATE.] This section is effective October 1, 2004. 203.29 Sec. 55. Minnesota Statutes 2002, section 256L.07, 203.30 subdivision 1, is amended to read: 203.31 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 203.32 enrolled in the original children's health plan as of September 203.33 30, 1992, children who enrolled in the MinnesotaCare program 203.34 after September 30, 1992, pursuant to Laws 1992, chapter 549, 203.35 article 4, section 17, and children who have family gross 203.36 incomes that are equal to or less than175150 percent of the 204.1 federal poverty guidelines are eligible without meeting the 204.2 requirements of subdivision 2 and the four-month requirement in 204.3 subdivision 3, as long as they maintain continuous coverage in 204.4 the MinnesotaCare program or medical assistance. Children who 204.5 apply for MinnesotaCare on or after the implementation date of 204.6 the employer-subsidized health coverage program as described in 204.7 Laws 1998, chapter 407, article 5, section 45, who have family 204.8 gross incomes that are equal to or less than175150 percent of 204.9 the federal poverty guidelines, must meet the requirements of 204.10 subdivision 2 to be eligible for MinnesotaCare. 204.11 (b) Families enrolled in MinnesotaCare under section 204.12 256L.04, subdivision 1, whose income increases above 275 percent 204.13 of the federal poverty guidelines, are no longer eligible for 204.14 the program and shall be disenrolled by the commissioner. 204.15 Individuals enrolled in MinnesotaCare under section 256L.04, 204.16 subdivision 7, whose income increases above 175 percent of the 204.17 federal poverty guidelines are no longer eligible for the 204.18 program and shall be disenrolled by the commissioner. For 204.19 persons disenrolled under this subdivision, MinnesotaCare 204.20 coverage terminates the last day of the calendar month following 204.21 the month in which the commissioner determines that the income 204.22 of a family or individual exceeds program income limits. 204.23 (c)(1) Notwithstanding paragraph (b),individuals and204.24 families enrolled in MinnesotaCare under section 256L.04, 204.25 subdivision 1, may remain enrolled in MinnesotaCare if ten 204.26 percent of their annual income is less than the annual premium 204.27 for a policy with a $500 deductible available through the 204.28 Minnesota comprehensive health association.Individuals and204.29 Families who are no longer eligible for MinnesotaCare under this 204.30 subdivision shall be given an 18-month notice period from the 204.31 date that ineligibility is determined before 204.32 disenrollment. This clause expires February 1, 2004. 204.33 (2) Effective February 1, 2004, notwithstanding paragraph 204.34 (b), children may remain enrolled in MinnesotaCare if ten 204.35 percent of their annual family income is less than the annual 204.36 premium for a policy with a $500 deductible available through 205.1 the Minnesota comprehensive health association. Children who 205.2 are no longer eligible for MinnesotaCare under this clause shall 205.3 be given a 12-month notice period from the date that 205.4 ineligibility is determined before disenrollment. The premium 205.5 for children remaining eligible under this clause shall be the 205.6 maximum premium determined under section 256L.15, subdivision 2, 205.7 paragraph (b), until July 1, 2005, when the premium shall be 205.8 determined by section 256L.15, subdivision 2, paragraph (c). 205.9 [EFFECTIVE DATE.] The amendments to paragraph (a) are 205.10 effective July 1, 2003. The amendments to paragraph (c), clause 205.11 (1), are effective October 1, 2003. 205.12 Sec. 56. Minnesota Statutes 2002, section 256L.07, 205.13 subdivision 2, is amended to read: 205.14 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 205.15 COVERAGE.] (a) To be eligible, a family or individual must not 205.16 have access to subsidized health coverage through an employer 205.17 and must not have had access to employer-subsidized coverage 205.18 through a current employer for 18 months prior to application or 205.19 reapplication. A family or individual whose employer-subsidized 205.20 coverage is lost due to an employer terminating health care 205.21 coverage as an employee benefit during the previous 18 months is 205.22 not eligible. 205.23 (b) This subdivision does not apply to a family or 205.24 individual who was enrolled in MinnesotaCare within six months 205.25 or less of reapplication and who no longer has 205.26 employer-subsidized coverage due to the employer terminating 205.27 health care coverage as an employee benefit. 205.28 (c) For purposes of this requirement, subsidized health 205.29 coverage means health coverage for which the employer pays at 205.30 least 50 percent of the cost of coverage for the employee or 205.31 dependent, or a higher percentage as specified by the 205.32 commissioner. Children are eligible for employer-subsidized 205.33 coverage through either parent, including the noncustodial 205.34 parent. The commissioner must treat employer contributions to 205.35 Internal Revenue Code Section 125 plans and any other employer 205.36 benefits intended to pay health care costs as qualified employer 206.1 subsidies toward the cost of health coverage for employees for 206.2 purposes of this subdivision. 206.3 (d) Notwithstanding paragraph (c), beginning October 1, 206.4 2004, health coverage for single adults and households without 206.5 children shall be considered to be subsidized health coverage if 206.6 the employer contributes any amount towards the cost of coverage. 206.7 (e) Notwithstanding paragraph (c), beginning February 1, 206.8 2004, health coverage for adults in families with children shall 206.9 be considered to be subsidized health coverage if the employer 206.10 contributes any amount towards the cost of coverage. 206.11 Sec. 57. Minnesota Statutes 2002, section 256L.07, 206.12 subdivision 3, is amended to read: 206.13 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 206.14 individuals enrolled in the MinnesotaCare program must have no 206.15 health coverage while enrolled or for at least four months prior 206.16 to application and renewal. Children enrolled in the original 206.17 children's health plan and children in families with income 206.18 equal to or less than175150 percent of the federal poverty 206.19 guidelines, who have other health insurance, are eligible if the 206.20 coverage: 206.21 (1) lacks two or more of the following: 206.22 (i) basic hospital insurance; 206.23 (ii) medical-surgical insurance; 206.24 (iii) prescription drug coverage; 206.25 (iv) dental coverage; or 206.26 (v) vision coverage; 206.27 (2) requires a deductible of $100 or more per person per 206.28 year; or 206.29 (3) lacks coverage because the child has exceeded the 206.30 maximum coverage for a particular diagnosis or the policy 206.31 excludes a particular diagnosis. 206.32 The commissioner may change this eligibility criterion for 206.33 sliding scale premiums in order to remain within the limits of 206.34 available appropriations. The requirement of no health coverage 206.35 does not apply to newborns. 206.36 (b) Medical assistance, general assistance medical care, 207.1 and the Civilian Health and Medical Program of the Uniformed 207.2 Service, CHAMPUS, or other coverage provided under United States 207.3 Code, title 10, subtitle A, part II, chapter 55, are not 207.4 considered insurance or health coverage for purposes of the 207.5 four-month requirement described in this subdivision. 207.6 (c) For purposes of this subdivision, Medicare Part A or B 207.7 coverage under title XVIII of the Social Security Act, United 207.8 States Code, title 42, sections 1395c to 1395w-4, is considered 207.9 health coverage. An applicant or enrollee may not refuse 207.10 Medicare coverage to establish eligibility for MinnesotaCare. 207.11 (d) Applicants who were recipients of medical assistance or 207.12 general assistance medical care within one month of application 207.13 must meet the provisions of this subdivision and subdivision 2. 207.14 (e) Effective October 1, 2003, applicants who were 207.15 recipients of medical assistance and had cost-effective health 207.16 insurance which was paid for by medical assistance are exempt 207.17 from the four-month requirement under this section. 207.18 (f) Notwithstanding paragraph (a), effective October 1, 207.19 2004, individuals enrolled in the MinnesotaCare program under 207.20 section 256L.04, subdivision 7, who have gross family income at 207.21 or below 75 percent are not subject to the requirement of having 207.22 no other health coverage for four months prior to application 207.23 and renewal. 207.24 [EFFECTIVE DATE.] This section is effective July 1, 2003, 207.25 except where a different effective date is specified in the text. 207.26 Sec. 58. Minnesota Statutes 2002, section 256L.09, 207.27 subdivision 4, is amended to read: 207.28 Subd. 4. [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 207.29 purposes of this section, a permanent Minnesota resident is a 207.30 person who has demonstrated, through persuasive and objective 207.31 evidence, that the person is domiciled in the state and intends 207.32 to live in the state permanently. 207.33 (b) To be eligible as a permanent resident, an applicant 207.34 must demonstrate the requisite intent to live in the state 207.35 permanently by: 207.36 (1) showing that the applicant maintains a residence at a 208.1 verified address other than a place of public accommodation, 208.2 through the use of evidence of residence described in section 208.3 256D.02, subdivision 12a, clause (1); 208.4 (2) demonstrating that the applicant has been continuously 208.5 domiciled in the state for no less than 180 days immediately 208.6 before the application;and208.7 (3) signing an affidavit declaring that (A) the applicant 208.8 currently resides in the state and intends to reside in the 208.9 state permanently; and (B) the applicant did not come to the 208.10 state for the primary purpose of obtaining medical coverage or 208.11 treatment; 208.12 (4) effective October 1, 2003, single adults and adults in 208.13 households without children who have gross family income at or 208.14 below 75 percent of the federal poverty guidelines are exempt 208.15 from the requirements of clause (1); 208.16 (5) effective October 1, 2004, single adults and adults in 208.17 households without children who have gross family income at or 208.18 below 75 percent of the federal poverty guidelines are exempt 208.19 from clauses (1) and (2), but shall demonstrate that they have 208.20 been continuously domiciled in the state for no less than 30 208.21 days before the date of application. In cases of medical 208.22 emergencies, the 30-day residency requirement is waived; and 208.23 (6) effective October 1, 2004, migrant workers as defined 208.24 in section 256J.08 who are single adults and adults in 208.25 households without children who have gross family income at or 208.26 below 75 percent of the federal poverty guidelines are exempt 208.27 from the residency requirements of this section, provided the 208.28 migrant worker provides verification that the migrant family 208.29 worked in this state within the last 12 months and earned at 208.30 least $1,000 in gross wages during the time the migrant worker 208.31 worked in this state. 208.32 (c) A person who is temporarily absent from the state does 208.33 not lose eligibility for MinnesotaCare. "Temporarily absent 208.34 from the state" means the person is out of the state for a 208.35 temporary purpose and intends to return when the purpose of the 208.36 absence has been accomplished. A person is not temporarily 209.1 absent from the state if another state has determined that the 209.2 person is a resident for any purpose. If temporarily absent 209.3 from the state, the person must follow the requirements of the 209.4 health plan in which the person is enrolled to receive services. 209.5 Sec. 59. Minnesota Statutes 2002, section 256L.15, 209.6 subdivision 1, is amended to read: 209.7 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 209.8 children and individuals shall pay a premium determined 209.9 according toa sliding fee based on a percentage of the family's209.10gross family incomesubdivision 2. 209.11 (b) Pregnant women and children under age two are exempt 209.12 from the provisions of section 256L.06, subdivision 3, paragraph 209.13 (b), clause (3), requiring disenrollment for failure to pay 209.14 premiums. For pregnant women, this exemption continues until 209.15 the first day of the month following the 60th day postpartum. 209.16 Women who remain enrolled during pregnancy or the postpartum 209.17 period, despite nonpayment of premiums, shall be disenrolled on 209.18 the first of the month following the 60th day postpartum for the 209.19 penalty period that otherwise applies under section 256L.06, 209.20 unless they begin paying premiums. 209.21 (c) Effective October 1, 2004, single adults and households 209.22 without children with gross family income at or below 75 percent 209.23 of the federal poverty guidelines who are eligible under section 209.24 256L.04, subdivision 7, do not have a premium obligation. 209.25 Sec. 60. Minnesota Statutes 2002, section 256L.15, 209.26 subdivision 2, is amended to read: 209.27 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 209.28 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 209.29 establish a sliding fee scale to determine the percentage of 209.30 grossindividual orfamily income that households at different 209.31 income levels must pay to obtain coverage through the 209.32 MinnesotaCare program. The sliding fee scale must be based on 209.33 the enrollee's grossindividual orfamily income. The sliding 209.34 fee scale must contain separate tables based on enrollment of 209.35 one, two, or three or more persons. The sliding fee scale 209.36 begins with a premium of 1.5 percent of grossindividual or210.1 family income forindividuals orfamilies with incomes below the 210.2 limits for the medical assistance program for families and 210.3 children in effect on January 1, 1999, and proceeds through the 210.4 following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 210.5 7.4, and 8.8 percent. These percentages are matched to evenly 210.6 spaced income steps ranging from the medical assistance income 210.7 limit for families and children in effect on January 1, 1999, to 210.8 275 percent of the federal poverty guidelines for the applicable 210.9 family size, up to a family size of five. The sliding fee scale 210.10 for a family of five must be used for families of more than 210.11 five. The sliding fee scale and percentages are not subject to 210.12 the provisions of chapter 14. If a familyor individualreports 210.13 increased income after enrollment, premiums shall not be 210.14 adjusted until eligibility renewal. 210.15 (b)(1) Enrolledindividuals andfamilies whose gross annual 210.16 income increases above 275 percent of the federal poverty 210.17 guideline shall pay the maximum premium. This clause expires 210.18 effective February 1, 2004. 210.19 (2) Effective October 1, 2003, enrolled single adults and 210.20 households without children who have gross family income above 210.21 75 percent of the federal poverty guidelines shall pay the 210.22 maximum premium. 210.23 (3) Effective February 1, 2004, adults in families with 210.24 children whose gross income is above 200 percent of the federal 210.25 poverty guidelines shall pay the maximum premium. 210.26 (4) The maximum premium is defined as a base charge for 210.27 one, two, or three or more enrollees so that if all 210.28 MinnesotaCare cases paid the maximum premium, the total revenue 210.29 would equal the total cost of MinnesotaCare medical coverage and 210.30 administration. In this calculation, administrative costs shall 210.31 be assumed to equal ten percent of the total. The costs of 210.32 medical coverage for pregnant women and children under age two 210.33 and the enrollees in these groups shall be excluded from the 210.34 total. The maximum premium for two enrollees shall be twice the 210.35 maximum premium for one, and the maximum premium for three or 210.36 more enrollees shall be three times the maximum premium for one. 211.1 (c) Effective July 1, 2005, single adults and households 211.2 without children who have gross family income above 75 percent 211.3 of the federal poverty guidelines and adults in families with 211.4 children whose gross income is above 200 percent of the federal 211.5 poverty guidelines shall pay the full cost premium. The full 211.6 cost premium is defined as a base charge for one, two, or three 211.7 or more enrollees so that if the base charge were paid by all 211.8 MinnesotaCare cases subject to the full cost premium, the total 211.9 revenue would approximately equal the total cost of 211.10 MinnesotaCare medical coverage and administration for cases 211.11 subject to the full cost premium. In this calculation, 211.12 administrative costs shall be assumed to equal ten percent of 211.13 the total. The full cost premium for two enrollees shall be 211.14 twice the full cost premium for one, and the full cost premium 211.15 for three or more enrollees shall be three times the full cost 211.16 premium for one. 211.17 [EFFECTIVE DATE.] The amendments to paragraph (a) are 211.18 effective October 1, 2004. The amendment to paragraph (b) is 211.19 effective October 1, 2003. 211.20 Sec. 61. Minnesota Statutes 2002, section 256L.15, 211.21 subdivision 3, is amended to read: 211.22 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 211.23 of $48 is required for all children in families with income at 211.24 or less than175150 percent of federal poverty guidelines. 211.25 [EFFECTIVE DATE.] This section is effective July 1, 2003. 211.26 Sec. 62. Minnesota Statutes 2002, section 295.58, is 211.27 amended to read: 211.28 295.58 [DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.] 211.29 The commissioner shall deposit all revenues, including 211.30 penalties and interest, derived from the taxes imposed by 211.31 sections 295.50 to 295.57 and from the insurance premiums tax 211.32 imposed by section 297I.05, subdivision 5, on health maintenance 211.33 organizations, community integrated service networks, and 211.34 nonprofit health service plan corporations in the health care 211.35 access fund. There is annually appropriated from the health 211.36 care access fund to the commissioner of revenue the amount 212.1 necessary to make refunds under this chapter. Beginning July 1, 212.2 2005, the commissioner shall deposit all revenues, including 212.3 penalties and interest, derived from the taxes imposed by 212.4 sections 295.50 to 295.57 and from the insurance premiums tax 212.5 imposed by section 297I.05, subdivision 5, on health maintenance 212.6 organizations, community integrated service networks, and 212.7 nonprofit health service plan corporations in the general fund. 212.8 There is annually appropriated from the general fund to the 212.9 commissioner of revenue the amount necessary to make refunds 212.10 under this chapter. 212.11 Sec. 63. Minnesota Statutes 2002, section 514.981, 212.12 subdivision 6, is amended to read: 212.13 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 212.14 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 212.15 the real property it describes for a period of ten years from 212.16 the date it attaches according to section 514.981, subdivision 212.17 2, paragraph (a), except as otherwise provided for in sections 212.18 514.980 to 514.985. The agency may renew a medical assistance 212.19 lien for an additional ten years from the date it would 212.20 otherwise expire by recording or filing a certificate of renewal 212.21 before the lien expires. The certificate shall be recorded or 212.22 filed in the office of the county recorder or registrar of 212.23 titles for the county in which the lien is recorded or filed. 212.24 The certificate must refer to the recording or filing data for 212.25 the medical assistance lien it renews. The certificate need not 212.26 be attested, certified, or acknowledged as a condition for 212.27 recording or filing. The registrar of titles or the recorder 212.28 shall file, record, index, and return the certificate of renewal 212.29 in the same manner as provided for medical assistance liens in 212.30 section 514.982, subdivision 2. 212.31 (b) A medical assistance lien is not enforceable against 212.32 the real property of an estate to the extent there is a 212.33 determination by a court of competent jurisdiction, or by an 212.34 officer of the court designated for that purpose, that there are 212.35 insufficient assets in the estate to satisfy the agency's 212.36 medical assistance lien in whole or in part because of the 213.1 homestead exemption under section 256B.15, subdivision 4, the 213.2 rights of the surviving spouse or minor children under section 213.3 524.2-403, paragraphs (a) and (b), or claims with a priority 213.4 under section 524.3-805, paragraph (a), clauses (1) to (4). For 213.5 purposes of this section, the rights of the decedent's adult 213.6 children to exempt property under section 524.2-403, paragraph 213.7 (b), shall not be considered costs of administration under 213.8 section 524.3-805, paragraph (a), clause (1). 213.9 (c) Notwithstanding any law or rule to the contrary, the 213.10 provisions in clauses (1) to (7) apply if a life estate subject 213.11 to a medical assistance lien ends according to its terms, or if 213.12 a medical assistance recipient who owns a life estate or any 213.13 interest in real property as a joint tenant that is subject to a 213.14 medical assistance lien dies. 213.15 (1) The medical assistance recipient's life estate or joint 213.16 tenancy interest in the real property shall not end upon the 213.17 recipient's death but shall merge into the remainder interest or 213.18 other interest in real property the medical assistance recipient 213.19 owned in joint tenancy with others. The medical assistance lien 213.20 shall attach to and run with the remainder or other interest in 213.21 the real property to the extent of the medical assistance 213.22 recipient's interest in the property at the time of the 213.23 recipient's death as determined under this section. 213.24 (2) If the medical assistance recipient's interest was a 213.25 life estate in real property, the lien shall be a lien against 213.26 the portion of the remainder equal to the percentage factor for 213.27 the life estate of a person the medical assistance recipient's 213.28 age on the date the life estate ended according to its terms or 213.29 the date of the medical assistance recipient's death as listed 213.30 in the Life Estate Mortality Table in the health care program's 213.31 manual. 213.32 (3) If the medical assistance recipient owned the interest 213.33 in real property in joint tenancy with others, the lien shall be 213.34 a lien against the portion of that interest equal to the 213.35 fractional interest the medical assistance recipient would have 213.36 owned in the jointly owned interest had the medical assistance 214.1 recipient and the other owners held title to that interest as 214.2 tenants in common on the date the medical assistance recipient 214.3 died. 214.4 (4) The medical assistance lien shall remain a lien against 214.5 the remainder or other jointly owned interest for the length of 214.6 time and be renewable as provided in paragraph (a). 214.7 (5) Section 514.981, subdivision 5, paragraphs (a), clause 214.8 (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), 214.9 do not apply to medical assistance liens which attach to 214.10 interests in real property as provided under this subdivision. 214.11 (6) The continuation of a medical assistance recipient's 214.12 life estate or joint tenancy interest in real property after the 214.13 medical assistance recipient's death for the purpose of 214.14 recovering medical assistance provided for in sections 514.980 214.15 to 514.985 modifies common law principles holding that these 214.16 interests terminate on the death of the holder. 214.17 (7) Notwithstanding any law or rule to the contrary, no 214.18 release, satisfaction, discharge, or affidavit under section 214.19 256B.15 shall extinguish or terminate the life estate or joint 214.20 tenancy interest of a medical assistance recipient subject to a 214.21 lien under sections 514.980 to 514.985 on the date the recipient 214.22 dies. 214.23 [EFFECTIVE DATE.] This section is effective August 1, 2003, 214.24 and applies to all medical assistance liens recorded or filed on 214.25 or after that date. 214.26 Sec. 64. [REVISOR'S INSTRUCTION.] 214.27 For sections in Minnesota Statutes and Minnesota Rules 214.28 affected by the repealed sections in this article, the revisor 214.29 shall delete internal cross-references where appropriate and 214.30 make changes necessary to correct the punctuation, grammar, or 214.31 structure of the remaining text and preserve its meaning. 214.32 Sec. 65. [REPEALER.] 214.33 (a) Minnesota Statutes 2002, sections 256.955, subdivision 214.34 8; 256B.0625, subdivision 5a; 256B.057, subdivision 1b; and 214.35 256B.195, subdivision 5, are repealed July 1, 2003. 214.36 (b) Minnesota Statutes 2002, section 256L.04, subdivision 215.1 9, is repealed October 1, 2004. 215.2 (c) Minnesota Statutes 2002, section 256B.055, subdivision 215.3 10a, is repealed July 1, 2003, or upon federal approval, 215.4 whichever is later. 215.5 (d) Minnesota Statutes 2002, section 256L.02, subdivision 215.6 3, is repealed June 30, 2005. 215.7 ARTICLE 3 215.8 LONG-TERM CARE 215.9 Section 1. Minnesota Statutes 2002, section 144A.4605, 215.10 subdivision 4, is amended to read: 215.11 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 215.12 establishment registered under chapter 144D that is required to 215.13 obtain a home care license must obtain an assisted living home 215.14 care license according to this section or a class A or class E 215.15 license according to rule. A housing with services 215.16 establishment that obtains a class E license under this 215.17 subdivision remains subject to the payment limitations in 215.18 sections 256B.0913, subdivision55f, paragraph(h)(b), and 215.19 256B.0915, subdivision3, paragraph (g)3d. 215.20 (b) A board and lodging establishment registered for 215.21 special services as of December 31, 1996, and also registered as 215.22 a housing with services establishment under chapter 144D, must 215.23 deliver home care services according to sections 144A.43 to 215.24 144A.47, and may apply for a waiver from requirements under 215.25 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 215.26 licensed agency under the standards of section 157.17. Such 215.27 waivers as may be granted by the department will expire upon 215.28 promulgation of home care rules implementing section 144A.4605. 215.29 (c) An adult foster care provider licensed by the 215.30 department of human services and registered under chapter 144D 215.31 may continue to provide health-related services under its foster 215.32 care license until the promulgation of home care rules 215.33 implementing this section. 215.34 (d) An assisted living home care provider licensed under 215.35 this section must comply with the disclosure provisions of 215.36 section 325F.72 to the extent they are applicable. 216.1 Sec. 2. Minnesota Statutes 2002, section 256.9657, 216.2 subdivision 1, is amended to read: 216.3 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 216.4 Effective July 1, 1993, each non-state-operated nursing home 216.5 licensed under chapter 144A shall pay to the commissioner an 216.6 annual surcharge according to the schedule in subdivision 4. 216.7 The surcharge shall be calculated as $620 per licensed bed. If 216.8 the number of licensed beds is reduced, the surcharge shall be 216.9 based on the number of remaining licensed beds the second month 216.10 following the receipt of timely notice by the commissioner of 216.11 human services that beds have been delicensed. The nursing home 216.12 must notify the commissioner of health in writing when beds are 216.13 delicensed. The commissioner of health must notify the 216.14 commissioner of human services within ten working days after 216.15 receiving written notification. If the notification is received 216.16 by the commissioner of human services by the 15th of the month, 216.17 the invoice for the second following month must be reduced to 216.18 recognize the delicensing of beds. Beds on layaway status 216.19 continue to be subject to the surcharge. The commissioner of 216.20 human services must acknowledge a medical care surcharge appeal 216.21 within 30 days of receipt of the written appeal from the 216.22 provider. 216.23 (b) Effective July 1, 1994, the surcharge in paragraph (a) 216.24 shall be increased to $625. 216.25 (c) Effective August 15, 2002, the surcharge under 216.26 paragraph (b) shall be increased to $990. 216.27 (d) Effective July 15, 2003, the surcharge under paragraph 216.28 (c) shall be increased to $2,700. 216.29 (e) The commissioner may reduce, and may subsequently 216.30 restore, the surcharge under paragraph (d) based on the 216.31 commissioner's determination of a permissible surcharge. 216.32 (f) Between April 1, 2002, and August 15,20032004, a 216.33 facility governed by this subdivision may elect to assume full 216.34 participation in the medical assistance program by agreeing to 216.35 comply with all of the requirements of the medical assistance 216.36 program, including the rate equalization law in section 256B.48, 217.1 subdivision 1, paragraph (a), and all other requirements 217.2 established in law or rule, and to begin intake of new medical 217.3 assistance recipients. Rates will be determined under Minnesota 217.4 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 217.5 256B.431, subdivision 27, paragraph (i), rate calculations will 217.6 be subject to limits as prescribed in rule and law. Other than 217.7 the adjustments in sections 256B.431, subdivisions 30 and 32; 217.8 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 217.9 9549.0057, and any other applicable legislation enacted prior to 217.10 the finalization of rates, facilities assuming full 217.11 participation in medical assistance under this paragraph are not 217.12 eligible for any rate adjustments until the July 1 following 217.13 their settle-up period. 217.14 [EFFECTIVE DATE.] This section is effective June 30, 2003. 217.15 Sec. 3. Minnesota Statutes 2002, section 256.9754, 217.16 subdivision 2, is amended to read: 217.17 Subd. 2. [CREATION.]The community services development217.18grants programThere is createdunder the administration of the217.19commissioner of human servicesthe consolidated ElderCare 217.20 development grant fund for the purpose of rebalancing the 217.21 long-term care system and increasing home and community-based 217.22 care alternatives that sustain independent living. 217.23 Sec. 4. Minnesota Statutes 2002, section 256.9754, 217.24 subdivision 3, is amended to read: 217.25 Subd. 3. [PROVISION OF GRANTS.]The commissioner shall217.26make grants available to communities, providers of older adult217.27services identified in subdivision 1, or to a consortium of217.28providers of older adult services, to establish older adult217.29services.Grants may be provided for capital and other costs 217.30 including, but not limited to, start-up and training costs, 217.31 equipment, and supplies related to older adult services or other 217.32 residential or service alternatives to nursing facility care. 217.33 Grants may also be made to renovate current buildings, provide 217.34 transportation services, fund programs that would allow older 217.35 adults or disabled individuals to stay in their own homes by 217.36 sharing a home, fund programs that coordinate and manage formal 218.1 and informal services to older adults in their homes to enable 218.2 them to live as independently as possible in their own homes as 218.3 an alternative to nursing home care, or expand state-funded 218.4 programs in the area. Other services eligible for funding 218.5 include: transportation; chore services and homemaking; home 218.6 health care and personal care assistance; care coordination; 218.7 housing with services, such as assisted living and foster care; 218.8 home modification; adult day services; caregiver support and 218.9 respite; living-at-home block nurse; service integration and 218.10 development; telemedicine, telehomecare, or other 218.11 technology-based solutions; grocery shopping; and services 218.12 identified as needed for community transition. 218.13 Sec. 5. Minnesota Statutes 2002, section 256.9754, 218.14 subdivision 4, is amended to read: 218.15 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 218.16 communities and providers, including for-profits, nonprofits, 218.17 and governmental units, or to a consortium of providers that 218.18 have a local match of 25 percent in the form of cash or in-kind 218.19 services, except that for capital costs the match is 50 percent 218.20of the costs for the project in the form of donations, local tax218.21dollars, in-kind donations, fund-raising, or other local matches. 218.22 Sec. 6. Minnesota Statutes 2002, section 256.9754, 218.23 subdivision 5, is amended to read: 218.24 Subd. 5. [GRANT PREFERENCE.] The commissionerof human218.25servicesshall give preference when awarding grants under this 218.26 section to areas where nursing facility closures have occurred 218.27 or are occurring. The commissioner may award grants to the 218.28 extent grant funds are available and to the extent applications 218.29 are approved by the commissioner. Denial of approval of an 218.30 application in one year does not preclude submission of an 218.31 application in a subsequent year.The maximum grant amount is218.32limited to $750,000.218.33 Sec. 7. Minnesota Statutes 2002, section 256B.0913, 218.34 subdivision 2, is amended to read: 218.35 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 218.36 services are available to Minnesotans age 65 or olderwho are219.1not eligible for medical assistance without a spenddown or219.2waiver obligation butwho would be eligible for medical 219.3 assistance within 180 days of admission to a nursing facility 219.4 and subject to subdivisions 4 to 13. 219.5 Sec. 8. Minnesota Statutes 2002, section 256B.0913, 219.6 subdivision 4, is amended to read: 219.7 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 219.8 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 219.9 under the alternative care program is available to persons who 219.10 meet the following criteria: 219.11 (1) the person has been determined by a community 219.12 assessment under section 256B.0911 to be a person who would 219.13 require the level of care provided in a nursing facility, but 219.14 for the provision of services under the alternative care 219.15 program; 219.16 (2) the person is age 65 or older; 219.17 (3) the person would be eligible for medical assistance 219.18 within 180 days of admission to a nursing facility; 219.19 (4) the person is not ineligible for the medical assistance 219.20 program due to an asset transfer penalty; 219.21 (5) the person needs services that are not funded through 219.22 other state or federal funding;and219.23 (6) the monthly cost of the alternative care services 219.24 funded by the program for this person does not exceed 75 percent 219.25 of thestatewide weighted average monthly nursing facility rate219.26of the case mix resident class to which the individual219.27alternative care client would be assigned under Minnesota Rules,219.28parts 9549.0050 to 9549.0059, less the recipient's maintenance219.29needs allowance as described in section 256B.0915, subdivision219.301d, paragraph (a), until the first day of the state fiscal year219.31in which the resident assessment system, under section 256B.437,219.32for nursing home rate determination is implemented. Effective219.33on the first day of the state fiscal year in which a resident219.34assessment system, under section 256B.437, for nursing home rate219.35determination is implemented and the first day of each219.36subsequent state fiscal year, the monthly cost of alternative220.1care services for this person shall not exceed the alternative220.2care monthly cap for the case mix resident class to which the220.3alternative care client would be assigned under Minnesota Rules,220.4parts 9549.0050 to 9549.0059, which was in effect on the last220.5day of the previous state fiscal year, and adjusted by the220.6greater of any legislatively adopted home and community-based220.7services cost-of-living percentage increase or any legislatively220.8adopted statewide percent rate increase for nursing220.9facilitiesmonthly limit described under section 256B.0915, 220.10 subdivision 3a. This monthly limit does not prohibit the 220.11 alternative care client from payment for additional services, 220.12 but in no case may the cost of additional services purchased 220.13 under this section exceed the difference between the client's 220.14 monthly service limit defined under section 256B.0915, 220.15 subdivision 3, and the alternative care program monthly service 220.16 limit defined in this paragraph. If medical supplies and 220.17 equipment or environmental modifications are or will be 220.18 purchased for an alternative care services recipient, the costs 220.19 may be prorated on a monthly basis for up to 12 consecutive 220.20 months beginning with the month of purchase. If the monthly 220.21 cost of a recipient's other alternative care services exceeds 220.22 the monthly limit established in this paragraph, the annual cost 220.23 of the alternative care services shall be determined. In this 220.24 event, the annual cost of alternative care services shall not 220.25 exceed 12 times the monthly limit described in this paragraph.; 220.26 and 220.27 (7) the person is not ineligible due to nonpayment of the 220.28 assessed monthly premium charge over 60 days past due. 220.29 Following disenrollment due to nonpayment of a monthly premium, 220.30 eligibility shall not be reinstated for a period of 90 days 220.31 pending eligibility redetermination. 220.32 (b) Alternative care funding under this subdivision is not 220.33 available for a person who is a medical assistance recipient or 220.34 who would be eligible for medical assistance without a spenddown 220.35 or waiver obligation. A person whose initial application for 220.36 medical assistance and the elderly waiver program is being 221.1 processed may be served under the alternative care program for a 221.2 period up to 60 days. If the individual is found to be eligible 221.3 for medical assistance, medical assistance must be billed for 221.4 services payable under the federally approved elderly waiver 221.5 plan and delivered from the date the individual was found 221.6 eligible for the federally approved elderly waiver plan. 221.7 Notwithstanding this provision,upon federal approval,221.8 alternative care funds may not be used to pay for any service 221.9 the cost of which is payable by medical assistance or which is 221.10 used by a recipient to meet amedical assistance income221.11spenddown orwaiver obligation; or a medical assistance income 221.12 spenddown for a person who is eligible to participate under the 221.13 special income standard provisions through the federally 221.14 approved elderly waiver program. 221.15 (c) Alternative care funding is not available for a person 221.16 who resides in a licensed nursing home, certified boarding care 221.17 home, hospital, or intermediate care facility, except for case 221.18 management services which are provided in support of the 221.19 discharge planning processtofor a nursing home resident or 221.20 certified boarding care home resident to assist with a 221.21 relocation process to a community-based setting. 221.22 (d) Alternative care funding is not available for a person 221.23 whose income is greater than the maintenance needs allowance 221.24 under section 256B.0915, subdivision 1, paragraph (d), but equal 221.25 to or less than 120 percent of the federal poverty guideline 221.26 effective July 1, in the year for which alternative care 221.27 eligibility is determined, who would be eligible for the elderly 221.28 waiver with a waiver obligation. 221.29 Sec. 9. Minnesota Statutes 2002, section 256B.0913, 221.30 subdivision 5, is amended to read: 221.31 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)221.32 Alternative care funding may be used for payment of costs of: 221.33 (1) adult foster care; 221.34 (2) adult day care; 221.35 (3) home health aide; 221.36 (4) homemaker services; 222.1 (5) personal care; 222.2 (6) case management; 222.3 (7) respite care; 222.4 (8) assisted living; 222.5 (9) residential care services; 222.6 (10) care-related supplies and equipment; 222.7 (11) meals delivered to the home; 222.8 (12) transportation; 222.9 (13) nursing services; 222.10 (14) chore services; 222.11 (15) companion services; 222.12 (16) nutrition services; 222.13 (17) training for direct informal caregivers; 222.14 (18) telehome caredevicestomonitor recipientsprovide 222.15 services in their own homesas an alternative to hospital care,222.16nursing home care, or homein conjunction with in-home visits; 222.17 (19)other services which includesdiscretionaryfunds and222.18direct cash payments to clients,services, for which counties 222.19 may make payment from their alternative care program allocation 222.20 or services not otherwise defined in this section or section 222.21 256B.0625, following approval by the commissioner, subject to222.22the provisions of paragraph (j). Total annual payments for222.23"other services" for all clients within a county may not exceed222.2425 percent of that county's annual alternative care program base222.25allocation;and222.26 (20) environmental modifications.; and 222.27 (21) direct cash payments for which counties may make 222.28 payment from their alternative care program allocation to 222.29 clients for the purpose of purchasing services, following 222.30 approval by the commissioner, and subject to the provisions of 222.31 subdivision 5h, until approval and implementation of 222.32 consumer-directed services through the federally approved 222.33 elderly waiver plan. Upon implementation, consumer-directed 222.34 services under the alternative care program are available 222.35 statewide and limited to the average monthly expenditures 222.36 representative of all alternative care program participants for 223.1 the same case mix resident class assigned in the most recent 223.2 fiscal year for which complete expenditure data is available. 223.3 Total annual payments for discretionary services and direct 223.4 cash payments, until the federally approved consumer-directed 223.5 service option is implemented statewide, for all clients within 223.6 a county may not exceed 25 percent of that county's annual 223.7 alternative care program base allocation. Thereafter, 223.8 discretionary services are limited to 25 percent of the county's 223.9 annual alternative care program base allocation. 223.10 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 223.11 STANDARDS.] (a) Unless specified in statute, the services, 223.12 service definitions, and standards for alternative care services 223.13 shall be the same as the services, service definitions, and 223.14 standards specified in the federally approved elderly waiver 223.15 plan, except for transitional support services. 223.16 (b) The county agency must ensure that the funds are not 223.17 used to supplant services available through other public 223.18 assistance or services programs. 223.19(c) Unless specified in statute, the services, service223.20definitions, and standards for alternative care services shall223.21be the same as the services, service definitions, and standards223.22specified in the federally approved elderly waiver plan. Except223.23for the county agencies' approval of direct cash payments to223.24clients as described in paragraph (j) orFor a provider of 223.25 supplies and equipment when the monthly cost of the supplies and 223.26 equipment is less than $250, persons or agencies must be 223.27 employed by or under a contract with the county agency or the 223.28 public health nursing agency of the local board of health in 223.29 order to receive funding under the alternative care program. 223.30 Supplies and equipment may be purchased from a vendor not 223.31 certified to participate in the Medicaid program if the cost for 223.32 the item is less than that of a Medicaid vendor. 223.33 (c) Personal care services must meet the service standards 223.34 defined in the federally approved elderly waiver plan, except 223.35 that a county agency may contract with a client's relative who 223.36 meets the relative hardship waiver requirements or a relative 224.1 who meets the criteria and is also the responsible party under 224.2 an individual service plan that ensures the client's health and 224.3 safety and supervision of the personal care services by a 224.4 qualified professional as defined in section 256B.0625, 224.5 subdivision 19c. Relative hardship is established by the county 224.6 when the client's care causes a relative caregiver to do any of 224.7 the following: resign from a paying job, reduce work hours 224.8 resulting in lost wages, obtain a leave of absence resulting in 224.9 lost wages, incur substantial client-related expenses, provide 224.10 services to address authorized, unstaffed direct care time, or 224.11 meet special needs of the client unmet in the formal service 224.12 plan. 224.13(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 224.14 care rate shall be considered a difficulty of care payment and 224.15 shall not include room and board. The adult foster care rate 224.16 shall be negotiated between the county agency and the foster 224.17 care provider. The alternative care payment for the foster care 224.18 service in combination with the payment for other alternative 224.19 care services, including case management, must not exceed the 224.20 limit specified in subdivision 4, paragraph (a), clause (6). 224.21(e) Personal care services must meet the service standards224.22defined in the federally approved elderly waiver plan, except224.23that a county agency may contract with a client's relative who224.24meets the relative hardship waiver requirement as defined in224.25section 256B.0627, subdivision 4, paragraph (b), clause (10), to224.26provide personal care services if the county agency ensures224.27supervision of this service by a qualified professional as224.28defined in section 256B.0625, subdivision 19c.224.29(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 224.30 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 224.31 section, residential care services are services which are 224.32 provided to individuals living in residential care homes. 224.33 Residential care homes are currently licensed as board and 224.34 lodging establishments under section 157.16, and are registered 224.35 with the department of health as providing special services 224.36 under section 157.17and are not subject to registrationexcept 225.1 settings that are currently registered under chapter 144D. 225.2 Residential care services are defined as "supportive services" 225.3 and "health-related services." "Supportive services" meansthe225.4provision of up to 24-hour supervision and oversight.225.5Supportive services includes: (1) transportation, when provided225.6by the residential care home only; (2) socialization, when225.7socialization is part of the plan of care, has specific goals225.8and outcomes established, and is not diversional or recreational225.9in nature; (3) assisting clients in setting up meetings and225.10appointments; (4) assisting clients in setting up medical and225.11social services; (5) providing assistance with personal laundry,225.12such as carrying the client's laundry to the laundry room.225.13Assistance with personal laundry does not include any laundry,225.14such as bed linen, that is included in the room and board rate225.15 services as defined in section 157.17, subdivision 1, paragraph 225.16 (a). "Health-related services"are limited to minimal225.17assistance with dressing, grooming, and bathing and providing225.18reminders to residents to take medications that are225.19self-administered or providing storage for medications, if225.20requestedmeans services covered in section 157.17, subdivision 225.21 1, paragraph (b). Individuals receiving residential care 225.22 services cannot receive homemaking services funded under this 225.23 section. 225.24(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 225.25 of this section, "assisted living" refers to supportive services 225.26 provided by a single vendor to clients who reside in the same 225.27 apartment building of three or more units which are not subject 225.28 to registration under chapter 144D and are licensed by the 225.29 department of health as a class A home care provider or a class 225.30 E home care provider. Assisted living services are defined as 225.31 up to 24-hour supervision,andoversight, and supportive 225.32 services as defined inclause (1)section 157.17, subdivision 1, 225.33 paragraph (a), individualized home care aide tasks as defined in 225.34clause (2)Minnesota Rules, part 4668.0110, and individualized 225.35 home management tasks as defined inclause (3)Minnesota Rules, 225.36 part 4668.0120 provided to residents of a residential center 226.1 living in their units or apartments with a full kitchen and 226.2 bathroom. A full kitchen includes a stove, oven, refrigerator, 226.3 food preparation counter space, and a kitchen utensil storage 226.4 compartment. Assisted living services must be provided by the 226.5 management of the residential center or by providers under 226.6 contract with the management or with the county. 226.7(1) Supportive services include:226.8(i) socialization, when socialization is part of the plan226.9of care, has specific goals and outcomes established, and is not226.10diversional or recreational in nature;226.11(ii) assisting clients in setting up meetings and226.12appointments; and226.13(iii) providing transportation, when provided by the226.14residential center only.226.15(2) Home care aide tasks means:226.16(i) preparing modified diets, such as diabetic or low226.17sodium diets;226.18(ii) reminding residents to take regularly scheduled226.19medications or to perform exercises;226.20(iii) household chores in the presence of technically226.21sophisticated medical equipment or episodes of acute illness or226.22infectious disease;226.23(iv) household chores when the resident's care requires the226.24prevention of exposure to infectious disease or containment of226.25infectious disease; and226.26(v) assisting with dressing, oral hygiene, hair care,226.27grooming, and bathing, if the resident is ambulatory, and if the226.28resident has no serious acute illness or infectious disease.226.29Oral hygiene means care of teeth, gums, and oral prosthetic226.30devices.226.31(3) Home management tasks means:226.32(i) housekeeping;226.33(ii) laundry;226.34(iii) preparation of regular snacks and meals; and226.35(iv) shopping.226.36 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 227.1 Individuals receiving assisted living services shall not receive 227.2 both assisted living services and homemaking services. 227.3 Individualized means services are chosen and designed 227.4 specifically for each resident's needs, rather than provided or 227.5 offered to all residents regardless of their illnesses, 227.6 disabilities, or physical conditions. Assisted living services 227.7 as defined in this section shall not be authorized in boarding 227.8 and lodging establishments licensed according to sections 227.9 157.011 and 157.15 to 157.22. 227.10(h)(b) For establishments registered under chapter 144D, 227.11 assisted living services under this section means either the 227.12 services described inparagraph (g)subdivision 5d and delivered 227.13 by a class E home care provider licensed by the department of 227.14 health or the services described under section 144A.4605 and 227.15 delivered by an assisted living home care provider or a class A 227.16 home care provider licensed by the commissioner of health. 227.17(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 227.18 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 227.19 and residential care services shall be a monthly rate negotiated 227.20 and authorized by the county agency based on an individualized 227.21 service plan for each resident and may not cover direct rent or 227.22 food costs. 227.23(1)(b) The individualized monthly negotiated payment for 227.24 assisted living services as described inparagraph227.25(g)subdivision 5d or(h)5e, paragraph (b), and residential 227.26 care services as described inparagraph (f)subdivision 5c, 227.27 shall not exceed the nonfederal share in effect on July 1 of the 227.28 state fiscal year for which the rate limit is being calculated 227.29 of the greater of either the statewide or any of the geographic 227.30groups' weighted average monthly nursing facility payment rate227.31of the case mix resident class to which the alternative care227.32eligible client would be assigned under Minnesota Rules, parts227.339549.0050 to 9549.0059, less the maintenance needs allowance as227.34described in section 256B.0915, subdivision 1d, paragraph (a),227.35until the first day of the state fiscal year in which a resident227.36assessment system, under section 256B.437, of nursing home rate228.1determination is implemented. Effective on the first day of the228.2state fiscal year in which a resident assessment system, under228.3section 256B.437, of nursing home rate determination is228.4implemented and the first day of each subsequent state fiscal228.5year, the individualized monthly negotiated payment for the228.6services described in this clause shall not exceed the limit228.7described in this clause which was in effect on the last day of228.8the previous state fiscal year and which has been adjusted by228.9the greater of any legislatively adopted home and228.10community-based services cost-of-living percentage increase or228.11any legislatively adopted statewide percent rate increase for228.12nursing facilitiesgroups according to subdivision 4, paragraph 228.13 (a), clause (6). 228.14(2)(c) The individualized monthly negotiated payment for 228.15 assisted living services described under section 144A.4605 and 228.16 delivered by a provider licensed by the department of health as 228.17 a class A home care provider or an assisted living home care 228.18 provider and provided in a building that is registered as a 228.19 housing with services establishment under chapter 144D and that 228.20 provides 24-hour supervision in combination with the payment for 228.21 other alternative care services, including case management, must 228.22 not exceed the limit specified in subdivision 4, paragraph (a), 228.23 clause (6). 228.24(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 228.25 A county agency may make payment from their alternative care 228.26 program allocation for"other services" which include use of228.27"discretionary funds" for services that are not otherwise228.28defined in this section anddirect cash payments to the client 228.29 for the purpose of purchasing the services. The following 228.30 provisions apply to payments under thisparagraphsubdivision: 228.31 (1) a cash payment to a client under this provision cannot 228.32 exceed the monthly payment limit for that client as specified in 228.33 subdivision 4, paragraph (a), clause (6); and 228.34 (2) a county may not approve any cash payment for a client 228.35 who meets either of the following: 228.36 (i) has been assessed as having a dependency in 229.1 orientation, unless the client has an authorized 229.2 representative. An "authorized representative" means an 229.3 individual who is at least 18 years of age and is designated by 229.4 the person or the person's legal representative to act on the 229.5 person's behalf. This individual may be a family member, 229.6 guardian, representative payee, or other individual designated 229.7 by the person or the person's legal representative, if any, to 229.8 assist in purchasing and arranging for supports; or 229.9 (ii) is concurrently receiving adult foster care, 229.10 residential care, or assisted living services;. 229.11(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 229.12 payments to a person or a person's family will be provided 229.13 through a monthly payment and be in the form of cash, voucher, 229.14 or direct county payment to a vendor. Fees or premiums assessed 229.15 to the person for eligibility for health and human services are 229.16 not reimbursable through this service option. Services and 229.17 goods purchased through cash payments must be identified in the 229.18 person's individualized care plan and must meet all of the 229.19 following criteria: 229.20(i)(1) they must be over and above the normal cost of 229.21 caring for the person if the person did not have functional 229.22 limitations; 229.23(ii)(2) they must be directly attributable to the person's 229.24 functional limitations; 229.25(iii)(3) they must have the potential to be effective at 229.26 meeting the goals of the program; and 229.27(iv)(4) they must be consistent with the needs identified 229.28 in the individualized service plan. The service plan shall 229.29 specify the needs of the person and family, the form and amount 229.30 of payment, the items and services to be reimbursed, and the 229.31 arrangements for management of the individual grant; and. 229.32(v)(b) The person, the person's family, or the legal 229.33 representative shall be provided sufficient information to 229.34 ensure an informed choice of alternatives. The local agency 229.35 shall document this information in the person's care plan, 229.36 including the type and level of expenditures to be reimbursed;. 230.1 (c) Persons receiving grants under this section shall have 230.2 the following responsibilities: 230.3 (1) spend the grant money in a manner consistent with their 230.4 individualized service plan with the local agency; 230.5 (2) notify the local agency of any necessary changes in the 230.6 grant expenditures; 230.7 (3) arrange and pay for supports; and 230.8 (4) inform the local agency of areas where they have 230.9 experienced difficulty securing or maintaining supports. 230.10 (d) The county shall report client outcomes, services, and 230.11 costs under this paragraph in a manner prescribed by the 230.12 commissioner. 230.13(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 230.14 lead agency under contract, or tribal government under contract 230.15 to administer the alternative care program shall not be liable 230.16 for damages, injuries, or liabilities sustained through the 230.17 purchase of direct supports or goods by the person, the person's 230.18 family, or the authorized representative with funds received 230.19 through the cash payments under this section. Liabilities 230.20 include, but are not limited to, workers' compensation, the 230.21 Federal Insurance Contributions Act (FICA), or the Federal 230.22 Unemployment Tax Act (FUTA);. 230.23(5) persons receiving grants under this section shall have230.24the following responsibilities:230.25(i) spend the grant money in a manner consistent with their230.26individualized service plan with the local agency;230.27(ii) notify the local agency of any necessary changes in230.28the grant expenditures;230.29(iii) arrange and pay for supports; and230.30(iv) inform the local agency of areas where they have230.31experienced difficulty securing or maintaining supports; and230.32(6) the county shall report client outcomes, services, and230.33costs under this paragraph in a manner prescribed by the230.34commissioner.230.35 Sec. 10. Minnesota Statutes 2002, section 256B.0913, 230.36 subdivision 6, is amended to read: 231.1 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 231.2 The alternative care program is administered by the county 231.3 agency. This agency is the lead agency responsible for the 231.4 local administration of the alternative care program as 231.5 described in this section. However, it may contract with the 231.6 public health nursing service to be the lead agency. The 231.7 commissioner may contract with federally recognized Indian 231.8 tribes with a reservation in Minnesota to serve as the lead 231.9 agency responsible for the local administration of the 231.10 alternative care program as described in the contract. 231.11 (b) Alternative care pilot projects operate according to 231.12 this section and the provisions of Laws 1993, First Special 231.13 Session chapter 1, article 5, section 133, under agreement with 231.14 the commissioner. Each pilot project contract period shall 231.15 begin no later than the first payment cycle of the state fiscal 231.16 year and continue through the last payment cycle of the state 231.17 fiscal year. 231.18 Sec. 11. Minnesota Statutes 2002, section 256B.0913, 231.19 subdivision 7, is amended to read: 231.20 Subd. 7. [CASE MANAGEMENT.]Providers of case management231.21services for persons receiving services funded by the231.22alternative care program must meet the qualification231.23requirements and standards specified in section 256B.0915,231.24subdivision 1b.The case manager must not approve alternative 231.25 care funding for a client in any setting in which the case 231.26 manager cannot reasonably ensure the client's health and 231.27 safety. The case manager is responsible for the 231.28 cost-effectiveness of the alternative care individual care plan 231.29 and must not approve any care plan in which the cost of services 231.30 funded by alternative care and client contributions exceeds the 231.31 limit specified in section 256B.0915, subdivision 3, paragraph 231.32 (b).The county may allow a case manager employed by the county231.33to delegate certain aspects of the case management activity to231.34another individual employed by the county provided there is231.35oversight of the individual by the case manager. The case231.36manager may not delegate those aspects which require232.1professional judgment including assessments, reassessments, and232.2care plan development.232.3 Sec. 12. Minnesota Statutes 2002, section 256B.0913, 232.4 subdivision 8, is amended to read: 232.5 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 232.6 case manager shall implement the plan of care for each 232.7 alternative care client and ensure that a client's service needs 232.8 and eligibility are reassessed at least every 12 months. The 232.9 plan shall include any services prescribed by the individual's 232.10 attending physician as necessary to allow the individual to 232.11 remain in a community setting. In developing the individual's 232.12 care plan, the case manager should include the use of volunteers 232.13 from families and neighbors, religious organizations, social 232.14 clubs, and civic and service organizations to support the formal 232.15 home care services. The county shall be held harmless for 232.16 damages or injuries sustained through the use of volunteers 232.17 under this subdivision including workers' compensation 232.18 liability. The lead agency shall provide documentation in each 232.19 individual's plan of care and, if requested, to the commissioner 232.20 that the most cost-effective alternatives available have been 232.21 offered to the individual and that the individual was free to 232.22 choose among available qualified providers, both public and 232.23 private, including qualified case management or service 232.24 coordination providers other than those employed by the lead 232.25 agency when the lead agency maintains responsibility for prior 232.26 authorizing services in accordance with statutory and 232.27 administrative requirements. The case manager must give the 232.28 individual a ten-day written notice of any denial, termination, 232.29 or reduction of alternative care services. 232.30 (b) If the county administering alternative care services 232.31 is different than the county of financial responsibility, the 232.32 care plan may be implemented without the approval of the county 232.33 of financial responsibility. 232.34 Sec. 13. Minnesota Statutes 2002, section 256B.0913, 232.35 subdivision 10, is amended to read: 232.36 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 233.1 appropriation for fiscal years 1992 and beyond shall cover only 233.2 alternative care eligible clients. By July 1 of each year, the 233.3 commissioner shall allocate to county agencies the state funds 233.4 available for alternative care for persons eligible under 233.5 subdivision 2. 233.6 (b) The adjusted base for each county is the county's 233.7 current fiscal year base allocation plus any targeted funds 233.8 approved during the current fiscal year. Calculations for 233.9 paragraphs (c) and (d) are to be made as follows: for each 233.10 county, the determination of alternative care program 233.11 expenditures shall be based on payments for services rendered 233.12 from April 1 through March 31 in the base year, to the extent 233.13 that claims have been submitted and paid by June 1 of that year. 233.14 (c) If the alternative care program expenditures as defined 233.15 in paragraph (b) are 95 percent or more of the county's adjusted 233.16 base allocation, the allocation for the next fiscal year is 100 233.17 percent of the adjusted base, plus inflation to the extent that 233.18 inflation is included in the state budget. 233.19 (d) If the alternative care program expenditures as defined 233.20 in paragraph (b) are less than 95 percent of the county's 233.21 adjusted base allocation, the allocation for the next fiscal 233.22 year is the adjusted base allocation less the amount of unspent 233.23 funds below the 95 percent level. 233.24 (e) If the annual legislative appropriation for the 233.25 alternative care program is inadequate to fund the combined 233.26 county allocations for a biennium, the commissioner shall 233.27 distribute to each county the entire annual appropriation as 233.28 that county's percentage of the computed base as calculated in 233.29 paragraphs (c) and (d). 233.30 (f) On agreement between the commissioner and the lead 233.31 agency, the commissioner may have discretion to reallocate 233.32 alternative care base allocations distributed to lead agencies 233.33 in which the base amount exceeds program expenditures. 233.34 Sec. 14. Minnesota Statutes 2002, section 256B.0913, 233.35 subdivision 12, is amended to read: 233.36 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 234.1 all alternative care eligible clients to help pay for the cost 234.2 of participating in the program. The amount of the premium for 234.3 the alternative care client shall be determined as follows: 234.4 (1) when the alternative care client's income less 234.5 recurring and predictable medical expenses isgreater than the234.6recipient's maintenance needs allowance as defined in section234.7256B.0915, subdivision 1d, paragraph (a), butless than 150 234.8 percent of the federal poverty guideline effective on July 1 of 234.9 the state fiscal year in which the premium is being computed, 234.10 and total assets are less than $10,000, the fee iszeroten 234.11 percent of the cost of alternative care services; or 234.12 (2) when the alternative care client's income less 234.13 recurring and predictable medical expenses isgreater than150 234.14 percent or greater of the federal poverty guideline effective on 234.15 July 1 of the state fiscal year in which the premium is being 234.16 computed, and total assets are less than $10,000, the fee is 25234.17percent of the cost of alternative care services or the234.18difference between 150 percent of the federal poverty guideline234.19effective on July 1 of the state fiscal year in which the234.20premium is being computed and the client's income less recurring234.21and predictable medical expenses, whichever is less; and234.22(3) when the alternative care client'sor total assets are 234.23 greater than $10,000, the fee is 25 percent of the cost of 234.24 alternative care services. 234.25 For married persons, total assets are defined as the total 234.26 marital assets less the estimated community spouse asset 234.27 allowance, under section 256B.059, if applicable. For married 234.28 persons, total income is defined as the client's income less the 234.29 monthly spousal allotment, under section 256B.058. 234.30 All alternative care servicesexcept case managementshall 234.31 be included in the estimated costs for the purpose of 234.32 determining25 percent ofthecostspremium amount. 234.33 Premiums are due and payable each month alternative care 234.34 services are received unless the actual cost of the services is 234.35 less than the premium, in which case the fee is the lesser 234.36 amount. 235.1 (b) The fee shall be waived by the commissioner when: 235.2 (1) a person who is residing in a nursing facility is 235.3 receiving case management only; 235.4 (2)a person is applying for medical assistance;235.5(3)a married couple is requesting an asset assessment 235.6 under the spousal impoverishment provisions; 235.7(4)(3) a person is found eligible for alternative care, 235.8 but is not yet receiving alternative care services;or235.9(5)(4) a person's fee under paragraph (a) is less than 235.10 $25; or 235.11 (5) a person has chosen to participate in a 235.12 consumer-directed service plan for which the cost is no greater 235.13 than the total cost of the person's alternative care service 235.14 plan less the monthly premium amount that would otherwise be 235.15 assessed. 235.16 (c) The county agency must record in the state's receivable 235.17 system the client's assessed premium amount or the reason the 235.18 premium has been waived. The commissioner will bill and collect 235.19 the premium from the client. Money collected must be deposited 235.20 in the general fund and is appropriated to the commissioner for 235.21 the alternative care program. The client must supply the county 235.22 with the client's social security number at the time of 235.23 application. The county shall supply the commissioner with the 235.24 client's social security number and other information the 235.25 commissioner requires to collect the premium from the client. 235.26 The commissioner shall collect unpaid premiums using the Revenue 235.27 Recapture Act in chapter 270A and other methods available to the 235.28 commissioner. The commissioner may require counties to inform 235.29 clients of the collection procedures that may be used by the 235.30 state if a premium is not paid. This paragraph does not apply 235.31 to alternative care pilot projects authorized in Laws 1993, 235.32 First Special Session chapter 1, article 5, section 133, if a 235.33 county operating under the pilot project reports the following 235.34 dollar amounts to the commissioner quarterly: 235.35 (1) total premiums billed to clients; 235.36 (2) total collections of premiums billed; and 236.1 (3) balance of premiums owed by clients. 236.2 If a county does not adhere to these reporting requirements, the 236.3 commissioner may terminate the billing, collecting, and 236.4 remitting portions of the pilot project and require the county 236.5 involved to operate under the procedures set forth in this 236.6 paragraph. 236.7 Sec. 15. Minnesota Statutes 2002, section 256B.0915, 236.8 subdivision 3, is amended to read: 236.9 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND236.10FORECASTING.](a)The number of medical assistance waiver 236.11 recipients that a county may serve must be allocated according 236.12 to the number of medical assistance waiver cases open on July 1 236.13 of each fiscal year. Additional recipients may be served with 236.14 the approval of the commissioner. 236.15(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 236.16 monthly limit for the cost of waivered services to an individual 236.17 elderly waiver client shall be the weighted average monthly 236.18 nursing facility rate of the case mix resident class to which 236.19 the elderly waiver client would be assigned under Minnesota 236.20 Rules, parts 9549.0050 to 9549.0059, less the recipient's 236.21 maintenance needs allowance as described in subdivision 1d, 236.22 paragraph (a), until the first day of the state fiscal year in 236.23 which the resident assessment system as described in section 236.24 256B.437 for nursing home rate determination is implemented. 236.25 Effective on the first day of the state fiscal year in which the 236.26 resident assessment system as described in section 256B.437 for 236.27 nursing home rate determination is implemented and the first day 236.28 of each subsequent state fiscal year, the monthly limit for the 236.29 cost of waivered services to an individual elderly waiver client 236.30 shall be the rate of the case mix resident class to which the 236.31 waiver client would be assigned under Minnesota Rules, parts 236.32 9549.0050 to 9549.0059, in effect on the last day of the 236.33 previous state fiscal year, adjusted by the greater of any 236.34 legislatively adopted home and community-based services 236.35 cost-of-living percentage increase or any legislatively adopted 236.36 statewide percent rate increase for nursing facilities. 237.1(c)(b) If extended medical supplies and equipment or 237.2 environmental modifications are or will be purchased for an 237.3 elderly waiver client, the costs may be prorated for up to 12 237.4 consecutive months beginning with the month of purchase. If the 237.5 monthly cost of a recipient's waivered services exceeds the 237.6 monthly limit established in paragraph(b)(a), the annual cost 237.7 of all waivered services shall be determined. In this event, 237.8 the annual cost of all waivered services shall not exceed 12 237.9 times the monthly limit of waivered services as described in 237.10 paragraph(b)(a). 237.11(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 237.12 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 237.13 nursing facility resident at the time of requesting a 237.14 determination of eligibility for elderly waivered services, a 237.15 monthly conversion limit for the cost of elderly waivered 237.16 services may be requested. The monthly conversion limit for the 237.17 cost of elderly waiver services shall be the resident class 237.18 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 237.19 for that resident in the nursing facility where the resident 237.20 currently resides until July 1 of the state fiscal year in which 237.21 the resident assessment system as described in section 256B.437 237.22 for nursing home rate determination is implemented. Effective 237.23 on July 1 of the state fiscal year in which the resident 237.24 assessment system as described in section 256B.437 for nursing 237.25 home rate determination is implemented, the monthly conversion 237.26 limit for the cost of elderly waiver services shall be the per 237.27 diem nursing facility rate as determined by the resident 237.28 assessment system as described in section 256B.437 for that 237.29 resident in the nursing facility where the resident currently 237.30 resides multiplied by 365 and divided by 12, less the 237.31 recipient's maintenance needs allowance as described in 237.32 subdivision 1d. The initially approved conversion rate may be 237.33 adjusted by the greater of any subsequent legislatively adopted 237.34 home and community-based services cost-of-living percentage 237.35 increase or any subsequent legislatively adopted statewide 237.36 percentage rate increase for nursing facilities. The limit 238.1 under thisclausesubdivision only applies to persons discharged 238.2 from a nursing facility after a minimum 30-day stay and found 238.3 eligible for waivered services on or after July 1, 1997. 238.4 (b) The following costs must be included in determining the 238.5 total monthly costs for the waiver client: 238.6 (1) cost of all waivered services, including extended 238.7 medical supplies and equipment and environmental modifications; 238.8 and 238.9 (2) cost of skilled nursing, home health aide, and personal 238.10 care services reimbursable by medical assistance. 238.11(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 238.12 PROVISIONS.] (a) Medical assistance funding for skilled nursing 238.13 services, private duty nursing, home health aide, and personal 238.14 care services for waiver recipients must be approved by the case 238.15 manager and included in the individual care plan. 238.16(f)(b) A county is not required to contract with a 238.17 provider of supplies and equipment if the monthly cost of the 238.18 supplies and equipment is less than $250. 238.19(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 238.20 care rate shall be considered a difficulty of care payment and 238.21 shall not include room and board. The adult foster care service 238.22 rate shall be negotiated between the county agency and the 238.23 foster care provider. The elderly waiver payment for the foster 238.24 care service in combination with the payment for all other 238.25 elderly waiver services, including case management, must not 238.26 exceed the limit specified in subdivision 3a, paragraph(b)(a). 238.27(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 238.28 for assisted living service shall be a monthly rate negotiated 238.29 and authorized by the county agency based on an individualized 238.30 service plan for each resident and may not cover direct rent or 238.31 food costs. 238.32(1)(b) The individualized monthly negotiated payment for 238.33 assisted living services as described in section 256B.0913, 238.34subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 238.35 residential care services as described in section 256B.0913, 238.36 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 239.1 share, in effect on July 1 of the state fiscal year for which 239.2 the rate limit is being calculated, of the greater of either the 239.3 statewide or any of the geographic groups' weighted average 239.4 monthly nursing facility rate of the case mix resident class to 239.5 which the elderly waiver eligible client would be assigned under 239.6 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 239.7 maintenance needs allowance as described in subdivision 1d, 239.8 paragraph (a), until the July 1 of the state fiscal year in 239.9 which the resident assessment system as described in section 239.10 256B.437 for nursing home rate determination is implemented. 239.11 Effective on July 1 of the state fiscal year in which the 239.12 resident assessment system as described in section 256B.437 for 239.13 nursing home rate determination is implemented and July 1 of 239.14 each subsequent state fiscal year, the individualized monthly 239.15 negotiated payment for the services described in this clause 239.16 shall not exceed the limit described in this clause which was in 239.17 effect on June 30 of the previous state fiscal year and which 239.18 has been adjusted by the greater of any legislatively adopted 239.19 home and community-based services cost-of-living percentage 239.20 increase or any legislatively adopted statewide percent rate 239.21 increase for nursing facilities. 239.22(2)(c) The individualized monthly negotiated payment for 239.23 assisted living services described in section 144A.4605 and 239.24 delivered by a provider licensed by the department of health as 239.25 a class A home care provider or an assisted living home care 239.26 provider and provided in a building that is registered as a 239.27 housing with services establishment under chapter 144D and that 239.28 provides 24-hour supervision in combination with the payment for 239.29 other elderly waiver services, including case management, must 239.30 not exceed the limit specified inparagraph (b)subdivision 3a. 239.31(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 239.32 FORECASTS.] (a) The county shall negotiate individual service 239.33 rates with vendors and may authorize payment for actual costs up 239.34 to the county's current approved rate. Persons or agencies must 239.35 be employed by or under a contract with the county agency or the 239.36 public health nursing agency of the local board of health in 240.1 order to receive funding under the elderly waiver program, 240.2 except as a provider of supplies and equipment when the monthly 240.3 cost of the supplies and equipment is less than $250. 240.4(j)(b) Reimbursement for the medical assistance recipients 240.5 under the approved waiver shall be made from the medical 240.6 assistance account through the invoice processing procedures of 240.7 the department's Medicaid Management Information System (MMIS), 240.8 only with the approval of the client's case manager. The budget 240.9 for the state share of the Medicaid expenditures shall be 240.10 forecasted with the medical assistance budget, and shall be 240.11 consistent with the approved waiver. 240.12(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 240.13 COSTS.] (a) To improve access to community services and 240.14 eliminate payment disparities between the alternative care 240.15 program and the elderly waiver, the commissioner shall establish 240.16 statewide maximum service rate limits and eliminate 240.17 county-specific service rate limits. 240.18(1)(b) Effective July 1, 2001, for service rate limits, 240.19 except those described or defined inparagraphs (g) and240.20(h)subdivisions 3d and 3e, the rate limit for each service 240.21 shall be the greater of the alternative care statewide maximum 240.22 rate or the elderly waiver statewide maximum rate. 240.23(2)(c) Counties may negotiate individual service rates 240.24 with vendors for actual costs up to the statewide maximum 240.25 service rate limit. 240.26 Sec. 16. Minnesota Statutes 2002, section 256B.15, 240.27 subdivision 1, is amended to read: 240.28 Subdivision 1. [DEFINITION.] For purposes of this section, 240.29 "medical assistance" includes the medical assistance program 240.30 under this chapter and the general assistance medical care 240.31 program under chapter 256D, but does not include the alternative240.32care program for nonmedical assistance recipients under section240.33256B.0913, subdivision 4and alternative care for nonmedical 240.34 assistance recipients under section 256B.0913. 240.35 [EFFECTIVE DATE.] This section is effective July 1, 2003, 240.36 for decedents dying on or after that date. 241.1 Sec. 17. Minnesota Statutes 2002, section 256B.15, 241.2 subdivision 1a, is amended to read: 241.3 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 241.4 receives any medical assistance hereunder, on the person's 241.5 death, if single, or on the death of the survivor of a married 241.6 couple, either or both of whom received medical assistance, the 241.7 total amount paid for medical assistance rendered for the person 241.8 and spouse shall be filed as a claim against the estate of the 241.9 person or the estate of the surviving spouse in the court having 241.10 jurisdiction to probate the estate or to issue a decree of 241.11 descent according to sections 525.31 to 525.313. 241.12 A claim shall be filed if medical assistance was rendered 241.13 for either or both persons under one of the following 241.14 circumstances: 241.15 (a) the person was over 55 years of age, and received 241.16 services under this chapter, excluding alternative care; 241.17 (b) the person resided in a medical institution for six 241.18 months or longer, received services under this chapterexcluding241.19alternative care,and, at the time of institutionalization or 241.20 application for medical assistance, whichever is later, the 241.21 person could not have reasonably been expected to be discharged 241.22 and returned home, as certified in writing by the person's 241.23 treating physician. For purposes of this section only, a 241.24 "medical institution" means a skilled nursing facility, 241.25 intermediate care facility, intermediate care facility for 241.26 persons with mental retardation, nursing facility, or inpatient 241.27 hospital; or 241.28 (c) the person received general assistance medical care 241.29 services under chapter 256D. 241.30 The claim shall be considered an expense of the last 241.31 illness of the decedent for the purpose of section 524.3-805. 241.32 Any statute of limitations that purports to limit any county 241.33 agency or the state agency, or both, to recover for medical 241.34 assistance granted hereunder shall not apply to any claim made 241.35 hereunder for reimbursement for any medical assistance granted 241.36 hereunder. Notice of the claim shall be given to all heirs and 242.1 devisees of the decedent whose identity can be ascertained with 242.2 reasonable diligence. The notice must include procedures and 242.3 instructions for making an application for a hardship waiver 242.4 under subdivision 5; time frames for submitting an application 242.5 and determination; and information regarding appeal rights and 242.6 procedures. Counties are entitled to one-half of the nonfederal 242.7 share of medical assistance collections from estates that are 242.8 directly attributable to county effort. Counties are entitled 242.9 to ten percent of the collections for alternative care directly 242.10 attributable to county effort. 242.11 [EFFECTIVE DATE.] This section is effective July 1, 2003, 242.12 for decedents dying on or after that date. 242.13 Sec. 18. Minnesota Statutes 2002, section 256B.15, 242.14 subdivision 2, is amended to read: 242.15 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 242.16 only the total amount of medical assistance rendered after age 242.17 55 or during a period of institutionalization described in 242.18 subdivision 1a, clause (b), and the total amount of general 242.19 assistance medical care rendered, and shall not include 242.20 interest. Claims that have been allowed but not paid shall bear 242.21 interest according to section 524.3-806, paragraph (d). A claim 242.22 against the estate of a surviving spouse who did not receive 242.23 medical assistance, for medical assistance rendered for the 242.24 predeceased spouse, is limited to the value of the assets of the 242.25 estate that were marital property or jointly owned property at 242.26 any time during the marriage. Claims for alternative care shall 242.27 be net of all premiums paid under section 256B.0913, subdivision 242.28 12, on or after July 1, 2003, and shall be limited to services 242.29 provided on or after July 1, 2003. 242.30 [EFFECTIVE DATE.] This section is effective July 1, 2003, 242.31 for decedents dying on or after that date. 242.32 Sec. 19. Minnesota Statutes 2002, section 256B.19, 242.33 subdivision 1d, is amended to read: 242.34 Subd. 1d. [PORTION OF NONFEDERAL SHARE TO BE PAID BY 242.35 CERTAIN COUNTIES.] (a) In addition to the percentage 242.36 contribution paid by a county under subdivision 1, the 243.1 governmental units designated in this subdivision shall be 243.2 responsible for an additional portion of the nonfederal share of 243.3 medical assistance cost. For purposes of this subdivision, 243.4 "designated governmental unit" means the counties of Becker, 243.5 Beltrami, Clearwater, Cook, Dodge, Hubbard, Itasca, Lake, 243.6 Pennington, Pipestone, Ramsey, St. Louis, Steele, Todd, 243.7 Traverse, and Wadena. 243.8 (b) Beginning in 1994, each of the governmental units 243.9 designated in this subdivision shall transfer before noon on May 243.10 31 to the state Medicaid agency an amount equal to the number of 243.11 licensed beds in any nursing home owned and operated by the 243.12 county on that date, with the county named as licensee, 243.13 multiplied by $5,723. If two or more counties own and operate a 243.14 nursing home, the payment shall be prorated. These sums shall 243.15 be part of the designated governmental unit's portion of the 243.16 nonfederal share of medical assistance costs. 243.17 (c) Beginning in 2002, in addition to any transfer under 243.18 paragraph (b), each of the governmental units designated in this 243.19 subdivision shall transfer before noon on May 31 to the state 243.20 Medicaid agency an amount equal to the number of licensed beds 243.21 in any nursing home owned and operated by the county on that 243.22 date, with the county named as licensee, multiplied by $10,784. 243.23 The provisions of paragraph (b) apply to transfers under this 243.24 paragraph. 243.25 (d) Beginning in 2004, in addition to any transfer under 243.26 paragraphs (b) and (c), each of the governmental units 243.27 designated in this subdivision shall transfer before noon on May 243.28 31 to the state Medicaid agency an amount equal to the number of 243.29 licensed beds in any nursing home owned and operated by the 243.30 county on that date, with the county named as licensee, 243.31 multiplied by $2,230. The provisions of paragraph (b) apply to 243.32 transfers under this paragraph. 243.33 (e) The commissioner may reduce the intergovernmental 243.34 transfers underparagraphparagraphs (c) and (d) based on the 243.35 commissioner's determination of the payment rate in section 243.36 256B.431, subdivision 23, paragraphs (c)and, (d), and (e). Any 244.1 adjustments must be made on a per-bed basis and must result in 244.2 an amount equivalent to the total amount resulting from the rate 244.3 adjustment in section 256B.431, subdivision 23, paragraphs (c) 244.4and, (d), and (e). 244.5 [EFFECTIVE DATE.] This section is effective June 30, 2003. 244.6 Sec. 20. Minnesota Statutes 2002, section 256B.431, 244.7 subdivision 2r, is amended to read: 244.8 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 244.9 July 1, 1993, the commissioner shall limit payment for leave 244.10 days in a nursing facility to 79 percent of that nursing 244.11 facility's total payment rate for the involved 244.12 resident. Effective July 1, 2003, for facilities reimbursed 244.13 under this section or section 256B.434, the commissioner shall 244.14 limit payment for leave days in a nursing facility to 60 percent 244.15 of that nursing facility's total payment rate for the involved 244.16 resident. 244.17 Sec. 21. Minnesota Statutes 2002, section 256B.431, is 244.18 amended by adding a subdivision to read: 244.19 Subd. 2t. [PAYMENT LIMITATION.] Beginning July 1, 2003, 244.20 for facilities reimbursed under this section or section 244.21 256B.434, the amount that shall be paid by or on behalf of the 244.22 Medicaid program for days with co-payments during a 244.23 Medicare-covered skilled nursing facility stay shall not result 244.24 in total payment to the facility by the Medicare program and the 244.25 Medicaid program being greater than the Medicaid RUG-III 244.26 case-mix payment rate. 244.27 Sec. 22. Minnesota Statutes 2002, section 256B.431, 244.28 subdivision 23, is amended to read: 244.29 Subd. 23. [COUNTY NURSING HOME PAYMENT ADJUSTMENTS.] (a) 244.30 Beginning in 1994, the commissioner shall pay a nursing home 244.31 payment adjustment on May 31 after noon to a county in which is 244.32 located a nursing home that, on that date, was county-owned and 244.33 operated, with the county named as licensee by the commissioner 244.34 of health, and had over 40 beds and medical assistance occupancy 244.35 in excess of 50 percent during the reporting year ending 244.36 September 30, 1991. The adjustment shall be an amount equal to 245.1 $16 per calendar day multiplied by the number of beds licensed 245.2 in the facilityas of September 30, 1991on that date. 245.3 (b) Payments under paragraph (a) are excluded from medical 245.4 assistance per diem rate calculations. These payments are 245.5 required notwithstanding any rule prohibiting medical assistance 245.6 payments from exceeding payments from private pay residents. A 245.7 facility receiving a payment under paragraph (a) may not 245.8 increase charges to private pay residents by an amount 245.9 equivalent to the per diem amount payments under paragraph (a) 245.10 would equal if converted to a per diem. 245.11 (c) Beginning in 2002, in addition to any payment under 245.12 paragraph (a), the commissioner shall pay to a nursing facility 245.13 described in paragraph (a) an adjustment in an amount equal to 245.14 $29.55 per calendar day multiplied by the number of beds 245.15 licensed in the facility on that date. The provisions of 245.16 paragraphs (a) and (b) apply to payments under this paragraph. 245.17 (d) Beginning in 2004, in addition to any payment under 245.18 paragraphs (a) and (c), the commissioner shall pay to a nursing 245.19 facility described in paragraph (a) an adjustment in an amount 245.20 equal to $6.11 per calendar day multiplied by the number of beds 245.21 licensed in the facility on that date. The provisions of 245.22 paragraphs (a) and (b) apply to payments under this paragraph. 245.23 (e) The commissioner may reduce payments under 245.24paragraphparagraphs (c) and (d) based on the commissioner's 245.25 determination of Medicare upper payment limits. Any adjustments 245.26 must be proportional to adjustments made under section 256B.19, 245.27 subdivision 1d, paragraph(d)(e). 245.28 [EFFECTIVE DATE.] This section is effective June 30, 2003. 245.29 Sec. 23. Minnesota Statutes 2002, section 256B.431, 245.30 subdivision 32, is amended to read: 245.31 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 245.32 years beginning on or after July 1, 2001, the total payment rate 245.33 for a facility reimbursed under this section, section 256B.434, 245.34 or any other section for the first 90 paid days after admission 245.35 shall be: 245.36 (1) for the first 30 paid days, the rate shall be 120 246.1 percent of the facility's medical assistance rate for each case 246.2 mix class;and246.3 (2) for the next 60 paid days after the first 30 paid days, 246.4 the rate shall be 110 percent of the facility's medical 246.5 assistance rate for each case mix class.; 246.6(b)(3) beginning with the 91st paid day after admission, 246.7 the payment rate shall be the rate otherwise determined under 246.8 this section, section 256B.434, or any other section.; and 246.9(c)(4) payments under thissubdivision appliesparagraph 246.10 apply to admissions occurring on or after July 1, 2001, and 246.11 resident days from that date through June 30, 2003. 246.12 (b) For rate years beginning on or after July 1, 2003, the 246.13 total payment rate for a facility reimbursed under this section, 246.14 section 256B.434, or any other section shall be: 246.15 (1) for the first 30 calendar days after admission, the 246.16 rate shall be 120 percent of the facility's medical assistance 246.17 rate for each RUG class; 246.18 (2) beginning with the 31st calendar day after admission, 246.19 the payment rate shall be the rate otherwise determined under 246.20 this section, section 256B.434, or any other section; and 246.21 (3) payments under this paragraph apply to admissions 246.22 occurring on or after July 1, 2003. 246.23 (c) Effective January 1, 2004, the enhanced rates under 246.24 this subdivision shall not be allowed if a resident has resided 246.25 in any other nursing facility during the previous 30 calendar 246.26 days. 246.27 Sec. 24. Minnesota Statutes 2002, section 256B.431, 246.28 subdivision 36, is amended to read: 246.29 Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 246.30 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 246.31 1, 2001, and June 30, 2003, the commissioner shall provide to 246.32 each nursing facility reimbursed under this section, section 246.33 256B.434, or any other section, a scholarship per diem of 25 246.34 cents to the total operating payment rate to be used: 246.35 (1) for employee scholarships that satisfy the following 246.36 requirements: 247.1 (i) scholarships are available to all employees who work an 247.2 average of at least 20 hours per week at the facility except the 247.3 administrator, department supervisors, and registered nurses; 247.4 and 247.5 (ii) the course of study is expected to lead to career 247.6 advancement with the facility or in long-term care, including 247.7 medical care interpreter services and social work; and 247.8 (2) to provide job-related training in English as a second 247.9 language. 247.10 (b) A facility receiving a rate adjustment under this 247.11 subdivision may submit to the commissioner on a schedule 247.12 determined by the commissioner and on a form supplied by the 247.13 commissioner a calculation of the scholarship per diem, 247.14 including: the amount received from this rate adjustment; the 247.15 amount used for training in English as a second language; the 247.16 number of persons receiving the training; the name of the person 247.17 or entity providing the training; and for each scholarship 247.18 recipient, the name of the recipient, the amount awarded, the 247.19 educational institution attended, the nature of the educational 247.20 program, the program completion date, and a determination of the 247.21 per diem amount of these costs based on actual resident days. 247.22 (c) On July 1, 2003, the commissioner shall remove the 25 247.23 cent scholarship per diem from the total operating payment rate 247.24 of each facility. 247.25(d) For rate years beginning after June 30, 2003, the247.26commissioner shall provide to each facility the scholarship per247.27diem determined in paragraph (b).247.28 Sec. 25. Minnesota Statutes 2002, section 256B.431, is 247.29 amended by adding a subdivision to read: 247.30 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 247.31 YEAR 2004.] Effective June 1, 2003, the commissioner shall 247.32 provide to each nursing home reimbursed under this section or 247.33 section 256B.434, an increase in each case mix payment rate 247.34 equal to the increase in the per-bed surcharge paid under 247.35 section 256.9657, subdivision 1, paragraph (d), divided by 365 247.36 and further divided by .90. The increase shall not be subject 248.1 to any annual percentage increase. The 30-day advance notice 248.2 requirement in section 256B.47, subdivision 2, shall not apply 248.3 to rate increases resulting from this section. The commissioner 248.4 shall not adjust the rate increase under this subdivision unless 248.5 an adjustment under section 256.9657, subdivision 1, paragraph 248.6 (e), is greater than 1.5 percent of the surcharge amount. 248.7 [EFFECTIVE DATE.] This section is effective May 31, 2003. 248.8 Sec. 26. Minnesota Statutes 2002, section 256B.431, is 248.9 amended by adding a subdivision to read: 248.10 Subd. 39. [NURSING FACILITY RATE ADJUSTMENT.] (a) For the 248.11 rate year beginning July 1, 2003, the commissioner shall 248.12 implement a reduction to the rates provided to each nursing 248.13 facility reimbursed under this section or section 256B.434, 248.14 equal to four percent of the operating and property components 248.15 of the total payment rates in effect on June 30, 2003. 248.16 (b) Nursing facilities, individually or as groups, may 248.17 elect to reduce their licensed capacity as an alternative to the 248.18 rate adjustment in paragraph (a). This election must be 248.19 requested within 60 days of the effective date of this section 248.20 and agreed to on a form to be provided by the commissioner. The 248.21 facility or group of facilities electing to reduce licensed 248.22 capacity must agree to: (i) reduce their licensed number of 248.23 beds by October 1, 2003, to 95 percent of the number of beds 248.24 actually occupied on January 1, 2003; (ii) reduce their licensed 248.25 number of beds by January 1, 2004, to 90 percent of the number 248.26 of beds actually occupied on January 1, 2003; (iii) reduce their 248.27 licensed number of beds by April 1, 2004, to 85 percent of the 248.28 number of beds actually occupied on January 1, 2003; and (iv) 248.29 not remove any beds from layaway until after June 30, 2007. For 248.30 beds placed in layaway prior to January 1, 2003, in determining 248.31 the five-year limit that a bed may remain in layaway under 248.32 section 144A.071, subdivision 4b, the commissioner shall allow 248.33 beds to be removed from layaway until January 1, 2008. For 248.34 purposes of this section, a vacant bed shall be considered 248.35 occupied on January 1, 2003, if the facility was holding the bed 248.36 for a resident on hospital leave or therapeutic leave. For 249.1 purposes of this section, a bed shall be considered removed from 249.2 service on the date the commissioner receives notification from 249.3 a nursing facility that a bed is to be delicensed within 60 249.4 days. Any bed delicensed on or after January 1, 2003, may be 249.5 counted by the facility toward the capacity reduction elected 249.6 under this paragraph. 249.7 (c) If a nursing facility that elects to reduce its 249.8 capacity according to paragraph (b) fails to do so, the 249.9 commissioner shall reduce the payment rate of that nursing 249.10 facility according to paragraph (a), retroactively from July 1, 249.11 2003. The commissioner may grant hardship extensions of up to 249.12 90 days to the requirements in paragraph (b) to facilities 249.13 electing to reduce capacity. In granting a hardship extension, 249.14 the commissioner shall consider the number of admissions to and 249.15 discharges from the facility, progress in reducing occupancy, 249.16 and the availability of beds in the county in which the facility 249.17 is located, measured by the number of beds per 1,000 individuals 249.18 age 65 and older. 249.19 [EFFECTIVE DATE.] This section is effective the day 249.20 following final enactment. 249.21 Sec. 27. Minnesota Statutes 2002, section 256B.434, 249.22 subdivision 4, is amended to read: 249.23 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 249.24 nursing facilities which have their payment rates determined 249.25 under this section rather than section 256B.431, the 249.26 commissioner shall establish a rate under this subdivision. The 249.27 nursing facility must enter into a written contract with the 249.28 commissioner. 249.29 (b) A nursing facility's case mix payment rate for the 249.30 first rate year of a facility's contract under this section is 249.31 the payment rate the facility would have received under section 249.32 256B.431. 249.33 (c) A nursing facility's case mix payment rates for the 249.34 second and subsequent years of a facility's contract under this 249.35 section are the previous rate year's contract payment rates plus 249.36 an inflation adjustment and, for facilities reimbursed under 250.1 this section or section 256B.431, an adjustment to include the 250.2 cost of any increase in health department licensing fees for the 250.3 facility taking effect on or after July 1, 2001. The index for 250.4 the inflation adjustment must be based on the change in the 250.5 Consumer Price Index-All Items (United States City average) 250.6 (CPI-U) forecasted byData Resources, Inc.the commissioner of 250.7 finance's national economic consultant, as forecasted in the 250.8 fourth quarter of the calendar year preceding the rate year. 250.9 The inflation adjustment must be based on the 12-month period 250.10 from the midpoint of the previous rate year to the midpoint of 250.11 the rate year for which the rate is being determined. For the 250.12 rate years beginning on July 1, 1999, July 1, 2000, July 1, 250.13 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 250.14 paragraph shall apply only to the property-related payment rate, 250.15 except that adjustments to include the cost of any increase in 250.16 health department licensing fees taking effect on or after July 250.17 1, 2001, shall be provided. In determining the amount of the 250.18 property-related payment rate adjustment under this paragraph, 250.19 the commissioner shall determine the proportion of the 250.20 facility's rates that are property-related based on the 250.21 facility's most recent cost report. 250.22 (d) The commissioner shall develop additional 250.23 incentive-based payments of up to five percent above the 250.24 standard contract rate for achieving outcomes specified in each 250.25 contract. The specified facility-specific outcomes must be 250.26 measurable and approved by the commissioner. The commissioner 250.27 may establish, for each contract, various levels of achievement 250.28 within an outcome. After the outcomes have been specified the 250.29 commissioner shall assign various levels of payment associated 250.30 with achieving the outcome. Any incentive-based payment cancels 250.31 if there is a termination of the contract. In establishing the 250.32 specified outcomes and related criteria the commissioner shall 250.33 consider the following state policy objectives: 250.34 (1) improved cost effectiveness and quality of life as 250.35 measured by improved clinical outcomes; 250.36 (2) successful diversion or discharge to community 251.1 alternatives; 251.2 (3) decreased acute care costs; 251.3 (4) improved consumer satisfaction; 251.4 (5) the achievement of quality; or 251.5 (6) any additional outcomes proposed by a nursing facility 251.6 that the commissioner finds desirable. 251.7 Sec. 28. Minnesota Statutes 2002, section 256B.48, 251.8 subdivision 1, is amended to read: 251.9 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 251.10 is not eligible to receive medical assistance payments unless it 251.11 refrains from all of the following: 251.12 (a) Charging private paying residents rates for similar 251.13 services which exceed those which are approved by the state 251.14 agency for medical assistance recipients as determined by the 251.15 prospective desk audit rate, except under the following 251.16 circumstances: (1) the nursing facility may(1)(i) charge 251.17 private paying residents a higher rate for a private room,and 251.18(2)(ii) charge for special services which are not included in 251.19 the daily rate if medical assistance residents are charged 251.20 separately at the same rate for the same services in addition to 251.21 the daily rate paid by the commissioner.; (2) effective July 1, 251.22 2003, nursing facilities may charge private paying residents 251.23 rates up to two percent higher than the allowable payment rate 251.24 in effect on June 30, 2003, plus an adjustment equal to any 251.25 other rate increase provided in law, for the RUGs group 251.26 currently assigned to the resident; (3) effective July 1, 2004, 251.27 nursing facilities may charge private paying residents rates up 251.28 to four percent higher than the allowable payment rate in effect 251.29 on June 30, 2003, plus an adjustment equal to any other rate 251.30 increase provided in law, for the RUGs group currently assigned 251.31 to the resident; and (4) effective July 1, 2005, nursing 251.32 facilities may charge private paying residents rates up to six 251.33 percent higher than the allowable payment rate in effect on June 251.34 30, 2003, plus an adjustment equal to any other rate increase 251.35 provided in law, for the RUGs group currently assigned to the 251.36 resident. For purposes of this subdivision, the allowable 252.1 payment rate is the total payment rate under section 256B.431 or 252.2 256B.434 including adjustments for enhanced rates during the 252.3 first 30 days under section 256B.431, subdivision 32, and 252.4 private room differentials under clause (1), item (i), and 252.5 Minnesota Rules, part 9549.0060, subpart 11, item C. Services 252.6 covered by the payment rate must be the same regardless of 252.7 payment source. Special services, if offered, must be available 252.8 to all residents in all areas of the nursing facility and 252.9 charged separately at the same rate. Residents are free to 252.10 select or decline special services. Special services must not 252.11 include services which must be provided by the nursing facility 252.12 in order to comply with licensure or certification standards and 252.13 that if not provided would result in a deficiency or violation 252.14 by the nursing facility. Services beyond those required to 252.15 comply with licensure or certification standards must not be 252.16 charged separately as a special service if they were included in 252.17 the payment rate for the previous reporting year. A nursing 252.18 facility that charges a private paying resident a rate in 252.19 violation of this clause is subject to an action by the state of 252.20 Minnesota or any of its subdivisions or agencies for civil 252.21 damages. A private paying resident or the resident's legal 252.22 representative has a cause of action for civil damages against a 252.23 nursing facility that charges the resident rates in violation of 252.24 this clause. The damages awarded shall include three times the 252.25 payments that result from the violation, together with costs and 252.26 disbursements, including reasonable attorneys' fees or their 252.27 equivalent. A private paying resident or the resident's legal 252.28 representative, the state, subdivision or agency, or a nursing 252.29 facility may request a hearing to determine the allowed rate or 252.30 rates at issue in the cause of action. Within 15 calendar days 252.31 after receiving a request for such a hearing, the commissioner 252.32 shall request assignment of an administrative law judge under 252.33 sections 14.48 to 14.56 to conduct the hearing as soon as 252.34 possible or according to agreement by the parties. The 252.35 administrative law judge shall issue a report within 15 calendar 252.36 days following the close of the hearing. The prohibition set 253.1 forth in this clause shall not apply to facilities licensed as 253.2 boarding care facilities which are not certified as skilled or 253.3 intermediate care facilities level I or II for reimbursement 253.4 through medical assistance. 253.5 (b) Effective July 1, 2006, paragraph (a) no longer 253.6 applies, except that special services, if offered, must be 253.7 available to all residents in all areas of the nursing facility 253.8 and charged separately at the same rate. Residents are free to 253.9 select or decline special services. Special services must not 253.10 include services which must be provided by the nursing facility 253.11 in order to comply with licensure or certification standards and 253.12 that if not provided would result in a deficiency or violation 253.13 by the nursing facility. 253.14(b)(c)(1) Charging, soliciting, accepting, or receiving 253.15 from an applicant for admission to the facility, or from anyone 253.16 acting in behalf of the applicant, as a condition of admission, 253.17 expediting the admission, or as a requirement for the 253.18 individual's continued stay, any fee, deposit, gift, money, 253.19 donation, or other consideration not otherwise required as 253.20 payment under the state plan for residents on medical 253.21 assistance, medical assistance payment according to the state 253.22 plan must be accepted as payment in full for continued stay, 253.23 except where otherwise provided for under statute; 253.24 (2) requiring an individual, or anyone acting in behalf of 253.25 the individual, to loan any money to the nursing facility; 253.26 (3) requiring an individual, or anyone acting in behalf of 253.27 the individual, to promise to leave all or part of the 253.28 individual's estate to the facility; or 253.29 (4) requiring a third-party guarantee of payment to the 253.30 facility as a condition of admission, expedited admission, or 253.31 continued stay in the facility. 253.32 Nothing in this paragraph would prohibit discharge for 253.33 nonpayment of services in accordance with state and federal 253.34 regulations. 253.35(c)(d) Requiring any resident of the nursing facility to 253.36 utilize a vendor of health care services chosen by the nursing 254.1 facility. A nursing facility may require a resident to use 254.2 pharmacies that utilize unit dose packing systems approved by 254.3 the Minnesota board of pharmacy, and may require a resident to 254.4 use pharmacies that are able to meet the federal regulations for 254.5 safe and timely administration of medications such as systems 254.6 with specific number of doses, prompt delivery of medications, 254.7 or access to medications on a 24-hour basis. Notwithstanding 254.8 the provisions of this paragraph, nursing facilities shall not 254.9 restrict a resident's choice of pharmacy because the pharmacy 254.10 utilizes a specific system of unit dose drug packing. 254.11(d)(e) Providing differential treatment on the basis of 254.12 status with regard to public assistance. 254.13(e)(f) Discriminating in admissions, services offered, or 254.14 room assignment on the basis of status with regard to public 254.15 assistanceor refusal to purchase special254.16services. Discrimination in admissionsdiscrimination, services 254.17 offered, or room assignment shall include, but is not limited to: 254.18 (1) basing admissions decisions uponassurance by the254.19applicant to the nursing facility, or the applicant's guardian254.20or conservator, that the applicant is neither eligible for nor254.21will seekinformation or assurances regarding current or future 254.22 eligibility for public assistance for payment of nursing 254.23 facility carecosts; and 254.24 (2)engaging in preferential selection from waiting lists254.25based on an applicant's ability to pay privately or an254.26applicant's refusal to pay for a special servicerequiring a 254.27 person who is eligible for public assistance to accept a room 254.28 transfer from a single bed room to a multiple bed room. 254.29 The collection and use by a nursing facility of financial 254.30 information of any applicant pursuant to a preadmission 254.31 screening program established by law shall not raise an 254.32 inference that the nursing facility is utilizing that 254.33 information for any purpose prohibited by this paragraph. 254.34 (g) In a case where the commissioner determines that a 254.35 nursing facility is not in compliance with the requirements in 254.36 paragraphs (a) to (f), the commissioner shall provide to the 255.1 facility notice of a finding of noncompliance. If after 30 days 255.2 the commissioner finds the facility is still not in compliance, 255.3 the commissioner shall initiate withholding of ten percent of 255.4 medical assistance payments due to the facility. If, after 90 255.5 days after the original notification, the nursing facility is 255.6 still not in compliance, the commissioner shall not assume 255.7 payments for any resident admitted after that date. Upon 255.8 determination by the commissioner that the facility is in 255.9 compliance, these penalties shall be removed and payments of 255.10 withheld amounts and for newly admitted residents shall be made 255.11 retroactive for no more than 90 days. 255.12(f)(h) Requiring any vendor of medical care as defined by 255.13 section 256B.02, subdivision 7, who is reimbursed by medical 255.14 assistance under a separate fee schedule, to pay any amount 255.15 based on utilization or service levels or any portion of the 255.16 vendor's fee to the nursing facility except as payment for 255.17 renting or leasing space or equipment or purchasing support 255.18 services from the nursing facility as limited by section 255.19 256B.433. All agreements must be disclosed to the commissioner 255.20 upon request of the commissioner. Nursing facilities and 255.21 vendors of ancillary services that are found to be in violation 255.22 of this provision shall each be subject to an action by the 255.23 state of Minnesota or any of its subdivisions or agencies for 255.24 treble civil damages on the portion of the fee in excess of that 255.25 allowed by this provision and section 256B.433. Damages awarded 255.26 must include three times the excess payments together with costs 255.27 and disbursements including reasonable attorney's fees or their 255.28 equivalent. 255.29(g)(i) Refusing, for more than 24 hours, to accept a 255.30 resident returning to the same bed or a bed certified for the 255.31 same level of care, in accordance with a physician's order 255.32 authorizing transfer, after receiving inpatient hospital 255.33 services. 255.34 For a period not to exceed 180 days, the commissioner may 255.35 continue to make medical assistance payments to a nursing 255.36 facility or boarding care home which is in violation of this 256.1 section if extreme hardship to the residents would result. In 256.2 these cases the commissioner shall issue an order requiring the 256.3 nursing facility to correct the violation. The nursing facility 256.4 shall have 20 days from its receipt of the order to correct the 256.5 violation. If the violation is not corrected within the 20-day 256.6 period the commissioner may reduce the payment rate to the 256.7 nursing facility by up to 20 percent. The amount of the payment 256.8 rate reduction shall be related to the severity of the violation 256.9 and shall remain in effect until the violation is corrected. 256.10 The nursing facility or boarding care home may appeal the 256.11 commissioner's action pursuant to the provisions of chapter 14 256.12 pertaining to contested cases. An appeal shall be considered 256.13 timely if written notice of appeal is received by the 256.14 commissioner within 20 days of notice of the commissioner's 256.15 proposed action. 256.16 In the event that the commissioner determines that a 256.17 nursing facility is not eligible for reimbursement for a 256.18 resident who is eligible for medical assistance, the 256.19 commissioner may authorize the nursing facility to receive 256.20 reimbursement on a temporary basis until the resident can be 256.21 relocated to a participating nursing facility. 256.22 Certified beds in facilities which do not allow medical 256.23 assistance intake on July 1, 1984, or after shall be deemed to 256.24 be decertified for purposes of section 144A.071 only. 256.25 Sec. 29. Minnesota Statutes 2002, section 256I.02, is 256.26 amended to read: 256.27 256I.02 [PURPOSE.] 256.28 The Group Residential Housing Act establishes a 256.29 comprehensive system of rates and payments for persons who 256.30 reside ina group residencethe community and who meet the 256.31 eligibility criteria under section 256I.04, subdivision 1. 256.32 Sec. 30. Minnesota Statutes 2002, section 256I.04, 256.33 subdivision 3, is amended to read: 256.34 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 256.35 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 256.36 into agreements for new group residential housing beds with 257.1 total rates in excess of the MSA equivalent rate except: (1) 257.2for group residential housing establishments meeting the257.3requirements of subdivision 2a, clause (2) with department257.4approval; (2)for group residential housing establishments 257.5 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 257.6 provided the facility is needed to meet the census reduction 257.7 targets for persons with mental retardation or related 257.8 conditions at regional treatment centers;(3)(2) to ensure 257.9 compliance with the federal Omnibus Budget Reconciliation Act 257.10 alternative disposition plan requirements for inappropriately 257.11 placed persons with mental retardation or related conditions or 257.12 mental illness;(4)(3) up to 80 beds in a single, specialized 257.13 facility located in Hennepin county that will provide housing 257.14 for chronic inebriates who are repetitive users of 257.15 detoxification centers and are refused placement in emergency 257.16 shelters because of their state of intoxication, and planning 257.17 for the specialized facility must have been initiated before 257.18 July 1, 1991, in anticipation of receiving a grant from the 257.19 housing finance agency under section 462A.05, subdivision 20a, 257.20 paragraph (b);(5)(4) notwithstanding the provisions of 257.21 subdivision 2a, for up to 190 supportive housing units in Anoka, 257.22 Dakota, Hennepin, or Ramsey county for homeless adults with a 257.23 mental illness, a history of substance abuse, or human 257.24 immunodeficiency virus or acquired immunodeficiency syndrome. 257.25 For purposes of this section, "homeless adult" means a person 257.26 who is living on the street or in a shelter or discharged from a 257.27 regional treatment center, community hospital, or residential 257.28 treatment program and has no appropriate housing available and 257.29 lacks the resources and support necessary to access appropriate 257.30 housing. At least 70 percent of the supportive housing units 257.31 must serve homeless adults with mental illness, substance abuse 257.32 problems, or human immunodeficiency virus or acquired 257.33 immunodeficiency syndrome who are about to be or, within the 257.34 previous six months, has been discharged from a regional 257.35 treatment center, or a state-contracted psychiatric bed in a 257.36 community hospital, or a residential mental health or chemical 258.1 dependency treatment program. If a person meets the 258.2 requirements of subdivision 1, paragraph (a), and receives a 258.3 federal or state housing subsidy, the group residential housing 258.4 rate for that person is limited to the supplementary rate under 258.5 section 256I.05, subdivision 1a, and is determined by 258.6 subtracting the amount of the person's countable income that 258.7 exceeds the MSA equivalent rate from the group residential 258.8 housing supplementary rate. A resident in a demonstration 258.9 project site who no longer participates in the demonstration 258.10 program shall retain eligibility for a group residential housing 258.11 payment in an amount determined under section 256I.06, 258.12 subdivision 8, using the MSA equivalent rate. Service funding 258.13 under section 256I.05, subdivision 1a, will end June 30, 1997, 258.14 if federal matching funds are available and the services can be 258.15 provided through a managed care entity. If federal matching 258.16 funds are not available, then service funding will continue 258.17 under section 256I.05, subdivision 1a; or (6) for group 258.18 residential housing beds in settings meeting the requirements of 258.19 subdivision 2a, clauses (1) and (3), which are used exclusively 258.20 for recipients receiving home and community-based waiver 258.21 services under sections 256B.0915, 256B.092, subdivision 5, 258.22 256B.093, and 256B.49, and who resided in a nursing facility for 258.23 the six months immediately prior to the month of entry into the 258.24 group residential housing setting. The group residential 258.25 housing rate for these beds must be set so that the monthly 258.26 group residential housing payment for an individual occupying 258.27 the bed when combined with the nonfederal share of services 258.28 delivered under the waiver for that person does not exceed the 258.29 nonfederal share of the monthly medical assistance payment made 258.30 for the person to the nursing facility in which the person 258.31 resided prior to entry into the group residential housing 258.32 establishment. The rate may not exceed the MSA equivalent rate 258.33 plus $426.37 for any case. 258.34 (b) A county agency may enter into a group residential 258.35 housing agreement for beds with rates in excess of the MSA 258.36 equivalent rate in addition to those currently covered under a 259.1 group residential housing agreement if the additional beds are 259.2 only a replacement of beds with rates in excess of the MSA 259.3 equivalent rate which have been made available due to closure of 259.4 a setting, a change of licensure or certification which removes 259.5 the beds from group residential housing payment, or as a result 259.6 of the downsizing of a group residential housing setting. The 259.7 transfer of available beds from one county to another can only 259.8 occur by the agreement of both counties. 259.9 Sec. 31. Minnesota Statutes 2002, section 256I.05, 259.10 subdivision 1, is amended to read: 259.11 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 259.12 rates negotiated by a county agency for a recipient living in 259.13 group residential housing must not exceed the MSA equivalent 259.14 rate specified under section 256I.03, subdivision 5,.with the259.15exception that a county agency may negotiate a supplementary259.16room and board rate that exceeds the MSA equivalent rate for259.17recipients of waiver services under title XIX of the Social259.18Security Act. This exception is subject to the following259.19conditions:259.20(1) the setting is licensed by the commissioner of human259.21services under Minnesota Rules, parts 9555.5050 to 9555.6265;259.22(2) the setting is not the primary residence of the license259.23holder and in which the license holder is not the primary259.24caregiver; and259.25(3) the average supplementary room and board rate in a259.26county for a calendar year may not exceed the average259.27supplementary room and board rate for that county in effect on259.28January 1, 2000. For calendar years beginning on or after259.29January 1, 2002, within the limits of appropriations259.30specifically for this purpose, the commissioner shall increase259.31each county's supplemental room and board rate average on an259.32annual basis by a factor consisting of the percentage change in259.33the Consumer Price Index-All items, United States city average259.34(CPI-U) for that calendar year compared to the preceding259.35calendar year as forecasted by Data Resources, Inc., in the259.36third quarter of the preceding calendar year. If a county has260.1not negotiated supplementary room and board rates for any260.2facilities located in the county as of January 1, 2000, or has260.3an average supplemental room and board rate under $100 per260.4person as of January 1, 2000, it may submit a supplementary room260.5and board rate request with budget information for a facility to260.6the commissioner for approval.260.7The county agency may at any time negotiate a higher or lower260.8room and board rate than the average supplementary room and260.9board rate.260.10(b) Notwithstanding paragraph (a), clause (3), county260.11agencies may negotiate a supplementary room and board rate that260.12exceeds the MSA equivalent rate by up to $426.37 for up to five260.13facilities, serving not more than 20 individuals in total, that260.14were established to replace an intermediate care facility for260.15persons with mental retardation and related conditions located260.16in the city of Roseau that became uninhabitable due to flood260.17damage in June 2002.260.18 [EFFECTIVE DATE.] This section is effective July 1, 2004, 260.19 or upon receipt of federal approval of waiver amendment, 260.20 whichever is later. 260.21 Sec. 32. Minnesota Statutes 2002, section 256I.05, 260.22 subdivision 1a, is amended to read: 260.23 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 260.24 the provisions of section 256I.04, subdivision 3,in addition to260.25the room and board rate specified in subdivision 1,the county 260.26 agency may negotiate a payment not to exceed $426.37 for other 260.27 services necessary to provide room and board provided by the 260.28 group residence if the residence is licensed by or registered by 260.29 the department of health, or licensed by the department of human 260.30 services to provide services in addition to room and board, and 260.31 if the provider of services is not also concurrently receiving 260.32 funding for services for a recipient under a home and 260.33 community-based waiver under title XIX of the Social Security 260.34 Act; or funding from the medical assistance program under 260.35 section 256B.0627, subdivision 4, for personal care services for 260.36 residents in the setting; or residing in a setting which 261.1 receives funding under Minnesota Rules, parts 9535.2000 to 261.2 9535.3000. If funding is available for other necessary services 261.3 through a home and community-based waiver, or personal care 261.4 services under section 256B.0627, subdivision 4, then the GRH 261.5 rate is limited to the rate set in subdivision 1. Unless 261.6 otherwise provided in law, in no case may the supplementary 261.7 service rateplus the supplementary room and board rateexceed 261.8 $426.37. The registration and licensure requirement does not 261.9 apply to establishments which are exempt from state licensure 261.10 because they are located on Indian reservations and for which 261.11 the tribe has prescribed health and safety requirements. 261.12 Service payments under this section may be prohibited under 261.13 rules to prevent the supplanting of federal funds with state 261.14 funds. The commissioner shall pursue the feasibility of 261.15 obtaining the approval of the Secretary of Health and Human 261.16 Services to provide home and community-based waiver services 261.17 under title XIX of the Social Security Act for residents who are 261.18 not eligible for an existing home and community-based waiver due 261.19 to a primary diagnosis of mental illness or chemical dependency 261.20 and shall apply for a waiver if it is determined to be 261.21 cost-effective. 261.22 (b) The commissioner is authorized to make cost-neutral 261.23 transfers from the GRH fund for beds under this section to other 261.24 funding programs administered by the department after 261.25 consultation with the county or counties in which the affected 261.26 beds are located. The commissioner may also make cost-neutral 261.27 transfers from the GRH fund to county human service agencies for 261.28 beds permanently removed from the GRH census under a plan 261.29 submitted by the county agency and approved by the 261.30 commissioner. The commissioner shall report the amount of any 261.31 transfers under this provision annually to the legislature. 261.32 (c) The provisions of paragraph (b) do not apply to a 261.33 facility that has its reimbursement rate established under 261.34 section 256B.431, subdivision 4, paragraph (c). 261.35 Sec. 33. Minnesota Statutes 2002, section 256I.05, 261.36 subdivision 7c, is amended to read: 262.1 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 262.2 authorized to pursue a demonstration project under federal food 262.3 stamp regulation for the purpose of gaining federal 262.4 reimbursement of food and nutritional costs currently paid by 262.5 the state group residential housing program. The commissioner 262.6 shall seek approval no later than January 1, 2004. Any 262.7 reimbursement received is nondedicated revenue to the general 262.8 fund. 262.9 Sec. 34. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 262.10 Subdivision 1. [APPLICABILITY.] The definitions in this 262.11 section apply to sections 514.991 to 514.995. 262.12 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 262.13 DEPARTMENT.] "Alternative care agency," "agency," or "department" 262.14 means the department of human services when it pays for or 262.15 provides alternative care benefits for a nonmedical assistance 262.16 recipient directly or through a county social services agency 262.17 under chapter 256B according to section 256B.0913. 262.18 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 262.19 BENEFITS.] "Alternative care benefit" or "benefits" means a 262.20 benefit provided to a nonmedical assistance recipient under 262.21 chapter 256B according to section 256B.0913. 262.22 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 262.23 RECIPIENT.] "Alternative care recipient" or "recipient" means a 262.24 person who receives alternative care grant benefits. 262.25 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 262.26 care lien" or "lien" means a lien filed under sections 514.992 262.27 to 514.995. 262.28 [EFFECTIVE DATE.] This section is effective July 1, 2003, 262.29 for services for persons first enrolling in the alternative care 262.30 program on or after that date and on the first day of the first 262.31 eligibility renewal period for persons enrolled in the 262.32 alternative care program prior to July 1, 2003. 262.33 Sec. 35. [514.992] [ALTERNATIVE CARE LIEN.] 262.34 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 262.35 Subject to sections 514.991 to 514.995, payments made by an 262.36 alternative care agency to provide benefits to a recipient or to 263.1 the recipient's spouse who owns property in this state 263.2 constitute a lien in favor of the agency on all real property 263.3 the recipient owns at and after the time the benefits are first 263.4 paid. 263.5 (b) The amount of the lien is limited to benefits paid for 263.6 services provided to recipients over 55 years of age and 263.7 provided on and after July 1, 2003. 263.8 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 263.9 enforceable against specific real property as of the date when 263.10 all of the following conditions are met: 263.11 (1) the agency has paid benefits for a recipient; 263.12 (2) the recipient has been given notice and an opportunity 263.13 for a hearing under paragraph (b); 263.14 (3) the lien has been filed as provided for in section 263.15 514.993 or memorialized on the certificate of title for the 263.16 property it describes; and 263.17 (4) all restrictions against enforcement have ceased to 263.18 apply. 263.19 (b) An agency may not file a lien until it has sent the 263.20 recipient, their authorized representative, or their legal 263.21 representative written notice of its lien rights by certified 263.22 mail, return receipt requested, or registered mail and there has 263.23 been an opportunity for a hearing under section 256.045. No 263.24 person other than the recipient shall have a right to a hearing 263.25 under section 256.045 prior to the time the lien is filed. The 263.26 hearing shall be limited to whether the agency has met all of 263.27 the prerequisites for filing the lien and whether any of the 263.28 exceptions in this section apply. 263.29 (c) An agency may not file a lien against the recipient's 263.30 homestead when any of the following exceptions apply: 263.31 (1) while the recipient's spouse is also physically present 263.32 and lawfully and continuously residing in the homestead; 263.33 (2) a child of the recipient who is under age 21 or who is 263.34 blind or totally and permanently disabled according to 263.35 supplemental security income criteria is also physically present 263.36 on the property and lawfully and continuously residing on the 264.1 property from and after the date the recipient first receives 264.2 benefits; 264.3 (3) a child of the recipient who has also lawfully and 264.4 continuously resided on the property for a period beginning at 264.5 least two years before the first day of the month in which the 264.6 recipient began receiving alternative care, and who provided 264.7 uncompensated care to the recipient which enabled the recipient 264.8 to live without alternative care services for the two-year 264.9 period; 264.10 (4) a sibling of the recipient who has an ownership 264.11 interest in the property of record in the office of the county 264.12 recorder or registrar of titles for the county in which the real 264.13 property is located and who has also continuously occupied the 264.14 homestead for a period of at least one year immediately prior to 264.15 the first day of the first month in which the recipient received 264.16 benefits and continuously since that date. 264.17 (d) A lien only applies to the real property it describes. 264.18 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 264.19 from the time it is filed until it is paid, satisfied, 264.20 discharged, or becomes unenforceable under sections 514.991 to 264.21 514.995. 264.22 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 264.23 the real property it describes is subject to the rights of 264.24 anyone else whose interest in the real property is perfected of 264.25 record before the lien has been recorded or filed under section 264.26 514.993, including: 264.27 (1) an owner, other than the recipient or the recipient's 264.28 spouse; 264.29 (2) a good faith purchaser for value without notice of the 264.30 lien; 264.31 (3) a holder of a mortgage or security interest; or 264.32 (4) a judgment lien creditor whose judgment lien has 264.33 attached to the recipient's interest in the real property. 264.34 (b) The rights of the other person have the same 264.35 protections against an alternative care lien as are afforded 264.36 against a judgment lien that arises out of an unsecured 265.1 obligation and arises as of the time of the filing of an 265.2 alternative care grant lien under section 514.993. The lien 265.3 shall be inferior to a lien for property taxes and special 265.4 assessments and shall be superior to all other matters first 265.5 appearing of record after the time and date the lien is filed or 265.6 recorded. 265.7 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 265.8 agency may, with absolute discretion, settle or subordinate the 265.9 lien to any other lien or encumbrance of record upon the terms 265.10 and conditions it deems appropriate. 265.11 (b) The agency filing the lien shall release and discharge 265.12 the lien: 265.13 (1) if it has been paid, discharged, or satisfied; 265.14 (2) if it has received reimbursement for the amounts 265.15 secured by the lien, has entered into a binding and legally 265.16 enforceable agreement under which it is reimbursed for the 265.17 amount of the lien, or receives other collateral sufficient to 265.18 secure payment of the lien; 265.19 (3) against some, but not all, of the property it describes 265.20 upon the terms, conditions, and circumstances the agency deems 265.21 appropriate; 265.22 (4) to the extent it cannot be lawfully enforced against 265.23 the property it describes because of an error, omission, or 265.24 other material defect in the legal description contained in the 265.25 lien or a necessary prerequisite to enforcement of the lien; and 265.26 (5) if, in its discretion, it determines the filing or 265.27 enforcement of the lien is contrary to the public interest. 265.28 (c) The agency executing the lien shall execute and file 265.29 the release as provided for in section 514.993, subdivision 2. 265.30 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 265.31 the real property it describes for a period of ten years from 265.32 the date it attaches according to subdivision 2, paragraph (a), 265.33 except as otherwise provided for in sections 514.992 to 265.34 514.995. The agency filing the lien may renew the lien for one 265.35 additional ten-year period from the date it would otherwise 265.36 expire by recording or filing a certificate of renewal before 266.1 the lien expires. The certificate of renewal shall be recorded 266.2 or filed in the office of the county recorder or registrar of 266.3 titles for the county in which the lien is recorded or filed. 266.4 The certificate must refer to the recording or filing data for 266.5 the lien it renews. The certificate need not be attested, 266.6 certified, or acknowledged as a condition for recording or 266.7 filing. The recorder or registrar of titles shall record, file, 266.8 index, and return the certificate of renewal in the same manner 266.9 provided for liens in section 514.993, subdivision 2. 266.10 (b) An alternative care lien is not enforceable against the 266.11 real property of an estate to the extent there is a 266.12 determination by a court of competent jurisdiction, or by an 266.13 officer of the court designated for that purpose, that there are 266.14 insufficient assets in the estate to satisfy the lien in whole 266.15 or in part because of the homestead exemption under section 266.16 256B.15, subdivision 4, the rights of a surviving spouse or a 266.17 minor child under section 524.2-403, paragraphs (a) and (b), or 266.18 claims with a priority under section 524.3-805, paragraph (a), 266.19 clauses (1) to (4). For purposes of this section, the rights of 266.20 the decedent's adult children to exempt property under section 266.21 524.2-403, paragraph (b), shall not be considered costs of 266.22 administration under section 524.3-805, paragraph (a), clause 266.23 (1). 266.24 [EFFECTIVE DATE.] This section is effective July 1, 2003, 266.25 for services for persons first enrolling in the alternative care 266.26 program on or after that date and on the first day of the first 266.27 eligibility renewal period for persons enrolled in the 266.28 alternative care program prior to July 1, 2003. 266.29 Sec. 36. [514.993] [LIEN; CONTENTS AND FILING.] 266.30 Subdivision 1. [CONTENTS.] A lien shall be dated and must 266.31 contain: 266.32 (1) the recipient's full name, last known address, and 266.33 social security number; 266.34 (2) a statement that benefits have been paid to or for the 266.35 recipient's benefit; 266.36 (3) a statement that all of the recipient's interests in 267.1 the in the real property described in the lien may be subject to 267.2 or affected by the agency's right to reimbursement for benefits; 267.3 (4) a legal description of the real property subject to the 267.4 lien and whether it is registered or abstract property; 267.5 (5) such other contents, if any, as the agency deems 267.6 appropriate. 267.7 Subd. 2. [FILING.] Any lien, release, or other document 267.8 required or permitted to be filed under sections 514.991 to 267.9 514.995 must be recorded or filed in the office of the county 267.10 recorder or registrar of titles, as appropriate, in the county 267.11 where the real property is located. Notwithstanding section 267.12 386.77, the agency shall pay the applicable filing fee for any 267.13 documents filed under sections 514.991 to 514.995. An 267.14 attestation, certification, or acknowledgment is not required as 267.15 a condition of filing. If the property described in the lien is 267.16 registered property, the registrar of titles shall record it on 267.17 the certificate of title for each parcel of property described 267.18 in the lien. If the property described in the lien is abstract 267.19 property, the recorder shall file the lien in the county's 267.20 grantor-grantee indexes and any tract indexes the county 267.21 maintains for each parcel of property described in the lien. 267.22 The recorder or registrar shall return the recorded or filed 267.23 lien to the agency at no cost. If the agency provides a 267.24 duplicate copy of the lien, the recorder or registrar of titles 267.25 shall show the recording or filing data on the copy and return 267.26 it to the agency at no cost. The agency is responsible for 267.27 filing any lien, release, or other documents under sections 267.28 514.991 to 514.995. 267.29 [EFFECTIVE DATE.] This section is effective July 1, 2003, 267.30 for services for persons first enrolling in the alternative care 267.31 program on or after that date and on the first day of the first 267.32 eligibility renewal period for persons enrolled in the 267.33 alternative care program prior to July 1, 2003. 267.34 Sec. 37. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 267.35 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 267.36 agency may enforce or foreclose a lien filed under sections 268.1 514.991 to 514.995 in the manner provided for by law for 268.2 enforcement of judgment liens against real estate or by a 268.3 foreclosure by action under chapter 581. The lien shall remain 268.4 enforceable as provided for in sections 514.991 to 514.995 268.5 notwithstanding any laws limiting the enforceability of 268.6 judgments. 268.7 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 268.8 enforced against the homestead property of the recipient or the 268.9 spouse while they physically occupy it as their lawful residence. 268.10 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 268.11 514.995 do not limit the agency's right to file a claim against 268.12 the recipient's estate or the estate of the recipient's spouse, 268.13 do not limit any other claims for reimbursement the agency may 268.14 have, and do not limit the availability of any other remedy to 268.15 the agency. 268.16 [EFFECTIVE DATE.] This section is effective July 1, 2003, 268.17 for services for persons first enrolling in the alternative care 268.18 program on or after that date and on the first day of the first 268.19 eligibility renewal period for persons enrolled in the 268.20 alternative care program prior to July 1, 2003. 268.21 Sec. 38. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 268.22 Amounts the agency receives to satisfy the lien must be 268.23 deposited in the state treasury and credited to the fund from 268.24 which the benefits were paid. 268.25 [EFFECTIVE DATE.] This section is effective July 1, 2003, 268.26 for services for persons first enrolling in the alternative care 268.27 program on or after that date and on the first day of the first 268.28 eligibility renewal period for persons enrolled in the 268.29 alternative care program prior to July 1, 2003. 268.30 Sec. 39. Minnesota Statutes 2002, section 524.3-805, is 268.31 amended to read: 268.32 524.3-805 [CLASSIFICATION OF CLAIMS.] 268.33 (a) If the applicable assets of the estate are insufficient 268.34 to pay all claims in full, the personal representative shall 268.35 make payment in the following order: 268.36 (1) costs and expenses of administration; 269.1 (2) reasonable funeral expenses; 269.2 (3) debts and taxes with preference under federal law; 269.3 (4) reasonable and necessary medical, hospital, or nursing 269.4 home expenses of the last illness of the decedent, including 269.5 compensation of persons attending the decedent, a claim filed 269.6 under section 256B.15 for recovery of expenditures for 269.7 alternative care for nonmedical assistance recipients under 269.8 section 256B.0913, and including a claim filed pursuant to 269.9 section 256B.15; 269.10 (5) reasonable and necessary medical, hospital, and nursing 269.11 home expenses for the care of the decedent during the year 269.12 immediately preceding death; 269.13 (6) debts with preference under other laws of this state, 269.14 and state taxes; 269.15 (7) all other claims. 269.16 (b) No preference shall be given in the payment of any 269.17 claim over any other claim of the same class, and a claim due 269.18 and payable shall not be entitled to a preference over claims 269.19 not due, except that if claims for expenses of the last illness 269.20 involve only claims filed under section 256B.15 for recovery of 269.21 expenditures for alternative care for nonmedical assistance 269.22 recipients under section 256B.0913, section 246.53 for costs of 269.23 state hospital care and claims filed under section 256B.15, 269.24 claims filed to recover expenditures for alternative care for 269.25 nonmedical assistance recipients under section 256B.0913 shall 269.26 have preference over claims filed under both sections 246.53 and 269.27 other claims filed under section 256B.15, and claims filed under 269.28 section 246.53 have preference over claims filed under section 269.29 256B.15 for recovery of amounts other than those for 269.30 expenditures for alternative care for nonmedical assistance 269.31 recipients under section 256B.0913. 269.32 [EFFECTIVE DATE.] This section is effective July 1, 2003, 269.33 for decedents dying on or after that date. 269.34 Sec. 40. [REVISOR'S INSTRUCTION.] 269.35 For sections in Minnesota Statutes and Minnesota Rules 269.36 affected by the repealed sections in this article, the revisor 270.1 shall delete internal cross-references where appropriate and 270.2 make changes necessary to correct the punctuation, grammar, or 270.3 structure of the remaining text and preserve its meaning. 270.4 Sec. 41. [REPEALER.] 270.5 (a) Minnesota Statutes 2002, sections 256.973; 256.9752; 270.6 256.9753; 256.976; 256.977; 256.9772; 256B.0917; 256B.0928; and 270.7 256B.437, subdivision 2, are repealed effective July 1, 2003. 270.8 (b) Laws 1988, chapter 689, article 2, section 251, is 270.9 repealed effective July 1, 2003. 270.10 ARTICLE 4 270.11 CONTINUING CARE FOR PERSONS WITH DISABILITIES 270.12 Section 1. Minnesota Statutes 2002, section 245B.06, 270.13 subdivision 8, is amended to read: 270.14 Subd. 8. [LEAVING THE RESIDENCE.] As specified in each 270.15 consumer's individual service plan, each consumer requiring a 270.16 24-hour plan of caremustmay leave the residence to participate 270.17 in regular education, employment, or community activities. 270.18 License holders, providing services to consumers living in a 270.19 licensed site, shall ensure that they are prepared to care for 270.20 consumers whenever they are at the residence during the day 270.21 because of illness, work schedules, or other reasons. 270.22 Sec. 2. Minnesota Statutes 2002, section 246.54, is 270.23 amended to read: 270.24 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 270.25 Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except 270.26 for chemical dependency services provided under sections 254B.01 270.27 to 254B.09, the client's county shall pay to the state of 270.28 Minnesota a portion of the cost of care provided in a regional 270.29 treatment center or a state nursing facility to a client legally 270.30 settled in that county. A county's payment shall be made from 270.31 the county's own sources of revenue and payments shall be paid 270.32 as follows: payments to the state from the county shall 270.33 equalten20 percent of the cost of care, as determined by the 270.34 commissioner, for each day, or the portion thereof, that the 270.35 client spends at a regional treatment center or a state nursing 270.36 facility. If payments received by the state under sections 271.1 246.50 to 246.53 exceed9080 percent of the cost of care, the 271.2 county shall be responsible for paying the state only the 271.3 remaining amount. The county shall not be entitled to 271.4 reimbursement from the client, the client's estate, or from the 271.5 client's relatives, except as provided in section 246.53. No 271.6 such payments shall be made for any client who was last 271.7 committed prior to July 1, 1947. 271.8 Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to 271.9 services provided at the Minnesota security hospital, the 271.10 Minnesota sex offender program, or the Minnesota extended 271.11 treatment options program. For services at these facilities, a 271.12 county's payment shall be made from the county's own sources of 271.13 revenue and payments shall be paid as follows: payments to the 271.14 state from the county shall equal ten percent of the cost of 271.15 care, as determined by the commissioner, for each day, or the 271.16 portion thereof, that the client spends at the facility. If 271.17 payments received by the state under sections 246.50 to 246.53 271.18 exceed 90 percent of the cost of care, the county shall be 271.19 responsible for paying the state only the remaining amount. The 271.20 county shall not be entitled to reimbursement from the client, 271.21 the client's estate, or from the client's relatives, except as 271.22 provided in section 246.53. 271.23 [EFFECTIVE DATE.] This section is effective January 1, 2004. 271.24 Sec. 3. Minnesota Statutes 2002, section 252.46, 271.25 subdivision 1, is amended to read: 271.26 Subdivision 1. [RATES.] (a) Payment rates to vendors, 271.27 except regional centers, for county-funded day training and 271.28 habilitation services and transportation provided to persons 271.29 receiving day training and habilitation services established by 271.30 a county board are governed by subdivisions 2 to 19. The 271.31 commissioner shall approve the following three payment rates for 271.32 services provided by a vendor: 271.33 (1) a full-day service rate for persons who receive at 271.34 least six service hours a day, including the time it takes to 271.35 transport the person to and from the service site; 271.36 (2) a partial-day service rate that must not exceed 75 272.1 percent of the full-day service rate for persons who receive 272.2 less than a full day of service; and 272.3 (3) a transportation rate for providing, or arranging and 272.4 paying for, transportation of a person to and from the person's 272.5 residence to the service site. 272.6(b) The commissioner may also approve an hourly job-coach,272.7follow-along rate for services provided by one employee at or en272.8route to or from community locations to supervise, support, and272.9assist one person receiving the vendor's services to learn272.10job-related skills necessary to obtain or retain employment when272.11and where no other persons receiving services are present and272.12when all the following criteria are met:272.13(1) the vendor requests and the county recommends the272.14optional rate;272.15(2) the service is prior authorized by the county on the272.16Medicaid Management Information System for no more than 414272.17hours in a 12-month period and the daily per person charge to272.18medical assistance does not exceed the vendor's approved full272.19day plus transportation rates;272.20(3) separate full day, partial day, and transportation272.21rates are not billed for the same person on the same day;272.22(4) the approved hourly rate does not exceed the sum of the272.23vendor's current average hourly direct service wage, including272.24fringe benefits and taxes, plus a component equal to the272.25vendor's average hourly nondirect service wage expenses; and272.26(5) the actual revenue received for provision of hourly272.27job-coach, follow-along services is subtracted from the vendor's272.28total expenses for the same time period and those adjusted272.29expenses are used for determining recommended full day and272.30transportation payment rates under subdivision 5 in accordance272.31with the limitations in subdivision 3.272.32 (b) Notwithstanding any law or rule to the contrary, the 272.33 commissioner may authorize county participation in a voluntary 272.34 individualized payment rate structure for day training and 272.35 habilitation services to allow a county the flexibility to 272.36 change from a site-based payment rate structure to an individual 273.1 payment rate structure for the providers of day training and 273.2 habilitation services in the county. The commissioner shall 273.3 establish procedures for determining the structure of voluntary 273.4 individualized payment rates to ensure that there is no 273.5 additional cost to the state. 273.6 (c) Medical assistance rates for home and community-based 273.7 service provided under section 256B.501, subdivision 4, by 273.8 licensed vendors of day training and habilitation services must 273.9 not be greater than the rates for the same services established 273.10 by counties under sections 252.40 to 252.46. For very dependent 273.11 persons with special needs the commissioner may approve an 273.12 exception to the approved payment rate under section 256B.501, 273.13 subdivision 4 or 8. 273.14 Sec. 4. Minnesota Statutes 2002, section 256.476, 273.15 subdivision 1, is amended to read: 273.16 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 273.17 human services shall establish a consumer support grant program 273.18 for individuals with functional limitations and their families 273.19 who wish to purchase and secure their own supports. The 273.20 commissioner and local agencies shall jointly develop an 273.21 implementation plan which must include a way to resolve the 273.22 issues related to county liability. The program shall: 273.23 (1) make support grantsor exception grants described in273.24subdivision 11available to individuals or families as an 273.25 effective alternative toexisting programs and services, such as273.26 the developmental disability family support program, personal 273.27 care attendant services, home health aide services, and private 273.28 duty nursing services; 273.29 (2) provide consumers more control, flexibility, and 273.30 responsibility over their services and supports; 273.31 (3) promote local program management and decision making; 273.32 and 273.33 (4) encourage the use of informal and typical community 273.34 supports. 273.35 Sec. 5. Minnesota Statutes 2002, section 256.476, 273.36 subdivision 3, is amended to read: 274.1 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 274.2 is eligible to apply for a consumer support grant if the person 274.3 meets all of the following criteria: 274.4 (1) the person is eligible for and has been approved to 274.5 receive services under medical assistance as determined under 274.6 sections 256B.055 and 256B.056 or the person has been approved 274.7 to receive a grant under the developmental disability family 274.8 support program under section 252.32; 274.9 (2) the person is able to direct and purchase the person's 274.10 own care and supports, or the person has a family member, legal 274.11 representative, or other authorized representative who can 274.12 purchase and arrange supports on the person's behalf; 274.13 (3) the person has functional limitations, requires ongoing 274.14 supports to live in the community, and is at risk of or would 274.15 continue institutionalization without such supports; and 274.16 (4) the person will live in a home. For the purpose of 274.17 this section, "home" means the person's own home or home of a 274.18 person's family member. These homes are natural home settings 274.19 and are not licensed by the department of health or human 274.20 services. 274.21 (b) Persons may not concurrently receive a consumer support 274.22 grant if they are: 274.23 (1) receivinghome and community-based services under274.24United States Code, title 42, section 1396h(c);personal care 274.25 attendant and home health aide services, or private duty nursing 274.26 under section 256B.0625; a developmental disability family 274.27 support grant; or alternative care services under section 274.28 256B.0913; or 274.29 (2) residing in an institutional or congregate care setting. 274.30 (c) A person or person's family receiving a consumer 274.31 support grant shall not be charged a fee or premium by a local 274.32 agency for participating in the program. 274.33 (d)The commissioner may limit the participation of274.34recipients of services from federal waiver programs in the274.35consumer support grant program if the participation of these274.36individuals will result in an increase in the cost to the275.1state.Individuals receiving home and community-based waivers 275.2 under United States Code, title 42, section 1396h(c), are not 275.3 eligible for the consumer support grant. 275.4 (e) The commissioner shall establish a budgeted 275.5 appropriation each fiscal year for the consumer support grant 275.6 program. The number of individuals participating in the program 275.7 will be adjusted so the total amount allocated to counties does 275.8 not exceed the amount of the budgeted appropriation. The 275.9 budgeted appropriation will be adjusted annually to accommodate 275.10 changes in demand for the consumer support grants. 275.11 Sec. 6. Minnesota Statutes 2002, section 256.476, 275.12 subdivision 4, is amended to read: 275.13 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 275.14 county board may choose to participate in the consumer support 275.15 grant program. If a county has not chosen to participate by 275.16 July 1, 2002, the commissioner shall contract with another 275.17 county or other entity to provide access to residents of the 275.18 nonparticipating county who choose the consumer support grant 275.19 option. The commissioner shall notify the county board in a 275.20 county that has declined to participate of the commissioner's 275.21 intent to enter into a contract with another county or other 275.22 entity at least 30 days in advance of entering into the 275.23 contract. The local agency shall establish written procedures 275.24 and criteria to determine the amount and use of support grants. 275.25 These procedures must include, at least, the availability of 275.26 respite care, assistance with daily living, and adaptive aids. 275.27 The local agency may establish monthly or annual maximum amounts 275.28 for grants and procedures where exceptional resources may be 275.29 required to meet the health and safety needs of the person on a 275.30 time-limited basis, however, the total amount awarded to each 275.31 individual may not exceed the limits established in subdivision 275.32 11. 275.33 (b) Support grants to a person or a person's family will be 275.34 provided through a monthly subsidy payment and be in the form of 275.35 cash, voucher, or direct county payment to vendor. Support 275.36 grant amounts must be determined by the local agency. Each 276.1 service and item purchased with a support grant must meet all of 276.2 the following criteria: 276.3 (1) it must be over and above the normal cost of caring for 276.4 the person if the person did not have functional limitations; 276.5 (2) it must be directly attributable to the person's 276.6 functional limitations; 276.7 (3) it must enable the person or the person's family to 276.8 delay or prevent out-of-home placement of the person; and 276.9 (4) it must be consistent with the needs identified in the 276.10 serviceplanagreement, when applicable. 276.11 (c) Items and services purchased with support grants must 276.12 be those for which there are no other public or private funds 276.13 available to the person or the person's family. Fees assessed 276.14 to the person or the person's family for health and human 276.15 services are not reimbursable through the grant. 276.16 (d) In approving or denying applications, the local agency 276.17 shall consider the following factors: 276.18 (1) the extent and areas of the person's functional 276.19 limitations; 276.20 (2) the degree of need in the home environment for 276.21 additional support; and 276.22 (3) the potential effectiveness of the grant to maintain 276.23 and support the person in the family environment or the person's 276.24 own home. 276.25 (e) At the time of application to the program or screening 276.26 for other services, the person or the person's family shall be 276.27 provided sufficient information to ensure an informed choice of 276.28 alternatives by the person, the person's legal representative, 276.29 if any, or the person's family. The application shall be made 276.30 to the local agency and shall specify the needs of the person 276.31 and family, the form and amount of grant requested, the items 276.32 and services to be reimbursed, and evidence of eligibility for 276.33 medical assistance. 276.34 (f) Upon approval of an application by the local agency and 276.35 agreement on a support plan for the person or person's family, 276.36 the local agency shall make grants to the person or the person's 277.1 family. The grant shall be in an amount for the direct costs of 277.2 the services or supports outlined in the service agreement. 277.3 (g) Reimbursable costs shall not include costs for 277.4 resources already available, such as special education classes, 277.5 day training and habilitation, case management, other services 277.6 to which the person is entitled, medical costs covered by 277.7 insurance or other health programs, or other resources usually 277.8 available at no cost to the person or the person's family. 277.9 (h) The state of Minnesota, the county boards participating 277.10 in the consumer support grant program, or the agencies acting on 277.11 behalf of the county boards in the implementation and 277.12 administration of the consumer support grant program shall not 277.13 be liable for damages, injuries, or liabilities sustained 277.14 through the purchase of support by the individual, the 277.15 individual's family, or the authorized representative under this 277.16 section with funds received through the consumer support grant 277.17 program. Liabilities include but are not limited to: workers' 277.18 compensation liability, the Federal Insurance Contributions Act 277.19 (FICA), or the Federal Unemployment Tax Act (FUTA). For 277.20 purposes of this section, participating county boards and 277.21 agencies acting on behalf of county boards are exempt from the 277.22 provisions of section 268.04. 277.23 Sec. 7. Minnesota Statutes 2002, section 256.476, 277.24 subdivision 5, is amended to read: 277.25 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 277.26 For the purpose of transferring persons to the consumer support 277.27 grant program fromspecific programs or services, such asthe 277.28 developmental disability family support program and personal 277.29 care assistant services, home health aide services, or private 277.30 duty nursing services, the amount of funds transferred by the 277.31 commissioner between the developmental disability family support 277.32 program account, the medical assistance account, or the consumer 277.33 support grant account shall be based on each county's 277.34 participation in transferring persons to the consumer support 277.35 grant program from those programs and services. 277.36 (b) At the beginning of each fiscal year, county 278.1 allocations for consumer support grants shall be based on: 278.2 (1) the number of persons to whom the county board expects 278.3 to provide consumer supports grants; 278.4 (2) their eligibility for current program and services; 278.5 (3) the amount of nonfederal dollars allowed under 278.6 subdivision 11; and 278.7 (4) projected dates when persons will start receiving 278.8 grants. County allocations shall be adjusted periodically by 278.9 the commissioner based on the actual transfer of persons or 278.10 service openings, and the nonfederal dollars associated with 278.11 those persons or service openings, to the consumer support grant 278.12 program. 278.13 (c) The amount of funds transferred by the commissioner 278.14 from the medical assistance account for an individual may be 278.15 changed if it is determined by the county or its agent that the 278.16 individual's need for support has changed. 278.17 (d) The authority to utilize funds transferred to the 278.18 consumer support grant account for the purposes of implementing 278.19 and administering the consumer support grant program will not be 278.20 limited or constrained by the spending authority provided to the 278.21 program of origination. 278.22 (e) The commissioner may use up to five percent of each 278.23 county's allocation, as adjusted, for payments for 278.24 administrative expenses, to be paid as a proportionate addition 278.25 to reported direct service expenditures. 278.26 (f) The county allocation for each individual or 278.27 individual's family cannot exceed the amount allowed under 278.28 subdivision 11. 278.29 (g) The commissioner may recover, suspend, or withhold 278.30 payments if the county board, local agency, or grantee does not 278.31 comply with the requirements of this section. 278.32 (h) Grant funds unexpended by consumers shall return to the 278.33 state once a year. The annual return of unexpended grant funds 278.34 shall occur in the quarter following the end of the state fiscal 278.35 year. 278.36 Sec. 8. Minnesota Statutes 2002, section 256.476, 279.1 subdivision 11, is amended to read: 279.2 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 279.3 2001.] (a) Effective July 1, 2001, the commissioner shall 279.4 allocate consumer support grant resources to serve additional 279.5 individuals based on a review of Medicaid authorization and 279.6 payment information of persons eligible for a consumer support 279.7 grant from the most recent fiscal year. The commissioner shall 279.8 use the following methodology to calculate maximum allowable 279.9 monthly consumer support grant levels: 279.10 (1) For individuals whose program of origination is medical 279.11 assistance home care under section 256B.0627, the maximum 279.12 allowable monthly grant levels are calculated by: 279.13 (i) determining the nonfederal share of the average service 279.14 authorization for each home care rating; 279.15 (ii) calculating the overall ratio of actual payments to 279.16 service authorizations by program; 279.17 (iii) applying the overall ratio to the average service 279.18 authorization level of each home care rating; 279.19 (iv) adjusting the result for any authorized rate increases 279.20 provided by the legislature; and 279.21 (v) adjusting the result for the average monthly 279.22 utilization per recipient; and. 279.23 (2)for persons with programs of origination other than the279.24program described in clause (1), the maximum grant level for an279.25individual shall not exceed the total of the nonfederal dollars279.26expended on the individual by the program of originationThe 279.27 commissioner may review and evaluate the methodology to reflect 279.28 changes in the home care programs overall ratio of actual 279.29 payments to service authorizations. 279.30 (b) Effective July 1, 2003, persons previously receiving 279.31consumer supportexception grantsprior to July 1, 2001, may279.32continue to receive the grant amount established prior to July279.331, 2001will have their grants calculated using the methodology 279.34 in paragraph (a), clause (1). If a person currently receiving 279.35 an exception grant wishes to have their home care rating 279.36 reevaluated, they may request an assessment as defined in 280.1 section 256B.0627, subdivision 1, paragraph (b). 280.2(c) The commissioner may provide up to 200 exception280.3grants, including grants in use under paragraph (b). Eligible280.4persons shall be provided an exception grant in priority order280.5based upon the date of the commissioner's receipt of the county280.6request. The maximum allowable grant level for an exception280.7grant shall be based upon the nonfederal share of the average280.8service authorization from the most recent fiscal year for each280.9home care rating category. The amount of each exception grant280.10shall be based upon the commissioner's determination of the280.11nonfederal dollars that would have been expended if services had280.12been available for an individual who is unable to obtain the280.13support needed from the program of origination due to the280.14unavailability of qualified service providers at the time or the280.15location where the supports are needed.280.16 Sec. 9. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 280.17 HEALTH SERVICES.] 280.18 Subdivision 1. [SCOPE.] Subject to federal approval, 280.19 medical assistance covers medically necessary, intensive 280.20 nonresidential and residential rehabilitative mental health 280.21 services as defined in subdivision 2, for recipients as defined 280.22 in subdivision 3, when the services are provided by an entity 280.23 meeting the standards in this section. 280.24 Subd. 2. [DEFINITIONS.] For purposes of this section, the 280.25 following terms have the meanings given them. 280.26 (a) "Intensive nonresidential rehabilitative mental health 280.27 services" means adult rehabilitative mental health services as 280.28 defined in section 256B.0623, subdivision 2, paragraph (a), 280.29 except that these services are provided by a multidisciplinary 280.30 staff using a total team approach consistent with assertive 280.31 community treatment and other evidence-based practices, and 280.32 directed to recipients with a serious mental illness who require 280.33 intensive services. 280.34 (b) "Intensive residential rehabilitative mental health 280.35 services" means short-term, time-limited services provided in a 280.36 residential setting to recipients who are in need of more 281.1 restrictive settings and are at risk of significant functional 281.2 deterioration if they do not receive these services. Services 281.3 are designed to develop and enhance psychiatric stability, 281.4 personal and emotional adjustment, self-sufficiency, and skills 281.5 to live in a more independent setting. Services must be 281.6 directed toward a targeted discharge date with specified client 281.7 outcomes and must be consistent with evidence-based practices. 281.8 (c) "Evidence-based practices" are nationally recognized 281.9 mental health services that are proven by substantial research 281.10 to be effective in helping individuals with serious mental 281.11 illness obtain specific treatment goals. 281.12 (d) "Overnight staff" means a member of the intensive 281.13 residential rehabilitative mental health treatment team who is 281.14 responsible during hours when recipients are typically asleep. 281.15 (e) "Treatment team" means all staff who provide services 281.16 under this section to recipients. At a minimum, this includes 281.17 the clinical supervisor, mental health professionals, mental 281.18 health practitioners, and mental health rehabilitation workers. 281.19 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 281.20 individual who: 281.21 (1) is age 18 or older; 281.22 (2) is eligible for medical assistance; 281.23 (3) is diagnosed with a mental illness; 281.24 (4) because of a mental illness, has substantial disability 281.25 and functional impairment in three or more of the areas listed 281.26 in section 245.462, subdivision 11a, so that self-sufficiency is 281.27 markedly reduced; 281.28 (5) has one or more of the following: a history of two or 281.29 more inpatient hospitalizations in the past year, significant 281.30 independent living instability, homelessness, or very frequent 281.31 use of mental health and related services yielding poor 281.32 outcomes; and 281.33 (6) in the written opinion of a licensed mental health 281.34 professional, has the need for mental health services that 281.35 cannot be met with other available community-based services, or 281.36 is likely to experience a mental health crisis or require a more 282.1 restrictive setting if intensive rehabilitative mental health 282.2 services are not provided. 282.3 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 282.4 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 282.5 mental health services provider must: 282.6 (1) have a contract with the host county to provide 282.7 intensive adult rehabilitative mental health services; and 282.8 (2) be certified by the commissioner as being in compliance 282.9 with this section and section 256B.0623. 282.10 (b) The intensive residential rehabilitative mental health 282.11 services provider must: 282.12 (1) be licensed under Minnesota Rules, parts 9520.0500 to 282.13 9520.0670; 282.14 (2) not exceed 16 beds per site; 282.15 (3) comply with the additional standards in this section; 282.16 and 282.17 (4) have a contract with the host county to provide these 282.18 services. 282.19 (c) The commissioner shall develop procedures for counties 282.20 and providers to submit contracts and other documentation as 282.21 needed to allow the commissioner to determine whether the 282.22 standards in this section are met. 282.23 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 282.24 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 282.25 qualified staff as defined in section 256B.0623, subdivision 5, 282.26 who are trained and supervised according to section 256B.0623, 282.27 subdivision 6, except that mental health rehabilitation workers 282.28 acting as overnight staff are not required to comply with 282.29 section 256B.0623, subdivision 5, clause (3)(iv). 282.30 (b) The clinical supervisor must be an active member of the 282.31 treatment team. The treatment team must meet with the clinical 282.32 supervisor at least weekly to discuss recipients' progress and 282.33 make rapid adjustments to meet recipients' needs. The team 282.34 meeting shall include recipient-specific case reviews and 282.35 general treatment discussions among team members. 282.36 Recipient-specific case reviews and planning must be documented 283.1 in the individual recipient's treatment record. 283.2 (c) Treatment staff must have prompt access in person or by 283.3 telephone to a mental health practitioner or mental health 283.4 professional. The provider must have the capacity to promptly 283.5 and appropriately respond to emergent needs and make any 283.6 necessary staffing adjustments to assure the health and safety 283.7 of recipients. 283.8 (d) The initial functional assessment must be completed 283.9 within ten days of intake and updated at least every three 283.10 months or prior to discharge from the service, whichever comes 283.11 first. 283.12 (e) The initial individual treatment plan must be completed 283.13 within ten days of intake and reviewed and updated at least 283.14 monthly with the recipient. 283.15 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 283.16 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 283.17 SERVICES.] (a) The provider of intensive residential services 283.18 must have sufficient staff to provide 24 hour per day coverage 283.19 to deliver the rehabilitative services described in the 283.20 treatment plan and to safely supervise and direct the activities 283.21 of recipients given the recipient's level of behavioral and 283.22 psychiatric stability, cultural needs, and vulnerability. The 283.23 provider must have the capacity within the facility to provide 283.24 integrated services for chemical dependency, illness management 283.25 services, and family education when appropriate. 283.26 (b) At a minimum: 283.27 (1) staff must be available and provide direction and 283.28 supervision whenever recipients are present in the facility; 283.29 (2) staff must remain awake during all work hours; 283.30 (3) there must be a staffing ratio of at least one to eight 283.31 recipients for each day and evening shift. If more than eight 283.32 recipients are present at the residential site, there must be a 283.33 minimum of two staff during day and evening shifts, one of whom 283.34 must be a mental health practitioner or mental health 283.35 professional; 283.36 (4) if services are provided to recipients who need the 284.1 services of a medical professional, the provider shall assure 284.2 that these services are provided either by the provider's own 284.3 medical staff or through referral to a medical professional; and 284.4 (5) the provider must employ or contract with a licensed 284.5 registered nurse to ensure the effectiveness and safety of 284.6 medication administration in the facility. 284.7 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 284.8 SERVICES.] The standards in this subdivision apply to intensive 284.9 nonresidential rehabilitative mental health services. 284.10 (1) The treatment team must use team treatment, not an 284.11 individual treatment model. 284.12 (2) The clinical supervisor must function as a practicing 284.13 clinician at least on a part-time basis. 284.14 (3) The staffing ratio must not exceed ten recipients to 284.15 one full-time equivalent treatment team position. 284.16 (4) At a minimum, the team must operate Monday through 284.17 Friday, eight hours per day, and be on call all other hours. 284.18 (5) The treatment team must actively and assertively engage 284.19 and reach out to the recipient's family members and significant 284.20 others, after obtaining the recipient's permission. 284.21 (6) The treatment team must establish ongoing communication 284.22 and collaboration between the team, family, and significant 284.23 others and educate the family and significant others about 284.24 mental illness, symptom management, and the family's role in 284.25 treatment. 284.26 (7) The treatment team must provide interventions to 284.27 promote positive interpersonal relationships. 284.28 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 284.29 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 284.30 residential and nonresidential services in this section shall be 284.31 based on one daily rate per provider inclusive of the following 284.32 services received by an eligible recipient in a given calendar 284.33 day: all rehabilitative services under section 256B.0623 and 284.34 crisis stabilization services under section 256B.0624. 284.35 (b) Payment will not be made to more than one entity for 284.36 each recipient for services provided under this section on a 285.1 given day. If services under this section are provided by a 285.2 team that includes staff from more than one entity, the team 285.3 must determine how to distribute the payment among the members. 285.4 (c) The host county shall recommend to the commissioner one 285.5 rate for each entity that will bill medical assistance for 285.6 services under this section. In developing this rate, the host 285.7 county shall consider and document: 285.8 (1) the cost for similar services in the local trade area; 285.9 (2) actual costs incurred by entities providing the 285.10 services; 285.11 (3) the intensity and frequency of services to be provided 285.12 to each recipient; 285.13 (4) the degree to which recipients will receive services 285.14 other than services under this section; 285.15 (5) the costs of other services, such as case management, 285.16 that will be separately reimbursed; and 285.17 (6) input from the local planning process authorized by the 285.18 adult mental health initiative under section 245.4661, regarding 285.19 recipients' service needs. 285.20 (d) The rate for intensive rehabilitative mental health 285.21 services must exclude room and board, as defined in section 285.22 256I.03, subdivision 6, and services not covered under this 285.23 section, such as case management, physician services, partial 285.24 hospitalization, home care, and inpatient services. The 285.25 county's recommendation shall specify the period for which the 285.26 rate will be applicable, not to exceed two years. 285.27 (e) When services under this section are provided by an 285.28 assertive community team, case management functions must be an 285.29 integral part of the team. The county must allocate costs which 285.30 are reimbursable under this section versus costs which are 285.31 reimbursable through case management or other reimbursement, so 285.32 that payment is not duplicated. 285.33 (f) The rate for a provider must not exceed the rate 285.34 charged by that provider for the same service to other payors. 285.35 (g) The commissioner shall approve or reject the county's 285.36 rate recommendation, based on the commissioner's own analysis of 286.1 the criteria in paragraph (c). 286.2 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 286.3 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 286.4 to provide services under this section shall apply directly to 286.5 the commissioner for enrollment and rate setting. In this case, 286.6 a county contract is not required and the commissioner shall 286.7 perform the program review and rate setting duties which would 286.8 otherwise be required of counties under this section. 286.9 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 286.10 SPECIALIZED PROGRAM.] A provider proposing to serve a 286.11 subpopulation of eligible recipients may bypass the county 286.12 approval procedures in this section and receive approval for 286.13 provider enrollment and rate setting directly from the 286.14 commissioner under the following circumstances: 286.15 (1) the provider demonstrates that the subpopulation to be 286.16 served requires a specialized program which is not available 286.17 from county-approved entities; and 286.18 (2) the subpopulation to be served is of such a low 286.19 incidence that it is not feasible to develop a program serving a 286.20 single county or regional group of counties. 286.21 For providers meeting the criteria in clauses (1) and (2), 286.22 the commissioner shall perform the program review and rate 286.23 setting duties which would otherwise be required of counties 286.24 under this section. 286.25 Sec. 10. Minnesota Statutes 2002, section 256B.0625, 286.26 subdivision 23, is amended to read: 286.27 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 286.28 covers day treatment services as specified in sections 245.462, 286.29 subdivision 8, and 245.4871, subdivision 10, that are provided 286.30 under contract with the county board. Medical assistance 286.31 coverage for day treatment for adults ends on June 30, 2005. 286.32 Sec. 11. Minnesota Statutes 2002, section 256B.19, 286.33 subdivision 1, is amended to read: 286.34 Subdivision 1. [DIVISION OF COST.] The state and county 286.35 share of medical assistance costs not paid by federal funds 286.36 shall be as follows: 287.1 (1) beginning January 1, 1992, 50 percent state funds and 287.2 50 percent county funds for the cost of placement of severely 287.3 emotionally disturbed children in regional treatment centers; 287.4and287.5 (2) beginning January 1, 2003, 80 percent state funds and 287.6 20 percent county funds for the costs of nursing facility 287.7 placements of persons with disabilities under the age of 65 that 287.8 have exceeded 90 days. This clause shall be subject to chapter 287.9 256G and shall not apply to placements in facilities not 287.10 certified to participate in medical assistance.; 287.11 (3) beginning January 1, 2004, 80 percent state funds and 287.12 20 percent county funds for the costs of placements that have 287.13 exceeded 90 days in intermediate care facilities for persons 287.14 with mental retardation or a related condition that have seven 287.15 or more beds. This provision includes pass-through payments 287.16 made under section 256B.5015; and 287.17 (4) beginning January 1, 2004, when state funds are used to 287.18 pay for a nursing facility placement due to the facility's 287.19 status as an institution for mental diseases (IMD), the county 287.20 shall pay 20 percent of the nonfederal share of costs that have 287.21 exceeded 90 days. This clause is subject to chapter 256G. 287.22 For counties that participate in a Medicaid demonstration 287.23 project under sections 256B.69 and 256B.71, the division of the 287.24 nonfederal share of medical assistance expenses for payments 287.25 made to prepaid health plans or for payments made to health 287.26 maintenance organizations in the form of prepaid capitation 287.27 payments, this division of medical assistance expenses shall be 287.28 95 percent by the state and five percent by the county of 287.29 financial responsibility. 287.30 In counties where prepaid health plans are under contract 287.31 to the commissioner to provide services to medical assistance 287.32 recipients, the cost of court ordered treatment ordered without 287.33 consulting the prepaid health plan that does not include 287.34 diagnostic evaluation, recommendation, and referral for 287.35 treatment by the prepaid health plan is the responsibility of 287.36 the county of financial responsibility. 288.1 Sec. 12. Minnesota Statutes 2002, section 256B.501, 288.2 subdivision 1, is amended to read: 288.3 Subdivision 1. [DEFINITIONS.] For the purposes of this 288.4 section, the following terms have the meaning given them. 288.5 (a) "Commissioner" means the commissioner of human services. 288.6 (b) "Facility" means a facility licensed as a mental 288.7 retardation residential facility under section 252.28, licensed 288.8 as a supervised living facility under chapter 144, and certified 288.9 as an intermediate care facility for persons with mental 288.10 retardation or related conditions. The term does not include a 288.11 state regional treatment center. 288.12 (c) "Services during the day" means services or supports 288.13 provided to a person that enables the person to be fully 288.14 integrated into the community. Services during the day may 288.15 include a variety of supports to enable the person to exercise 288.16 choices for community integration and inclusion activities. 288.17 Services during the day may include, but are not limited to: 288.18 supported work, support during community adult education, 288.19 community volunteer opportunities, adult day care, recreational 288.20 activities, and other individualized integrated supports. 288.21 (d) "Waivered service" means home or community-based 288.22 service authorized under United States Code, title 42, section 288.23 1396n(c), as amended through December 31, 1987, and defined in 288.24 the Minnesota state plan for the provision of medical assistance 288.25 services. Waivered services include, at a minimum, case 288.26 management, family training and support, developmental training 288.27 homes, supervised living arrangements, semi-independent living 288.28 services, respite care, and training and habilitation services. 288.29 Sec. 13. Minnesota Statutes 2002, section 256B.501, is 288.30 amended by adding a subdivision to read: 288.31 Subd. 3m. [SERVICES DURING THE DAY.] When establishing a 288.32 rate for services during the day, the commissioner shall ensure 288.33 that these services comply with active treatment requirements 288.34 for persons residing in an ICF/MR as defined under federal 288.35 regulations. 288.36 Sec. 14. Minnesota Statutes 2002, section 256B.5012, is 289.1 amended by adding a subdivision to read: 289.2 Subd. 5. [PAYMENT RATE REDUCTION.] (a) Effective July 1, 289.3 2003, the commissioner shall reduce payment rates for each 289.4 facility reimbursed under this section by decreasing the total 289.5 operating payment rate for intermediate care facilities for the 289.6 mentally retarded by four percent. 289.7 (b) For each facility, the commissioner shall apply the 289.8 adjustment using the percentage specified in paragraph (a) 289.9 multiplied by the total payment rate, excluding the 289.10 property-related payment rate, in effect on June 30. 289.11 (c) A facility whose payment rates are governed by closure 289.12 agreements, receivership agreements, or Minnesota Rules, part 289.13 9553.0075, is not eligible for an adjustment otherwise granted 289.14 under this subdivision. 289.15 Sec. 15. Minnesota Statutes 2002, section 256B.5015, is 289.16 amended to read: 289.17 256B.5015 [PASS-THROUGH OFTRAINING AND HABILITATIONOTHER 289.18 SERVICES COSTS.] 289.19 Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.] 289.20 Day training and habilitation services costs shall be paid as a 289.21 pass-through payment at the lowest rate paid for the comparable 289.22 services at that site under sections 252.40 to 252.46. The 289.23 pass-through payments for training and habilitation services 289.24 shall be paid separately by the commissioner and shall not be 289.25 included in the computation of the ICF/MR facility total payment 289.26 rate. 289.27 Subd. 2. [SERVICES DURING THE DAY.] Services during the 289.28 day, as defined in section 256B.501, shall be paid as a 289.29 pass-through payment no later than January 1, 2004. The 289.30 commissioner shall establish rates for these services at levels 289.31 that do not exceed 75 percent of a recipient's day training and 289.32 habilitation costs prior to the service change. 289.33 When establishing a rate for these services, the 289.34 commissioner shall also consider: an individual recipient's 289.35 needs as identified in the individualized service plan and the 289.36 person's need for active treatment as defined under federal 290.1 regulations. The pass-through payments for services during the 290.2 day may be paid separately by the commissioner and may be 290.3 included in the computation of the ICF/MR facility total payment 290.4 rate. 290.5 Sec. 16. Minnesota Statutes 2002, section 256E.081, 290.6 subdivision 3, is amended to read: 290.7 Subd. 3. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 290.8 county has made reasonable efforts, as defined in subdivision 2, 290.9 to comply with all social services administrative rule 290.10 requirements and is unable to meet all requirements, the county 290.11 must provide services according to an amended community social 290.12 services plan developed by the county and approved by the 290.13 commissioner under section 256E.09, subdivision 6. The plan 290.14 must identify for the remainder of the calendar year the social 290.15 services administrative rule requirements the county shall 290.16 comply with within its fiscal limitations and identify the 290.17 social services administrative rule requirements the county will 290.18 not comply with due to fiscal limitations. The plan must 290.19 specify how the county intends to provide services required by 290.20 federal law or state statute, including but not limited to: 290.21 (1) providing services needed to protect children and 290.22 vulnerable adults from maltreatment, abuse, and neglect; 290.23 (2) providing emergency and crisis services needed to 290.24 protect clients from physical, emotional, or psychological harm; 290.25 (3) assessing and documenting the needs of persons applying 290.26 for services; 290.27 (4) providing case management services to developmentally 290.28 disabled clients, adults with serious and persistent mental 290.29 illness, and children with severe emotional disturbances; 290.30 (5) providingday training and habilitation services for290.31persons with developmental disabilities andfamily community 290.32 support services for children with severe emotional 290.33 disturbances; 290.34 (6) providing subacute detoxification services; 290.35 (7) providing public guardianship services; and 290.36 (8) fulfilling licensing responsibilities delegated to the 291.1 county by the commissioner under section 245A.16. 291.2 Sec. 17. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 291.3 FACILITY STAYS.] 291.4 Beginning January 1, 2004, if group residential housing is 291.5 used to pay for a nursing facility placement due to the 291.6 facility's status as an Institution for Mental Diseases, the 291.7 county is liable for 20 percent of the nonfederal share of costs 291.8 for persons under the age of 65 that have exceeded 90 days. 291.9 Sec. 18. [REVISOR'S INSTRUCTION.] 291.10 For sections in Minnesota Statutes and Minnesota Rules 291.11 affected by the repealed sections in this article, the revisor 291.12 shall delete internal cross-references where appropriate and 291.13 make changes necessary to correct the punctuation, grammar, or 291.14 structure of the remaining text and preserve its meaning. 291.15 Sec. 19. [REPEALER.] 291.16 (a) Minnesota Statutes 2002, sections 254A.17, subdivision 291.17 3; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 291.18 256B.0955; and 256B.5013, subdivision 4, are repealed July 1, 291.19 2003. 291.20 (b) Minnesota Statutes 2002, section 245.4712, subdivision 291.21 2, is repealed July 1, 2005. 291.22 (c) Laws 2001, First Special Session chapter 9, article 13, 291.23 section 24, is repealed July 1, 2003. 291.24 ARTICLE 5 291.25 CHILDREN'S SERVICES 291.26 Section 1. Minnesota Statutes 2002, section 144.551, 291.27 subdivision 1, is amended to read: 291.28 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 291.29 (a) The following construction or modification may not be 291.30 commenced: 291.31 (1) any erection, building, alteration, reconstruction, 291.32 modernization, improvement, extension, lease, or other 291.33 acquisition by or on behalf of a hospital that increases the bed 291.34 capacity of a hospital, relocates hospital beds from one 291.35 physical facility, complex, or site to another, or otherwise 291.36 results in an increase or redistribution of hospital beds within 292.1 the state; and 292.2 (2) the establishment of a new hospital. 292.3 (b) This section does not apply to: 292.4 (1) construction or relocation within a county by a 292.5 hospital, clinic, or other health care facility that is a 292.6 national referral center engaged in substantial programs of 292.7 patient care, medical research, and medical education meeting 292.8 state and national needs that receives more than 40 percent of 292.9 its patients from outside the state of Minnesota; 292.10 (2) a project for construction or modification for which a 292.11 health care facility held an approved certificate of need on May 292.12 1, 1984, regardless of the date of expiration of the 292.13 certificate; 292.14 (3) a project for which a certificate of need was denied 292.15 before July 1, 1990, if a timely appeal results in an order 292.16 reversing the denial; 292.17 (4) a project exempted from certificate of need 292.18 requirements by Laws 1981, chapter 200, section 2; 292.19 (5) a project involving consolidation of pediatric 292.20 specialty hospital services within the Minneapolis-St. Paul 292.21 metropolitan area that would not result in a net increase in the 292.22 number of pediatric specialty hospital beds among the hospitals 292.23 being consolidated; 292.24 (6) a project involving the temporary relocation of 292.25 pediatric-orthopedic hospital beds to an existing licensed 292.26 hospital that will allow for the reconstruction of a new 292.27 philanthropic, pediatric-orthopedic hospital on an existing site 292.28 and that will not result in a net increase in the number of 292.29 hospital beds. Upon completion of the reconstruction, the 292.30 licenses of both hospitals must be reinstated at the capacity 292.31 that existed on each site before the relocation; 292.32 (7) the relocation or redistribution of hospital beds 292.33 within a hospital building or identifiable complex of buildings 292.34 provided the relocation or redistribution does not result in: 292.35 (i) an increase in the overall bed capacity at that site; (ii) 292.36 relocation of hospital beds from one physical site or complex to 293.1 another; or (iii) redistribution of hospital beds within the 293.2 state or a region of the state; 293.3 (8) relocation or redistribution of hospital beds within a 293.4 hospital corporate system that involves the transfer of beds 293.5 from a closed facility site or complex to an existing site or 293.6 complex provided that: (i) no more than 50 percent of the 293.7 capacity of the closed facility is transferred; (ii) the 293.8 capacity of the site or complex to which the beds are 293.9 transferred does not increase by more than 50 percent; (iii) the 293.10 beds are not transferred outside of a federal health systems 293.11 agency boundary in place on July 1, 1983; and (iv) the 293.12 relocation or redistribution does not involve the construction 293.13 of a new hospital building; 293.14 (9) a construction project involving up to 35 new beds in a 293.15 psychiatric hospital in Rice county that primarily serves 293.16 adolescents and that receives more than 70 percent of its 293.17 patients from outside the state of Minnesota; 293.18 (10) a project to replace a hospital or hospitals with a 293.19 combined licensed capacity of 130 beds or less if: (i) the new 293.20 hospital site is located within five miles of the current site; 293.21 and (ii) the total licensed capacity of the replacement 293.22 hospital, either at the time of construction of the initial 293.23 building or as the result of future expansion, will not exceed 293.24 70 licensed hospital beds, or the combined licensed capacity of 293.25 the hospitals, whichever is less; 293.26 (11) the relocation of licensed hospital beds from an 293.27 existing state facility operated by the commissioner of human 293.28 services to a new or existing facility, building, or complex 293.29 operated by the commissioner of human services; from one 293.30 regional treatment center site to another; or from one building 293.31 or site to a new or existing building or site on the same 293.32 campus; 293.33 (12) the construction or relocation of hospital beds 293.34 operated by a hospital having a statutory obligation to provide 293.35 hospital and medical services for the indigent that does not 293.36 result in a net increase in the number of hospital beds; 294.1 (13) a construction project involving the addition of up to 294.2 31 new beds in an existing nonfederal hospital in Beltrami 294.3 county;or294.4 (14) a construction project involving the addition of up to 294.5 eight new beds in an existing nonfederal hospital in Otter Tail 294.6 county with 100 licensed acute care beds; or 294.7 (15) a project for the construction or relocation of up to 294.8 20 hospital beds for the operation of up to two psychiatric 294.9 facilities or units for children provided that the operation of 294.10 the facilities or units have received the approval of the 294.11 commissioner of human services. 294.12 Sec. 2. Minnesota Statutes 2002, section 245.4874, is 294.13 amended to read: 294.14 245.4874 [DUTIES OF COUNTY BOARD.] 294.15 The county board in each county shall use its share of 294.16 mental health and Community Social Services Act funds allocated 294.17 by the commissioner according to a biennial children's mental 294.18 health component of the community social services plan required 294.19 under section 245.4888, and approved by the commissioner. The 294.20 county board must: 294.21 (1) develop a system of affordable and locally available 294.22 children's mental health services according to sections 245.487 294.23 to 245.4888; 294.24 (2) establish a mechanism providing for interagency 294.25 coordination as specified in section 245.4875, subdivision 6; 294.26 (3) develop a biennial children's mental health component 294.27 of the community social services plan required under section 294.28 256E.09 which considers the assessment of unmet needs in the 294.29 county as reported by the local children's mental health 294.30 advisory council under section 245.4875, subdivision 5, 294.31 paragraph (b), clause (3). The county shall provide, upon 294.32 request of the local children's mental health advisory council, 294.33 readily available data to assist in the determination of unmet 294.34 needs; 294.35 (4) assure that parents and providers in the county receive 294.36 information about how to gain access to services provided 295.1 according to sections 245.487 to 245.4888; 295.2 (5) coordinate the delivery of children's mental health 295.3 services with services provided by social services, education, 295.4 corrections, health, and vocational agencies to improve the 295.5 availability of mental health services to children and the 295.6 cost-effectiveness of their delivery; 295.7 (6) assure that mental health services delivered according 295.8 to sections 245.487 to 245.4888 are delivered expeditiously and 295.9 are appropriate to the child's diagnostic assessment and 295.10 individual treatment plan; 295.11 (7) provide the community with information about predictors 295.12 and symptoms of emotional disturbances and how to access 295.13 children's mental health services according to sections 245.4877 295.14 and 245.4878; 295.15 (8) provide for case management services to each child with 295.16 severe emotional disturbance according to sections 245.486; 295.17 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 295.18 and 5; 295.19 (9) provide for screening of each child under section 295.20 245.4885 upon admission to a residential treatment facility, 295.21 acute care hospital inpatient treatment, or informal admission 295.22 to a regional treatment center; 295.23 (10) prudently administer grants and purchase-of-service 295.24 contracts that the county board determines are necessary to 295.25 fulfill its responsibilities under sections 245.487 to 245.4888; 295.26 (11) assure that mental health professionals, mental health 295.27 practitioners, and case managers employed by or under contract 295.28 to the county to provide mental health services are qualified 295.29 under section 245.4871; 295.30 (12) assure that children's mental health services are 295.31 coordinated with adult mental health services specified in 295.32 sections 245.461 to 245.486 so that a continuum of mental health 295.33 services is available to serve persons with mental illness, 295.34 regardless of the person's age;and295.35 (13) assure that culturally informed mental health 295.36 consultants are used as necessary to assist the county board in 296.1 assessing and providing appropriate treatment for children of 296.2 cultural or racial minority heritage; and 296.3 (14) arrange for or provide a children's mental health 296.4 screening to a child receiving child protective services or a 296.5 child in out-of-home placement, a child for whom parental rights 296.6 have been terminated, a child alleged or found to be delinquent, 296.7 and a child found to have committed a juvenile petty offense for 296.8 the third or subsequent time, unless a screening has been 296.9 performed within the previous 180 days, or the child is 296.10 currently under the care of a mental health professional. The 296.11 screening shall be conducted with a screening instrument 296.12 approved by the commissioner of human services and shall be 296.13 conducted by a mental health practitioner as defined in section 296.14 245.4871, subdivision 26, or a probation officer or local social 296.15 services agency staff person who is trained in the use of the 296.16 screening instrument. If the screen indicates a need for 296.17 assessment, the child's family, or if the family lacks mental 296.18 health insurance, the local social services agency, in 296.19 consultation with the child's family, shall have conducted a 296.20 diagnostic assessment, including a functional assessment, as 296.21 defined in section 245.4871. 296.22 Sec. 3. Minnesota Statutes 2002, section 256B.0625, 296.23 subdivision 20, is amended to read: 296.24 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 296.25 extent authorized by rule of the state agency, medical 296.26 assistance covers case management services to persons with 296.27 serious and persistent mental illness and children with severe 296.28 emotional disturbance. Services provided under this section 296.29 must meet the relevant standards in sections 245.461 to 296.30 245.4888, the Comprehensive Adult and Children's Mental Health 296.31 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 296.32 9505.0322, excluding subpart 10. 296.33 (b) Entities meeting program standards set out in rules 296.34 governing family community support services as defined in 296.35 section 245.4871, subdivision 17, are eligible for medical 296.36 assistance reimbursement for case management services for 297.1 children with severe emotional disturbance when these services 297.2 meet the program standards in Minnesota Rules, parts 9520.0900 297.3 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 297.4 (c) Medical assistance and MinnesotaCare payment for mental 297.5 health case management shall be made on a monthly basis. In 297.6 order to receive payment for an eligible child, the provider 297.7 must document at least a face-to-face contact with the child, 297.8 the child's parents, or the child's legal representative. To 297.9 receive payment for an eligible adult, the provider must 297.10 document: 297.11 (1) at least a face-to-face contact with the adult or the 297.12 adult's legal representative; or 297.13 (2) at least a telephone contact with the adult or the 297.14 adult's legal representative and document a face-to-face contact 297.15 with the adult or the adult's legal representative within the 297.16 preceding two months. 297.17 (d) Payment for mental health case management provided by 297.18 county or state staff shall be based on the monthly rate 297.19 methodology under section 256B.094, subdivision 6, paragraph 297.20 (b), with separate rates calculated for child welfare and mental 297.21 health, and within mental health, separate rates for children 297.22 and adults. 297.23 (e) Payment for mental health case management provided by 297.24 Indian health services or by agencies operated by Indian tribes 297.25 may be made according to this section or other relevant 297.26 federally approved rate setting methodology. 297.27 (f) Payment for mental health case management provided by 297.28 vendors who contract with a county or Indian tribe shall be 297.29 based on a monthly rate negotiated by the host county or tribe. 297.30 The negotiated rate must not exceed the rate charged by the 297.31 vendor for the same service to other payers. If the service is 297.32 provided by a team of contracted vendors, the county or tribe 297.33 may negotiate a team rate with a vendor who is a member of the 297.34 team. The team shall determine how to distribute the rate among 297.35 its members. No reimbursement received by contracted vendors 297.36 shall be returned to the county or tribe, except to reimburse 298.1 the county or tribe for advance funding provided by the county 298.2 or tribe to the vendor. 298.3 (g) If the service is provided by a team which includes 298.4 contracted vendors, tribal staff, and county or state staff, the 298.5 costs for county or state staff participation in the team shall 298.6 be included in the rate for county-provided services. In this 298.7 case, the contracted vendor, the tribal agency, and the county 298.8 may each receive separate payment for services provided by each 298.9 entity in the same month. In order to prevent duplication of 298.10 services, each entity must document, in the recipient's file, 298.11 the need for team case management and a description of the roles 298.12 of the team members. 298.13 (h) The commissioner shall calculate the nonfederal share 298.14 of actual medical assistance and general assistance medical care 298.15 payments for each county, based on the higher of calendar year 298.16 1995 or 1996, by service date, project that amount forward to 298.17 1999, and transfer one-half of the result from medical 298.18 assistance and general assistance medical care to each county's 298.19 mental health grants under sections 245.4886 and 256E.12 for 298.20 calendar year 1999. The annualized minimum amount added to each 298.21 county's mental health grant shall be $3,000 per year for 298.22 children and $5,000 per year for adults. The commissioner may 298.23 reduce the statewide growth factor in order to fund these 298.24 minimums. The annualized total amount transferred shall become 298.25 part of the base for future mental health grants for each county. 298.26 (i)Any net increase in revenue to the county or tribe as a298.27result of the change in this section must be used to provide298.28expanded mental health services as defined in sections 245.461298.29to 245.4888, the Comprehensive Adult and Children's Mental298.30Health Acts, excluding inpatient and residential treatment. For298.31adults, increased revenue may also be used for services and298.32consumer supports which are part of adult mental health projects298.33approved under Laws 1997, chapter 203, article 7, section 25.298.34For children, increased revenue may also be used for respite298.35care and nonresidential individualized rehabilitation services298.36as defined in section 245.492, subdivisions 17 and 23.299.1"Increased revenue" has the meaning given in Minnesota Rules,299.2part 9520.0903, subpart 3.299.3(j)Notwithstanding section 256B.19, subdivision 1, the 299.4 nonfederal share of costs for mental health case management 299.5 shall be provided by the recipient's county of responsibility, 299.6 as defined in sections 256G.01 to 256G.12, from sources other 299.7 than federal funds or funds used to match other federal funds. 299.8 If the service is provided by a tribal agency, the nonfederal 299.9 share, if any, shall be provided by the recipient's tribe. 299.10(k)(j) The commissioner may suspend, reduce, or terminate 299.11 the reimbursement to a provider that does not meet the reporting 299.12 or other requirements of this section. The county of 299.13 responsibility, as defined in sections 256G.01 to 256G.12, or, 299.14 if applicable, the tribal agency, is responsible for any federal 299.15 disallowances. The county or tribe may share this 299.16 responsibility with its contracted vendors. 299.17(l)(k) The commissioner shall set aside a portion of the 299.18 federal funds earned under this section to repay the special 299.19 revenue maximization account under section 256.01, subdivision 299.20 2, clause (15). The repayment is limited to: 299.21 (1) the costs of developing and implementing this section; 299.22 and 299.23 (2) programming the information systems. 299.24(m)(l) Payments to counties and tribal agencies for case 299.25 management expenditures under this section shall only be made 299.26 from federal earnings from services provided under this 299.27 section. Payments to county-contracted vendors shall include 299.28 both the federal earnings and the county share. 299.29(n)(m) Notwithstanding section 256B.041, county payments 299.30 for the cost of mental health case management services provided 299.31 by county or state staff shall not be made to the state 299.32 treasurer. For the purposes of mental health case management 299.33 services provided by county or state staff under this section, 299.34 the centralized disbursement of payments to counties under 299.35 section 256B.041 consists only of federal earnings from services 299.36 provided under this section. 300.1(o)(n) Case management services under this subdivision do 300.2 not include therapy, treatment, legal, or outreach services. 300.3(p)(o) If the recipient is a resident of a nursing 300.4 facility, intermediate care facility, or hospital, and the 300.5 recipient's institutional care is paid by medical assistance, 300.6 payment for case management services under this subdivision is 300.7 limited to the last 180 days of the recipient's residency in 300.8 that facility and may not exceed more than six months in a 300.9 calendar year. 300.10(q)(p) Payment for case management services under this 300.11 subdivision shall not duplicate payments made under other 300.12 program authorities for the same purpose. 300.13(r)(q) By July 1, 2000, the commissioner shall evaluate 300.14 the effectiveness of the changes required by this section, 300.15 including changes in number of persons receiving mental health 300.16 case management, changes in hours of service per person, and 300.17 changes in caseload size. 300.18(s)(r) For each calendar year beginning with the calendar 300.19 year 2001, the annualized amount of state funds for each county 300.20 determined under paragraph (h) shall be adjusted by the county's 300.21 percentage change in the average number of clients per month who 300.22 received case management under this section during the fiscal 300.23 year that ended six months prior to the calendar year in 300.24 question, in comparison to the prior fiscal year. 300.25(t)(s) For counties receiving the minimum allocation of 300.26 $3,000 or $5,000 described in paragraph (h), the adjustment in 300.27 paragraph(s)(r) shall be determined so that the county 300.28 receives the higher of the following amounts: 300.29 (1) a continuation of the minimum allocation in paragraph 300.30 (h); or 300.31 (2) an amount based on that county's average number of 300.32 clients per month who received case management under this 300.33 section during the fiscal year that ended six months prior to 300.34 the calendar year in question, times the average statewide grant 300.35 per person per month for counties not receiving the minimum 300.36 allocation. 301.1(u)(t) The adjustments in paragraphs(s)(r) and 301.2(t)(s) shall be calculated separately for children and adults. 301.3 Sec. 4. Minnesota Statutes 2002, section 256B.0625, 301.4 subdivision 23, is amended to read: 301.5 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 301.6 covers day treatment services for adults as specified in 301.7sectionssection 245.462, subdivision 8,and 245.4871,301.8subdivision 10,that are provided under contract with the county 301.9 board. Medical assistance covers day treatment services for 301.10 children as specified under section 256B.0943. 301.11 [EFFECTIVE DATE.] This section is effective July 1, 2004. 301.12 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 301.13 amended by adding a subdivision to read: 301.14 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 301.15 SERVICES.] Medical assistance covers children's mental health 301.16 crisis response services according to section 256B.0944. 301.17 [EFFECTIVE DATE.] This section is effective July 1, 2004. 301.18 Sec. 6. Minnesota Statutes 2002, section 256B.0625, is 301.19 amended by adding a subdivision to read: 301.20 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 301.21 Medical assistance covers children's therapeutic services and 301.22 supports according to section 256B.0943. 301.23 Sec. 7. Minnesota Statutes 2002, section 256B.0625, is 301.24 amended by adding a subdivision to read: 301.25 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 301.26 YEARS OF AGE.] Medical assistance covers subacute psychiatric 301.27 care for person under 21 years of age when: 301.28 (1) the services meet the requirements of Code of Federal 301.29 Regulations, title 42, section 440.160; 301.30 (2) the facility is accredited as a psychiatric treatment 301.31 facility by the joint commission on accreditation of healthcare 301.32 organizations, the commission on accreditation of rehabilitation 301.33 facilities, or the council on accreditation; and 301.34 (3) the facility is licensed by the commissioner of health 301.35 under section 144.50. 301.36 Sec. 8. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 302.1 SUPPORTS.] 302.2 Subdivision 1. [SCOPE.] Children's therapeutic services 302.3 and supports are an array of mental health services for children 302.4 who require different therapeutic and rehabilitative levels of 302.5 intervention. 302.6 Subd. 2. [DEFINITIONS.] For the purposes of this section, 302.7 the following terms have the meanings given them. 302.8 (a) [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 302.9 "Children's therapeutic services and supports" means the array 302.10 of mental health services for children who require different 302.11 therapeutic and rehabilitative levels of intervention as 302.12 identified in the client's individual treatment plan through a 302.13 child-centered, family-driven planning process that identifies 302.14 individualized, planned, and culturally appropriate 302.15 interventions. Children's therapeutic services and supports are 302.16 time-limited interventions that are delivered using various 302.17 treatment modalities and combinations of service to reach 302.18 treatment outcomes identified in the individual treatment plan. 302.19 Services such as psychotherapy, skills training, crisis 302.20 assistance, and mental health behavioral aide services may be 302.21 provided to a child in the child's home or a community setting. 302.22 Community settings may include the child's preschool or school, 302.23 the home of a relative of the child, a recreational or leisure 302.24 setting, or a site where the child receives day care. 302.25 (b) [CLINICAL SUPERVISION.] "Clinical supervision" means 302.26 the overall responsibility of the mental health professional as 302.27 defined in section 245.4871, subdivision 27, clauses (1) to (5), 302.28 for the control and direction of individualized treatment 302.29 planning, service delivery, and treatment review for each 302.30 client. The mental health professional who is an enrolled 302.31 Minnesota health care program provider accepts full professional 302.32 responsibility for the actions and decisions of the persons 302.33 supervised, instructs the person in the person's work, and 302.34 oversees or directs the work of the person supervised. 302.35 (c) [COUNTY BOARD.] "County board" means the county board 302.36 of commissioners or board established under sections 402.01 to 303.1 402.10 or 471.59. 303.2 (d) [CRISIS ASSISTANCE.] "Crisis assistance" has the 303.3 meaning given in section 245.4871, subdivision 9a. 303.4 (e) [CULTURAL COMPETENCE OR CULTURALLY COMPETENT.] 303.5 "Cultural competence or culturally competent" means the ability 303.6 and the capacity to respond to the unique needs of an individual 303.7 client that arise from the client's culture and the ability to 303.8 use the person's culture as a resource or tool to assist with 303.9 the intervention and help meet the person's needs. 303.10 (f) [CULTURALLY COMPETENT PROVIDER.] "Culturally competent 303.11 provider" means a service professional who understands, and can 303.12 utilize to the client's benefit, the client's culture either 303.13 because the service professional is of the same cultural or 303.14 ethnic group or because the provider has developed the knowledge 303.15 and skills through training and personal growth to provide 303.16 high-quality service to diverse clients. 303.17 (g) [CULTURALLY SPECIFIC PROVIDER.] "Culturally specific 303.18 provider" means one that is characteristically found or proven 303.19 especially effective within a particular cultural or linguistic 303.20 population. 303.21 (h) [DAY TREATMENT PROGRAM FOR CHILDREN.] "Day treatment 303.22 program for children" means a site-based structured program 303.23 consisting of group psychotherapy for more than three 303.24 individuals and other intensive therapeutic services provided by 303.25 a multidisciplinary team, under the clinical supervision of a 303.26 mental health professional. Day treatment services stabilize 303.27 the client's mental health status while developing and improving 303.28 the client's independent living and socialization skills. The 303.29 goal is to reduce or relieve the effects of mental illness and 303.30 provide training to enable the client to live in the community. 303.31 Day treatment services are not part of inpatient or residential 303.32 treatment services. Day treatment services are provided to a 303.33 client in and by: an outpatient hospital accredited by the 303.34 joint commission on accreditation of health organizations and 303.35 licensed under sections 144.50 to 144.55; a community mental 303.36 health center under section 245.62; or an entity that is under 304.1 contract with the county board to operate a program that meets 304.2 the requirements of sections 245.4712, subdivision 2, 245.4884, 304.3 subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. 304.4 (i) [DIAGNOSTIC ASSESSMENT.] "Diagnostic assessment" has 304.5 the meaning given in section 245.4871, subdivision 11. A 304.6 written evaluation by a mental health professional of a person's 304.7 current life situation and sources of stress, including the 304.8 reasons for referral; history of the person's current mental 304.9 health problem, including important developmental incidents, 304.10 strengths, and vulnerabilities; current functioning and 304.11 symptoms; diagnosis, including whether or not a person has an 304.12 emotional disturbance or serious emotional disturbance; and 304.13 mental health services needed by the client. 304.14 (j) [DIRECTION OF MENTAL HEALTH BEHAVIORAL AIDE.] 304.15 "Direction of mental health behavioral aide" means the 304.16 activities of the mental health professional, or mental health 304.17 practitioner under the clinical supervision of a mental health 304.18 professional, to guide the work of the mental health behavioral 304.19 aide. Direction is based on the individualized treatment plan. 304.20 The person giving direction begins with the goals on the 304.21 individualized treatment plan, and instructs the mental health 304.22 behavioral aide in how to construct therapeutic activities and 304.23 interventions that will lead to goal attainment. The person 304.24 giving direction also instructs the mental health behavioral 304.25 aide about the diagnosis, functional status, and other 304.26 characteristics of the client that are likely to affect service 304.27 delivery. Direction must also include determining whether the 304.28 mental health behavioral aide has the skills to interact with 304.29 the client and the client's family in ways which convey personal 304.30 and cultural respect and that the aide actively solicits 304.31 information relevant to treatment from the family while being 304.32 able to clearly explain the activities the aide is doing with 304.33 the client and their relationship to treatment goals. Direction 304.34 is more didactic than is supervision, and requires the 304.35 professional and practitioner providing direction to 304.36 continuously evaluate the mental health behavioral aide's 305.1 ability to carry out the activities of the individualized 305.2 treatment plan and the individualized behavior plan. 305.3 (k) [EMOTIONAL DISTURBANCE.] "Emotional disturbance" is 305.4 defined in section 245.4871, subdivision 15, and, for persons 305.5 age 18 to 20, a mental illness as defined in section 245.462, 305.6 subdivision 20, paragraph (a). 305.7 (l) [FACE-TO-FACE TIME.] "Face-to-face time" means time 305.8 that a mental health professional, mental health practitioner, 305.9 or mental health behavioral aide spends face-to-face with the 305.10 client and the client's family. This includes time in which the 305.11 provider performs tasks such as obtaining a history, or 305.12 providing service components of children's therapeutic services 305.13 and supports. Activities such as scheduling, maintaining 305.14 clinical records, consulting with others about the client's 305.15 mental health status, preparing reports, receiving clinical 305.16 supervision directly related to the client's psychotherapy 305.17 session, and revising the client's individual treatment plan are 305.18 not included in the time component of services in this section. 305.19 (m) [INDIVIDUAL BEHAVIORAL PLAN.] "Individual behavioral 305.20 plan" means a plan of intervention, treatment, and services 305.21 written by a mental health professional or mental health 305.22 practitioner under the clinical supervision of a mental health 305.23 professional, for a mental health behavioral aide to provide. 305.24 The plan documents instruction for services to be provided by 305.25 the mental health behavioral aide. The individual behavior plan 305.26 must include: 305.27 (1) detailed instructions on the service to be provided; 305.28 (2) time allocated to each service; 305.29 (3) methods of documenting the child's behavior; 305.30 (4) methods of monitoring the progress of the child in 305.31 reaching objectives; and 305.32 (5) goals to increase or decrease targeted behavior as 305.33 identified in the individual treatment plan. 305.34 (n) [INDIVIDUAL TREATMENT PLAN.] "Individual treatment plan" 305.35 has the meaning given in section 245.4871, subdivision 21. 305.36 (o) [MENTAL HEALTH PROFESSIONAL.] "Mental health 306.1 professional" means an individual as defined in section 306.2 245.4871, subdivision 27, clauses (1) to (5), or tribal vendor 306.3 as defined in section 256B.02, subdivision 7, paragraph (b). 306.4 (p) [PRESCHOOL PROGRAM.] "Preschool program" means a day 306.5 program licensed under Minnesota Rules, parts 9503.0005 to 306.6 9503.0175, and enrolled as a children's therapeutic services and 306.7 supports provider to provide a structured program of treatment 306.8 that includes therapeutic and rehabilitative components of 306.9 mental health services provided by a team of multidisciplinary 306.10 staff under the clinical supervision of a mental health 306.11 professional to a child who is at least 33 months old but who 306.12 has not yet reached the first day of kindergarten. The 306.13 structured program of treatment must be available at least one 306.14 day a week for a minimum two-hour time block. The two-hour time 306.15 block may include individual and group psychotherapy and any of 306.16 the following developmentally and therapeutically appropriate 306.17 activities: recreation therapy, socialization therapy, and 306.18 independent living skills therapy to the extent the activities 306.19 are included in the child's individual treatment plan. 306.20 (q) [RESIDENCE.] "Residence" means a person's own home, 306.21 foster home, shelter, or a setting where a child resides that 306.22 does not provide active mental health treatment services as part 306.23 of the per diem charged by a residential program. Residence 306.24 does not include an acute care hospital licensed under chapter 306.25 144, a regional treatment center, nursing home, ICF/MR facility, 306.26 or facilities that provide active treatment services. 306.27 (r) [SKILLS TRAINING.] "Skills training" means individual, 306.28 family, or group skills training designed to improve the basic 306.29 functioning of the child with severe emotional disturbance and 306.30 the child's family in the activities of daily living and 306.31 community living, and to improve the social functioning of the 306.32 child and the child's family in areas important to the child's 306.33 maintaining or reestablishing residency in the community. The 306.34 individual, family, and group skills training must: 306.35 (1) consist of activities designed to promote skill 306.36 development of the child and the child's family in the use of 307.1 age-appropriate daily living skills, interpersonal and family 307.2 relationships, and leisure and recreational services; 307.3 (2) consist of activities which will assist the family in 307.4 improving the family's understanding of normal child development 307.5 and to use parenting skills that will help the child with 307.6 emotional disturbance or severe emotional disturbance achieve 307.7 the goals outlined in the child's individual treatment plan; and 307.8 (3) promote family preservation and unification, promote 307.9 the family's integration with the community, and reduce the use 307.10 of unnecessary out-of-home placement or institutionalization of 307.11 children with emotional disturbance or severe emotional 307.12 disturbance. 307.13 Subd. 3. [COVERED SERVICE COMPONENTS OF CHILDREN'S 307.14 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 307.15 approval, medical assistance covers medically necessary 307.16 children's therapeutic services and supports as defined in this 307.17 section for clients defined under subdivision 5, by providers 307.18 under subdivisions 7 and 8. The service components of 307.19 children's therapeutic services and supports are: 307.20 (1) individual, family, and group psychotherapy provided by 307.21 a mental health professional; 307.22 (2) individual, family, or group skills training provided 307.23 by a mental health professional or mental health practitioner 307.24 under the clinical supervision of a mental health professional; 307.25 (3) crisis assistance as defined in this section; 307.26 (4) mental health behavioral aide services as defined in 307.27 this section; and 307.28 (5) direction of a mental health behavioral aide or a 307.29 program staff as defined in subdivision 2, paragraph (j). 307.30 (b) Service components may be combined to constitute 307.31 therapeutic programs, including day treatment programs, 307.32 preschool programs, home-based mental health treatment, and 307.33 therapeutic support of foster care. While these programs have 307.34 specific client and provider eligibility requirements and 307.35 service standards, medical assistance only pays for the service 307.36 components listed in paragraph (a). 308.1 Subd. 4. [DIAGNOSIS OF EMOTIONAL DISTURBANCE OR MENTAL 308.2 ILLNESS.] A client's eligibility for mental health services 308.3 under this section shall be based on a diagnostic assessment 308.4 performed within 180 days that documents a diagnosis of 308.5 emotional disturbance or mental illness. A diagnostic 308.6 assessment that includes current diagnoses on all five axes of 308.7 the client's current mental health status and service needs, and 308.8 determines whether the client has a diagnosis of emotional 308.9 disturbance or mental illness, shall be used in the development 308.10 of the individualized treatment plan. A new diagnostic 308.11 assessment must be completed yearly until the client reaches the 308.12 age of 18. The diagnostic assessment is necessary to verify 308.13 diagnosis of emotional disturbance or mental illness, verify the 308.14 need for mental health services, and to structure the individual 308.15 treatment plan. For individuals between the ages of 18 and 21, 308.16 a diagnostic assessment which documents a diagnosis of emotional 308.17 disturbance or mental illness must be performed within 180 308.18 days. For continuing services, an updated assessment must be 308.19 done yearly. Updating means a written summary by a mental 308.20 health professional of the client's current mental health status 308.21 and service needs including current diagnoses on all five axes. 308.22 The client record must include the initial diagnostic assessment 308.23 and all subsequent written updates or diagnostic assessments. 308.24 Subd. 5. [DETERMINATION OF CLIENT ELIGIBILITY.] The 308.25 determination of a client's eligibility to receive children's 308.26 therapeutic services and supports under this section shall be 308.27 based on a diagnostic assessment by a mental health professional 308.28 that documents mental health services are medically necessary to 308.29 address identified disability, functional impairments, and 308.30 individual client needs and goals. An eligible client is a 308.31 child under the age of 18 who has been diagnosed with emotional 308.32 disturbance, or if the individual is between the ages of 18 and 308.33 21, a person who has been diagnosed with mental illness. 308.34 Subd. 6. [DETERMINATION OF PROVIDER ENTITY ELIGIBILITY.] 308.35 (a) The provider entity must complete the provider application 308.36 and certification process as established by the commissioner to 309.1 become a children's therapeutic services and supports provider. 309.2 The process shall determine whether the entity meets the 309.3 applicable requirements in subdivisions 7 to 10. 309.4 Recertification must occur at least every two years. The 309.5 county, tribe, and the commissioner shall be equally responsible 309.6 and accountable for certification. A provider entity must be: 309.7 (1) an Indian health services facility or a facility owned 309.8 and operated by a tribe or tribal organization operating as a 309.9 638 facility under Public Law 93-638 certified by the state; 309.10 (2) a county-operated entity certified by the state; or 309.11 (3) a noncounty entity certified by the provider's host 309.12 county. 309.13 (b) If a noncounty entity seeks to provide services outside 309.14 the host county, it must obtain additional recommendations for 309.15 certification from each county in which it will provide 309.16 services. The additional recommendations must be based on the 309.17 adequacy of the entity's knowledge of that county's local health 309.18 and human service system, and the ability of the entity to 309.19 coordinate its services with the other services available in 309.20 that county. 309.21 (c) The commissioner may intervene at any time and 309.22 decertify providers with cause. The decertification is subject 309.23 to appeal to the state. A county board or tribal government may 309.24 recommend that the state decertify a provider for cause, based 309.25 on the decertification process as established by the 309.26 commissioner. The commissioner shall develop statewide 309.27 procedures for provider certification, including timelines for 309.28 counties to certify qualified providers. 309.29 Subd. 7. [PROVIDER ENTITY ADMINISTRATIVE STANDARDS.] (a) 309.30 An entity shall have written policies and procedures regarding 309.31 organizational operation and service provision. These policies 309.32 and procedures will be reviewed and updated every two years and 309.33 distributed to staff initially and upon each subsequent update. 309.34 (b) An entity's written policies and procedures must 309.35 include: 309.36 (1) organizational policies for clinical, ethical, 310.1 administrative, fiscal, and quality assurance responsibilities 310.2 that include: 310.3 (i) clear lines of accountability, authority, and 310.4 supervision of all clinical personnel and documentation of such 310.5 supervision; 310.6 (ii) a clinical and organizational code of ethics and 310.7 procedures for investigating, reporting, and acting on 310.8 violations of codes, policies, and procedures; 310.9 (iii) data privacy policies regarding record keeping, 310.10 communication, treatment, reporting, and reimbursement that are 310.11 compliant with federal and state laws; 310.12 (iv) fiscal policies and internal control practices; 310.13 (v) a performance measurement system that includes 310.14 monitoring to determine cultural appropriateness as determined 310.15 by the client's culture, beliefs, values, and language as 310.16 identified in the individual treatment plan and family-driven 310.17 services; 310.18 (vi) criteria for preservice and in-service training for 310.19 all staff; 310.20 (vii) criteria to ensure a flexible response to the 310.21 changing and intermittent care needs of a client as identified 310.22 by the client and in the individual treatment plan; 310.23 (viii) service coordination policies and procedures that 310.24 ensure services are coordinated with other service entities or 310.25 providers and others after obtaining the consent of the client. 310.26 If the client is receiving case management or care coordination 310.27 services, services must also be coordinated with the client's 310.28 case manager or care coordinator; 310.29 (ix) criteria for health and safety of clients, employees, 310.30 subcontractors, and volunteers; 310.31 (x) documentation policies regarding client records, 310.32 personnel records, and clinical supervision that are consistent 310.33 with federal and state laws; and 310.34 (xi) provider entities that offer site-based programs such 310.35 as day treatment or therapeutic preschool programs must provide 310.36 staffing and facilities to ensure the health, safety, and 311.1 protection of rights of each client; 311.2 (2) personnel policies for recruiting, hiring, training, 311.3 and retention of individuals providing administrative and 311.4 clinical services that include: 311.5 (i) recruiting procedures that define a process to recruit, 311.6 train, and retain culturally and linguistically competent 311.7 providers; 311.8 (ii) screening criteria for employees, subcontractors, and 311.9 volunteers to determine whether the knowledge, skills, ability, 311.10 and behaviors possessed by the individual are sufficient to 311.11 allow the individual to perform the job correctly and skillfully 311.12 and a process for criminal background checks for all direct 311.13 service providers; 311.14 (iii) the duties, responsibilities, and required minimum 311.15 qualifications of personnel for various positions; 311.16 (iv) standards governing the ethical conduct of staff and 311.17 volunteers; 311.18 (v) standards governing confidentiality of information 311.19 regarding clients and client records; 311.20 (vi) written policies and procedures governing volunteer 311.21 services for entities that utilize volunteers that include 311.22 screening of applicants, training, supervision, and 311.23 documentation of the supervision and liability coverage for 311.24 volunteers; and 311.25 (vii) staff development and evaluation; and 311.26 (3) documentation policies for client records, personnel 311.27 files, and records of fiscal activities where individual 311.28 providers are responsible to document service provisions that 311.29 include: 311.30 (i) for the individual personnel file of each employee or 311.31 subcontractor: the individual's name, birth date, address, and 311.32 telephone number; documentation that the staff member or 311.33 volunteer meets the qualifications required in this section and 311.34 are included in the job description to provide children's 311.35 therapeutic services and supports; evidence of academic degree 311.36 and qualifications; a copy of any required professional license; 312.1 documentation that includes a record of the dates and locations 312.2 of work experience, education, and training; dates of employment 312.3 or volunteer assignments; a copy of required licenses or 312.4 certification; documentation of all clinical supervision or 312.5 direction provided; an annual performance review; a summary of 312.6 on-site service observations and charting review; a criminal 312.7 background check of all direct service staff; any job 312.8 performance recognition and disciplinary actions; any written 312.9 input from individual staff; and documentation of compliance 312.10 with continuing education requirements; and 312.11 (ii) for the individual client file: the client's name, 312.12 address, telephone number, date of birth, primary language, and 312.13 culture or ethnicity; diagnostic assessment and updates; 312.14 individual treatment plan and individual behavior plan, if 312.15 necessary; progress notes documenting delivery of services; 312.16 telephone contacts; and discharge plan. 312.17 Subd. 8. [PROVIDER ENTITY CLINICAL STANDARDS.] An 312.18 effective mental health system of care utilizes diagnostic 312.19 assessment, individualized treatment plan, service delivery, and 312.20 individual treatment plan review that is culturally competent, 312.21 child-centered, and family-driven to achieve maximum benefit for 312.22 the client. The diagnostic assessment must identify acute and 312.23 chronic clinical disorders, co-occurring medical conditions, 312.24 sources of psychological and environmental problems, and 312.25 functional assessment. The functional assessment should clearly 312.26 summarize the individual strengths and needs of the client. The 312.27 individual treatment plan is a written plan of intervention, 312.28 treatment, and services developed on the basis of the diagnostic 312.29 assessment. Service delivery is the process of implementing the 312.30 individual treatment plan in order to achieve the goals and 312.31 objectives identified in it. Individual treatment plan review 312.32 determines the extent to which the services have met the goals 312.33 and objectives and may lead to an updating of the individual 312.34 treatment plan. Clinical policies and procedures will be 312.35 reviewed and updated every two years and distributed to staff 312.36 initially and upon each subsequent update. Services billed 313.1 under children's therapeutic services and supports that are not 313.2 documented according to this subdivision shall be subject to 313.3 monetary recovery by the commissioner. Clinical policies must: 313.4 (1) define policies and procedures for providing or 313.5 obtaining a diagnostic assessment for each client as required in 313.6 this section; 313.7 (2) define policies and procedures for development of an 313.8 individual treatment plan to ensure that individual treatment 313.9 plan standards are met. The individualized treatment plan must: 313.10 (i) be based on the information and outcome of the client's 313.11 diagnostic assessment; 313.12 (ii) be developed no later than the end of the first 313.13 psychotherapy session or skills training after the completion of 313.14 the client's diagnostic assessment by the mental health 313.15 professional who provides the client's psychotherapy, or the 313.16 mental health practitioner under the clinical supervision of a 313.17 mental health professional who is a provider; 313.18 (iii) be developed through a child-centered, family-driven 313.19 planning process that identifies individualized, planned, and 313.20 culturally appropriate interventions that contain specific 313.21 treatment goals and objectives for the client and the client's 313.22 family or foster family and identify service needs; 313.23 (iv) be reviewed at least once every 90 days and revised, 313.24 if necessary. The treatment plan review assesses the client's 313.25 progress and ensures that services and treatment goals continue 313.26 to be necessary and appropriate to the client and the client's 313.27 family or foster family. Revision of the individual treatment 313.28 plan does not require a new diagnostic assessment unless the 313.29 client's mental health status has changed markedly; and 313.30 (v) be signed by the client, as appropriate, the client's 313.31 parent, primary caregiver, or other person authorized by statute 313.32 to consent to mental health services for the child; 313.33 (3) define a service coordination process to ensure 313.34 services are provided in the most appropriate manner to achieve 313.35 maximum benefit to the client if the client is receiving 313.36 services from other providers or provider entities. If it is 314.1 determined that the client has a relationship with other 314.2 providers, the children's therapeutic services and support 314.3 provider shall ensure coordination and nonduplication of 314.4 services consistent with the county board coordination 314.5 procedures under section 245.4881, subdivision 5; 314.6 (4) define caseload size for each direct service provider. 314.7 The caseload of each provider must be of a size that recognizes 314.8 both clients with severe, complex needs and clients with less 314.9 intensive needs. The size of each caseload should reasonably be 314.10 expected to enable the provider to play a very active role in 314.11 service planning, monitoring, and service delivery to meet the 314.12 needs of the client and the client's family as specified in each 314.13 client's individual treatment plan; 314.14 (5) define clinical supervision policies and procedures 314.15 that identify who will provide clinical supervision, who must 314.16 have supervision, how supervision will be implemented, and how 314.17 clinical supervision standards, as developed by the 314.18 commissioner, will be met. The mental health professional must 314.19 document the clinical supervision by cosigning individual 314.20 treatment plans and by making entries in the client's record on 314.21 supervisory activities. Clinical supervision does not include 314.22 authority to make or terminate court-ordered placements of the 314.23 child. A clinical supervisor must be available for urgent 314.24 consultation as needed by the individual client or the clinical 314.25 situation necessitates. Clinical supervision may occur 314.26 individually or in a small group to discuss treatment and review 314.27 of the client's progress toward goals. The focus of supervision 314.28 should be the client's treatment needs and progress and the 314.29 supervised person's ability to effect the change; 314.30 (6) define policies and procedures for providing direction 314.31 to a mental health behavior aide. For provider entities that 314.32 employ mental health behavioral aides, the clinical supervisor 314.33 must be employed by the provider entity to ensure necessary and 314.34 appropriate oversight for the treatment and continuity of care 314.35 for the client. When providing direction, the mental health 314.36 professional or the mental health practitioner under a mental 315.1 health professional supervision must: 315.2 (i) review progress notes prepared by the mental health 315.3 behavioral aide for accuracy and consistency with diagnostic 315.4 assessment, treatment plan, and behavior goals. Progress notes 315.5 must be approved and signed by the mental health professional or 315.6 mental health practitioner; 315.7 (ii) identify changes in treatment strategies, revise the 315.8 individual behavior plan, and communicate treatment instructions 315.9 and methodologies appropriate to ensure that treatment is 315.10 implemented correctly; 315.11 (iii) demonstrate family-friendly behaviors that support 315.12 healthy collaboration among the child, the child's family, and 315.13 providers as treatment is planned and implemented; 315.14 (iv) ensure that the mental health behavioral aide is able 315.15 to effectively communicate with the child, the child's family, 315.16 and the provider; and 315.17 (v) record the results of any evaluation and corrective 315.18 actions taken to modify the work of the mental health behavioral 315.19 aide; 315.20 (7) ensure that documentation standards meet requirements 315.21 of federal and state laws. The individual mental health 315.22 provider must maintain sufficient documentation to support each 315.23 service for which billing is made. Documentation in the 315.24 client's record must include: 315.25 (i) the specific service rendered, including the date, 315.26 time, length, setting, and scope of the mental health service; 315.27 (ii) the name of the person who gave the service; 315.28 (iii) contact, including the name and date of the contact, 315.29 made with other persons interested in the client such as 315.30 representatives of the courts, corrections systems, or schools; 315.31 (iv) any contact made with the client's other mental health 315.32 providers, case manager, family members, primary caregiver, 315.33 legal representative, or, if applicable, the reason the client's 315.34 family members, primary caregiver, or legal representative was 315.35 not contacted; and 315.36 (v) as appropriate, required clinical supervision. 316.1 Documentation must be completed promptly after the provision of 316.2 service. 316.3 Subd. 9. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 316.4 PROVIDERS.] Children's therapeutic services and supports are 316.5 provided by individual or team providers working within the 316.6 scope of the provider's practice or qualifications to provide 316.7 services identified as medically necessary by the individual 316.8 treatment plan. Providers and multidisciplinary teams include: 316.9 (1) a mental health professional as defined in subdivision 316.10 2; 316.11 (2) a mental health practitioner as defined in section 316.12 245.4871, subdivision 26. The mental health practitioner must 316.13 work under the clinical supervision of a mental health 316.14 professional; 316.15 (3) a mental health behavioral aide who is a 316.16 paraprofessional working under the direction of a mental health 316.17 professional or mental health practitioner who is under the 316.18 clinical supervision of a mental health professional in the 316.19 implementation of rehabilitative mental health services as 316.20 identified in the client's individual treatment plan. 316.21 (i) A level I mental health behavioral aide must: 316.22 (A) be at least 18 years of age; 316.23 (B) have a high school diploma or general equivalency 316.24 diploma (GED) or two years of experience as a primary caregiver 316.25 to a child with severe emotional disturbance within the previous 316.26 ten years; and 316.27 (C) meet preservices and continuing education requirements 316.28 in subdivision 10. 316.29 (ii) A level II mental health behavioral aide must: 316.30 (A) be at least 18 years of age; 316.31 (B) have an associate or bachelor's degree or 4,000 hours 316.32 of experience in delivering clinical services in the treatment 316.33 of mental illness concerning children or adolescents; and 316.34 (C) meet the orientation and training requirements in 316.35 subdivision 10; 316.36 (4) a preschool program multidisciplinary team that 317.1 includes at least one mental health professional and one or more 317.2 of the following under the clinical supervision of a mental 317.3 health professional: a mental health practitioner or a program 317.4 person such as a teacher, assistant teacher, or aide, who meets 317.5 the qualifications and training standards of a level I mental 317.6 health behavioral aid; and 317.7 (5) a day treatment multidisciplinary team that includes 317.8 mental health professionals and mental health practitioners as 317.9 defined in this section. 317.10 Subd. 10. [REQUIRED PRESERVICE AND ONGOING TRAINING.] (a) 317.11 A provider entity shall establish a plan to provide preservices 317.12 and continuing education for staff that clearly describes the 317.13 type of training necessary to maintain current skills, obtain 317.14 new skills, and that relates to the goals and objectives of the 317.15 provider entity program plan for services offered. A provider 317.16 that employs a mental health behavioral aide under this section 317.17 shall require the aide to complete 30 hours of preservice 317.18 training. Topics covered during preservice training include 317.19 those specified in Minnesota Rules, part 9535.4068, subparts 1 317.20 and 2, and parent team training. The preservice training must 317.21 include 15 hours of face-to-face training in mental health 317.22 services delivery and eight hours of parent team training. 317.23 Components of parent team training include: (1) partnering with 317.24 parents; (2) fundamentals of family support; (3) fundamentals of 317.25 policy and decision-making; (4) defining equal partnership; (5) 317.26 complexities of parent and service provider partnership in 317.27 multiple service delivery systems due to system strengths and 317.28 weaknesses; (6) sibling impacts; (7) support networks; and (8) 317.29 community resources. 317.30 (b) A provider entity that employs a mental health 317.31 practitioner and mental health behavioral aide to provide 317.32 children's therapeutic services and supports under this section 317.33 shall require the mental health practitioner and mental health 317.34 behavioral aide to complete 20 hours of continuing education 317.35 every two calendar years. The continuing education must be 317.36 related to serving the needs of a child with emotional 318.1 disturbance or severe emotional disturbance in the child's home 318.2 environment and the child's family. The topics covered in 318.3 orientation and training must conform to Minnesota Rules, part 318.4 9535.4068. The provider, as specified in subdivisions 6 and 7, 318.5 shall document completion of the required continuing education 318.6 on an annual basis. The documentation must include: 318.7 (1) documentation of staff development and training 318.8 sessions, which shall be kept for each employee at a central 318.9 location and in the employee's personnel file. Documentation 318.10 must include the: date, number of hours, training subject, 318.11 attendance as verified by the signature of a staff member with 318.12 job title, and the instructor's name; and 318.13 (2) records of attendance at professional workshops and 318.14 conferences which shall be kept for each employee at a central 318.15 location and in the employee's personnel file. 318.16 Subd. 11. [SERVICE DELIVERY REQUIREMENTS.] (a) Service 318.17 delivery is the process of implementing the individual treatment 318.18 plan to achieve the goals and objectives identified in it. The 318.19 commissioner shall develop procedures for disseminating 318.20 information on evidence-based practices and for providing 318.21 ongoing technical assistance and consultation to county, tribes, 318.22 and certified provider entities in order to promote statewide 318.23 development of appropriate, accessible, and cost-effective 318.24 medical assistance services and related policy. A provider 318.25 entity must comply with the following service delivery 318.26 requirements: 318.27 (1) individual, family, and group psychotherapy must be 318.28 delivered as specified in Minnesota Rules, part 9505.0323; and 318.29 (2) individual, family, or group skills training must be 318.30 designed as specified in subdivision 2 and delivered according 318.31 to the goals and objectives of the individual treatment plan. 318.32 (b) Up to 35 hours of children's therapeutic services and 318.33 supports are eligible for medical assistance payment if the 318.34 services and supports are part of the discharge plan and are 318.35 provided within a six-month period to a child with severe 318.36 emotional disturbance who is residing in a hospital, a group 319.1 home, a licensed residential treatment facility, a regional 319.2 treatment center, or other institutional group setting or is 319.3 participating in a program of partial hospitalization. 319.4 (c) Provider entities that offer site-based programs such 319.5 as day treatment and therapeutic preschool programs must provide 319.6 staffing and facilities to ensure the health, safety, and 319.7 protection of rights of each client and be able to implement 319.8 each client's individual treatment plan. 319.9 (d) The structured treatment program offered by a licensed 319.10 preschool program must be available at least one day per week 319.11 for a minimum two-hour time block. The structured treatment 319.12 program may include individual or group psychotherapy and any of 319.13 the following: recreational therapy, socialization therapy, and 319.14 independent living skills therapy that is necessary, 319.15 appropriate, and included in the client's individual treatment 319.16 plan. Notwithstanding other requirements in this section, 319.17 documentation of day treatment may be provided on a daily basis 319.18 by use of a checklist of available therapies in which the client 319.19 participated and on a weekly basis by a summary of the 319.20 information required under this subdivision. 319.21 (e) Crisis assistance for a child is an intense component 319.22 of children's therapeutic services and supports designed to 319.23 address abrupt or substantial changes in the functioning of the 319.24 child or the child's family evidenced by a sudden change in 319.25 behavior with negative consequences for well being, a loss of 319.26 usual coping mechanisms, or the presentation of danger to self 319.27 or others. The services must focus on crisis prevention, 319.28 identification, and management. Crisis assistance may be used 319.29 to reduce immediate personal distress and to assess factors that 319.30 precipitated the crisis in order to reduce the chance of future 319.31 crisis situations by implementing preventive strategies and 319.32 plans. These are time-limited services designed to resolve or 319.33 stabilize crisis through the arrangement of direct intervention, 319.34 support services to the child and family, and the utilization of 319.35 more appropriate resources. Crisis assistance service 319.36 components are: crisis risk assessment, screening for 320.1 hospitalization, referral and follow up to suitable community 320.2 resources, and planning for crisis intervention and counseling 320.3 services with other service providers, the child, and the 320.4 child's family. Crisis assistance does not mean necessary 320.5 emergency services or services designed to secure the safety of 320.6 a child who is at risk of abuse or neglect. 320.7 (f) Medically necessary services provided by a mental 320.8 health behavioral aide are designed to improve the functioning 320.9 of the child and support the family in activities of daily and 320.10 community living. Delivery of these services must be documented 320.11 by the mental health behavioral aide by written progress notes. 320.12 The mental health behavioral aide must implement goals in the 320.13 treatment plan that allows the child to acquire developmentally 320.14 and therapeutically appropriate daily living skills, social 320.15 skills, and leisure and recreational skills through targeted 320.16 activities. These activities may include: 320.17 (1) assisting the child with skill development in dressing, 320.18 eating, and toileting; 320.19 (2) assisting, monitoring, and guiding the child to 320.20 complete tasks, including facilitating the child's participation 320.21 in medical appointments; 320.22 (3) observing and intervening to redirect inappropriate 320.23 behavior; 320.24 (4) assisting the child in using age-appropriate 320.25 self-management skills as related to the child's emotional 320.26 disorder or mental illness, including problem solving, decision 320.27 making, communication, conflict resolution, anger management, 320.28 social skills, and recreational skills; 320.29 (5) implementing deescalation techniques as recommended by 320.30 the mental health professional; 320.31 (6) implementing any other mental health service that the 320.32 mental health professional has approved as being within the 320.33 scope of the behavioral aide's duties; or 320.34 (7) assisting the parents to develop and use parenting 320.35 skills that help the child achieve the goals outlined in the 320.36 child's individual treatment plan or individual behavioral 321.1 plan. Parenting skills must be directed exclusively to the 321.2 treatment of the child. 321.3 (g) Direction for a mental health behavioral aide must be 321.4 delivered as specified in subdivision 8, clause (6). 321.5 (h) A day treatment program must be provided to a group of 321.6 clients by a multidisciplinary staff under the clinical 321.7 supervision of a mental health professional. The program must 321.8 be available at least one day per week for a minimum three-hour 321.9 time block. The three-hour time block must include at least one 321.10 hour, but no more than two hours, of individual or group 321.11 psychotherapy. The remainder of the three-hour time block must 321.12 consist of any of the following: recreational therapy, 321.13 socialization therapy, and independent living skills therapy. 321.14 The remainder of the three-hour time block may include 321.15 recreational therapy, socialization therapy, and independent 321.16 living skills therapy only if they are included in the client's 321.17 individual treatment plan as necessary and appropriate. 321.18 Subd. 12. [SERVICE AUTHORIZATION.] The commissioner shall 321.19 publish in the State Register a list of health services that 321.20 require prior authorization as well as the criteria and 321.21 standards used to select health services on the list. The list 321.22 and the criteria and standards used to formulate the list are 321.23 not subject to the requirements of sections 14.001 to 14.69. 321.24 The commissioner's decision on whether prior authorization is 321.25 required for a health service is not subject to administrative 321.26 appeal. 321.27 Subd. 13. [EXCLUDED SERVICES.] The services specified in 321.28 clauses (1) to (6) are not eligible for medical assistance 321.29 payment as children's therapeutic services and supports: 321.30 (1) children's therapeutic services and supports 321.31 simultaneously provided by more than one provider entity unless 321.32 prior authorization is obtained; 321.33 (2) children's therapeutic services and supports provided 321.34 to a child who, at the time of service provision, has not had a 321.35 diagnostic assessment to determine if the child has an emotional 321.36 disturbance, except that the first ten hours of children's 322.1 therapeutic services and supports provided to a child who is 322.2 later assessed and determined to have an emotional disturbance 322.3 at the time services were initiated shall be eligible for 322.4 medical assistance payments; 322.5 (3) children's therapeutic services and supports provided 322.6 in violation of medical assistance policy in Minnesota Rules, 322.7 part 9505.0220; 322.8 (4) mental health behavioral aide services provided by a 322.9 personal care assistant who is not qualified as a mental health 322.10 behavioral aide despite being employed by a certified children's 322.11 therapeutic services and supports provider entity; 322.12 (5) services that are the responsibility of a residential 322.13 or program license holder, including foster care providers under 322.14 the terms of a service agreement or administrative rules 322.15 governing licensure; 322.16 (6) adjunctive activities which otherwise may be offered by 322.17 a provider entity but are not covered by medical assistance, 322.18 including: 322.19 (i) a service that is primarily recreation-oriented or that 322.20 is provided in a setting that is not medically supervised. This 322.21 includes sports activities, exercise groups, activities such as 322.22 craft hours, leisure time, social hours, meal or snack time, 322.23 trips to community activities, and tours; 322.24 (ii) a social or educational service that does not have or 322.25 cannot reasonably be expected to have a therapeutic outcome 322.26 related to the client's emotional disturbance; 322.27 (iii) consultation with other providers or service agency 322.28 staff about the care or progress of a client; 322.29 (iv) prevention or education programs provided to the 322.30 community; 322.31 (v) treatment for clients with primary diagnoses of alcohol 322.32 or other drug abuse; and 322.33 (vi) psychotherapy in a day treatment program for more than 322.34 two hours daily; and 322.35 (7) activities such as recreational therapy, socialization 322.36 therapy, and independent living skills therapy. These 323.1 activities may be authorized as components of skills training on 323.2 an individual basis. 323.3 [EFFECTIVE DATE.] This section is effective July 1, 2004. 323.4 Sec. 9. [256B.0944] [COVERED SERVICE; CHILDREN'S MENTAL 323.5 HEALTH CRISIS RESPONSE SERVICES.] 323.6 Subdivision 1. [SCOPE.] Medical assistance covers 323.7 medically necessary children's mental health crisis response 323.8 services as defined in subdivision 2, paragraphs (c) to (e), 323.9 subject to federal approval, if provided to an eligible 323.10 recipient and provided by a qualified provider entity and by a 323.11 qualified individual provider working within the provider's 323.12 scope of practice and identified in the recipient's individual 323.13 crisis treatment plan as defined in subdivision 11. 323.14 Subd. 2. [DEFINITIONS.] For purposes of this section, the 323.15 following terms have the meanings given them. 323.16 (a) "Mental health crisis" is a children's behavioral, 323.17 emotional, or psychiatric situation which, but for the provision 323.18 of crisis response services, would likely result in 323.19 significantly reduced levels of functioning in primary 323.20 activities of daily living, or in an emergency situation, or in 323.21 the placement of the recipient in a more restrictive setting, 323.22 including, but not limited to, inpatient hospitalization. 323.23 (b) "Mental health emergency" is a children's behavioral, 323.24 emotional, or psychiatric situation which causes an immediate 323.25 need for mental health services and is consistent with section 323.26 62Q.55. A mental health crisis or emergency is determined for 323.27 medical assistance service reimbursement by a physician, a 323.28 mental health professional, or crisis mental health practitioner 323.29 with input from the recipient whenever possible. 323.30 (c) "Mental health crisis assessment" means an immediate 323.31 face-to-face assessment by a physician, a mental health 323.32 professional, or a mental health practitioner under the clinical 323.33 supervision of a mental health professional, following a 323.34 screening that suggests the child may be experiencing a mental 323.35 health crisis or mental health emergency situation. 323.36 (d) "Mental health mobile crisis intervention services" 324.1 means face-to-face, short-term, intensive mental health services 324.2 initiated during a mental health crisis or mental health 324.3 emergency to help the recipient cope with immediate stressors, 324.4 identify and utilize available resources and strengths, and 324.5 begin to return to the recipient's baseline level of functioning. 324.6 (1) This service is provided on site by a mobile crisis 324.7 intervention team outside of an inpatient hospital setting. 324.8 (2) The initial screening must consider other available 324.9 services to determine which service intervention would best 324.10 address the recipient's needs and circumstances. 324.11 (3) The mobile crisis intervention team must be available 324.12 to meet promptly face-to-face with a person in a mental health 324.13 crisis or mental health emergency in a community setting. 324.14 (4) The intervention must be based on a mental health 324.15 crisis assessment and a crisis treatment plan. 324.16 (5) The treatment plan must include recommendations for any 324.17 needed crisis stabilization services for the recipient. 324.18 (e) "Mental health crisis stabilization services" means 324.19 individualized mental health services provided to a recipient 324.20 following crisis intervention services which are designed to 324.21 restore the recipient to the recipient's prior functional 324.22 level. The individual treatment plan recommending mental health 324.23 crisis stabilization must be completed by the intervention team 324.24 or by staff after an inpatient or urgent care visit. Mental 324.25 health crisis stabilization services may be provided in the 324.26 recipient's home, the home of a family member or friend of the 324.27 recipient, another community setting, or a short-term 324.28 supervised, licensed residential program (if the service is not 324.29 included in the facilities cost pool or per diem). Mental 324.30 health crisis stabilization does not include partial 324.31 hospitalization or day treatment. 324.32 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 324.33 individual who: 324.34 (a) is under age 21; 324.35 (b) is screened as possibly experiencing a mental health 324.36 crisis or mental health emergency where a mental health crisis 325.1 assessment is needed; and 325.2 (c) is assessed as experiencing a mental health crisis or 325.3 mental health emergency, and mental health crisis intervention 325.4 or crisis intervention and stabilization services are determined 325.5 to be medically necessary. 325.6 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 325.7 entity is an entity that meets the standards listed in paragraph 325.8 (b) and: 325.9 (1) is an Indian health service facility or a facility 325.10 owned and operated by a tribe or a tribal organization operating 325.11 as a 638 facility under Public Law 93-638 certified by the 325.12 state; 325.13 (2) is a county board operated facility; or 325.14 (3) is a provider entity that is under contract with the 325.15 county board in the county where the potential crisis or 325.16 emergency is occurring. To provide services under this section, 325.17 the provider entity must directly provide the services; or if 325.18 services are subcontracted, the provider entity must maintain 325.19 clinical responsibility for services and billing. 325.20 (b) The children's mental health crisis response services 325.21 provider entity must meet the following standards: 325.22 (1) has the capacity to recruit, hire, train, and retain 325.23 culturally and linguistically competent mental health 325.24 professionals and practitioners; 325.25 (2) has adequate administrative ability to ensure 325.26 availability of services; 325.27 (3) is able to ensure adequate preservice and in-service 325.28 training; 325.29 (4) is able to ensure that staff providing these services 325.30 are skilled in the delivery of mental health crisis response 325.31 services to recipients; 325.32 (5) is able to ensure that staff are capable of 325.33 implementing culturally specific treatment identified in the 325.34 individual treatment plan that is meaningful and appropriate as 325.35 determined by the recipient's culture, beliefs, values, and 325.36 language; 326.1 (6) is able to ensure enough flexibility to respond to the 326.2 changing intervention and care needs of a recipient as 326.3 identified by the recipient during the service partnership 326.4 between the recipient and providers; 326.5 (7) is able to ensure that mental health professionals and 326.6 mental health practitioners have the communication tools and 326.7 procedures to communicate and consult promptly about crisis 326.8 assessment and interventions as services occur; 326.9 (8) is able to coordinate these services with county 326.10 emergency services and mental health crisis services; 326.11 (9) is able to ensure that mental health crisis assessment 326.12 and mobile crisis intervention services are available 24 hours a 326.13 day, seven days a week; 326.14 (10) is able to ensure that services are coordinated with 326.15 other mental health service providers, county mental health 326.16 authorities, or federally recognized American Indian authorities 326.17 and others as necessary, with the consent of the recipient or 326.18 legal guardian. Services must also be coordinated with the 326.19 recipient's case manager if the child is receiving case 326.20 management services; 326.21 (11) is able to ensure that crisis intervention services 326.22 are provided in a manner consistent with sections 245.487 to 326.23 245.4888; 326.24 (12) is able to submit information as required by the 326.25 state; 326.26 (13) maintains staff training and personnel files; 326.27 (14) is able to establish and maintain a quality assurance 326.28 and evaluation plan to evaluate the outcomes of services and 326.29 recipient satisfaction; 326.30 (15) is able to keep records as required by applicable 326.31 laws; 326.32 (16) is able to comply with all applicable laws and 326.33 statutes; and 326.34 (17) develops and maintains written policies and procedures 326.35 regarding service provision and administration of the provider 326.36 entity, including safety of staff and recipients in high-risk 327.1 situations. 327.2 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 327.3 QUALIFICATIONS.] For provision of children's mental health 327.4 mobile crisis intervention services, a mobile crisis 327.5 intervention team is comprised of at least two mental health 327.6 professionals as defined in section 245.4871, subdivision 27, 327.7 clauses (1) to (5), or a combination of at least one mental 327.8 health professional and one mental health practitioner as 327.9 defined in section 245.4871, subdivision 26, with the required 327.10 mental health crisis training under the clinical supervision of 327.11 a mental health professional on the team. The team must have at 327.12 least two people with at least one member providing on-site 327.13 crisis intervention services when needed. Team members must be 327.14 experienced in mental health assessment, crisis intervention 327.15 techniques, and clinical decision-making under emergency 327.16 conditions and have knowledge of local services and resources. 327.17 The team must recommend and coordinate the team's services with 327.18 appropriate local resources such as the county social services 327.19 agency, mental health services, and local law enforcement when 327.20 necessary. 327.21 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 327.22 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 327.23 crisis intervention services, a screening of the potential 327.24 crisis situation must be conducted. The screening may use the 327.25 resources of crisis assistance and emergency services as defined 327.26 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 327.27 1 and 2. The screening must gather information, determine 327.28 whether a crisis situation exists, identify parties involved, 327.29 and determine an appropriate response. 327.30 (b) If a crisis exists, a crisis assessment must be 327.31 completed. A crisis assessment evaluates any immediate needs 327.32 for which emergency services are needed and, as time permits, 327.33 the recipient's current life situation, sources of stress, 327.34 mental health problems and symptoms, strengths, cultural 327.35 considerations, support network, vulnerabilities, and current 327.36 functioning. 328.1 (c) If the crisis assessment determines mobile crisis 328.2 intervention services are needed, the intervention services must 328.3 be provided promptly. As opportunity presents during the 328.4 intervention, at least two members of the mobile crisis 328.5 intervention team must confer directly or by telephone about the 328.6 assessment, treatment plan, and actions taken and needed. At 328.7 least one of the team members must be on site providing crisis 328.8 intervention services. If providing on-site crisis intervention 328.9 services, a mental health practitioner must seek clinical 328.10 supervision as required in subdivision 9. 328.11 (d) The mobile crisis intervention team must develop an 328.12 initial, brief crisis treatment plan as soon as appropriate, but 328.13 no later than 24 hours after the initial face-to-face 328.14 intervention. The plan must address the needs and problems 328.15 noted in the crisis assessment and include measurable short-term 328.16 goals, cultural considerations, and frequency and type of 328.17 services to be provided to achieve the goals and reduce or 328.18 eliminate the crisis. The treatment plan must be updated as 328.19 needed to reflect current goals and services. The team must 328.20 involve the child and the child's family in developing and 328.21 implementing the plan. 328.22 (e) The team must document which short-term goals have been 328.23 met and when no further crisis intervention services are 328.24 required. 328.25 (f) If the recipient's crisis is stabilized, but the 328.26 recipient needs a referral to other services, the team must 328.27 provide referrals to these services. If the recipient has a 328.28 case manager, planning for other services must be coordinated 328.29 with the case manager. 328.30 Subd. 7. [CRISIS STABILIZATION SERVICES.] Crisis 328.31 stabilization services must be provided by qualified staff of a 328.32 crisis stabilization services provider entity and must meet the 328.33 following standards: 328.34 (1) a crisis stabilization treatment plan must be developed 328.35 which meets the criteria in subdivision 11; 328.36 (2) staff must be qualified as defined in subdivision 8; 329.1 and 329.2 (3) services must be delivered according to the treatment 329.3 plan and include face-to-face contact with the recipient by 329.4 qualified staff for further assessment, help with referrals, 329.5 updating of the crisis stabilization treatment plan, supportive 329.6 counseling, skills training, and collaboration with other 329.7 service providers in the community. 329.8 Subd. 8. [CHILDREN'S CRISIS STABILIZATION STAFF 329.9 QUALIFICATIONS.] Children's mental health crisis stabilization 329.10 services must be provided by qualified individual staff of a 329.11 qualified provider entity. Individual provider staff must have 329.12 the following qualifications: 329.13 (1) be a mental health professional as defined in section 329.14 245.4871, subdivision 27, clauses (1) to (5); or 329.15 (2) be a mental health practitioner as defined in section 329.16 245.4871, subdivision 26. The mental health practitioner must 329.17 work under the clinical supervision of a mental health 329.18 professional and have completed at least 30 hours of training in 329.19 crisis intervention and stabilization during the past two years. 329.20 Subd. 9. [SUPERVISION.] (a) Mental health practitioners 329.21 may provide crisis assessment and mobile crisis intervention 329.22 services if the following clinical supervision requirements are 329.23 met: 329.24 (1) the mental health provider entity must accept full 329.25 responsibility for the services provided; 329.26 (2) the mental health professional who is supervising the 329.27 mental health practitioner and is an employee or under contract 329.28 with the provider entity, must be immediately available by 329.29 telephone or in person for clinical supervision; and 329.30 (3) the mental health professional is consulted, in person 329.31 or by telephone, during the first three hours when a mental 329.32 health practitioner provides on-site service. 329.33 (b) The mental health professional must: 329.34 (1) review and approve of the tentative crisis assessment 329.35 and crisis treatment plan; 329.36 (2) document the consultation; and 330.1 (3) sign the crisis assessment and treatment plan within 330.2 the next business day. 330.3 (c) If the mobile crisis intervention services continue 330.4 into a second calendar day, a mental health professional must 330.5 contact the recipient face-to-face on the second day to provide 330.6 services and update the crisis treatment plan. The on-site 330.7 observation must be documented in the recipient's record and 330.8 signed by the mental health professional. 330.9 Subd. 10. [RECIPIENT FILE.] (a) Providers of mobile crisis 330.10 intervention or crisis stabilization services must maintain a 330.11 file for each recipient containing the following information: 330.12 (1) individual crisis treatment plans signed by the 330.13 recipient, mental health professional, and mental health 330.14 practitioner who developed the crisis treatment plan, or if the 330.15 recipient refused to sign the plan, the date and reason stated 330.16 by the recipient as to why the recipient would not sign the 330.17 plan; 330.18 (2) signed release of information forms; 330.19 (3) recipient health information and current medications; 330.20 (4) emergency contacts for the recipient; 330.21 (5) case records which document the date of service, place 330.22 of service delivery, direct or telephone contact with the 330.23 recipient's family or others, signature of the person providing 330.24 the service, and the nature, extent, and units of service; 330.25 (6) required clinical supervision by mental health 330.26 professionals; 330.27 (7) summary of the recipient's case reviews by staff; and 330.28 (8) any written information by the recipient that the 330.29 recipient wants in the file. 330.30 (b) Documentation in the file must comply with all 330.31 requirements of the commissioner. 330.32 Subd. 11. [TREATMENT PLAN.] (a) The individual crisis 330.33 stabilization treatment plan must include, at a minimum: 330.34 (1) a list of problems identified in the assessment; 330.35 (2) a list of the recipient's strengths and resources; 330.36 (3) concrete, measurable, short-term goals and tasks to be 331.1 achieved, including time frames for achievement; 331.2 (4) specific objectives directed toward the achievement of 331.3 each of the goals; 331.4 (5) documentation of the participants involved in the 331.5 service planning; 331.6 (6) planned frequency and type of services initiated; 331.7 (7) a crisis response action plan if a crisis should occur; 331.8 and 331.9 (8) clear progress notes on outcome of goals. 331.10 (b) The recipient, if possible, must be a participant. The 331.11 recipient or the recipient's legal guardian must sign the 331.12 service plan or document why this was not possible. A copy of 331.13 the plan must be given to the recipient and the recipient's 331.14 legal guardian. The plan should include the services arranged, 331.15 including specific providers where applicable. 331.16 (c) A treatment plan must be developed by a mental health 331.17 professional or mental health practitioner under the clinical 331.18 supervision of a mental health professional. A written plan 331.19 must be completed within 24 hours of beginning services with the 331.20 recipient. The mental health professional must approve and sign 331.21 all treatment plans. 331.22 Subd. 12. [EXCLUDED SERVICES.] (a) The following services 331.23 are excluded from reimbursement under this section: 331.24 (1) room and board services; 331.25 (2) services delivered to a recipient while admitted to an 331.26 inpatient hospital; 331.27 (3) transportation services under children's mental health 331.28 crisis response service; 331.29 (4) services provided and billed by a provider who is not 331.30 enrolled under medical assistance to provide children's mental 331.31 health crisis response services; 331.32 (5) crisis response services provided by a residential 331.33 treatment center to recipients in their facility; 331.34 (6) services performed by volunteers; 331.35 (7) direct billing of time spent "on call" when not 331.36 delivering services to a recipient; 332.1 (8) provider service time included in case management 332.2 reimbursement; 332.3 (9) outreach services to potential recipients; and 332.4 (10) a mental health service that is not medically 332.5 necessary. 332.6 (b) When a provider is eligible to provide more than one 332.7 type of medical assistance service, the recipient must have a 332.8 choice of provider for each service, unless otherwise provided 332.9 by law. 332.10 [EFFECTIVE DATE.] This section is effective July 1, 2004. 332.11 Sec. 10. Minnesota Statutes 2002, section 256B.0945, 332.12 subdivision 2, is amended to read: 332.13 Subd. 2. [COVERED SERVICES.] All services must be included 332.14 in a child's individualized treatment or multiagency plan of 332.15 care as defined in chapter 245. 332.16(a) For facilities that are institutions for mental332.17diseases according to statute and regulation or are not332.18institutions for mental diseases but are approved by the332.19commissioner to provide services under this paragraph, medical332.20assistance covers the full contract rate, including room and332.21board if the services meet the requirements of Code of Federal332.22Regulations, title 42, section 440.160.332.23(b)For facilities that are not institutions for mental 332.24 diseases according to federal statute and regulationand are not332.25providing services under paragraph (a), medical assistance 332.26 covers mental health related services that are required to be 332.27 provided by a residential facility under section 245.4882 and 332.28 administrative rules promulgated thereunder, except for room and 332.29 board. 332.30 Sec. 11. Minnesota Statutes 2002, section 256B.0945, 332.31 subdivision 4, is amended to read: 332.32 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 332.33 256B.19 and 256B.041, payments to counties for residential 332.34 services provided by a residential facility shall only be made 332.35 of federal earnings for services provided under this section, 332.36 and the nonfederal share of costs for services provided under 333.1 this section shall be paid by the county from sources other than 333.2 federal funds or funds used to match other federal funds. 333.3Payment to counties for services provided according to333.4subdivision 2, paragraph (a), shall be the federal share of the333.5contract rate.Payment to counties for services provided 333.6 according tosubdivision 2, paragraph (b),this section shall be 333.7 a proportion of the per day contract rate that relates to 333.8 rehabilitative mental health services and shall not include 333.9 payment for costs or services that are billed to the IV-E 333.10 program as room and board. 333.11 (b) The commissioner shall set aside a portion not to 333.12 exceed five percent of the federal funds earned under this 333.13 section to cover the state costs of administering this section. 333.14 Any unexpended funds from the set-aside shall be distributed to 333.15 the counties in proportion to their earnings under this section. 333.16 Sec. 12. Minnesota Statutes 2002, section 256F.10, 333.17 subdivision 6, is amended to read: 333.18 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 333.19 for portion set aside in paragraph (b), the federal funds earned 333.20 under this section and section 256B.094 by providers shall be 333.21 paid to each provider based on its earnings, and must be used by333.22each provider to expand preventive child welfare services. 333.23 If a county or tribal social services agency chooses to be a 333.24 provider of child welfare targeted case management and if that 333.25 county or tribal social services agency also joins a local 333.26 children's mental health collaborative as authorized by the 1993 333.27 legislature, then the federal reimbursement received by the 333.28 county or tribal social services agency for providing child 333.29 welfare targeted case management services to children served by 333.30 the local collaborative shall be transferred by the county or 333.31 tribal social services agency to the integrated fund. The 333.32 federal reimbursement transferred to the integrated fund by the 333.33 county or tribal social services agency must not be used for 333.34 residential care other than respite care described under 333.35 subdivision 7, paragraph (d). 333.36 (b) The commissioner shall set aside a portion of the 334.1 federal funds earned under this section to repay the special 334.2 revenue maximization account under section 256.01, subdivision 334.3 2, clause (15). The repayment is limited to: 334.4 (1) the costs of developing and implementing this section 334.5 and sections 256B.094 and 256J.48; 334.6 (2) programming the information systems; and 334.7 (3) the lost federal revenue for the central office claim 334.8 directly caused by the implementation of these sections. 334.9 Any unexpended funds from the set aside under this 334.10 paragraph shall be distributed to providers according to 334.11 paragraph (a). 334.12 Sec. 13. Minnesota Statutes 2002, section 259.67, 334.13 subdivision 4, is amended to read: 334.14 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 334.15 shall use the AFDC requirements as specified in federal law as 334.16 of July 16, 1996, when determining the child's eligibility for 334.17 adoption assistance under title IV-E of the Social Security 334.18 Act. If the child does not qualify, the placing agency shall 334.19 certify a child as eligible for state funded adoption assistance 334.20 only if the following criteria are met: 334.21 (1) Due to the child's characteristics or circumstances it 334.22 would be difficult to provide the child an adoptive home without 334.23 adoption assistance. 334.24 (2)(i) A placement agency has made reasonable efforts to 334.25 place the child for adoption without adoption assistance, but 334.26 has been unsuccessful; or 334.27 (ii) the child's licensed foster parents desire to adopt 334.28 the child and it is determined by the placing agency that the 334.29 adoption is in the best interest of the child. 334.30 (3) The child has been a ward of the commissioneror, a 334.31 Minnesota-licensed child-placing agency, or a tribal social 334.32 service agency of Minnesota recognized by the Secretary of the 334.33 Interior. 334.34 (b) For purposes of this subdivision, the characteristics 334.35 or circumstances that may be considered in determining whether a 334.36 child is a child with special needs under United States Code, 335.1 title 42, chapter 7, subchapter IV, part E, or meets the 335.2 requirements of paragraph (a), clause (1), are the following: 335.3 (1) The child is a member of a sibling group to be placed 335.4 as one unit in which at least one sibling is older than 15 335.5 months of age or is described in clause (2) or (3). 335.6 (2) The child has documented physical, mental, emotional, 335.7 or behavioral disabilities. 335.8 (3) The child has a high risk of developing physical, 335.9 mental, emotional, or behavioral disabilities. 335.10 (4) The child is adopted according to tribal law without a 335.11 termination of parental rights or relinquishment, provided that 335.12 the tribe has documented the valid reason why the child cannot 335.13 or should not be returned to the home of the child's parent. 335.14 (c) When a child's eligibility for adoption assistance is 335.15 based upon the high risk of developing physical, mental, 335.16 emotional, or behavioral disabilities, payments shall not be 335.17 made under the adoption assistance agreement unless and until 335.18 the potential disability manifests itself as documented by an 335.19 appropriate health care professional. 335.20 Sec. 14. Minnesota Statutes 2002, section 260B.157, 335.21 subdivision 1, is amended to read: 335.22 Subdivision 1. [INVESTIGATION.] Upon request of the court 335.23 the local social services agency or probation officer shall 335.24 investigate the personal and family history and environment of 335.25 any minor coming within the jurisdiction of the court under 335.26 section 260B.101 and shall report its findings to the court. 335.27 The court may order any minor coming within its jurisdiction to 335.28 be examined by a duly qualified physician, psychiatrist, or 335.29 psychologist appointed by the court. 335.30 The court shall have a chemical use assessment conducted 335.31 when a child is (1) found to be delinquent for violating a 335.32 provision of chapter 152, or for committing a felony-level 335.33 violation of a provision of chapter 609 if the probation officer 335.34 determines that alcohol or drug use was a contributing factor in 335.35 the commission of the offense, or (2) alleged to be delinquent 335.36 for violating a provision of chapter 152, if the child is being 336.1 held in custody under a detention order. The assessor's 336.2 qualifications and the assessment criteria shall comply with 336.3 Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 336.4 chapter 254B are to be used to pay for the recommended 336.5 treatment, the assessment and placement must comply with all 336.6 provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 336.7 9530.7000 to 9530.7030. The commissioner of human services 336.8 shall reimburse the court for the cost of the chemical use 336.9 assessment, up to a maximum of $100. 336.10 The court shall have a children's mental health screening 336.11 conducted when a child is alleged to be delinquent or is found 336.12 to be delinquent. The screening shall be conducted with a 336.13 screening instrument approved by the commissioner of human 336.14 services and shall be conducted by a mental health practitioner 336.15 as defined in section 245.4871, subdivision 26, or a probation 336.16 officer who is trained in the use of the screening instrument. 336.17 If the screening indicates a need for assessment, the local 336.18 social services agency, in consultation with the child's family, 336.19 shall have a diagnostic assessment conducted, including a 336.20 functional assessment, as defined in section 245.4871. 336.21 With the consent of the commissioner of corrections and 336.22 agreement of the county to pay the costs thereof, the court may, 336.23 by order, place a minor coming within its jurisdiction in an 336.24 institution maintained by the commissioner for the detention, 336.25 diagnosis, custody and treatment of persons adjudicated to be 336.26 delinquent, in order that the condition of the minor be given 336.27 due consideration in the disposition of the case. Any funds 336.28 received under the provisions of this subdivision shall not 336.29 cancel until the end of the fiscal year immediately following 336.30 the fiscal year in which the funds were received. The funds are 336.31 available for use by the commissioner of corrections during that 336.32 period and are hereby appropriated annually to the commissioner 336.33 of corrections as reimbursement of the costs of providing these 336.34 services to the juvenile courts. 336.35 Sec. 15. Minnesota Statutes 2002, section 260B.176, 336.36 subdivision 2, is amended to read: 337.1 Subd. 2. [REASONS FOR DETENTION.] (a) If the child is not 337.2 released as provided in subdivision 1, the person taking the 337.3 child into custody shall notify the court as soon as possible of 337.4 the detention of the child and the reasons for detention. 337.5 (b) No child may be detained in a juvenile secure detention 337.6 facility or shelter care facility longer than 36 hours, 337.7 excluding Saturdays, Sundays, and holidays, after being taken 337.8 into custody for a delinquent act as defined in section 337.9 260B.007, subdivision 6, unless a petition has been filed and 337.10 the judge or referee determines pursuant to section 260B.178 337.11 that the child shall remain in detention. 337.12 (c) No child may be detained in an adult jail or municipal 337.13 lockup longer than 24 hours, excluding Saturdays, Sundays, and 337.14 holidays, or longer than six hours in an adult jail or municipal 337.15 lockup in a standard metropolitan statistical area, after being 337.16 taken into custody for a delinquent act as defined in section 337.17 260B.007, subdivision 6, unless: 337.18 (1) a petition has been filed under section 260B.141; and 337.19 (2) a judge or referee has determined under section 337.20 260B.178 that the child shall remain in detention. 337.21 After August 1, 1991, no child described in this paragraph 337.22 may be detained in an adult jail or municipal lockup longer than 337.23 24 hours, excluding Saturdays, Sundays, and holidays, or longer 337.24 than six hours in an adult jail or municipal lockup in a 337.25 standard metropolitan statistical area, unless the requirements 337.26 of this paragraph have been met and, in addition, a motion to 337.27 refer the child for adult prosecution has been made under 337.28 section 260B.125. Notwithstanding this paragraph, continued 337.29 detention of a child in an adult detention facility outside of a 337.30 standard metropolitan statistical area county is permissible if: 337.31 (i) the facility in which the child is detained is located 337.32 where conditions of distance to be traveled or other ground 337.33 transportation do not allow for court appearances within 24 337.34 hours. A delay not to exceed 48 hours may be made under this 337.35 clause; or 337.36 (ii) the facility is located where conditions of safety 338.1 exist. Time for an appearance may be delayed until 24 hours 338.2 after the time that conditions allow for reasonably safe 338.3 travel. "Conditions of safety" include adverse life-threatening 338.4 weather conditions that do not allow for reasonably safe travel. 338.5 The continued detention of a child under clause (i) or (ii) 338.6 must be reported to the commissioner of corrections. 338.7 (d) If a child described in paragraph (c) is to be detained 338.8 in a jail beyond 24 hours, excluding Saturdays, Sundays, and 338.9 holidays, the judge or referee, in accordance with rules and 338.10 procedures established by the commissioner of corrections, shall 338.11 notify the commissioner of the place of the detention and the 338.12 reasons therefor. The commissioner shall thereupon assist the 338.13 court in the relocation of the child in an appropriate juvenile 338.14 secure detention facility or approved jail within the county or 338.15 elsewhere in the state, or in determining suitable 338.16 alternatives. The commissioner shall direct that a child 338.17 detained in a jail be detained after eight days from and 338.18 including the date of the original detention order in an 338.19 approved juvenile secure detention facility with the approval of 338.20 the administrative authority of the facility. If the court 338.21 refers the matter to the prosecuting authority pursuant to 338.22 section 260B.125, notice to the commissioner shall not be 338.23 required. 338.24 (e) When a child is detained for an alleged delinquent act 338.25 in a state licensed juvenile facility or program, or when a 338.26 child is detained in an adult jail or municipal lockup as 338.27 provided in paragraph (c), the supervisor of the facility shall 338.28 have a children's mental health screening conducted with a 338.29 screening instrument approved by the commissioner of human 338.30 services, unless a screening has been performed within the 338.31 previous 180 days or the child is currently under the care of a 338.32 mental health professional. The screening shall be conducted by 338.33 a mental health practitioner as defined in section 245.4871, 338.34 subdivision 26, or a probation officer who is trained in the use 338.35 of the screening instrument. The screening shall be conducted 338.36 after the child is taken into custody for a delinquent act but 339.1 before any subsequent detention hearing, as defined in section 339.2 260B.178, and the results of the screening shall be presented to 339.3 the court at the detention hearing. If the screening indicates 339.4 a need for assessment, the local social services agency or 339.5 probation officer, in consultation with the child's family, 339.6 shall have a diagnostic assessment conducted, including a 339.7 functional assessment, as defined in section 245.4871. 339.8 Sec. 16. Minnesota Statutes 2002, section 260B.178, 339.9 subdivision 1, is amended to read: 339.10 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) The 339.11 court shall hold a detention hearing: 339.12 (1) within 36 hours of the time the child was taken into 339.13 custody, excluding Saturdays, Sundays, and holidays, if the 339.14 child is being held at a juvenile secure detention facility or 339.15 shelter care facility; or 339.16 (2) within 24 hours of the time the child was taken into 339.17 custody, excluding Saturdays, Sundays, and holidays, if the 339.18 child is being held at an adult jail or municipal lockup. 339.19 (b) Unless there is reason to believe that the child would 339.20 endanger self or others, not return for a court hearing, run 339.21 away from the child's parent, guardian, or custodian or 339.22 otherwise not remain in the care or control of the person to 339.23 whose lawful custody the child is released, or that the child's 339.24 health or welfare would be immediately endangered, the child 339.25 shall be released to the custody of a parent, guardian, 339.26 custodian, or other suitable person, subject to reasonable 339.27 conditions of release including, but not limited to, a 339.28 requirement that the child undergo a chemical use assessment as 339.29 provided in section 260B.157, subdivision 1, and a children's 339.30 mental health screening as provided in section 260B.176, 339.31 subdivision 2, paragraph (e). In determining whether the 339.32 child's health or welfare would be immediately endangered, the 339.33 court shall consider whether the child would reside with a 339.34 perpetrator of domestic child abuse. 339.35 Sec. 17. Minnesota Statutes 2002, section 260B.193, 339.36 subdivision 2, is amended to read: 340.1 Subd. 2. [CONSIDERATION OF REPORTS.] Before making a 340.2 disposition in a case, or appointing a guardian for a child, the 340.3 court may consider any report or recommendation made by the 340.4 local social services agency, probation officer, licensed 340.5 child-placing agency, foster parent, guardian ad litem, tribal 340.6 representative, or other authorized advocate for the child or 340.7 child's family, a school district concerning the effect on 340.8 student transportation of placing a child in a school district 340.9 in which the child is not a resident, or any other information 340.10 deemed material by the court. In addition, the court may 340.11 consider the results of the children's mental health screening 340.12 provided in section 260B.157, subdivision 1. 340.13 Sec. 18. Minnesota Statutes 2002, section 260B.235, 340.14 subdivision 6, is amended to read: 340.15 Subd. 6. [ALTERNATIVE DISPOSITION.] In addition to 340.16 dispositional alternatives authorized by subdivision34, in the 340.17 case of a third or subsequent finding by the court pursuant to 340.18 an admission in court or after trial that a child has committed 340.19 a juvenile alcohol or controlled substance offense, the juvenile 340.20 court shall order a chemical dependency evaluation of the child 340.21 and if warranted by the evaluation, the court may order 340.22 participation by the child in an inpatient or outpatient 340.23 chemical dependency treatment program, or any other treatment 340.24 deemed appropriate by the court. In the case of a third or 340.25 subsequent finding that a child has committed any juvenile petty 340.26 offense, the court shall order a children's mental health 340.27 screening be conducted as provided in section 260B.157, 340.28 subdivision 1, and if indicated by the screening, to undergo a 340.29 diagnostic assessment, including a functional assessment, as 340.30 defined in section 245.4871. 340.31 Sec. 19. [CONFLICTS.] 340.32 The amendments to Minnesota Statutes 2002, section 256F.10, 340.33 subdivision 6, in this article prevail over any conflicting law 340.34 that amends or repeals it regardless of the order or date of 340.35 enactment. 340.36 Sec. 20. [REVISOR'S INSTRUCTION.] 341.1 For sections in Minnesota Statutes and Minnesota Rules 341.2 affected by the repealed sections in this article, the revisor 341.3 shall delete internal cross-references where appropriate and 341.4 make changes necessary to correct the punctuation, grammar, or 341.5 structure of the remaining text and preserve its meaning. 341.6 Sec. 21. [REPEALER.] 341.7 (a) Minnesota Statutes 2002, sections 256B.0945, 341.8 subdivision 10; and 256F.10, subdivision 7, are repealed. 341.9 (b) Minnesota Statutes 2002, section 256B.0625, 341.10 subdivisions 35 and 36, are repealed effective July 1, 2004. 341.11 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 341.12 9505.0327, are repealed effective July 1, 2004. 341.13 ARTICLE 6 341.14 COMMUNITY SERVICES ACT 341.15 Section 1. [256M.01] [CITATION.] 341.16 Sections 256M.01 to 256M.80 may be cited as the "Children 341.17 and Community Services Act." This act establishes a fund to 341.18 address the needs of children, adolescents, and young adults 341.19 within each county in accordance with a service agreement 341.20 entered into by the board of county commissioners of each county 341.21 and the commissioner of human services. The service agreement 341.22 shall specify the outcomes to be achieved, the general 341.23 strategies to be employed, and the respective state and county 341.24 roles. The service agreement shall be reviewed and updated 341.25 every two years, or sooner if both the state and the county deem 341.26 it necessary. 341.27 Sec. 2. [256M.10] [DEFINITIONS.] 341.28 Subdivision 1. [SCOPE.] For the purposes of sections 341.29 256M.01 to 256M.80, the terms defined in this section have the 341.30 meanings given them. 341.31 Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 341.32 and community services" means services provided or arranged for 341.33 by county boards for children, adolescents, and young adults who 341.34 experience dependency, abuse, neglect, poverty, disability, 341.35 chronic health conditions, or other factors, including ethnicity 341.36 and race, that may result in poor outcomes or disparities, as 342.1 well as services for family members to support those individuals. 342.2 (b) Services eligible as allowable expenditures under 342.3 sections 256M.01 to 256M.80 include, but are not limited to, 342.4 services that: (1) protect a person from harm; (2) support 342.5 permanent living arrangements; (3) provide treatment; (4) 342.6 maintain family relationships; (5) increase parenting skills; 342.7 (6) reduce substance abuse; and (7) reduce domestic violence. 342.8 These services may be provided by professionals or 342.9 nonprofessionals, including the person's natural supports in the 342.10 community. 342.11 (c) Services shall, to the extent possible: (1) build on 342.12 family and community strengths; (2) help prevent crisis by 342.13 meeting needs early; (3) provide transitional supports to 342.14 adolescents and young adults making the transition to adulthood; 342.15 (4) offer help in basic needs, special needs, and referrals; (5) 342.16 respond flexibly to the needs of the person and the family; (6) 342.17 be culturally sensitive and responsive to the needs of the 342.18 person; and (7) be offered in the family home as well as in 342.19 other settings. 342.20 (d) Children and community services do not include services 342.21 under the public assistance programs known as the Minnesota 342.22 family investment program, Minnesota supplemental aid, medical 342.23 assistance, general assistance, general assistance medical care, 342.24 MinnesotaCare, or community health services. 342.25 Subd. 3. [COMMISSIONER.] "Commissioner" means the 342.26 commissioner of human services. 342.27 Subd. 4. [COUNTY BOARD.] "County board" means the board of 342.28 county commissioners in each county. 342.29 Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 342.30 GRANTS.] "Former children's services and community service 342.31 grants" means allocations for the following grants: 342.32 (1) community social service grants under sections 252.24, 342.33 256E.06, and 256E.14; 342.34 (2) family preservation grants under section 256F.05, 342.35 subdivision 3; 342.36 (3) concurrent permanency planning grants under section 343.1 260C.213, subdivision 5; 343.2 (4) social service block grants (Title XX) under section 343.3 256E.07; 343.4 (5) children's mental health grants under sections 245.4886 343.5 and 260.152. 343.6 Subd. 6. [HUMAN SERVICES BOARD.] "Human services board" 343.7 means a board established under section 402.02; Laws 1974, 343.8 chapter 293; or Laws 1976, chapter 340. 343.9 Subd. 7. [YOUNG ADULT.] "Young adult" means a person 343.10 between the ages of 18 and 25. 343.11 Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 343.12 SERVICES.] 343.13 Subdivision 1. [GENERAL SUPERVISION.] Each year the 343.14 commissioner shall allocate funds to each county according to 343.15 section 256M.40 and service agreements under section 256M.30. 343.16 The funds shall be used to address the needs of children, 343.17 adolescents, and young adults. The commissioner, in 343.18 consultation with counties, shall establish performance 343.19 standards, provide technical assistance, and evaluate county 343.20 performance in achieving outcomes. 343.21 Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall: 343.22 (1) provide necessary information and instructions to each 343.23 county for establishing baselines and desired improvements on 343.24 safety, permanency, and well-being for children, adolescents, 343.25 and young adults; 343.26 (2) provide training, technical assistance, and other 343.27 supports to each county board to assist in needs assessment, 343.28 planning, implementation, and monitoring of outcomes and service 343.29 quality; 343.30 (3) design and implement a continuous quality improvement 343.31 method, including site visits that utilize quality reviews and 343.32 timely feedback to each county regarding the county's 343.33 performance in the context of the service agreement under 343.34 section 256M.30; 343.35 (4) specify requirements for reports, including fiscal 343.36 reports to account for funds distributed; 344.1 (5) request waivers from federal programs as necessary to 344.2 implement this act; and 344.3 (6) have authority under sections 14.055 and 14.056 to 344.4 grant a variance to existing state rules as needed to eliminate 344.5 barriers to achieving desired outcomes. 344.6 Subd. 3. [SANCTIONS.] (a) The commissioner shall establish 344.7 and maintain a monitoring program designed to reduce the 344.8 possibility of noncompliance with federal laws and federal 344.9 regulations that may result in federal fiscal sanctions. If a 344.10 county is not complying with federal law or federal regulation 344.11 and the noncompliance may result in federal fiscal sanctions, 344.12 the commissioner may withhold a portion of the county's share of 344.13 state and federal funds for that program. The amount withheld 344.14 must be equal to the percentage difference between the level of 344.15 compliance maintained by the county and the level of compliance 344.16 required by the federal regulations, multiplied by the county's 344.17 share of state and federal funds for the program. The state and 344.18 federal funds may be withheld until the county is found to be in 344.19 compliance with all federal laws or federal regulations 344.20 applicable to the program. If a county remains out of 344.21 compliance for more than six consecutive months, the 344.22 commissioner may reallocate the withheld funds to counties that 344.23 are in compliance with the federal regulations. 344.24 (b) The commissioner may require a county to enter into a 344.25 joint powers agreement with one or more counties in good 344.26 standing if the commissioner determines that a county has failed 344.27 to reach the targets identified in its approved service 344.28 agreements over a four-year period for the core outcomes 344.29 established for all counties. 344.30 Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner 344.31 must comply with the following procedures when reducing county 344.32 funds under subdivision 3, paragraph (a), or requiring a joint 344.33 powers agreement under subdivision 3, paragraph (b). 344.34 (a) The commissioner shall notify the county, by certified 344.35 mail, of the statute, rule, federal law, or federal regulation 344.36 with which the county has not complied. 345.1 (b) The commissioner shall give the county 30 days to 345.2 demonstrate to the commissioner that the county is in compliance 345.3 with the statute, rule, federal law, or federal regulation cited 345.4 in the notice or to develop a corrective action plan to address 345.5 the problem. Upon request from the county, the commissioner 345.6 shall provide technical assistance to the county in developing a 345.7 corrective action plan. The county shall have 30 days from the 345.8 date the technical assistance is provided to develop the 345.9 corrective action plan. 345.10 (c) The commissioner shall take no further action if the 345.11 county demonstrates compliance with the statute, rule, federal 345.12 law, or federal regulation cited in the notice. 345.13 (d) The commissioner shall review and approve or disapprove 345.14 the corrective action plan within 30 days after the commissioner 345.15 receives the corrective action plan. 345.16 (e) If the commissioner approves the corrective action plan 345.17 submitted by the county, the county has 90 days after the date 345.18 of approval to implement the corrective action plan. 345.19 (f) If the county fails to demonstrate compliance or fails 345.20 to implement the corrective action plan approved by the 345.21 commissioner, the commissioner may reduce the county's share of 345.22 state or federal funds according to subdivision 3. 345.23 Sec. 4. [256M.30] [SERVICE AGREEMENT.] 345.24 Subdivision 1. [APPROVAL REQUIRED BY COMMISSIONER.] 345.25 Effective January 1, 2004, and each two-year period thereafter, 345.26 each county must have a biennial service agreement approved by 345.27 the commissioner in order to receive funds. Counties may submit 345.28 multicounty or regional service agreements. 345.29 Subd. 2. [CONTENTS.] The service agreement shall be 345.30 completed in a form prescribed by the commissioner. The 345.31 agreement must include: 345.32 (1) a statement of the needs of the children, adolescents, 345.33 and young adults who experience the conditions defined in 345.34 section 256M.10, subdivision 2, paragraph (a), and strengths and 345.35 resources available in the community to address those needs; 345.36 (2) outcomes prescribed by the commissioner that set 346.1 minimum performance standards for all counties, and additional 346.2 outcomes, identified by the county, to improve the safety, 346.3 permanency, and well-being of these individuals to be 346.4 accomplished annually. This information shall include current 346.5 baseline information for each outcome and annual performance 346.6 target to be reached; 346.7 (3) strategies the county will pursue to achieve the 346.8 performance targets. Strategies must include specification of 346.9 how funds under this section and other community resources will 346.10 be used to achieve desired performance targets; and 346.11 (4) description of the county's process to solicit public 346.12 input and a summary of that input. 346.13 Subd. 3. [INFORMATION.] The commissioner shall provide 346.14 each county with information and technical assistance needed to 346.15 complete the service agreement, including: information on child 346.16 safety, permanency, and well-being in the county; comparisons 346.17 with other counties; baseline performance on outcome measures; 346.18 and promising program practices. 346.19 Subd. 4. [TIMELINES.] The preliminary service agreement 346.20 must be submitted to the commissioner by October 15, 2003, and 346.21 October 15 of every two years thereafter. 346.22 Subd. 5. [PUBLIC COMMENT.] The county board must determine 346.23 how citizens in the county will participate in the development 346.24 of the service agreement and provide opportunities for such 346.25 participation. The county must allow a period of no less than 346.26 30 days prior to the submission of the agreement to the 346.27 commissioner to solicit comments from the public on the contents 346.28 of the agreement. 346.29 Subd. 6. [COMMISSIONER RESPONSIBILITIES.] The commissioner 346.30 must, within 60 days of receiving each county service agreement, 346.31 inform the county if the service agreement has been approved. 346.32 If the service agreement is not approved, the commissioner must 346.33 inform the county of any revisions needed prior to approval. 346.34 Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 346.35 GRANT ALLOCATION.] 346.36 Subdivision 1. [FORMULA.] Exclusive of subdivision 3, the 347.1 commissioner shall allocate state funds appropriated for 347.2 children and community services grants to each county board on a 347.3 calendar year basis in an amount determined according to the 347.4 formula in paragraphs (a) to (c). 347.5 (a) For July 1, 2003, through December 31, 2003, the 347.6 commissioner shall allocate funds to each county equal to that 347.7 county's allocation for the grants under section 256M.10, 347.8 subdivision 5, for calendar year 2003 less payments made on or 347.9 before June 30, 2003. 347.10 (b) For calendar year 2004 and 2005, the commissioner shall 347.11 allocate available funds to each county in proportion to that 347.12 county's share of the calendar year 2003 allocations for the 347.13 grants under section 256M.10, subdivision 5. 347.14 (c) For calendar year 2006 and each calendar year 347.15 thereafter, the commissioner shall allocate available funds to 347.16 each county in proportion to that county's share in the 347.17 preceding calendar year. 347.18 Subd. 2. [PERFORMANCE INCENTIVE.] Beginning with the 347.19 calendar year 2006 allocation, the commissioner shall withhold 347.20 five percent of the annual allocation for each county. This 347.21 portion shall be released to the county based on the 347.22 commissioner's determination of the county's achievement of 347.23 positive outcomes as agreed to in the service agreement. Any 347.24 funds not disbursed under this subdivision to a county shall be 347.25 reallocated by the commissioner to other counties who, based on 347.26 the commissioner's determination, have achieved positive 347.27 outcomes as agreed to in the service agreements. 347.28 Subd. 3. [PROJECT OF REGIONAL SIGNIFICANCE.] Beginning 347.29 with the calendar year 2006 allocation, $25,000,000 of the 347.30 available annual funds are dedicated for projects of regional 347.31 significance. The commissioner shall publish a request to 347.32 solicit proposals from groups of counties by region. The 347.33 regional groupings shall be designated by the commissioner, in 347.34 consultation with counties. These projects shall support the 347.35 efforts in paragraphs (a) to (c). 347.36 (a) Funds are available to regional consortia of counties 348.1 to support cooperative regional projects between governments, 348.2 schools, and nonprofit providers designed to put in place 348.3 comprehensive health and developmental screening for all 348.4 children below six years, and to support projects that address 348.5 early identification of physical and mental health needs in 348.6 children. Project partners applying under this provision must 348.7 show how local resources will also be aligned to meet project 348.8 goals. 348.9 (b) Funds are available to the different geographic regions 348.10 to support efforts that lead to simplification and improve 348.11 outcomes through regional administration of human services. 348.12 (c) Funds are available to counties for innovative regional 348.13 projects designed to improve outcomes for children, adolescents, 348.14 young adults, and their families to reduce the cost of providing 348.15 services through innovative delivery or service design 348.16 strategies, to test alternative incentives within a support 348.17 strategy, or to develop new strategies to engage communities in 348.18 caring for risk populations especially populations with 348.19 disparities in outcome indicators. Up to five percent of funds 348.20 for innovation may be made to organizations other than counties. 348.21 Subd. 4. [PAYMENTS.] Calendar year allocations under 348.22 subdivisions 1 and 2 shall be paid to counties on or before July 348.23 10 of each year. Funds awarded under subdivision 3 shall be 348.24 paid according to requirements in the contract between the 348.25 commissioner and the contracting entities. 348.26 Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 348.27 GRANT ALLOCATION.] 348.28 In federal fiscal year 2004 and subsequent years, money for 348.29 social services received from the federal government to 348.30 reimburse counties for social service expenditures according to 348.31 Title XX of the Social Security Act shall be allocated to each 348.32 county according to section 256M.40, except for funds allocated 348.33 for migrant day care. 348.34 Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.] 348.35 Subdivision 1. [RESPONSIBILITIES.] The county board of 348.36 each county shall be responsible for administration and funding 349.1 of children and community services as defined in section 349.2 256M.10, subdivisions 1 and 2. Each county board shall singly 349.3 or in combination with other county boards use funds available 349.4 to the county under this act to carry out these responsibilities. 349.5 The county board shall coordinate and facilitate the effective 349.6 use of formal and informal helping systems to best support and 349.7 nurture children, adolescents, and young adults within the 349.8 county who experience dependency, abuse, neglect, poverty, 349.9 disability, chronic health conditions, or other factors, 349.10 including ethnicity and race, that may result in poor outcomes 349.11 or disparities, as well as services for family members to 349.12 support such individuals. This includes assisting individuals 349.13 to function at the highest level of ability while maintaining 349.14 family and community relationships to the greatest extent 349.15 possible. 349.16 Subd. 2. [REPORTS.] The county board shall provide 349.17 necessary reports and data as required by the commissioner. 349.18 Subd. 3. [CONTRACTS FOR SERVICES.] The county board may 349.19 contract with a human services board, a multicounty board 349.20 established by a joint powers agreement, other political 349.21 subdivisions, a children's mental health collaborative, a family 349.22 services collaborative, or private organizations in discharging 349.23 its duties. 349.24 Subd. 4. [EXEMPTION FROM LIABILITY.] The state of 349.25 Minnesota, the county boards, or the agencies acting on behalf 349.26 of the county boards in the implementation and administration of 349.27 children and community services shall not be liable for damages, 349.28 injuries, or liabilities sustained through the purchase of 349.29 services by the individual, the individual's family, or the 349.30 authorized representative under this section. 349.31 Sec. 8. [256M.70] [FISCAL LIMITATIONS.] 349.32 Subdivision 1. [SERVICE LIMITATION.] If the county has met 349.33 the requirements in subdivisions 2 to 4, the county shall not be 349.34 required to provide children and community services beyond 349.35 requirements in federal or state law. 349.36 Subd. 2. [DEMONSTRATION OF REASONABLE EFFORT.] The county 350.1 shall make reasonable efforts to comply with all children and 350.2 community services requirements. For the purposes of this 350.3 section, a county is making reasonable efforts if the county has 350.4 made efforts to comply with requirements within the limits of 350.5 available funding, including efforts to identify and apply for 350.6 commonly available state and federal funding for services. 350.7 Subd. 3. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 350.8 county has made reasonable efforts to comply with all applicable 350.9 administrative rule requirements and is unable to meet all 350.10 requirements, the county must provide services using the 350.11 following considerations: 350.12 (1) providing services needed to protect children, 350.13 adolescents, and young adults from maltreatment, abuse, and 350.14 neglect; 350.15 (2) providing emergency and crisis services needed to 350.16 protect clients from physical, emotional, or psychological harm; 350.17 (3) assessing and documenting the needs of persons applying 350.18 for services and referring to appropriate services when 350.19 necessary; 350.20 (4) providing public guardianship services for children; 350.21 and 350.22 (5) fulfilling licensing responsibilities delegated to the 350.23 county by the commissioner under section 245A.16. 350.24 Subd. 4. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 350.25 DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 350.26 terminates services to an individual due to fiscal limitations, 350.27 the county must meet the requirements in subdivisions 2 and 3. 350.28 The county must notify the individual and the individual's 350.29 guardian in writing of the reason for the denial, reduction, or 350.30 termination of services and must inform the individual and the 350.31 individual's guardian in writing that the county will, upon 350.32 request, meet to discuss alternatives before services are 350.33 terminated or reduced. 350.34 Subd. 5. [APPEAL RIGHTS.] An individual who applies for or 350.35 receives children and community services under this chapter, 350.36 whose application is denied, or whose services are reduced or 351.1 terminated does not have the right to a fair hearing under 351.2 section 256.045. 351.3 Subd. 6. [RIGHT TO PETITION FOR REVIEW.] Any individual 351.4 who applies for or receives children and community services 351.5 under this chapter, whose application is denied, or whose 351.6 services are reduced or terminated may petition the commissioner 351.7 to review the county's performance under the county service 351.8 agreement. The petition must be in writing and must be specific 351.9 as to what action the individual believes is inconsistent with 351.10 the county service agreement, and what action the individual 351.11 believes should be required. Upon receiving a petition, the 351.12 commissioner shall have 60 days in which to make a reply in 351.13 writing as to its determination and any corrective action 351.14 required. 351.15 Sec. 9. [256M.80] [PROGRAM EVALUATION.] 351.16 Subdivision 1. [COUNTY EVALUATION.] Each county shall 351.17 submit to the commissioner data from the past calendar year on 351.18 the outcomes in the approved service agreement. The 351.19 commissioner shall prescribe standard methods to be used by the 351.20 counties in providing the data. The data shall be submitted no 351.21 later than March 1 of each year, beginning with March 1, 2005. 351.22 Subd. 2. [STATEWIDE EVALUATION.] Six months after the end 351.23 of the first full calendar year and annually thereafter, the 351.24 commissioner shall prepare a report on the counties' progress in 351.25 improving the outcomes of children, adolescents, and young 351.26 adults related to safety, permanency, and well-being. This 351.27 report shall be disseminated throughout the state. 351.28 Sec. 10. [REVISOR'S INSTRUCTION.] 351.29 For sections in Minnesota Statutes and Minnesota Rules 351.30 affected by the repealed sections in this article, the revisor 351.31 shall delete internal cross-references where appropriate and 351.32 make changes necessary to correct the punctuation, grammar, or 351.33 structure of the remaining text and preserve its meaning. 351.34 Sec. 11. [REPEALER.] 351.35 (a) Minnesota Statutes 2002, sections 245.4886; 245.496; 351.36 254A.17; 256B.0945, subdivisions 6, 7, 8, 9, and 10; 256E.01; 352.1 256E.02; 256E.03; 256E.04; 256E.05; 256E.06; 256E.07; 256E.08; 352.2 256E.081; 256E.09; 256E.10; 256E.11; 256E.115; 256E.12; 256E.13; 352.3 256E.14; 256E.15; 256F.01; 256F.02; 256F.03; 256F.04; 256F.05; 352.4 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 256F.14; 257.075; 352.5 257.81; 260.152; and 626.562, are repealed. 352.6 (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 352.7 9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 352.8 9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 352.9 ARTICLE 7 352.10 HUMAN SERVICES MISCELLANEOUS 352.11 Section 1. Minnesota Statutes 2002, section 69.021, 352.12 subdivision 11, is amended to read: 352.13 Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 352.14 The excess police state-aid holding account is established in 352.15 the general fund. The excess police state-aid holding account 352.16 must be administered by the commissioner. 352.17 (b) Excess police state aid determined according to 352.18 subdivision 10, must be deposited in the excess police state-aid 352.19 holding account. 352.20 (c) From the balance in the excess police state-aid holding 352.21 account,$1,000,000$900,000 is appropriated to and must be 352.22 transferred annually to the ambulance service personnel 352.23 longevity award and incentive suspense account established by 352.24 section 144E.42, subdivision 2. 352.25 (d) If a police officer stress reduction program is created 352.26 by law and money is appropriated for that program, an amount 352.27 equal to that appropriation must be transferred from the balance 352.28 in the excess police state-aid holding account. 352.29 (e) On October 1, 1997, and annually on each subsequent 352.30 October 1, one-half of the balance of the excess police 352.31 state-aid holding account remaining after the deductions under 352.32 paragraphs (c) and (d) is appropriated for additional 352.33 amortization aid under section 423A.02, subdivision 1b. 352.34 (f) Annually, the remaining balance in the excess police 352.35 state-aid holding account, after the deductions under paragraphs 352.36 (c), (d), and (e), cancels to the general fund. 353.1 Sec. 2. Minnesota Statutes 2002, section 245A.10, is 353.2 amended to read: 353.3 245A.10 [FEES.] 353.4 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 353.5 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 353.6 (b), the commissioner shall charge a fee for evaluation of 353.7 applications and inspection of programs, other than family day353.8care and foster care,which are licensed under this chapter. 353.9The commissioner may charge a fee for the licensing of school353.10age child care programs, in an amount sufficient to cover the353.11cost to the state agency of processing the license.353.12 (b) Notwithstanding paragraph (a), no application or 353.13 license fee shall be charged for family child care, child foster 353.14 care, adult foster care, or state-operated programs, unless the 353.15 state-operated program is an intermediate care facility for 353.16 persons with mental retardation or related conditions (ICF/MR). 353.17 Subd. 2. [APPLICATION FEE FOR INITIAL LICENSE OR 353.18 CERTIFICATION.] (a) Unless exempt from paying a license fee 353.19 under subdivision 1, an applicant for an initial license or 353.20 certification issued by the commissioner shall submit a $500 353.21 application fee with each new application required under this 353.22 subdivision. The application fee shall not be prorated, is 353.23 nonrefundable, and is in lieu of the annual license or 353.24 certification fee that expires on December 31. The commissioner 353.25 shall not process an application until the application fee is 353.26 paid. 353.27 (b) Except as provided in clauses (1) to (3), an applicant 353.28 shall apply for a license to provide services at a specific 353.29 location. 353.30 (1) For a license to provide waivered services to persons 353.31 with developmental disabilities or related conditions, an 353.32 applicant shall submit an application for each county in which 353.33 the waivered services will be provided. 353.34 (2) For a license to provide semi-independent living 353.35 services to persons with developmental disabilities or related 353.36 conditions, an applicant shall submit a single application to 354.1 provide services statewide. 354.2 (3) For a license to provide independent living assistance 354.3 for youth under section 245A.22, an applicant shall submit a 354.4 single application to provide services statewide. 354.5 Subd. 3. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 354.6 WITH LICENSED CAPACITY.] (a) Child care centers and programs 354.7 with a licensed capacity shall pay an annual nonrefundable 354.8 license or certification fee based on the following schedule: 354.9 Licensed Capacity Child Care Residential 354.10 Center Program 354.11 License Fee License Fee 354.12 1 to 24 persons $300 $400 354.13 25 to 49 persons $450 $600 354.14 50 to 74 persons $600 $800 354.15 75 to 99 persons $750 $1,000 354.16 100 to 124 persons $900 $1,200 354.17 125 to 149 persons $1,200 $1,400 354.18 150 to 174 persons $1,400 $1,600 354.19 175 to 199 persons $1,600 $1,800 354.20 200 to 224 persons $1,800 $2,000 354.21 225 or more persons $2,000 $2,500 354.22 (b) A day training and habilitation program serving persons 354.23 with developmental disabilities or related conditions shall be 354.24 assessed a license fee based on the schedule in paragraph (a) 354.25 unless the license holder serves more than 50 percent of the 354.26 same persons at two or more locations in the community. When a 354.27 day training and habilitation program serves more than 50 354.28 percent of the same persons in two or more locations in a 354.29 community, the day training and habilitation program shall pay a 354.30 license fee based on the licensed capacity of the largest 354.31 facility and the other facility or facilities shall be charged a 354.32 license fee based on a licensed capacity of a residential 354.33 program serving one to 24 persons. 354.34 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 354.35 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 354.36 paragraph (b), a program without a stated licensed capacity 355.1 shall pay a license or certification fee of $400. 355.2 (b) A mental health center or mental health clinic 355.3 requesting certification for purposes of insurance and 355.4 subscriber contract reimbursement under Minnesota Rules, parts 355.5 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 355.6 per year. If the mental health center or mental health clinic 355.7 provides services at a primary location with satellite 355.8 facilities, the satellite facilities shall be certified with the 355.9 primary location without an additional charge. 355.10 Subd. 5. [LICENSE NOT ISSUED UNTIL LICENSE OR 355.11 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 355.12 license or certification until the license or certification fee 355.13 is paid. The commissioner shall send a bill for the license or 355.14 certification fee to the billing address identified by the 355.15 license holder. If the license holder does not submit the 355.16 license or certification fee payment by the due date, the 355.17 commissioner shall send the license holder a past due notice. 355.18 If the license holder fails to pay the license or certification 355.19 fee by the due date on the past due notice, the commissioner 355.20 shall send a final notice to the license holder informing the 355.21 license holder that the program license will expire on December 355.22 31 unless the license fee is paid before December 31. If a 355.23 license expires, the program is no longer licensed and, unless 355.24 exempt from licensure under section 245A.03, subdivision 2, must 355.25 not operate after the expiration date. After a license expires, 355.26 if the former license holder wishes to provide licensed 355.27 services, the former license holder must submit a new license 355.28 application and application fee under subdivision 2. 355.29 Sec. 3. Minnesota Statutes 2002, section 252.27, 355.30 subdivision 2a, is amended to read: 355.31 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 355.32 adoptive parents of a minor child, including a child determined 355.33 eligible for medical assistance without consideration of 355.34 parental income, must contribute monthly to the cost of 355.35 services, unless the child is married or has been married, 355.36 parental rights have been terminated, or the child's adoption is 356.1 subsidized according to section 259.67 or through title IV-E of 356.2 the Social Security Act. 356.3 (b) For households with adjusted gross income equal to or 356.4 greater than 100 percent of federal poverty guidelines, the 356.5 parental contribution shall bethe greater of a minimum monthly356.6fee of $25 for households with adjusted gross income of $30,000356.7and over, or an amount to becomputed by applying the following 356.8 schedule of rates to the adjusted gross income of the natural or 356.9 adoptive parentsthat exceeds 150 percent of the federal poverty356.10guidelines for the applicable household size, the following356.11schedule of rates: 356.12 (1)on the amount of adjusted gross income over 150 percent356.13of poverty, but not over $50,000, ten percentif the adjusted 356.14 gross income is equal to or greater than 100 percent of federal 356.15 poverty guidelines and less than 175 percent of federal poverty 356.16 guidelines, the parental contribution is $4 per month; 356.17 (2)onif theamount ofadjusted gross incomeover 150356.18percent of poverty and over $50,000 but not over $60,000, 12356.19percentis equal to or greater than 175 percent of federal 356.20 poverty guidelines and less than or equal to 375 percent of 356.21 federal poverty guidelines, the parental contribution shall be 356.22 determined using a sliding fee scale established by the 356.23 commissioner of human services which begins at one percent of 356.24 adjusted gross income at 175 percent of federal poverty 356.25 guidelines and increases to 7.5 percent of adjusted gross income 356.26 for those with adjusted gross income up to 375 percent of 356.27 federal poverty guidelines; 356.28 (3)onif theamount ofadjusted gross incomeover 150is 356.29 greater than 375 percent of federal poverty, and over $60,000356.30but not over $75,000, 14 percentguidelines and less than 675 356.31 percent of federal poverty guidelines, the parental contribution 356.32 shall be 7.5 percent of adjusted gross income;and356.33 (4)on allif the adjusted gross incomeamounts over 150is 356.34 equal to or greater than 675 percent of federal poverty, and356.35over $75,000, 15 percentguidelines and less than 975 percent of 356.36 federal poverty guidelines, the parental contribution shall be 357.1 ten percent of adjusted gross income; and 357.2 (5) if the adjusted gross income is equal to or greater 357.3 than 975 percent of federal poverty guidelines, the parental 357.4 contribution shall be 12.5 percent of adjusted gross income. 357.5 If the child lives with the parent, theparental357.6contributionannual adjusted gross income is reduced by$200,357.7except that the parent must pay the minimum monthly $25 fee357.8under this paragraph$2,400 prior to calculating the parental 357.9 contribution. If the child resides in an institution specified 357.10 in section 256B.35, the parent is responsible for the personal 357.11 needs allowance specified under that section in addition to the 357.12 parental contribution determined under this section. The 357.13 parental contribution is reduced by any amount required to be 357.14 paid directly to the child pursuant to a court order, but only 357.15 if actually paid. 357.16 (c) The household size to be used in determining the amount 357.17 of contribution under paragraph (b) includes natural and 357.18 adoptive parents and their dependents under age 21, including 357.19 the child receiving services. Adjustments in the contribution 357.20 amount due to annual changes in the federal poverty guidelines 357.21 shall be implemented on the first day of July following 357.22 publication of the changes. 357.23 (d) For purposes of paragraph (b), "income" means the 357.24 adjusted gross income of the natural or adoptive parents 357.25 determined according to the previous year's federal tax form. 357.26 (e) The contribution shall be explained in writing to the 357.27 parents at the time eligibility for services is being 357.28 determined. The contribution shall be made on a monthly basis 357.29 effective with the first month in which the child receives 357.30 services. Annually upon redetermination or at termination of 357.31 eligibility, if the contribution exceeded the cost of services 357.32 provided, the local agency or the state shall reimburse that 357.33 excess amount to the parents, either by direct reimbursement if 357.34 the parent is no longer required to pay a contribution, or by a 357.35 reduction in or waiver of parental fees until the excess amount 357.36 is exhausted. 358.1 (f) The monthly contribution amount must be reviewed at 358.2 least every 12 months; when there is a change in household size; 358.3 and when there is a loss of or gain in income from one month to 358.4 another in excess of ten percent. The local agency shall mail a 358.5 written notice 30 days in advance of the effective date of a 358.6 change in the contribution amount. A decrease in the 358.7 contribution amount is effective in the month that the parent 358.8 verifies a reduction in income or change in household size. 358.9 (g) Parents of a minor child who do not live with each 358.10 other shall each pay the contribution required under paragraph 358.11 (a), except that a. An amount equal to the annual court-ordered 358.12 child support payment actually paid on behalf of the child 358.13 receiving services shall be deducted from thecontribution358.14 adjusted gross income of the parent making the payment prior to 358.15 calculating the parental contribution under paragraph (b). 358.16 (h) The contribution under paragraph (b) shall be increased 358.17 by an additional five percent if the local agency determines 358.18 that insurance coverage is available but not obtained for the 358.19 child. For purposes of this section, "available" means the 358.20 insurance is a benefit of employment for a family member at an 358.21 annual cost of no more than five percent of the family's annual 358.22 income. For purposes of this section, "insurance" means health 358.23 and accident insurance coverage, enrollment in a nonprofit 358.24 health service plan, health maintenance organization, 358.25 self-insured plan, or preferred provider organization. 358.26 Parents who have more than one child receiving services 358.27 shall not be required to pay more than the amount for the child 358.28 with the highest expenditures. There shall be no resource 358.29 contribution from the parents. The parent shall not be required 358.30 to pay a contribution in excess of the cost of the services 358.31 provided to the child, not counting payments made to school 358.32 districts for education-related services. Notice of an increase 358.33 in fee payment must be given at least 30 days before the 358.34 increased fee is due. 358.35 (i) The contribution under paragraph (b) shall be reduced 358.36 by $300 per fiscal year if, in the 12 months prior to July 1: 359.1 (1) the parent applied for insurance for the child; 359.2 (2) the insurer denied insurance; 359.3 (3) the parents submitted a complaint or appeal, in writing 359.4 to the insurer, submitted a complaint or appeal, in writing, to 359.5 the commissioner of health or the commissioner of commerce, or 359.6 litigated the complaint or appeal; and 359.7 (4) as a result of the dispute, the insurer reversed its 359.8 decision and granted insurance. 359.9 For purposes of this section, "insurance" has the meaning 359.10 given in paragraph (h). 359.11 A parent who has requested a reduction in the contribution 359.12 amount under this paragraph shall submit proof in the form and 359.13 manner prescribed by the commissioner or county agency, 359.14 including, but not limited to, the insurer's denial of 359.15 insurance, the written letter or complaint of the parents, court 359.16 documents, and the written response of the insurer approving 359.17 insurance. The determinations of the commissioner or county 359.18 agency under this paragraph are not rules subject to chapter 14. 359.19 [EFFECTIVE DATE.] This section is effective July 1, 2003. 359.20 Sec. 4. Minnesota Statutes 2002, section 518.551, 359.21 subdivision 7, is amended to read: 359.22 Subd. 7. [SERVICE FEEFEES AND COST RECOVERY FEES FOR IV-D 359.23 SERVICES.]When the public agency responsible for child support359.24enforcement provides child support collection services either to359.25a public assistance recipient or to a party who does not receive359.26public assistance, the public agency may upon written notice to359.27the obligor charge a monthly collection fee equivalent to the359.28full monthly cost to the county of providing collection359.29services, in addition to the amount of the child support which359.30was ordered by the court. The fee shall be deposited in the359.31county general fund. The service fee assessed is limited to ten359.32percent of the monthly court ordered child support and shall not359.33be assessed to obligors who are current in payment of the359.34monthly court ordered child support.(a) When a recipient of 359.35 IV-D services is no longer receiving assistance under the 359.36 state's plan for foster care, medical assistance, or 360.1 MinnesotaCare programs, the public authority responsible for 360.2 child support enforcement must notify the recipient, within five 360.3 working days of the notification of ineligibility, that IV-D 360.4 services will be continued unless the public authority is 360.5 notified to the contrary by the recipient. The notice must 360.6 include the implications of continuing to receive IV-D services, 360.7 including the available services and fees, cost recovery fees, 360.8 and distribution policies relating to fees. 360.9 (b) An application fee of $25 shall be paid by the person 360.10 who applies for child support and maintenance collection 360.11 services, except persons who are receiving public assistance as 360.12 defined in section 256.741 and, if enacted, the diversionary 360.13 work program under section 256J.95, persons who transfer from 360.14 public assistance to nonpublic assistance status, and minor 360.15 parents and parents enrolled in a public secondary school, area 360.16 learning center, or alternative learning program approved by the 360.17 commissioner of children, families, and learning. 360.18 (c) When the public authority provides full IV-D services 360.19 to an obligee who has applied for those services, upon written 360.20 notice to the obligee, the public authority must charge a cost 360.21 recovery fee of one percent of the amount collected. This fee 360.22 must be deducted from the amount of the child support and 360.23 maintenance collected and not assigned under section 256.741, 360.24 before disbursement to the obligee. This fee applies to an 360.25 obligee who: 360.26 (1) has never received assistance under the state's title 360.27 IV-A, IV-E foster care, medical assistance, or MinnesotaCare 360.28 programs; 360.29 (2) has received assistance under the state's medical 360.30 assistance or MinnesotaCare programs. The fee must be charged 360.31 immediately upon becoming ineligible; or 360.32 (3) has received assistance under the state's title IV-A or 360.33 IV-E foster care programs. The fee must not be charged until 360.34 the person has not received these services for 24 consecutive 360.35 months. 360.36 (d) When the public authority provides full IV-D services 361.1 to an obligor who has applied for such services, upon written 361.2 notice to the obligor, the public authority must charge a cost 361.3 recovery fee of one percent of the monthly court ordered child 361.4 support and maintenance obligation and may be collected through 361.5 income withholding, as well as by any other enforcement remedy 361.6 available to the public authority responsible for child support 361.7 enforcement. 361.8 (e) Fees assessed by state and federal tax agencies for 361.9 collection of overdue support owed to or on behalf of a person 361.10 not receiving public assistance must be imposed on the person 361.11 for whom these services are provided. The public authority upon 361.12 written notice to the obligee shall assess a fee of $25 to the 361.13 person not receiving public assistance for each successful 361.14 federal tax interception. The fee must be withheld prior to the 361.15 release of the funds received from each interception and 361.16 deposited in the general fund. 361.17 (f) Cost recovery fees collected under paragraphs (c) and 361.18 (d) shall be considered child support program income according 361.19 to Code of Federal Regulations, title 45, section 304.50, and 361.20 shall be deposited in the cost recovery fee account established 361.21 under paragraph (h). The commissioner of human services must 361.22 elect to recover costs based on either actual or standardized 361.23 costs. 361.24However,(g) The limitations of this subdivision on the 361.25 assessment of fees shall not apply to the extent inconsistent 361.26 with the requirements of federal law for receiving funds for the 361.27 programs under Title IV-A and Title IV-D of the Social Security 361.28 Act, United States Code, title 42, sections 601 to 613 and 361.29 United States Code, title 42, sections 651 to 662. 361.30 (h) The commissioner of human services is authorized to 361.31 establish a special revenue fund account to receive child 361.32 support cost recovery fees. A portion of the nonfederal share 361.33 of these fees may be retained for expenditures necessary to 361.34 administer the fee, and must be transferred to the child support 361.35 system special revenue account. The remaining nonfederal share 361.36 of the cost recovery fee must be retained by the commissioner 362.1 and dedicated to the child support general fund county 362.2 performance based grant account authorized under sections 362.3 256.979 and 256.9791. 362.4 [EFFECTIVE DATE.] This section is effective July 1, 2004, 362.5 except paragraph (d) is effective July 1, 2005. 362.6 Sec. 5. Minnesota Statutes 2002, section 518.6111, 362.7 subdivision 2, is amended to read: 362.8 Subd. 2. [APPLICATION.] This section applies to all 362.9 support orders issued by a court or an administrative tribunal 362.10 and orders for or notices of withholding issued by the public 362.11 authorityaccording to section 518.5513, subdivision 5,362.12paragraph (a), clause (5). 362.13 [EFFECTIVE DATE.] This section is effective July 1, 2004. 362.14 Sec. 6. Minnesota Statutes 2002, section 518.6111, 362.15 subdivision 3, is amended to read: 362.16 Subd. 3. [ORDER.] Every support order must address income 362.17 withholding. Whenever a support order is initially entered or 362.18 modified, the full amount of the support order must be 362.19withheldsubject to income withholding from the income of the 362.20 obligor. If the obligee or obligor applies for either full IV-D 362.21 services or for income withholding only services from the public 362.22 authority responsible for child support enforcement, the full 362.23 amount of the support order must be withheld from the income of 362.24 the obligor and forwarded to the public authority. Every order 362.25 for support or maintenance shall provide for a conspicuous 362.26 notice of the provisions of this section that complies with 362.27 section 518.68, subdivision 2. An order without this notice 362.28 remains subject to this section. This section applies 362.29 regardless of the source of income of the person obligated to 362.30 pay the support or maintenance. 362.31 A payor of funds shall implement income withholding 362.32 according to this section upon receipt of an order for or notice 362.33 of withholding. The notice of withholding shall be on a form 362.34 provided by the commissioner of human services. 362.35 [EFFECTIVE DATE.] This section is effective July 1, 2004. 362.36 Sec. 7. Minnesota Statutes 2002, section 518.6111, 363.1 subdivision 4, is amended to read: 363.2 Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of 363.3 human services shall prepare and make available to the courts a 363.4 notice of services that explains child support and maintenance 363.5 collection services available through the public authority, 363.6 including income withholding, and the fees for such services. 363.7 Upon receiving a petition for dissolution of marriage or legal 363.8 separation, the court administrator shall promptly send the 363.9 notice of services to the petitioner and respondent at the 363.10 addresses stated in the petition. 363.11 (b) Either the obligee or obligor may at any time apply to 363.12 the public authority for either full IV-D services or for income 363.13 withholding only services. 363.14Upon receipt of a support order requiring income363.15withholding, a petitioner or respondent, who is not a recipient363.16of public assistance and does not receive child support services363.17from the public authority, shall apply to the public authority363.18for either full child support collection services or for income363.19withholding only services.363.20 (c) For those persons applying for income withholding only 363.21 services, a monthly service fee of $15 must be charged to the 363.22 obligor. This fee is in addition to the amount of the support 363.23 order and shall be withheld through income withholding. The 363.24 public authority shall explain the service options in this 363.25 section to the affected parties and encourage the application 363.26 for full child support collection services. 363.27 (d) If the obligee is not a current recipient of public 363.28 assistance as defined in section 256.741, the person who applied 363.29 for services may at any time choose to terminate either full 363.30 IV-D services or income withholding only services regardless of 363.31 whether income withholding is currently in place. The obligee 363.32 or obligor may reapply for either full IV-D services or income 363.33 withholding only services at any time. Unless the applicant is 363.34 a recipient of public assistance as defined in section 256.741, 363.35 a $25 application fee shall be charged at the time of each 363.36 application. 364.1 (e) When a person terminates IV-D services, if an arrearage 364.2 for public assistance as defined in section 256.741 exists, the 364.3 public authority may continue income withholding, as well as use 364.4 any other enforcement remedy for the collection of child 364.5 support, until all public assistance arrears are paid in full. 364.6 Income withholding shall be in an amount equal to 20 percent of 364.7 the support order in effect at the time the services terminated. 364.8 [EFFECTIVE DATE.] This section is effective July 1, 2004. 364.9 Sec. 8. Minnesota Statutes 2002, section 518.6111, 364.10 subdivision 16, is amended to read: 364.11 Subd. 16. [WAIVER.] (a) If the public authority is 364.12 providing child support and maintenance enforcement services and 364.13 child support or maintenance is not assigned under section 364.14 256.741, the court may waive the requirements of this section if 364.15the court finds there is no arrearage in child support and364.16maintenance as of the date of the hearing and: 364.17 (1) one party demonstrates and the courtfindsdetermines 364.18 there is good cause to waive the requirements of this section or 364.19 to terminate an order for or notice of income withholding 364.20 previously entered under this section. The court must make 364.21 written findings to include the reasons income withholding would 364.22 not be in the best interests of the child. In cases involving a 364.23 modification of support, the court must also make a finding that 364.24 support payments have been timely made; or 364.25 (2)all parties reach anthe obligee and obligor sign a 364.26 written agreementand the agreementproviding for an alternative 364.27 payment arrangement which isapprovedreviewed and entered in 364.28 the record by the courtafter a finding that the agreement is364.29likely to result in regular and timely payments. The court's364.30findings waiving the requirements of this paragraph shall364.31include a written explanation of the reasons why income364.32withholding would not be in the best interests of the child. 364.33In addition to the other requirements in this subdivision,364.34if the case involves a modification of support, the court shall364.35make a finding that support has been timely made.364.36 (b) If the public authority is not providing child support 365.1 and maintenance enforcement services and child support or 365.2 maintenance is not assigned under section 256.741, the court may 365.3 waive the requirements of this section if the parties sign a 365.4 written agreement. 365.5 (c) If the court waives income withholding, the obligee or 365.6 obligor may at any time request income withholding under 365.7 subdivision 7. 365.8 [EFFECTIVE DATE.] This section is effective July 1, 2004. 365.9 Sec. 9. [REVISOR'S INSTRUCTION.] 365.10 For sections in Minnesota Statutes and Minnesota Rules 365.11 affected by the repealed sections in this article, the revisor 365.12 shall delete internal cross-references where appropriate and 365.13 make changes necessary to correct the punctuation, grammar, or 365.14 structure of the remaining text and preserve its meaning. 365.15 Sec. 10. [REPEALER.] 365.16 Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 365.17 9545.2030; and 9545.2040, are repealed. 365.18 ARTICLE 8 365.19 HEALTH DEPARTMENT MISCELLANEOUS 365.20 Section 1. Minnesota Statutes 2002, section 62J.692, 365.21 subdivision 4, is amended to read: 365.22 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 365.23 shall annually distribute medical education funds to all 365.24 qualifying applicants based on the following criteria: 365.25 (1) total medical education funds available for 365.26 distribution; 365.27 (2) total number of eligible trainee FTEs in each clinical 365.28 medical education program; and 365.29 (3) the statewide average cost per trainee as determined by 365.30 the application information provided in the first year of the 365.31 biennium, by type of trainee, in each clinical medical education 365.32 program. 365.33 (b) Funds distributed shall not be used to displace current 365.34 funding appropriations from federal or state sources. 365.35 (c) Funds shall be distributed to the sponsoring 365.36 institutions indicating the amount to be distributed to each of 366.1 the sponsor's clinical medical education programs based on the 366.2 criteria in this subdivision and in accordance with the 366.3 commissioner's approval letter. Each clinical medical education 366.4 program must distribute funds to the training sites as specified 366.5 in the commissioner's approval letter. Sponsoring institutions, 366.6 which are accredited through an organization recognized by the 366.7 department of education or the Centers for Medicare and Medicaid 366.8 Services, may contract directly with training sites to provide 366.9 clinical training. To ensure the quality of clinical training, 366.10 those accredited sponsoring institutions must: 366.11 (1) develop contracts specifying the terms, expectations, 366.12 and outcomes of the clinical training conducted at sites; and 366.13 (2) take necessary action if the contract requirements are 366.14 not met. Action may include the withholding of payments under 366.15 this section or the removal of students from the site. 366.16 (d) Any funds not distributed in accordance with the 366.17 commissioner's approval letter must be returned to the medical 366.18 education and research fund within 30 days of receiving notice 366.19 from the commissioner. The commissioner shall distribute 366.20 returned funds to the appropriate training sites in accordance 366.21 with the commissioner's approval letter. 366.22 (e) The commissioner shall distribute by June 30 of each 366.23 year an amount equal to the funds transferred undersection366.2462J.694, subdivision 2a, paragraph (b)subdivision 10, plus five 366.25 percent interest to the University of Minnesota board of regents 366.26 for thecosts of the academic health center as specified under366.27section 62J.694, subdivision 2a, paragraph (a).instructional 366.28 costs of health professional programs at the academic health 366.29 center and for interdisciplinary academic initiatives within the 366.30 academic health center. 366.31 (f) A maximum of $150,000 of the funds dedicated to the 366.32 commissioner under section 297F.10, subdivision 1, paragraph 366.33 (b), clause (2), may be used by the commissioner for 366.34 administrative expenses associated with implementing this 366.35 section. 366.36 Sec. 2. Minnesota Statutes 2002, section 62J.692, is 367.1 amended by adding a subdivision to read: 367.2 Subd. 10. [TRANSFERS FROM UNIVERSITY OF MINNESOTA.] Of the 367.3 funds dedicated to the academic health center under section 367.4 297F.10, subdivision 1, paragraph (b), clause (1), $4,850,000 367.5 shall be transferred annually to the commissioner of health no 367.6 later than April 15 of each year for distribution under 367.7 subdivision 4, paragraph (e). 367.8 Sec. 3. Minnesota Statutes 2002, section 62Q.19, 367.9 subdivision 1, is amended to read: 367.10 Subdivision 1. [DESIGNATION.] (a) The commissioner shall 367.11 designate essential community providers. The criteria for 367.12 essential community provider designation shall be the following: 367.13 (1) a demonstrated ability to integrate applicable 367.14 supportive and stabilizing services with medical care for 367.15 uninsured persons and high-risk and special needs populations, 367.16 underserved, and other special needs populations; and 367.17 (2) a commitment to serve low-income and underserved 367.18 populations by meeting the following requirements: 367.19 (i) has nonprofit status in accordance with chapter 317A; 367.20 (ii) has tax exempt status in accordance with the Internal 367.21 Revenue Service Code, section 501(c)(3); 367.22 (iii) charges for services on a sliding fee schedule based 367.23 on current poverty income guidelines; and 367.24 (iv) does not restrict access or services because of a 367.25 client's financial limitation; 367.26 (3) status as a local government unit as defined in section 367.27 62D.02, subdivision 11, a hospital district created or 367.28 reorganized under sections 447.31 to 447.37, an Indian tribal 367.29 government, an Indian health service unit, or a community health 367.30 board as defined in chapter 145A; 367.31 (4) a former state hospital that specializes in the 367.32 treatment of cerebral palsy, spina bifida, epilepsy, closed head 367.33 injuries, specialized orthopedic problems, and other disabling 367.34 conditions; or 367.35 (5)a rural hospital that has qualified fora sole 367.36 community hospitalfinancial assistance grant in the past three368.1years under section 144.1484, subdivision 1. For these rural 368.2 hospitals, the essential community provider designation applies 368.3 to all health services provided, including both inpatient and 368.4 outpatient services. For purposes of this section, "sole 368.5 community hospital" means a rural hospital that: 368.6 (i) is eligible to be classified as a sole community 368.7 hospital according to Code of Federal Regulations, title 42, 368.8 section 412.92, or is located in a community with a population 368.9 of less than 5,000 and located more than 25 miles from a like 368.10 hospital currently providing acute short-term services; 368.11 (ii) has experienced net operating income losses in two of 368.12 the previous three most recent consecutive hospital fiscal years 368.13 for which audited financial information is available; and 368.14 (iii) consists of 40 or fewer licensed beds. 368.15 (b) Prior to designation, the commissioner shall publish 368.16 the names of all applicants in the State Register. The public 368.17 shall have 30 days from the date of publication to submit 368.18 written comments to the commissioner on the application. No 368.19 designation shall be made by the commissioner until the 30-day 368.20 period has expired. 368.21 (c) The commissioner may designate an eligible provider as 368.22 an essential community provider for all the services offered by 368.23 that provider or for specific services designated by the 368.24 commissioner. 368.25 (d) For the purpose of this subdivision, supportive and 368.26 stabilizing services include at a minimum, transportation, child 368.27 care, cultural, and linguistic services where appropriate. 368.28 Sec. 4. Minnesota Statutes 2002, section 144.1222, is 368.29 amended by adding a subdivision to read: 368.30 Subd. 1a. [FEES.] All plans and specifications for public 368.31 swimming pool and spa construction, installation, or alteration 368.32 or requests for a variance that are submitted to the 368.33 commissioner according to Minnesota Rules, part 4717.3975, shall 368.34 be accompanied by the appropriate fees. If the commissioner 368.35 determines, upon review of the plans, that inadequate fees were 368.36 paid, the necessary additional fees shall be paid before plan 369.1 approval. For purposes of determining fees, a project is 369.2 defined as a proposal to construct or install a public pool, 369.3 spa, special purpose pool, or wading pool and all associated 369.4 water treatment equipment and drains, gutters, decks, water 369.5 recreation features, spray pads, and those design and safety 369.6 features that are within five feet of any pool or spa. The 369.7 commissioner shall charge the following fees for plan review and 369.8 inspection of public pools and spas and for requests for 369.9 variance from the public pool and spa rules: 369.10 (1) each spa pool, $500; 369.11 (2) projects valued at $250,000 or less, a minimum of $800 369.12 plus: 369.13 (i) for each slide, an additional $400; and 369.14 (ii) for each spa pool, an additional $500; 369.15 (3) projects valued at $250,000 or more, 0.5 percent of 369.16 documented estimated project cost to a maximum fee of $10,000; 369.17 (4) alterations to an existing pool without changing the 369.18 size or configuration of the pool, $400; 369.19 (5) removal or replacement of pool disinfection equipment 369.20 only, $75; and 369.21 (6) request for variance from the public pool and spa 369.22 rules, $500. 369.23 Sec. 5. Minnesota Statutes 2002, section 144.125, is 369.24 amended to read: 369.25 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS369.26 HERITABLE AND CONGENITAL DISORDERS.] 369.27 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 369.28 of (1) the administrative officer or other person in charge of 369.29 each institution caring for infants 28 days or less of age, (2) 369.30 the person required in pursuance of the provisions of section 369.31 144.215, to register the birth of a child, or (3) the nurse 369.32 midwife or midwife in attendance at the birth, to arrange to 369.33 have administered to every infant or child in its care tests for 369.34inborn errors of metabolism in accordance withheritable and 369.35 congenital disorders according to subdivision 2 and rules 369.36 prescribed by the state commissioner of health.In determining370.1which tests must be administered, the commissioner shall take370.2into consideration the adequacy of laboratory methods to detect370.3the inborn metabolic error, the ability to treat or prevent370.4medical conditions caused by the inborn metabolic error, and the370.5severity of the medical conditions caused by the inborn370.6metabolic error.Testing and the recording and reporting of 370.7 test results shall be performed at the times and in the manner 370.8 prescribed by the commissioner of health. The commissioner 370.9 shall charge laboratory service fees so that the total of fees 370.10 collected will approximate the costs of conducting the tests and 370.11 implementing and maintaining a system to follow-up infants with 370.12inborn metabolic errorsheritable or congenital disorders. The 370.13 laboratory service fee is $61 per specimen. Costs associated 370.14 with capital expenditures and the development of new procedures 370.15 may be prorated over a three-year period when calculating the 370.16 amount of the fees. 370.17 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 370.18 commissioner shall periodically revise the list of tests to be 370.19 administered for determining the presence of a heritable or 370.20 congenital disorder. Revisions to the list shall reflect 370.21 advances in medical science, new and improved testing methods, 370.22 or other factors that will improve the public health. In 370.23 determining whether a test must be administered, the 370.24 commissioner shall take into consideration the adequacy of 370.25 laboratory methods to detect the heritable or congenital 370.26 disorder, the ability to treat or prevent medical conditions 370.27 caused by the heritable or congenital disorder, and the severity 370.28 of the medical conditions caused by the heritable or congenital 370.29 disorder. The list of tests to be performed may be revised if 370.30 the changes are recommended by the advisory committee 370.31 established under section 144.1255, approved by the 370.32 commissioner, and published in the State Register. The revision 370.33 is exempt from the rulemaking requirements in chapter 14 and 370.34 sections 14.385 and 14.386 do not apply. 370.35 Subd. 3. [OBJECTION OF PARENTS TO TEST.] If the parents of 370.36 an infant object in writing to testing for heritable and 371.1 congenital disorders as being in conflict with their religious 371.2 tenets and practice, the objection shall be recorded on a form 371.3 that is signed by a parent or legal guardian and made part of 371.4 the infant's medical record. A written objection exempts an 371.5 infant from the requirements of this section and section 144.128. 371.6 Sec. 6. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 371.7 CONGENITAL DISORDERS.] 371.8 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 371.9 2003, the commissioner of health shall appoint an advisory 371.10 committee to provide advice and recommendations to the 371.11 commissioner concerning tests and treatments for heritable and 371.12 congenital disorders found in newborn children. Membership of 371.13 the committee shall include, but not be limited to, at least one 371.14 member from each of the following representative groups: 371.15 (1) parents and other consumers; 371.16 (2) primary care providers; 371.17 (3) clinicians and researchers specializing in newborn 371.18 diseases and disorders; 371.19 (4) genetic counselors; 371.20 (5) birth hospital representatives; 371.21 (6) newborn screening laboratory professionals; 371.22 (7) nutritionists; and 371.23 (8) other experts as needed representing related fields 371.24 such as emerging technologies and health insurance. 371.25 (b) The terms and removal of members are governed by 371.26 section 15.059. Members shall not receive per diems but shall 371.27 be compensated for expenses. Notwithstanding section 15.059, 371.28 subdivision 5, the advisory committee does not expire. 371.29 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 371.30 activities include, but are not limited to: 371.31 (1) collection of information on the efficacy and 371.32 reliability of various tests for heritable and congenital 371.33 disorders; 371.34 (2) collection of information on the availability and 371.35 efficacy of treatments for heritable and congenital disorders; 371.36 (3) collection of information on the severity of medical 372.1 conditions caused by heritable and congenital disorders; 372.2 (4) discussion and assessment of the benefits of performing 372.3 tests for heritable or congenital disorders as compared to the 372.4 costs, treatment limitations, or other potential disadvantages 372.5 of requiring the tests; 372.6 (5) discussion and assessment of ethical considerations 372.7 surrounding the testing, treatment, and handling of data and 372.8 specimens generated by the testing requirements of sections 372.9 144.125 to 144.128; and 372.10 (6) providing advice and recommendations to the 372.11 commissioner concerning tests and treatments for heritable and 372.12 congenital disorders found in newborn children. 372.13 [EFFECTIVE DATE.] This section is effective the day 372.14 following final enactment. 372.15 Sec. 7. Minnesota Statutes 2002, section 144.128, is 372.16 amended to read: 372.17 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF372.18CASESCOMMISSIONER'S DUTIES.] 372.19 The commissioner shall: 372.20 (1) makearrangementsreferrals for the necessary treatment 372.21 of diagnosed cases ofhemoglobinopathy, phenylketonuria, and372.22other inborn errors of metabolismheritable or congenital 372.23 disorders when treatment is indicatedand the family is372.24uninsured and, because of a lack of available income, is unable372.25to pay the cost of the treatment; 372.26 (2) maintain a registry of the cases ofhemoglobinopathy,372.27phenylketonuria, and other inborn errors of metabolismheritable 372.28 and congenital disorders detected by the screening program for 372.29 the purpose of follow-up services; and 372.30 (3) adopt rules to carry outsection 144.126 and this372.31sectionsections 144.125 to 144.128. 372.32 Sec. 8. Minnesota Statutes 2002, section 144.1483, is 372.33 amended to read: 372.34 144.1483 [RURAL HEALTH INITIATIVES.] 372.35 The commissioner of health, through the office of rural 372.36 health, and consulting as necessary with the commissioner of 373.1 human services, the commissioner of commerce, the higher 373.2 education services office, and other state agencies, shall: 373.3 (1) develop a detailed plan regarding the feasibility of 373.4 coordinating rural health care services by organizing individual 373.5 medical providers and smaller hospitals and clinics into 373.6 referral networks with larger rural hospitals and clinics that 373.7 provide a broader array of services; 373.8 (2) develop and implement a program to assist rural 373.9 communities in establishing community health centers, as 373.10 required by section 144.1486; 373.11 (3)administer the program of financial assistance373.12established under section 144.1484 for rural hospitals in373.13isolated areas of the state that are in danger of closing373.14without financial assistance, and that have exhausted local373.15sources of support;373.16(4)develop recommendations regarding health education and 373.17 training programs in rural areas, including but not limited to a 373.18 physician assistants' training program, continuing education 373.19 programs for rural health care providers, and rural outreach 373.20 programs for nurse practitioners within existing training 373.21 programs; 373.22(5)(4) develop a statewide, coordinated recruitment 373.23 strategy for health care personnel and maintain a database on 373.24 health care personnel as required under section 144.1485; 373.25(6)(5) develop and administer technical assistance 373.26 programs to assist rural communities in: (i) planning and 373.27 coordinating the delivery of local health care services; and 373.28 (ii) hiring physicians, nurse practitioners, public health 373.29 nurses, physician assistants, and other health personnel; 373.30(7)(6) study and recommend changes in the regulation of 373.31 health care personnel, such as nurse practitioners and physician 373.32 assistants, related to scope of practice, the amount of on-site 373.33 physician supervision, and dispensing of medication, to address 373.34 rural health personnel shortages; 373.35(8)(7) support efforts to ensure continued funding for 373.36 medical and nursing education programs that will increase the 374.1 number of health professionals serving in rural areas; 374.2(9)(8) support efforts to secure higher reimbursement for 374.3 rural health care providers from the Medicare and medical 374.4 assistance programs; 374.5(10)(9) coordinate the development of a statewide plan for 374.6 emergency medical services, in cooperation with the emergency 374.7 medical services advisory council; 374.8(11)(10) establish a Medicare rural hospital flexibility 374.9 program pursuant to section 1820 of the federal Social Security 374.10 Act, United States Code, title 42, section 1395i-4, by 374.11 developing a state rural health plan and designating, consistent 374.12 with the rural health plan, rural nonprofit or public hospitals 374.13 in the state as critical access hospitals. Critical access 374.14 hospitals shall include facilities that are certified by the 374.15 state as necessary providers of health care services to 374.16 residents in the area. Necessary providers of health care 374.17 services are designated as critical access hospitals on the 374.18 basis of being more than 20 miles, defined as official mileage 374.19 as reported by the Minnesota department of transportation, from 374.20 the next nearest hospital, being the sole hospital in the 374.21 county, being a hospital located in a county with a designated 374.22 medically underserved area or health professional shortage area, 374.23 or being a hospital located in a county contiguous to a county 374.24 with a medically underserved area or health professional 374.25 shortage area. A critical access hospital located in a county 374.26 with a designated medically underserved area or a health 374.27 professional shortage area or in a county contiguous to a county 374.28 with a medically underserved area or health professional 374.29 shortage area shall continue to be recognized as a critical 374.30 access hospital in the event the medically underserved area or 374.31 health professional shortage area designation is subsequently 374.32 withdrawn; and 374.33(12)(11) carry out other activities necessary to address 374.34 rural health problems. 374.35 Sec. 9. Minnesota Statutes 2002, section 144.1488, 374.36 subdivision 4, is amended to read: 375.1 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 375.2 eligible to apply to the commissioner for the loan repayment 375.3 program, health professionals must be citizens or nationals of 375.4 the United States, must not have any unserved obligations for 375.5 service to a federal, state, or local government, or other 375.6 entity, must have a current and unrestricted Minnesota license 375.7 to practice, and must be ready to begin full-time clinical 375.8 practice upon signing a contract for obligated service. 375.9 (b) Eligible providers are those specified by the federal 375.10 Bureau ofPrimary Health CareHealth Professions in the policy 375.11 information notice for the state's current federal grant 375.12 application. A health professional selected for participation 375.13 is not eligible for loan repayment until the health professional 375.14 has an employment agreement or contract with an eligible loan 375.15 repayment site and has signed a contract for obligated service 375.16 with the commissioner. 375.17 Sec. 10. Minnesota Statutes 2002, section 144.1491, 375.18 subdivision 1, is amended to read: 375.19 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 375.20 program participant who fails to completetwothe required years 375.21 of obligated service shall repay the amount paid, as well as a 375.22 financial penaltybased upon the length of the service375.23obligation not fulfilled. If the participant has served at375.24least one year, the financial penalty is the number of unserved375.25months multiplied by $1,000. If the participant has served less375.26than one year, the financial penalty is the total number of375.27obligated months multiplied by $1,000specified by the federal 375.28 Bureau of Health Professions in the policy information notice 375.29 for the state's current federal grant application. The 375.30 commissioner shall report to the appropriate health-related 375.31 licensing board a participant who fails to complete the service 375.32 obligation and fails to repay the amount paid or fails to pay 375.33 any financial penalty owed under this subdivision. 375.34 Sec. 11. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 375.35 FORGIVENESS PROGRAM.] 375.36 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 376.1 section, the following definitions apply. 376.2 (b) "Designated rural area" means: 376.3 (1) an area in Minnesota outside the counties of Anoka, 376.4 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 376.5 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 376.6 and St. Cloud; or 376.7 (2) a municipal corporation, as defined under section 376.8 471.634, that is physically located, in whole or in part, in an 376.9 area defined as a designated rural area under clause (1). 376.10 (c) "Emergency circumstances" means those conditions that 376.11 make it impossible for the participant to fulfill the service 376.12 commitment, including death, total and permanent disability, or 376.13 temporary disability lasting more than two years. 376.14 (d) "Medical resident" means an individual participating in 376.15 a medical residency in family practice, internal medicine, 376.16 obstetrics and gynecology, pediatrics, or psychiatry. 376.17 (e) "Midlevel practitioner" means a nurse practitioner, 376.18 nurse-midwife, nurse anesthetist, advanced clinical nurse 376.19 specialist, or physician assistant. 376.20 (f) "Nurse" means an individual who has completed training 376.21 and received all licensing or certification necessary to perform 376.22 duties as a licensed practical nurse or registered nurse. 376.23 (g) "Nurse-midwife" means a registered nurse who has 376.24 graduated from a program of study designed to prepare registered 376.25 nurses for advanced practice as nurse-midwives. 376.26 (h) "Nurse practitioner" means a registered nurse who has 376.27 graduated from a program of study designed to prepare registered 376.28 nurses for advanced practice as nurse practitioners. 376.29 (i) "Physician" means an individual who is licensed to 376.30 practice medicine in the areas of family practice, internal 376.31 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 376.32 (j) "Physician assistant" means a person registered under 376.33 chapter 147A. 376.34 (k) "Qualified educational loan" means a government, 376.35 commercial, or foundation loan for actual costs paid for 376.36 tuition, reasonable education expenses, and reasonable living 377.1 expenses related to the graduate or undergraduate education of a 377.2 health care professional. 377.3 (l) "Underserved urban community" means a Minnesota urban 377.4 area or population included in the list of designated primary 377.5 medical care health professional shortage areas (HPSAs), 377.6 medically underserved areas (MUAs), or medically underserved 377.7 populations (MUPs) maintained and updated by the United States 377.8 Department of Health and Human Services. 377.9 Subd. 2. [CREATION OF ACCOUNT.] A health professional 377.10 education loan forgiveness program account is established. The 377.11 commissioner of health shall use money from the account to 377.12 establish a loan forgiveness program for medical residents 377.13 agreeing to practice in designated rural areas or underserved 377.14 urban communities, for midlevel practitioners agreeing to 377.15 practice in designated rural areas, and for nurses who agree to 377.16 practice in a Minnesota nursing home or intermediate care 377.17 facility for persons with mental retardation or related 377.18 conditions. Appropriations made to the account do not cancel 377.19 and are available until expended, except that at the end of each 377.20 biennium, any remaining balance in the account that is not 377.21 committed by contract and not needed to fulfill existing 377.22 obligations shall cancel to the fund. 377.23 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 377.24 in the loan forgiveness program, an individual must: 377.25 (1) be a medical resident or be enrolled in a midlevel 377.26 practitioner, registered nurse, or a licensed practical nurse 377.27 training program; and 377.28 (2) submit an application to the commissioner of health. 377.29 (b) An applicant selected to participate must sign a 377.30 contract to agree to serve a minimum three-year full-time 377.31 service obligation according to subdivision 2, which shall begin 377.32 no later than March 31 following completion of required training. 377.33 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 377.34 may select applicants each year for participation in the loan 377.35 forgiveness program, within the limits of available funding. 377.36 The commissioner shall distribute available funds for loan 378.1 forgiveness proportionally among the eligible professions 378.2 according to the vacancy rate for each profession in the 378.3 required geographic area or facility type specified in 378.4 subdivision 2. The commissioner shall allocate funds for 378.5 physician loan forgiveness so that 75 percent of the funds 378.6 available are used for rural physician loan forgiveness and 25 378.7 percent of the funds available are used for underserved urban 378.8 communities loan forgiveness. If the commissioner does not 378.9 receive enough qualified applicants each year to use the entire 378.10 allocation of funds for urban underserved communities, the 378.11 remaining funds may be allocated for rural physician loan 378.12 forgiveness. Applicants are responsible for securing their own 378.13 qualified educational loans. The commissioner shall select 378.14 participants based on their suitability for practice serving the 378.15 required geographic area or facility type specified in 378.16 subdivision 2, as indicated by experience or training. The 378.17 commissioner shall give preference to applicants closest to 378.18 completing their training. For each year that a participant 378.19 meets the service obligation required under subdivision 3, up to 378.20 a maximum of four years, the commissioner shall make annual 378.21 disbursements directly to the participant equivalent to 15 378.22 percent of the average educational debt for indebted graduates 378.23 in their profession in the year closest to the applicant's 378.24 selection for which information is available, not to exceed the 378.25 balance of the participant's qualifying educational loans. 378.26 Before receiving loan repayment disbursements and as requested, 378.27 the participant must complete and return to the commissioner an 378.28 affidavit of practice form provided by the commissioner 378.29 verifying that the participant is practicing as required under 378.30 subdivisions 2 and 3. The participant must provide the 378.31 commissioner with verification that the full amount of loan 378.32 repayment disbursement received by the participant has been 378.33 applied toward the designated loans. After each disbursement, 378.34 verification must be received by the commissioner and approved 378.35 before the next loan repayment disbursement is made. 378.36 Participants who move their practice remain eligible for loan 379.1 repayment as long as they practice as required under subdivision 379.2 2. 379.3 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 379.4 does not fulfill the required minimum commitment of service 379.5 according to subdivision 3, the commissioner of health shall 379.6 collect from the participant the total amount paid to the 379.7 participant under the loan forgiveness program plus interest at 379.8 a rate established according to section 270.75. The 379.9 commissioner shall deposit the money collected in the health 379.10 care access fund to be credited to the health professional 379.11 education loan forgiveness program account established in 379.12 subdivision 2. The commissioner shall allow waivers of all or 379.13 part of the money owed the commissioner as a result of a 379.14 nonfulfillment penalty if emergency circumstances prevented 379.15 fulfillment of the minimum service commitment. 379.16 Subd. 6. [RULES.] The commissioner may adopt rules to 379.17 implement this section. 379.18 Sec. 12. Minnesota Statutes 2002, section 144.1502, 379.19 subdivision 4, is amended to read: 379.20 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 379.21 may acceptup to 14applicantspereach year for participation 379.22 in the loan forgiveness program, within the limits of available 379.23 funding. Applicants are responsible for securing their own 379.24 loans. The commissioner shall select participants based on 379.25 their suitability for practice serving public program patients, 379.26 as indicated by experience or training. The commissioner shall 379.27 give preference to applicants who have attended a Minnesota 379.28 dentistry educational institution and to applicants closest to 379.29 completing their training. For each year that a participant 379.30 meets the service obligation required under subdivision 3, up to 379.31 a maximum of four years, the commissioner shall make annual 379.32 disbursements directly to the participant equivalent to$10,000379.33per year of service, not to exceed $40,00015 percent of the 379.34 average educational debt for indebted dental school graduates in 379.35 the year closest to the applicant's selection for which 379.36 information is available or the balance of the qualifying 380.1 educational loans, whichever is less. Before receiving loan 380.2 repayment disbursements and as requested, the participant must 380.3 complete and return to the commissioner an affidavit of practice 380.4 form provided by the commissioner verifying that the participant 380.5 is practicing as required under subdivision 3. The participant 380.6 must provide the commissioner with verification that the full 380.7 amount of loan repayment disbursement received by the 380.8 participant has been applied toward the designated loans. After 380.9 each disbursement, verification must be received by the 380.10 commissioner and approved before the next loan repayment 380.11 disbursement is made. Participants who move their practice 380.12 remain eligible for loan repayment as long as they practice as 380.13 required under subdivision 3. 380.14 Sec. 13. Minnesota Statutes 2002, section 147A.08, is 380.15 amended to read: 380.16 147A.08 [EXEMPTIONS.] 380.17 (a) This chapter does not apply to, control, prevent, or 380.18 restrict the practice, service, or activities of persons listed 380.19 in section 147.09, clauses (1) to (6) and (8) to (13), persons 380.20 regulated under section 214.01, subdivision 2, or persons 380.21 defined in section144.1495144.1501, subdivision 1, 380.22 paragraphs(a) to (d)(e), (g), and (h). 380.23 (b) Nothing in this chapter shall be construed to require 380.24 registration of: 380.25 (1) a physician assistant student enrolled in a physician 380.26 assistant or surgeon assistant educational program accredited by 380.27 the Committee on Allied Health Education and Accreditation or by 380.28 its successor agency approved by the board; 380.29 (2) a physician assistant employed in the service of the 380.30 federal government while performing duties incident to that 380.31 employment; or 380.32 (3) technicians, other assistants, or employees of 380.33 physicians who perform delegated tasks in the office of a 380.34 physician but who do not identify themselves as a physician 380.35 assistant. 380.36 Sec. 14. Minnesota Statutes 2002, section 148.5194, 381.1 subdivision 1, is amended to read: 381.2 Subdivision 1. [FEE PRORATION.] The commissioner shall 381.3 prorate the registration fee for clinical fellowship, temporary, 381.4 and first time registrants according to the number of months 381.5 that have elapsed between the date registration is issued and 381.6 the date registration expires or must be renewed under section 381.7 148.5191, subdivision 4. 381.8 Sec. 15. Minnesota Statutes 2002, section 148.5194, 381.9 subdivision 2, is amended to read: 381.10 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 381.11 registration and biennial registration, clinical fellowship 381.12 registration, temporary registration, or renewal is $200. 381.13 Sec. 16. Minnesota Statutes 2002, section 148.5194, 381.14 subdivision 3, is amended to read: 381.15 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 381.16 REGISTRATION.] The fee for initial registration and biennial 381.17 registration, clinical fellowship registration, temporary 381.18 registration, or renewal is $200. 381.19 Sec. 17. Minnesota Statutes 2002, section 148.5194, is 381.20 amended by adding a subdivision to read: 381.21 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 381.22 verification of credentialed status is $25. 381.23 Sec. 18. Minnesota Statutes 2002, section 148.6445, 381.24 subdivision 7, is amended to read: 381.25 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 381.26 fee forcertificationverification of licensure to other states 381.27 is $25. 381.28 Sec. 19. [148C.12] [FEES.] 381.29 Subdivision 1. [APPLICATION.] The application fee for a 381.30 license to practice alcohol and drug counseling is $295. 381.31 Subd. 2. [BIENNIAL RENEWAL.] The license renewal fee is 381.32 $295. If the commissioner changes the renewal schedule and the 381.33 expiration date is less than two years, the fee must be prorated. 381.34 Subd. 3. [TEMPORARY PRACTICE STATUS.] The initial fee for 381.35 applicants under section 148C.04, subdivision 6, paragraph (a), 381.36 clause (1), item (i), is $100. The initial fee for applicants 382.1 under section 148C.04, subdivision 6, paragraph (a), clause (1), 382.2 item (ii) or (iii), is the license application fee under 382.3 subdivision 1. The fee for annual renewal of temporary practice 382.4 status is $100. 382.5 Subd. 4. [EXAMINATION.] The examination fee is $95 for the 382.6 written examination and $200 for the oral examination. 382.7 Subd. 5. [INACTIVE RENEWAL.] The inactive renewal fee is 382.8 $150. 382.9 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 382.10 biennial renewal fee, the inactive renewal fee, or the annual 382.11 fee for renewal of temporary practice status. 382.12 Subd. 7. [RENEWAL AFTER EXPIRATION.] The fee for renewal 382.13 of a license that has expired is the total of the biennial 382.14 renewal fee, the late fee, and a fee of $100 for review and 382.15 approval of the continuing education report. 382.16 Subd. 8. [LICENSE VERIFICATION.] The fee for license 382.17 verification to institutions and other jurisdictions is $25. 382.18 Subd. 9. [SURCHARGE.] Notwithstanding section 16A.1285, 382.19 subdivision 2, a surcharge of $172 shall be paid at the time of 382.20 application for or renewal of an alcohol and drug counseling 382.21 license until June 30, 2009. 382.22 Subd. 10. [RENEWAL FOLLOWING LAPSE IN LICENSING 382.23 STATUS.] Renewal applications received after the expiration date 382.24 of the license shall include an amount equal to 50 percent of 382.25 the renewal fee in addition to the late fee. 382.26 Subd. 11. [NONREFUNDABLE FEES.] All fees are nonrefundable. 382.27 Sec. 20. Minnesota Statutes 2002, section 153A.17, is 382.28 amended to read: 382.29 153A.17 [EXPENSES; FEES.] 382.30 The expenses for administering the certification 382.31 requirements including the complaint handling system for hearing 382.32 aid dispensers in sections 153A.14 and 153A.15 and the consumer 382.33 information center under section 153A.18 must be paid from 382.34 initial application and examination fees, renewal fees, 382.35 penalties, and fines. All fees are nonrefundable. The 382.36 certificate application fee is$165 for audiologists registered383.1under section 148.511 and $490 for all others$350, the 383.2 examination fee is$200$250 for the written portion and 383.3$200$250 for the practical portion each time one or the other 383.4 is taken, and the trainee application fee 383.5 is$100$200.Notwithstanding the policy set forth in section383.616A.1285, subdivision 2, a surcharge of $165 for audiologists383.7registered under section 148.511 and $330 for all others shall383.8be paid at the time of application or renewal until June 30,383.92003, to recover the commissioner's accumulated direct383.10expenditures for administering the requirements of this383.11chapter.The penalty fee for late submission of a renewal 383.12 application is $200. The fee for verification of certification 383.13 to other jurisdictions or entities is $25. All fees, penalties, 383.14 and fines received must be deposited in the state government 383.15 special revenue fund. The commissioner may prorate the 383.16 certification fee for new applicants based on the number of 383.17 quarters remaining in the annual certification period. 383.18 Sec. 21. Minnesota Statutes 2002, section 256B.69, 383.19 subdivision 5c, is amended to read: 383.20 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 383.21 commissioner of human services shall transfer each year to the 383.22 medical education and research fund established under section 383.23 62J.692, the following: 383.24 (1) an amount equal to the reduction in the prepaid medical 383.25 assistance and prepaid general assistance medical care payments 383.26 as specified in this clause. Until January 1, 2002, the county 383.27 medical assistance and general assistance medical care 383.28 capitation base rate prior to plan specific adjustments and 383.29 after the regional rate adjustments under section 256B.69, 383.30 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 383.31 percent for the remaining metropolitan counties, and no 383.32 reduction for nonmetropolitan Minnesota counties; and after 383.33 January 1, 2002, the county medical assistance and general 383.34 assistance medical care capitation base rate prior to plan 383.35 specific adjustments is reduced 6.3 percent for Hennepin county, 383.36 two percent for the remaining metropolitan counties, and 1.6 384.1 percent for nonmetropolitan Minnesota counties. Nursing 384.2 facility and elderly waiver payments and demonstration project 384.3 payments operating under subdivision 23 are excluded from this 384.4 reduction. The amount calculated under this clause shall not be 384.5 adjusted for periods already paid due to subsequent changes to 384.6 the capitation payments; 384.7 (2) beginning July 1, 2001,$2,537,000$2,157,000 from the 384.8 capitation rates paid under this section plus any federal 384.9 matching funds on this amount; 384.10 (3) beginning July 1, 2002, an additional $12,700,000 from 384.11 the capitation rates paid under this section; and 384.12 (4) beginning July 1, 2003, an additional $4,700,000 from 384.13 the capitation rates paid under this section. 384.14 (b) This subdivision shall be effective upon approval of a 384.15 federal waiver which allows federal financial participation in 384.16 the medical education and research fund. 384.17 Sec. 22. Minnesota Statutes 2002, section 295.55, 384.18 subdivision 2, is amended to read: 384.19 Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 384.20 Each hospital or surgical center must make estimated payments of 384.21 the taxes for the calendar year in monthly installments to the 384.22 commissioner within 15 days after the end of the month. 384.23 (b) Estimated tax payments are not required of hospitals or 384.24 surgical centers if: (1) the tax for the current calendar year 384.25 is less than $500; or (2) the tax for the previous calendar year 384.26 is less than $500, if the taxpayer had a tax liability and was 384.27 doing business the entire year; or (3) if a hospital has been384.28allowed a grant under section 144.1484, subdivision 2, for the384.29year. 384.30 (c) Underpayment of estimated installments bear interest at 384.31 the rate specified in section 270.75, from the due date of the 384.32 payment until paid or until the due date of the annual return 384.33 whichever comes first. An underpayment of an estimated 384.34 installment is the difference between the amount paid and the 384.35 lesser of (1) 90 percent of one-twelfth of the tax for the 384.36 calendar year or (2) one-twelfth of the total tax for the 385.1 previous calendar year if the taxpayer had a tax liability and 385.2 was doing business the entire year. 385.3 Sec. 23. Minnesota Statutes 2002, section 326.42, is 385.4 amended to read: 385.5 326.42 [APPLICATIONS, FEES.] 385.6 Subdivision 1. [APPLICATION.] Applications for plumber's 385.7 license shall be made to the state commissioner of health, with 385.8 fee. Unless the applicant is entitled to a renewal, the 385.9 applicant shall be licensed by the state commissioner of health 385.10 only after passing a satisfactory examination by the examiners 385.11 showing fitness. Examination fees for both journeyman and 385.12 master plumbers shall be in an amount prescribed by the state 385.13 commissioner of health pursuant to section 144.122. Upon being 385.14 notified that of having successfully passed the examination for 385.15 original license the applicant shall submit an application, with 385.16 the license fee herein provided. License fees shall be in an 385.17 amount prescribed by the state commissioner of health pursuant 385.18 to section 144.122. Licenses shall expire and be renewed as 385.19 prescribed by the commissioner pursuant to section 144.122. 385.20 Subd. 2. [FEES.] Plumbing system plans and specifications 385.21 that are submitted to the commissioner for review shall be 385.22 accompanied by the appropriate plan examination fees. If the 385.23 commissioner determines, upon review of the plans, that 385.24 inadequate fees were paid, the necessary additional fees shall 385.25 be paid prior to plan approval. The commissioner shall charge 385.26 the following fees for plan reviews and audits of plumbing 385.27 installations for public, commercial, and industrial buildings: 385.28 (1) systems with both water distribution and drain, waste, 385.29 and vent systems and having: 385.30 (i) 25 or fewer drainage fixture units, $150; 385.31 (ii) 26 to 50 drainage fixture units, $250; 385.32 (iii) 51 to 150 drainage fixture units, $350; 385.33 (iv) 151 to 249 drainage fixture units, $500; 385.34 (v) 250 or more drainage fixture units, $3 per drainage 385.35 fixture unit to a maximum of $4,000; and 385.36 (vi) interceptors, separators, or catch basins, $70 per 386.1 interceptor, separator, or catch basin; 386.2 (2) building sewer service only, $150; 386.3 (3) building water service only, $150; 386.4 (4) building water distribution system only, no drainage 386.5 system, $5 per supply fixture unit or $150, whichever is 386.6 greater; 386.7 (5) storm drainage system, a minimum fee of $150 or: 386.8 (i) $50 per drain opening, up to a maximum of $500; and 386.9 (ii) $70 per interceptor, separator, or catch basin; 386.10 (6) manufactured home park or campground, 1 to 25 sites, 386.11 $300; 386.12 (7) manufactured home park or campground, 26 to 50 sites, 386.13 $350; 386.14 (8) manufactured home park or campground, 51 to 125 sites, 386.15 $400; 386.16 (9) manufactured home park or campground, more than 125 386.17 sites, $500; 386.18 (10) accelerated review, double the regular fee, one-half 386.19 to be refunded if no response from the commissioner within 15 386.20 business days; and 386.21 (11) revision to previously reviewed or incomplete plans: 386.22 (i) review of plans for which commissioner has issued two 386.23 or more requests for additional information, per review, $100 or 386.24 ten percent of the original fee, whichever is greater; 386.25 (ii) proposer-requested revision with no increase in 386.26 project scope, $50 or ten percent of original fee, whichever is 386.27 greater; and 386.28 (iii) proposer-requested revision with an increase in 386.29 project scope, $50 plus the difference between the original 386.30 project fee and the revised project fee. 386.31 Sec. 24. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 386.32 (a) The commissioner's authority to collect the certificate 386.33 application fee from hearing instrument dispensers under 386.34 Minnesota Statutes, section 153A.17, is suspended for certified 386.35 hearing instrument dispensers renewing certification in fiscal 386.36 year 2004. 387.1 (b) The commissioner's authority to collect the license 387.2 renewal fee from occupational therapy practitioners under 387.3 Minnesota Statutes, section 148.6445, subdivision 2, is 387.4 suspended for fiscal years 2004 and 2005. 387.5 Sec. 25. [REVISOR'S INSTRUCTION.] 387.6 (a) The revisor of statutes shall delete the reference to 387.7 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 387.8 "144.1501." 387.9 (b) For sections in Minnesota Statutes and Minnesota Rules 387.10 affected by the repealed sections in this article, the revisor 387.11 shall delete internal cross-references where appropriate and 387.12 make changes necessary to correct the punctuation, grammar, or 387.13 structure of the remaining text and preserve its meaning. 387.14 Sec. 26. [REPEALER.] 387.15 (a) Minnesota Statutes 2002, sections 62J.694, subdivisions 387.16 1, 2, 2a, and 3; 144.126; 144.1484; 144.1494; 144.1495; 387.17 144.1496; 144.1497; 144.395, subdivisions 1 and 2; 144.396; 387.18 144A.36; 144A.38; 148.5194, subdivision 3a; and 148.6445, 387.19 subdivision 9, are repealed. 387.20 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 387.21 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 387.22 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 387.23 4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 387.24 4763.0285; 4763.0295; and 4763.0300, are repealed. 387.25 ARTICLE 9 387.26 LOCAL PUBLIC HEALTH GRANTS 387.27 Section 1. Minnesota Statutes 2002, section 144E.11, 387.28 subdivision 6, is amended to read: 387.29 Subd. 6. [REVIEW CRITERIA.] When reviewing an application 387.30 for licensure, the board and administrative law judge shall 387.31 consider the following factors: 387.32 (1)the relationship of the proposed service or expansion387.33in primary service area to the current community health plan as387.34approved by the commissioner of health under section 145A.12,387.35subdivision 4;387.36(2)the recommendations or comments of the governing bodies 388.1 of the counties, municipalities, community health boards as 388.2 defined under section 145A.09, subdivision 2, and regional 388.3 emergency medical services system designated under section 388.4 144E.50 in which the service would be provided; 388.5(3)(2) the deleterious effects on the public health from 388.6 duplication, if any, of ambulance services that would result 388.7 from granting the license; 388.8(4)(3) the estimated effect of the proposed service or 388.9 expansion in primary service area on the public health; and 388.10(5)(4) whether any benefit accruing to the public health 388.11 would outweigh the costs associated with the proposed service or 388.12 expansion in primary service area. The administrative law judge 388.13 shall recommend that the board either grant or deny a license or 388.14 recommend that a modified license be granted. The reasons for 388.15 the recommendation shall be set forth in detail. The 388.16 administrative law judge shall make the recommendations and 388.17 reasons available to any individual requesting them. 388.18 Sec. 2. Minnesota Statutes 2002, section 145.88, is 388.19 amended to read: 388.20 145.88 [PURPOSE.] 388.21The legislature finds that it is in the public interest to388.22assure:388.23(a) statewide planning and coordination of maternal and388.24child health services through the acquisition and analysis of388.25population-based health data, provision of technical support and388.26training, and coordination of the various public and private388.27maternal and child health efforts; and388.28(b) support for targeted maternal and child health services388.29in communities with significant populations of high risk, low388.30income families through a grants process.388.31 Federal money received by the Minnesota department of 388.32 health, pursuant to United States Code, title 42, sections 701 388.33 to 709, shall be expended to: 388.34 (1) assure access to quality maternal and child health 388.35 services for mothers and children, especially those of low 388.36 income and with limited availability to health services and 389.1 those children at risk of physical, neurological, emotional, and 389.2 developmental problems arising from chemical abuse by a mother 389.3 during pregnancy; 389.4 (2) reduce infant mortality and the incidence of 389.5 preventable diseases and handicapping conditions among children; 389.6 (3) reduce the need for inpatient and long-term care 389.7 services and to otherwise promote the health of mothers and 389.8 children, especially by providing preventive and primary care 389.9 services for low-income mothers and children and prenatal, 389.10 delivery and postpartum care for low-income mothers; 389.11 (4) provide rehabilitative services for blind and disabled 389.12 children under age 16 receiving benefits under title XVI of the 389.13 Social Security Act; and 389.14 (5) provide and locate medical, surgical, corrective and 389.15 other service for children who are crippled or who are suffering 389.16 from conditions that lead to crippling. 389.17 Sec. 3. Minnesota Statutes 2002, section 145.881, 389.18 subdivision 2, is amended to read: 389.19 Subd. 2. [DUTIES.] The advisory task force shall meet on a 389.20 regular basis to perform the following duties: 389.21 (a) review and report on the health care needs of mothers 389.22 and children throughout the state of Minnesota; 389.23 (b) review and report on the type, frequency and impact of 389.24 maternal and child health care services provided to mothers and 389.25 children under existing maternal and child health care programs, 389.26 including programs administered by the commissioner of health; 389.27 (c) establish, review, and report to the commissioner a 389.28 list of program guidelines and criteria which the advisory task 389.29 force considers essential to providing an effective maternal and 389.30 child health care program to low income populations and high 389.31 risk persons and fulfilling the purposes defined in section 389.32 145.88; 389.33 (d)review staff recommendations of the department of389.34health regarding maternal and child health grant awards before389.35the awards are made;389.36(e)make recommendations to the commissioner for the use of 390.1 other federal and state funds available to meet maternal and 390.2 child health needs; 390.3(f)(e) make recommendations to the commissioner of health 390.4 on priorities for funding the following maternal and child 390.5 health services: (1) prenatal, delivery and postpartum care, (2) 390.6 comprehensive health care for children, especially from birth 390.7 through five years of age, (3) adolescent health services, (4) 390.8 family planning services, (5) preventive dental care, (6) 390.9 special services for chronically ill and handicapped children 390.10 and (7) any other services which promote the health of mothers 390.11 and children; and 390.12(g) make recommendations to the commissioner of health on390.13the process to distribute, award and administer the maternal and390.14child health block grant funds; and390.15(h) review the measures that are used to define the390.16variables of the funding distribution formula in section390.17145.882, subdivision 4, every two years and make recommendations390.18to the commissioner of health for changes based upon principles390.19established by the advisory task force for this purpose.390.20 (f) establish, in consultation with the commissioner and 390.21 the state community health advisory committee established under 390.22 section 145A.10, subdivision 10, paragraph (a), statewide 390.23 outcomes that will improve the health status of mothers and 390.24 children as required in section 145A.12, subdivision 7. 390.25 Sec. 4. Minnesota Statutes 2002, section 145.882, 390.26 subdivision 1, is amended to read: 390.27 Subdivision 1. [FUNDINGLEVELS AND ADVISORY TASK FORCE390.28REVIEW.] Any decrease in the amount of federal funding to the 390.29 state for the maternal and child health block grant must be 390.30 apportioned to reflect a proportional decrease for each 390.31 recipient. Any increase in the amount of federal funding to the 390.32 state must be distributed under subdivisions 2,and 3, and 4. 390.33The advisory task force shall review and recommend the390.34proportion of maternal and child health block grant funds to be390.35expended for indirect costs, direct services and special390.36projects.391.1 Sec. 5. Minnesota Statutes 2002, section 145.882, 391.2 subdivision 2, is amended to read: 391.3 Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 391.4 Beginning January 1, 1986, up to one-third of the total maternal 391.5 and child health block grant money may be retained by the 391.6 commissioner of healthfor administrative and technical391.7assistance services, projects of regional or statewide391.8significance, direct services to children with handicaps, and391.9other activities of the commissioner.to: 391.10 (1) meet federal maternal and child block grant 391.11 requirements of a statewide needs assessment every five years 391.12 and prepare the annual federal block grant application and 391.13 report; 391.14 (2) collect and disseminate statewide data on the health 391.15 status of mothers and children; 391.16 (3) provide technical assistance to community health boards 391.17 in meeting statewide outcomes under section 145A.12, subdivision 391.18 7; 391.19 (4) evaluate the impact of maternal and child health 391.20 activities on the health status of mothers and children; 391.21 (5) provide services to children under age 16 receiving 391.22 benefits under title XVI of the Social Security Act; and 391.23 (6) perform other maternal and child health activities 391.24 listed in section 145.88 and as deemed necessary by the 391.25 commissioner. 391.26 Sec. 6. Minnesota Statutes 2002, section 145.882, 391.27 subdivision 3, is amended to read: 391.28 Subd. 3. [ALLOCATION TO COMMUNITY HEALTHSERVICES391.29AREASBOARDS.](a)The maternal and child health block grant 391.30 money remaining after distributions made under subdivision 2 391.31 must be allocated according to the formula insubdivision 4 to391.32community health services areassection 145A.131, subdivision 2, 391.33 for distributionbyto community health boards.as defined in391.34section 145A.02, subdivision 5, to qualified programs that391.35provide essential services within the community health services391.36area as long as:392.1(1) the Minneapolis community health service area is392.2allocated at least $1,626,215 per year;392.3(2) the St. Paul community health service area is allocated392.4at least $822,931 per year; and392.5(3) all other community health service areas are allocated392.6at least $30,000 per county per year or their 1988-1989 funding392.7cycle award, whichever is less.392.8(b) Notwithstanding paragraph (a), if the total amount of392.9maternal and child health block grant funding decreases, the392.10decrease must be apportioned to reflect a proportional decrease392.11for each recipient, including recipients who would otherwise392.12receive a guaranteed minimum allocation under paragraph (a).392.13 Sec. 7. Minnesota Statutes 2002, section 145.882, is 392.14 amended by adding a subdivision to read: 392.15 Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 392.16 community health board decides not to participate in maternal 392.17 and child health block grant activities under subdivision 3 or 392.18 the commissioner determines under section 145A.131, subdivision 392.19 7, not to fund the community health board, the commissioner is 392.20 responsible for directing maternal and child health block grant 392.21 activities in that community health board's geographic area. 392.22 The commissioner may elect to directly provide public health 392.23 activities to meet the statewide outcomes or to contract with 392.24 other governmental units or nonprofit organizations. 392.25 Sec. 8. Minnesota Statutes 2002, section 145.882, 392.26 subdivision 7, is amended to read: 392.27 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 392.28 child health block grant money allocated to a community health 392.29 boardor community health services areaunder this section must 392.30 be used for qualified programs for high risk and low-income 392.31 individuals. Block grant money must be used for programs that: 392.32 (1) specifically address the highest risk populations, 392.33 particularly low-income and minority groups with a high rate of 392.34 infant mortality and children with low birth weight, by 392.35 providing services, including prepregnancy family planning 392.36 services, calculated to produce measurable decreases in infant 393.1 mortality rates, instances of children with low birth weight, 393.2 and medical complications associated with pregnancy and 393.3 childbirth, including infant mortality, low birth rates, and 393.4 medical complications arising from chemical abuse by a mother 393.5 during pregnancy; 393.6 (2) specifically target pregnant women whose age, medical 393.7 condition, maternal history, or chemical abuse substantially 393.8 increases the likelihood of complications associated with 393.9 pregnancy and childbirth or the birth of a child with an 393.10 illness, disability, or special medical needs; 393.11 (3) specifically address the health needs of young children 393.12 who have or are likely to have a chronic disease or disability 393.13 or special medical needs, including physical, neurological, 393.14 emotional, and developmental problems that arise from chemical 393.15 abuse by a mother during pregnancy; 393.16 (4) provide family planning and preventive medical care for 393.17 specifically identified target populations, such as minority and 393.18 low-income teenagers, in a manner calculated to decrease the 393.19 occurrence of inappropriate pregnancy and minimize the risk of 393.20 complications associated with pregnancy and childbirth;or393.21 (5) specifically address the frequency and severity of 393.22 childhood and adolescent health issues, including injuries in 393.23 high risk target populations by providing services calculated to 393.24 produce measurable decreases in mortality and morbidity.; 393.25However, money may be used for this purpose only if the393.26community health board's application includes program components393.27for the purposes in clauses (1) to (4) in the proposed393.28geographic service area and the total expenditure for393.29injury-related programs under this clause does not exceed ten393.30percent of the total allocation under subdivision 3.393.31(b) Maternal and child health block grant money may be used393.32for purposes other than the purposes listed in this subdivision393.33only under the following conditions:393.34(1) the community health board or community health services393.35area can demonstrate that existing programs fully address the393.36needs of the highest risk target populations described in this394.1subdivision; or394.2(2) the money is used to continue projects that received394.3funding before creation of the maternal and child health block394.4grant in 1981.394.5(c) Projects that received funding before creation of the394.6maternal and child health block grant in 1981, must be allocated394.7at least the amount of maternal and child health special project394.8grant funds received in 1989, unless (1) the local board of394.9health provides equivalent alternative funding for the project394.10from another source; or (2) the local board of health394.11demonstrates that the need for the specific services provided by394.12the project has significantly decreased as a result of changes394.13in the demographic characteristics of the population, or other394.14factors that have a major impact on the demand for services. If394.15the amount of federal funding to the state for the maternal and394.16child health block grant is decreased, these projects must394.17receive a proportional decrease as required in subdivision 1.394.18Increases in allocation amounts to local boards of health under394.19subdivision 4 may be used to increase funding levels for these394.20projects.394.21 (6) specifically address preventing child abuse and 394.22 neglect, reducing juvenile delinquency, promoting positive 394.23 parenting and resiliency in children, and promoting family 394.24 health and economic sufficiency through public health nurse home 394.25 visits under section 145A.17; or 394.26 (7) specifically address nutritional issues of women, 394.27 infants, and young children through WIC clinic services. 394.28 Sec. 9. [145.8821] [ACCOUNTABILITY.] 394.29 (a) Coordinating with the statewide outcomes established 394.30 under section 145A.12, subdivision 7, and with accountability 394.31 measures outlined in section 145A.131, subdivision 7, each 394.32 community health board that receives money under section 394.33 145.882, subdivision 3, shall select by December 31, 2005, and 394.34 every five years thereafter, up to two statewide maternal and 394.35 child health outcomes. 394.36 (b) For the period January 1, 2004, to December 31, 2005, 395.1 each community health board must work to achieve the Healthy 395.2 People 2010 goal to reduce the state's percentage of low birth 395.3 weight infants to no more than five percent of all births. 395.4 (c) The commissioner shall monitor and evaluate whether 395.5 each community health board has made sufficient progress toward 395.6 the statewide outcomes established in paragraph (b) and under 395.7 section 145A.12, subdivision 7. 395.8 (d) Community health boards shall provide the commissioner 395.9 with annual information necessary to evaluate progress toward 395.10 statewide outcomes and to meet federal reporting requirements. 395.11 Sec. 10. Minnesota Statutes 2002, section 145.883, 395.12 subdivision 1, is amended to read: 395.13 Subdivision 1. [SCOPE.] For purposes of sections 145.881 395.14 to145.888145.883, the terms defined in this section shall have 395.15 the meanings given them. 395.16 Sec. 11. Minnesota Statutes 2002, section 145.883, 395.17 subdivision 9, is amended to read: 395.18 Subd. 9. [COMMUNITY HEALTHSERVICES AREABOARD.] 395.19 "Community healthservices areaboard" meansa city, county, or395.20multicounty area that is organized as a community health board395.21under section 145A.09 and for which a state subsidy is received395.22under sections 145A.09 to 145A.13a board of health established, 395.23 operating, and eligible for a local public health grant under 395.24 sections 145A.09 to 145A.131. 395.25 Sec. 12. Minnesota Statutes 2002, section 145A.02, 395.26 subdivision 5, is amended to read: 395.27 Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health 395.28 board" means a board of health established, operating, and 395.29 eligible for asubsidylocal public health grant under sections 395.30 145A.09 to145A.13145A.131. 395.31 Sec. 13. Minnesota Statutes 2002, section 145A.02, 395.32 subdivision 6, is amended to read: 395.33 Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health 395.34 services" means activities designed to protect and promote the 395.35 health of the general population within a community health 395.36 service area by emphasizing the prevention of disease, injury, 396.1 disability, and preventable death through the promotion of 396.2 effective coordination and use of community resources, and by 396.3 extending health services into the community.Program396.4categories of community health services include disease396.5prevention and control, emergency medical care, environmental396.6health, family health, health promotion, and home health care.396.7 Sec. 14. Minnesota Statutes 2002, section 145A.02, 396.8 subdivision 7, is amended to read: 396.9 Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community 396.10 health service area" means a city, county, or multicounty area 396.11 that is organized as a community health board under section 396.12 145A.09 and for which asubsidylocal public health grant is 396.13 received under sections 145A.09 to145A.13145A.131. 396.14 Sec. 15. Minnesota Statutes 2002, section 145A.06, 396.15 subdivision 1, is amended to read: 396.16 Subdivision 1. [GENERALLY.] In addition to other powers 396.17 and duties provided by law, the commissioner has the powers 396.18 listed in subdivisions 2 to45. 396.19 Sec. 16. Minnesota Statutes 2002, section 145A.09, 396.20 subdivision 2, is amended to read: 396.21 Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 396.22 health that meets the requirements of sections 145A.09 396.23 to145A.13145A.131 is a community health board and is eligible 396.24 for acommunity health subsidylocal public health grant under 396.25 section145A.13145A.131. 396.26 Sec. 17. Minnesota Statutes 2002, section 145A.09, 396.27 subdivision 4, is amended to read: 396.28 Subd. 4. [CITIES.] A city that received a subsidy under 396.29 section 145A.13 and that meets the requirements of sections 396.30 145A.09 to145A.13145A.131 is eligible for acommunity health396.31subsidylocal public health grant under section 396.32145A.13145A.131. 396.33 Sec. 18. Minnesota Statutes 2002, section 145A.09, 396.34 subdivision 7, is amended to read: 396.35 Subd. 7. [WITHDRAWAL.] (a) A county or city that has 396.36 established or joined a community health board may withdraw from 397.1 thesubsidylocal public health grant program authorized by 397.2 sections 145A.09 to145A.13145A.131 by resolution of its 397.3 governing body in accordance with section 145A.03, subdivision 397.4 3, and this subdivision. 397.5 (b) A county or city may not withdraw from a joint powers 397.6 community health board during the first two calendar years 397.7 following that county's or city's initial adoption of the joint 397.8 powers agreement. 397.9 (c) The withdrawal of a county or city from a community 397.10 health board does not affect the eligibility for thecommunity397.11health subsidylocal public health grant of any remaining county 397.12 or city for one calendar year following the effective date of 397.13 withdrawal. 397.14 (d)The amount of additional annual payment for calendar397.15year 1985 made pursuant to Minnesota Statutes 1984, section397.16145.921, subdivision 4, must be subtracted from the subsidy for397.17a county that, due to withdrawal from a community health board,397.18ceases to meet the terms and conditions under which that397.19additional annual payment was madeThe local public health grant 397.20 for a county that chooses to withdraw from a multicounty 397.21 community health board shall be reduced by the amount of the 397.22 local partnership incentive under section 145A.131, subdivision 397.23 2, paragraph (c). 397.24 Sec. 19. Minnesota Statutes 2002, section 145A.10, 397.25 subdivision 2, is amended to read: 397.26 Subd. 2. [PREEMPTION.] (a) Not later than 365 days after 397.27 theapproval of a community health plan by the397.28commissionerformation of a community health board, any other 397.29 board of health within the community health service area for 397.30 which the plan has been prepared must cease operation, except as 397.31 authorized in a joint powers agreement under section 145A.03, 397.32 subdivision 2, or delegation agreement under section 145A.07, 397.33 subdivision 2, or as otherwise allowed by this subdivision. 397.34 (b) This subdivision does not preempt or otherwise change 397.35 the powers and duties of any city or county eligible forsubsidy397.36 a local public health grant under section 145A.09. 398.1 (c) This subdivision does not preempt the authority to 398.2 operate a community health services program of any city of the 398.3 first or second class operating an existing program of community 398.4 health services located within a county with a population of 398.5 300,000 or more persons until the city council takes action to 398.6 allow the county to preempt the city's powers and duties. 398.7 Sec. 20. Minnesota Statutes 2002, section 145A.10, is 398.8 amended by adding a subdivision to read: 398.9 Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and 398.10 standards established under section 145A.12, and in consultation 398.11 with the community health advisory committee established under 398.12 subdivision 10, paragraph (b), the community health board shall: 398.13 (1) establish local public health priorities based on an 398.14 assessment of community health needs and assets; and 398.15 (2) determine the mechanisms by which the community health 398.16 board will address the local public health priorities 398.17 established under clause (1) and achieve the statewide outcomes 398.18 established under sections 145.8821 and 145A.12, subdivision 7, 398.19 including leveraging local and regional partnerships and 398.20 contracting with community-based organizations, private sector 398.21 organizations, or other units of government, including tribal 398.22 governments. In determining the mechanisms to address local 398.23 public health priorities and achieve statewide outcomes, the 398.24 community health board shall consider the recommendations of the 398.25 community health advisory committee and the following essential 398.26 public health services: 398.27 (i) monitor health status to identify community health 398.28 problems; 398.29 (ii) diagnose and investigate problems and health hazards 398.30 in the community; 398.31 (iii) inform, educate, and empower people about health 398.32 issues; 398.33 (iv) mobilize community partnerships to identify and solve 398.34 health problems; 398.35 (v) develop policies and plans that support individual and 398.36 community health efforts; 399.1 (vi) enforce laws and regulations that protect health and 399.2 ensure safety; 399.3 (vii) link people to needed personal health care services; 399.4 (viii) ensure a competent public health and personal health 399.5 care workforce; 399.6 (ix) evaluate effectiveness, accessibility, and quality of 399.7 personal and population-based health services; and 399.8 (x) research for new insights and innovative solutions to 399.9 health problems. 399.10 (b) By February 1, 2005, and every five years thereafter, 399.11 each community health board that receives a local public health 399.12 grant under section 145A.131 shall notify the commissioner in 399.13 writing of the statewide outcomes established under sections 399.14 145.8821 and 145A.12, subdivision 7, that the board will address 399.15 and the local priorities established under paragraph (a) that 399.16 the board will address. 399.17 (c) Each community health board receiving a local public 399.18 health grant under section 145A.131 must submit an annual report 399.19 to the commissioner documenting progress towards the achievement 399.20 of statewide outcomes established under sections 145.8821 and 399.21 145A.12, subdivision 7, and the local public health priorities 399.22 established under paragraph (a), using reporting standards and 399.23 procedures established by the commissioner and in compliance 399.24 with all applicable federal requirements. If a community health 399.25 board has identified additional local priorities for use of the 399.26 local public health grant since the last notification of 399.27 outcomes and priorities under paragraph (b), the community 399.28 health board shall notify the commissioner of the additional 399.29 local public health priorities in the annual report. 399.30 Sec. 21. Minnesota Statutes 2002, section 145A.10, 399.31 subdivision 10, is amended to read: 399.32 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 399.33 state community health advisory committee is established to 399.34 advise, consult with, and make recommendations to the 399.35 commissioner on the development, maintenance, funding, and 399.36 evaluation of community health services. Each community health 400.1 board may appoint a member to serve on the committee. The 400.2 committee must meet at least quarterly, and special meetings may 400.3 be called by the committee chair or a majority of the members. 400.4 Members or their alternates mayreceive a per diem and mustbe 400.5 reimbursed for travel and other necessary expenses while engaged 400.6 in their official duties. 400.7 (b) The city councils or county boards that have 400.8 established or are members of a community health board must 400.9 appoint a community health advisory committee to advise, consult 400.10 with, and make recommendations to the community health board on 400.11matters relating to the development, maintenance, funding, and400.12evaluation of community health services. The committee must400.13consist of at least five members and must be generally400.14representative of the population and health care providers of400.15the community health service area. The committee must meet at400.16least three times a year and at the call of the chair or a400.17majority of the members. Members may receive a per diem and400.18reimbursement for travel and other necessary expenses while400.19engaged in their official duties.400.20(c) State and local advisory committees must adopt bylaws400.21or operating procedures that specify the length of terms of400.22membership, procedures for assuring that no more than half of400.23these terms expire during the same year, and other matters400.24relating to the conduct of committee business. Bylaws or400.25operating procedures may allow one alternate to be appointed for400.26each member of a state or local advisory committee. Alternates400.27may be given full or partial powers and duties of membersthe 400.28 duties under subdivision 5a. The committee must be broadly 400.29 representative, including health care, nonprofit, private 400.30 sector, and consumer members, and must reflect the racial and 400.31 ethnic populations within the geographic area served by the 400.32 community health board. The community health advisory committee 400.33 shall recommend to the community health board mechanisms by 400.34 which community resources can most effectively be used to 400.35 achieve local public health priorities and statewide outcomes 400.36 with local public health grant funds, including leveraging local 401.1 and regional partnerships and contracting with community-based 401.2 organizations, private sector organizations, or other units of 401.3 government, including tribal governments. 401.4 Sec. 22. Minnesota Statutes 2002, section 145A.11, 401.5 subdivision 2, is amended to read: 401.6 Subd. 2. [CONSIDERATION OFCOMMUNITY HEALTH PLANLOCAL 401.7 PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 401.8 levying taxes authorized under section 145A.08, subdivision 3, a 401.9 city council or county board that has formed or is a member of a 401.10 community health board must consider the income and expenditures 401.11 required to meetthe objectives of the community health plan for401.12its arealocal public health priorities established under 401.13 section 145A.10, subdivision 5a, and statewide outcomes 401.14 established under section 145A.12, subdivision 7. 401.15 Sec. 23. Minnesota Statutes 2002, section 145A.11, 401.16 subdivision 4, is amended to read: 401.17 Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH 401.18 SERVICES.] A city council or county board that has established 401.19 or is a member of a community health board may by ordinance 401.20 adopt and enforce minimum standards for services provided 401.21 according to sections 145A.02 and 145A.10, subdivision 5. An 401.22 ordinance must not conflict with state law or with more 401.23 stringent standards established either by rule of an agency of 401.24 state government or by the provisions of the charter or 401.25 ordinances of any city organized under section 145A.09, 401.26 subdivision 4. 401.27 Sec. 24. Minnesota Statutes 2002, section 145A.12, 401.28 subdivision 1, is amended to read: 401.29 Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 401.30 commissioner must assist community health boards in the 401.31 development, administration, and implementation of community 401.32 health services. This assistance may consist of but is not 401.33 limited to: 401.34 (1) informational resources, consultation, and training to 401.35 help community health boards plan, develop, integrate, provide 401.36 and evaluate community health services; and 402.1 (2) administrative and program guidelines and standards, 402.2 developed with the advice of the state community health advisory 402.3 committee.Adoption of these guidelines by a community health402.4board is not a prerequisite for plan approval as prescribed in402.5subdivision 4.402.6 Sec. 25. Minnesota Statutes 2002, section 145A.12, 402.7 subdivision 2, is amended to read: 402.8 Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter 402.9 14, and in consultation with the state community health advisory 402.10 committee, the commissioner may adopt rules to set standards for 402.11 administrative and program personnel to ensure competence in 402.12 administration and planningand in each program area defined in402.13section 145A.02. 402.14 Sec. 26. Minnesota Statutes 2002, section 145A.12, is 402.15 amended by adding a subdivision to read: 402.16 Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in 402.17 consultation with the state community health advisory committee 402.18 established under section 145A.10, subdivision 10, paragraph 402.19 (a), shall establish statewide outcomes for local public health 402.20 grant funds allocated to community health boards between January 402.21 1, 2004, and December 31, 2005. 402.22 (b) At least one statewide outcome must be established in 402.23 each of the following public health areas: 402.24 (1) preventing diseases; 402.25 (2) protecting against environmental hazards; 402.26 (3) preventing injuries; 402.27 (4) promoting healthy behavior; 402.28 (5) responding to disasters; and 402.29 (6) ensuring access to health services. 402.30 (c) The commissioner shall use Minnesota's public health 402.31 goals established under section 62J.212 and the essential public 402.32 health services under section 145A.10, subdivision 5a, as a 402.33 basis for the development of statewide outcomes. 402.34 (d) The statewide maternal and child health outcomes 402.35 established under section 145.8821 shall be included as 402.36 statewide outcomes under this section. 403.1 (e) By December 31, 2005, and every five years thereafter, 403.2 the commissioner, in consultation with the state community 403.3 health advisory committee established under section 145A.10, 403.4 subdivision 10, paragraph (a), and the maternal and child health 403.5 advisory task force established under section 145.881, shall 403.6 develop statewide outcomes for the local public health grant 403.7 established under section 145A.131, based on state and local 403.8 assessment data regarding the health of Minnesota residents, the 403.9 essential public health services under section 145A.10, and 403.10 current Minnesota public health goals established under section 403.11 62J.212. 403.12 Sec. 27. Minnesota Statutes 2002, section 145A.13, is 403.13 amended by adding a subdivision to read: 403.14 Subd. 4. [EXPIRATION.] This section expires January 1, 403.15 2004. 403.16 Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 403.17 Subdivision 1. [TRIBAL GOVERNMENTS.] (a) Of the funding 403.18 available for local public health grants, $2,000,000 per year is 403.19 available to tribal governments for: 403.20 (1) maternal and child health activities under section 403.21 145.882, subdivision 7; 403.22 (2) activities to reduce health disparities under section 403.23 145.928, subdivision 10; and 403.24 (3) emergency preparedness. 403.25 (b) The commissioner, in consultation with tribal 403.26 governments, shall establish a formula for distributing the 403.27 funds and developing the outcomes to be measured. Any decrease 403.28 or increase in the amount of funding available under the local 403.29 public health grant must be apportioned to reflect a 403.30 proportional change to both tribal governments and to community 403.31 health boards. 403.32 Subd. 2. [FUNDING FORMULA FOR COMMUNITY HEALTH 403.33 BOARDS.] (a) A local public health grant shall be distributed to 403.34 community health boards organized and operating under section 403.35 145A.09 to 145A.131 to achieve locally identified priorities 403.36 under section 145A.10, subdivision 5a, and statewide outcomes 404.1 under section 145A.12, subdivision 7. 404.2 (b) A community health board eligible for a local public 404.3 health grant under section 145A.09, subdivision 2, shall receive 404.4 no less for any calendar year than 95 percent of the board's 404.5 total 2002 community health services subsidy award and 95 404.6 percent of the board's total 2002 maternal and child health 404.7 special projects grant. 404.8 (c) Multicounty community health boards shall receive a 404.9 local partnership incentive of $25,000 per year for each county 404.10 included in the community health board. 404.11 (d) The remaining funds shall be distributed on a per 404.12 capita basis using the population figures established according 404.13 to section 145A.02, subdivision 16. 404.14 Subd. 3. [LOCAL MATCH.] (a) A community health board that 404.15 receives a local public health grant shall provide a 50 percent 404.16 match for the local public health grant funds described in 404.17 subdivision 2, paragraph (b), subject to paragraphs (b) to (e). 404.18 (b) Eligible funds must be used to meet match requirements. 404.19 Eligible funds include funds from local property taxes, 404.20 reimbursements from third parties, other state funds, and 404.21 donations or nonfederal grants that are used for community 404.22 health services described in section 145A.02, subdivision 6. 404.23 (c) Community health boards must provide documentation that 404.24 the 50 percent match for funds received under United States 404.25 Code, title 42, sections 701 to 709, is used for maternal and 404.26 child health activities as described in section 145.88. 404.27 (d) When the amount of local matching funds for a community 404.28 health board is less than the amount required under paragraph 404.29 (a), the local public health grant provided for that community 404.30 health board under this section shall be reduced proportionally. 404.31 (e) A city organized under the provision of sections 404.32 145A.09 to 145A.131 that levies a tax for provision of community 404.33 health services is exempt from any county levy for the same 404.34 services to the extent of the levy imposed by the city. 404.35 Subd. 4. [ADDITIONAL FUNDS.] Additional state or federal 404.36 funds distributed to community health boards to achieve specific 405.1 outcomes shall be distributed as part of the local public health 405.2 grant established in subdivision 2. These funds may be 405.3 distributed in proportion to the basic award described in 405.4 subdivision 2. Additional outcomes for these funds, if not 405.5 specified by federal or state law, shall be developed by the 405.6 commissioner in consultation with the state community health 405.7 advisory committee established under section 145A.10, 405.8 subdivision 10, and the maternal and child health advisory task 405.9 force established under section 145.881. 405.10 Subd. 5. [SPECIAL PROJECT GRANTS.] Notwithstanding other 405.11 requirements of this section, the commissioner may choose to 405.12 fund noncompetitive special project grants for projects by 405.13 select community health boards, according to state or federal 405.14 law. These special project grant funds shall be distributed as 405.15 a part of a community health board's local public health grant 405.16 established in subdivision 2. 405.17 Subd. 6. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 405.18 STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 405.19 community health board and operates as a board of health or if a 405.20 community health board elects not to accept the local public 405.21 health grant, the commissioner shall retain the amount of 405.22 funding that would have been allocated to the community health 405.23 board using the formula described in subdivision 2 and assume 405.24 responsibility for public health activities to meet the 405.25 statewide outcomes in the geographic area served by the board of 405.26 health or community health board. The commissioner may elect to 405.27 directly provide public health activities to meet the statewide 405.28 outcomes or contract with other units of government or with 405.29 community-based organizations. If a city that is currently a 405.30 community health board withdraws from a community health board 405.31 or elects not to accept the local public health grant, the local 405.32 public health grant funds that would have been allocated to that 405.33 city shall be distributed to the county in which the city is 405.34 located, if the county is part of a community health board. 405.35 Subd. 7. [ACCOUNTABILITY.] (a) Community health boards 405.36 accepting local public health grants must demonstrate progress 406.1 towards the statewide outcomes established in section 145A.12, 406.2 subdivision 7, to maintain eligibility to receive the local 406.3 public health grant. 406.4 (b) If the commissioner determines that a community health 406.5 board has not by the applicable deadline demonstrated progress 406.6 in one or more of the statewide outcomes established under 406.7 section 145.8821 or 145A.12, subdivision 7, then the 406.8 commissioner may determine not to distribute future funds to the 406.9 community health board under subdivision 2. If the commissioner 406.10 determines not to distribute future funds, the commissioner must 406.11 give the community health board written notice of this 406.12 determination. In determining whether or not to distribute 406.13 future funds to the community health board, the commissioner 406.14 shall consider the following factors with respect to the 406.15 statewide outcomes for which the community health board did not 406.16 demonstrate sufficient progress: 406.17 (1) the difficulty of meeting the statewide outcome; 406.18 (2) the effort put forth by the community health board to 406.19 meet the statewide outcome; 406.20 (3) the number of statewide outcomes that the community 406.21 health board did not meet; 406.22 (4) whether the community health board has previously 406.23 failed to meet statewide outcomes under this section; 406.24 (5) the amount of funding received by the community health 406.25 board to address the statewide outcomes; and 406.26 (6) other factors as justice may require, if the 406.27 commissioner specifically identifies the additional factors in 406.28 the commissioner's written notice of determination. 406.29 (c) If a community health board does not demonstrate 406.30 progress towards the statewide outcomes, the commissioner may 406.31 retain local public health grant funds and assume responsibility 406.32 for directly carrying out activities to meet the statewide 406.33 outcomes or contract with other units of government or 406.34 community-based organizations to assume responsibility for the 406.35 statewide outcomes. If the community health board that does not 406.36 demonstrate progress towards the statewide outcomes is a city, 407.1 the commissioner shall distribute the local public health grant 407.2 funds that would have been allocated to that city to the county 407.3 in which the city is located, if the county is part of a 407.4 community health board. 407.5 (d) The commissioner shall establish a reporting system for 407.6 community health boards to report their progress. The system 407.7 shall be developed in consultation with the state community 407.8 health advisory committee established under section 145A.10, 407.9 subdivision 10, paragraph (a), and the maternal and child health 407.10 advisory task force established under section 145.881. 407.11 Subd. 8. [LOCAL PUBLIC HEALTH PRIORITIES.] Community 407.12 health boards may use their local public health grant to address 407.13 local public health priorities identified under section 145A.10, 407.14 subdivision 5a. 407.15 Sec. 29. Minnesota Statutes 2002, section 145A.14, 407.16 subdivision 2, is amended to read: 407.17 Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may 407.18 make special grants tocommunity health boards toestablish, 407.19 operate, or subsidize clinic facilities and services to furnish 407.20 health services for American Indians who reside off reservations. 407.21 (b)To qualify for a grant under this subdivision the407.22community health plan submitted by the community health board407.23must contain a proposal for the delivery of the services and407.24documentation that representatives of the Indian community407.25affected by the plan were involved in its development.407.26(c)Applicants must submit for approval a plan and budget 407.27 for the use of the funds in the form and detail specified by the 407.28 commissioner. 407.29(d)(c) Applicants must keep records, including records of 407.30 expenditures to be audited, as the commissioner specifies. 407.31 Sec. 30. [REVISOR'S INSTRUCTION.] 407.32 (a) The revisor of statutes shall delete "145A.13" and 407.33 insert "145A.131" in Minnesota Statutes, sections 145A.03, 407.34 subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 407.35 256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 407.36 subdivision 2. 408.1 (b) For sections in Minnesota Statutes and Minnesota Rules 408.2 affected by the repealed sections in this article, the revisor 408.3 shall delete internal cross-references where appropriate and 408.4 make changes necessary to correct the punctuation, grammar, or 408.5 structure of the remaining text and preserve its meaning. 408.6 Sec. 31. [REPEALER.] 408.7 (a) Minnesota Statutes 2002, sections 144.401; 144.9507, 408.8 subdivision 3; 145.56, subdivision 2; 145.882, subdivisions 4, 408.9 5, 6, and 8; 145.883, subdivisions 4 and 7; 145.884; 145.885; 408.10 145.886; 145.888; 145.889; 145.890; 145.9266, subdivisions 2, 4, 408.11 5, 6, and 7; 145.928, subdivision 9; 145A.02, subdivisions 9, 408.12 10, 11, 12, 13, and 14; 145A.10, subdivisions 5, 6, and 8; 408.13 145A.11, subdivision 3; 145A.12, subdivisions 3, 4, and 5; 408.14 145A.14, subdivisions 3 and 4; and 145A.17, subdivision 2, are 408.15 repealed. 408.16 (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 408.17 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 408.18 4736.0090; 4736.0120; and 4736.0130, are repealed effective 408.19 January 1, 2004. 408.20 ARTICLE 10 408.21 APPROPRIATIONS 408.22 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 408.23 The sums shown in the columns marked "APPROPRIATIONS" are 408.24 appropriated from the general fund, or any other fund named, to 408.25 the agencies and for the purposes specified in the sections of 408.26 this article, to be available for the fiscal years indicated for 408.27 each purpose. The figures "2004" and "2005" where used in this 408.28 article, mean that the appropriation or appropriations listed 408.29 under them are available for the fiscal year ending June 30, 408.30 2004, or June 30, 2005, respectively. Where a dollar amount 408.31 appears in parentheses, it means a reduction of an appropriation. 408.32 SUMMARY BY FUND 408.33 BIENNIAL 408.34 2004 2005 TOTAL 408.35 General $3,588,648,000 $3,499,118,000 $7,087,766,000 408.36 State Government 408.37 Special Revenue 45,162,000 44,899,000 90,061,000 409.1 Health Care 409.2 Access 269,351,000 339,443,000 608,794,000 409.3 Federal TANF 267,482,000 267,161,000 534,643,000 409.4 Lottery Prize 409.5 Fund 1,306,000 1,306,000 2,612,000 409.6 TOTAL $4,171,949,000 $4,151,927,000 $8,323,876,000 409.7 APPROPRIATIONS 409.8 Available for the Year 409.9 Ending June 30 409.10 2004 2005 409.11 Sec. 2. COMMISSIONER OF 409.12 HUMAN SERVICES 409.13 Subdivision 1. Total 409.14 Appropriation $ 4,021,515 $ 4,002,077 409.15 Summary by Fund 409.16 General 3,495,179 3,405,970 409.17 State Government 409.18 Special Revenue 534 534 409.19 Health Care 409.20 Access 263,014 333,106 409.21 Federal TANF 261,482 261,161 409.22 Lottery Cash 409.23 Flow 1,306 1,306 409.24 [RECEIPTS FOR SYSTEMS PROJECTS.] 409.25 Appropriations and federal receipts for 409.26 information system projects for MAXIS, 409.27 PRISM, MMIS, and SSIS must be deposited 409.28 in the state system account authorized 409.29 in Minnesota Statutes, section 409.30 256.014. Money appropriated for 409.31 computer projects approved by the 409.32 Minnesota office of technology, funded 409.33 by the legislature, and approved by the 409.34 commissioner of finance may be 409.35 transferred from one project to another 409.36 and from development to operations as 409.37 the commissioner of human services 409.38 considers necessary. Any unexpended 409.39 balance in the appropriation for these 409.40 projects does not cancel but is 409.41 available for ongoing development and 409.42 operations. 409.43 [GIFTS.] Notwithstanding Minnesota 409.44 Statutes, chapter 7, the commissioner 409.45 may accept on behalf of the state 409.46 additional funding from sources other 409.47 than state funds for the purpose of 409.48 financing the cost of assistance 409.49 program grants or nongrant 409.50 administration. All additional funding 409.51 is appropriated to the commissioner for 409.52 use as designated by the grantor of 409.53 funding. 409.54 [SYSTEMS CONTINUITY.] In the event of 409.55 disruption of technical systems or 410.1 computer operations, the commissioner 410.2 may use available grant appropriations 410.3 to ensure continuity of payments for 410.4 maintaining the health, safety, and 410.5 well-being of clients served by 410.6 programs administered by the department 410.7 of human services. Grant funds must be 410.8 used in a manner consistent with the 410.9 original intent of the appropriation. 410.10 [NONFEDERAL SHARE TRANSFERS.] The 410.11 nonfederal share of activities for 410.12 which federal administrative 410.13 reimbursement is appropriated to the 410.14 commissioner may be transferred to the 410.15 special revenue fund. 410.16 [TANF FUNDS APPROPRIATED TO OTHER 410.17 ENTITIES.] Any expenditures from the 410.18 TANF block grant shall be expended in 410.19 accordance with the requirements and 410.20 limitations of part A of title IV of 410.21 the Social Security Act, as amended, 410.22 and any other applicable federal 410.23 requirement or limitation. Prior to 410.24 any expenditure of these funds, the 410.25 commissioner shall assure that funds 410.26 are expended in compliance with the 410.27 requirements and limitations of federal 410.28 law and that any reporting requirements 410.29 of federal law are met. It shall be 410.30 the responsibility of any entity to 410.31 which these funds are appropriated to 410.32 implement a memorandum of understanding 410.33 with the commissioner that provides the 410.34 necessary assurance of compliance prior 410.35 to any expenditure of funds. The 410.36 commissioner shall receipt TANF funds 410.37 appropriated to other state agencies 410.38 and coordinate all related interagency 410.39 accounting transactions necessary to 410.40 implement these appropriations. 410.41 Unexpended TANF funds appropriated to 410.42 any state, local, or nonprofit entity 410.43 cancel at the end of the state fiscal 410.44 year unless appropriating language 410.45 permits otherwise. 410.46 [TANF FUNDS TRANSFERRED TO OTHER 410.47 FEDERAL GRANTS.] The commissioner must 410.48 authorize transfers from TANF to other 410.49 federal block grants so that funds are 410.50 available to meet the annual 410.51 expenditure needs as appropriated. 410.52 Transfers may be authorized prior to 410.53 the expenditure year with the agreement 410.54 of the receiving entity. Transferred 410.55 funds must be expended in the year for 410.56 which the funds were appropriated 410.57 unless appropriation language permits 410.58 otherwise. In accelerating transfer 410.59 authorizations, the commissioner must 410.60 aim to preserve the future potential 410.61 transfer capacity from TANF to other 410.62 block grants. 410.63 [TANF MAINTENANCE OF EFFORT.] (a) In 410.64 order to meet the basic maintenance of 410.65 effort (MOE) requirements of the TANF 410.66 block grant specified under Code of 410.67 Federal Regulations, title 45, section 411.1 263.1, the commissioner may only report 411.2 nonfederal money expended for allowable 411.3 activities listed in the following 411.4 clauses as TANF/MOE expenditures: 411.5 (1) MFIP cash, diversionary work 411.6 program, and food assistance benefits 411.7 under Minnesota Statutes, chapter 256J; 411.8 (2) the child care assistance programs 411.9 under Minnesota Statutes, sections 411.10 119B.03 and 119B.05, and county child 411.11 care administrative costs under 411.12 Minnesota Statutes, section 119B.15; 411.13 (3) state and county MFIP 411.14 administrative costs under Minnesota 411.15 Statutes, chapters 256J and 256K; 411.16 (4) state, county, and tribal MFIP 411.17 employment services under Minnesota 411.18 Statutes, chapters 256J and 256K; 411.19 (5) expenditures made on behalf of 411.20 noncitizen MFIP recipients who qualify 411.21 for the medical assistance without 411.22 federal financial participation program 411.23 under Minnesota Statutes, section 411.24 256B.06, subdivision 4, paragraphs (d), 411.25 (e), and (j). 411.26 (b) The commissioner shall ensure that 411.27 sufficient qualified nonfederal 411.28 expenditures are made each year to meet 411.29 the state's TANF/MOE requirements. For 411.30 the activities listed in paragraph (a), 411.31 clauses (2) to (5), the commissioner 411.32 may only report expenditures that are 411.33 excluded from the definition of 411.34 assistance under Code of Federal 411.35 Regulations, title 45, section 260.31. 411.36 (c) By August 31 of each year, the 411.37 commissioner shall make a preliminary 411.38 calculation to determine the likelihood 411.39 that the state will meet its annual 411.40 federal work participation requirement 411.41 under Code of Federal Regulations, 411.42 title 45, sections 261.21 and 261.23, 411.43 after adjustment for any caseload 411.44 reduction credit under Code of Federal 411.45 Regulations, title 45, section 261.41. 411.46 If the commissioner determines that the 411.47 state will meet its federal work 411.48 participation rate for the federal 411.49 fiscal year ending that September, the 411.50 commissioner may reduce the expenditure 411.51 under paragraph (a), clause (1), to the 411.52 extent allowed under Code of Federal 411.53 Regulations, title 45, section 411.54 263.1(a)(2). 411.55 (d) For fiscal years beginning with 411.56 state fiscal year 2003, the 411.57 commissioner shall assure that the 411.58 maintenance of effort used by the 411.59 commissioner of finance for the 411.60 February and November forecasts 411.61 required under Minnesota Statutes, 411.62 section 16A.103, contains expenditures 411.63 under paragraph (a), clause (1), equal 412.1 to at least 25 percent of the total 412.2 required under Code of Federal 412.3 Regulations, title 45, section 263.1. 412.4 (e) If nonfederal expenditures for the 412.5 programs and purposes listed in 412.6 paragraph (a) are insufficient to meet 412.7 the state's TANF/MOE requirements, the 412.8 commissioner shall recommend additional 412.9 allowable sources of nonfederal 412.10 expenditures to the legislature, if the 412.11 legislature is or will be in session to 412.12 take action to specify additional 412.13 sources of nonfederal expenditures for 412.14 TANF/MOE before a federal penalty is 412.15 imposed. The commissioner shall 412.16 otherwise provide notice to the 412.17 legislative commission on planning and 412.18 fiscal policy under paragraph (g). 412.19 (f) If the commissioner uses authority 412.20 granted under section 9, or similar 412.21 authority granted by a subsequent 412.22 legislature, to meet the state's 412.23 TANF/MOE requirement in a reporting 412.24 period, the commissioner shall inform 412.25 the chairs of the appropriate 412.26 legislative committees about all 412.27 transfers made under that authority for 412.28 this purpose. 412.29 (g) If the commissioner determines that 412.30 nonfederal expenditures under paragraph 412.31 (a) are insufficient to meet TANF/MOE 412.32 expenditure requirements, and if the 412.33 legislature is not or will not be in 412.34 session to take timely action to avoid 412.35 a federal penalty, the commissioner may 412.36 report nonfederal expenditures from 412.37 other allowable sources as TANF/MOE 412.38 expenditures after the requirements of 412.39 this paragraph are met. The 412.40 commissioner may report nonfederal 412.41 expenditures in addition to those 412.42 specified under paragraph (a) as 412.43 nonfederal TANF/MOE expenditures, but 412.44 only ten days after the commissioner of 412.45 finance has first submitted the 412.46 commissioner's recommendations for 412.47 additional allowable sources of 412.48 nonfederal TANF/MOE expenditures to the 412.49 members of the legislative commission 412.50 on planning and fiscal policy for their 412.51 review. 412.52 (h) The commissioner of finance shall 412.53 not incorporate any changes in federal 412.54 TANF expenditures or nonfederal 412.55 expenditures for TANF/MOE that may 412.56 result from reporting additional 412.57 allowable sources of nonfederal 412.58 TANF/MOE expenditures under the interim 412.59 procedures in paragraph (g) into the 412.60 February or November forecasts required 412.61 under Minnesota Statutes, section 412.62 16A.103, unless the commissioner of 412.63 finance has approved the additional 412.64 sources of expenditures under paragraph 412.65 (g). 412.66 (i) Minnesota Statutes, section 413.1 256.011, subdivision 3, which requires 413.2 that federal grants or aids secured or 413.3 obtained under that subdivision be used 413.4 to reduce any direct appropriations 413.5 provided by law, do not apply if the 413.6 grants or aids are federal TANF funds. 413.7 (j) Notwithstanding section 12, 413.8 paragraph (a), clauses (1) to (5), and 413.9 paragraphs (b) to (j) expire June 30, 413.10 2007. 413.11 [SHIFT COUNTY PAYMENT.] The 413.12 commissioner shall make up to 100 413.13 percent of the calendar year 2005 413.14 payments to counties for developmental 413.15 disabilities semi-independent living 413.16 services grants, developmental 413.17 disabilities family support grants, and 413.18 adult mental health grants from fiscal 413.19 year 2006 appropriations. This is a 413.20 onetime payment shift. Calendar year 413.21 2006 and future payments for these 413.22 grants are not affected by this shift. 413.23 This provision expires June 30, 2006. 413.24 [CAPITATION RATE INCREASE.] Of the 413.25 health care access fund appropriations 413.26 to the University of Minnesota in the 413.27 higher education omnibus appropriation 413.28 bill, $2,157,000 in fiscal year 2004 413.29 and $2,157,000 in fiscal year 2005 are 413.30 to be used to increase the capitation 413.31 payments under Minnesota Statutes, 413.32 section 256B.69. Notwithstanding the 413.33 provisions of section 11, this 413.34 provision shall not expire. 413.35 Subd. 2. Agency Management 413.36 Summary by Fund 413.37 General 41,473 27,868 413.38 State Government 413.39 Special Revenue 415 415 413.40 Health Care Access 3,673 3,673 413.41 Federal TANF 320 320 413.42 The amounts that may be spent from the 413.43 appropriation for each purpose are as 413.44 follows: 413.45 (a) Financial Operations 413.46 General 8,751 9,056 413.47 Health Care Access 828 828 413.48 Federal TANF 220 220 413.49 (b) Legal and 413.50 Regulation Operations 413.51 General 7,896 8,168 413.52 State Government 413.53 Special Revenue 415 415 414.1 Health Care Access 244 244 414.2 Federal TANF 100 100 414.3 (c) Management Operations 414.4 General 17,373 3,076 414.5 Health Care Access 1,623 1,623 414.6 (d) Information Technology 414.7 Operations 414.8 General 7,453 7,568 414.9 Health Care Access 978 978 414.10 Subd. 3. Revenue and Pass-Through 414.11 Federal TANF 54,845 51,221 414.12 [TANF TRANSFER TO SOCIAL SERVICES BLOCK 414.13 GRANT.] $9,272,000 is appropriated to 414.14 the commissioner in fiscal year 2005 414.15 for the purposes of providing services 414.16 for families with children whose 414.17 incomes are at or below 200 percent of 414.18 the federal poverty guidelines. The 414.19 commissioner shall authorize a 414.20 sufficient transfer of funds from the 414.21 state's federal TANF block grant to the 414.22 state's federal social services block 414.23 grant to meet this appropriation. The 414.24 funds shall be distributed to counties 414.25 for the children and community services 414.26 grant according to the formula for the 414.27 state appropriations in Minnesota 414.28 Statutes, chapter 256M. 414.29 [TANF FUNDS FOR FISCAL YEAR 2006 AND 414.30 FISCAL YEAR 2007 REFINANCING.] 414.31 $10,724,000 in fiscal year 2006 and 414.32 $10,827,000 in fiscal year 2007 in TANF 414.33 funds are available to the commissioner 414.34 to replace general funds in the amount 414.35 of $10,724,000 in fiscal year 2006 and 414.36 $10,827,000 in fiscal year 2007 in 414.37 expenditures that may be counted toward 414.38 TANF maintenance of effort requirements 414.39 or as an allowable TANF expenditure. 414.40 [REDUCTION IN TANF TRANSFER TO CHILD 414.41 CARE AND DEVELOPMENT FUND.] Transfers 414.42 of TANF to the child care development 414.43 fund for the purposes of MFIP child 414.44 care assistance shall be reduced by 414.45 $1,126,000 in fiscal year 2004 and 414.46 $118,000 in fiscal year 2005. 414.47 Subd. 4. Children's Services Grants 414.48 Summary by Fund 414.49 General 111,760 94,256 414.50 Federal TANF -0- 9,272 414.51 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 414.52 Federal funds available during fiscal 414.53 year 2004 and fiscal year 2005, for 414.54 adoption incentive grants are 415.1 appropriated to the commissioner for 415.2 these purposes. 415.3 [ADOPTION ASSISTANCE AND RELATIVE 415.4 CUSTODY ASSISTANCE.] The commissioner 415.5 may transfer unencumbered appropriation 415.6 balances for adoption assistance and 415.7 relative custody assistance between 415.8 fiscal years and between programs. 415.9 Subd. 5. Children's Services Management 415.10 General 5,221 5,283 415.11 Subd. 6. Basic Health Care Grants 415.12 Summary by Fund 415.13 General 1,490,406 1,465,637 415.14 Health Care Access 243,539 313,877 415.15 [UPDATING FEDERAL POVERTY GUIDELINES.] 415.16 Annual updates to the federal poverty 415.17 guidelines are effective each July 1, 415.18 following publication by the United 415.19 States Department of Health and Human 415.20 Services for health care programs under 415.21 Minnesota Statutes, chapters 256, 256B, 415.22 256D, and 256L. 415.23 The amounts that may be spent from this 415.24 appropriation for each purpose are as 415.25 follows: 415.26 (a) MinnesotaCare Grants 415.27 Health Care Access 242,789 313,127 415.28 [MINNESOTACARE FEDERAL RECEIPTS.] 415.29 Receipts received as a result of 415.30 federal participation pertaining to 415.31 administrative costs of the Minnesota 415.32 health care reform waiver shall be 415.33 deposited as nondedicated revenue in 415.34 the health care access fund. Receipts 415.35 received as a result of federal 415.36 participation pertaining to grants 415.37 shall be deposited in the federal fund 415.38 and shall offset health care access 415.39 funds for payments to providers. 415.40 [MINNESOTACARE FUNDING.] The 415.41 commissioner may expend money 415.42 appropriated from the health care 415.43 access fund for MinnesotaCare in either 415.44 fiscal year of the biennium. 415.45 (b) MA Basic Health Care Grants - 415.46 Families and Children 415.47 General 560,470 574,389 415.48 (c) MA Basic Health Care Grants - Elderly 415.49 and Disabled 415.50 General 687,945 759,657 415.51 [DELAY MA FEE FOR SERVICE - ACUTE 415.52 CARE.] The last payment in fiscal year 415.53 2005 from the Medicaid Management 416.1 Information System that would otherwise 416.2 have been made to providers for medical 416.3 assistance and general assistance 416.4 medical care services shall be delayed 416.5 and included in the first payment in 416.6 fiscal year 2006. This payment delay 416.7 shall not include payments to skilled 416.8 nursing facilities, intermediate care 416.9 facilities for mental retardation, 416.10 prepaid health plans, home health 416.11 agencies, personal care nursing 416.12 providers, and providers of only waiver 416.13 services. The provisions of Minnesota 416.14 Statutes, section 16A.124, shall not 416.15 apply to these delayed payments. 416.16 Notwithstanding section 12, this 416.17 provision shall not expire. 416.18 (d) General Assistance Medical Care 416.19 Grants 416.20 General 228,293 115,756 416.21 (e) Health Care Grants - Other 416.22 Assistance 416.23 General 3,067 3,123 416.24 Health Care Access 750 750 416.25 (f) Prescription Drug Program 416.26 General 10,631 12,712 416.27 Subd. 7. Health Care Management 416.28 Summary by Fund 416.29 General 23,684 24,202 416.30 Health Care Access 14,395 14,179 416.31 The amounts that may be spent from this 416.32 appropriation for each purpose are as 416.33 follows: 416.34 (a) Health Care Policy Administration 416.35 General 4,532 5,226 416.36 Health Care Access 846 846 416.37 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 416.38 Federal administrative reimbursement 416.39 resulting from MinnesotaCare outreach 416.40 is appropriated to the commissioner for 416.41 this activity. 416.42 [MINNESOTA SENIOR HEALTH OPTIONS 416.43 REIMBURSEMENT.] Federal administrative 416.44 reimbursement resulting from the 416.45 Minnesota senior health options project 416.46 is appropriated to the commissioner for 416.47 this activity. 416.48 [UTILIZATION REVIEW.] Federal 416.49 administrative reimbursement resulting 416.50 from prior authorization and inpatient 416.51 admission certification by a 416.52 professional review organization shall 416.53 be dedicated to the commissioner for 417.1 these purposes. A portion of these 417.2 funds must be used for activities to 417.3 decrease unnecessary pharmaceutical 417.4 costs in medical assistance. 417.5 (b) Health Care Options 417.6 General 19,152 18,976 417.7 Health Care Access 13,549 13,333 417.8 [PREPAID MEDICAL PROGRAMS.] For all 417.9 counties in which the PMAP program has 417.10 been operating for 12 or more months, 417.11 state funding for the nonfederal share 417.12 of prepaid medical assistance program 417.13 administration costs for county managed 417.14 care advocacy and enrollment operations 417.15 is eliminated. State funding will 417.16 continue for these activities for 417.17 counties and tribes establishing new 417.18 PMAP programs for a maximum of 16 417.19 months (four months prior to beginning 417.20 PMAP enrollment and through the first 417.21 12 months of their PMAP program 417.22 operation). Those counties operating 417.23 PMAP programs for less than 12 months 417.24 can continue to receive state funding 417.25 for advocacy and enrollment activities 417.26 through their first year of operation. 417.27 Subd. 8. State-operated Services 417.28 General 195,062 186,775 417.29 [MITIGATION RELATED TO STATE-OPERATED 417.30 SERVICES RESTRUCTURING.] Money 417.31 appropriated to finance mitigation 417.32 expenses related to restructuring 417.33 state-operated services programs and 417.34 administrative services may be 417.35 transferred between fiscal years within 417.36 the biennium. 417.37 [STATE-OPERATED SERVICES 417.38 RESTRUCTURING.] For purposes of 417.39 restructuring state-operated services, 417.40 any state-operated services employee 417.41 whose position is to be eliminated 417.42 shall be afforded the options provided 417.43 in applicable collective bargaining 417.44 agreements. All salary and mitigation 417.45 allocations from fiscal year 2004 shall 417.46 be carried forward into fiscal year 417.47 2005. Provided there is no conflict 417.48 with any collective bargaining 417.49 agreement, any state-operated services 417.50 position reduction must only be 417.51 accomplished through mitigation, 417.52 attrition, transfer, and other measures 417.53 as provided in state or applicable 417.54 collective bargaining agreements and in 417.55 Minnesota Statutes, section 252.50, 417.56 subdivision 11, and not through layoff. 417.57 [REPAIRS AND BETTERMENTS.] The 417.58 commissioner may transfer unencumbered 417.59 appropriation balances between fiscal 417.60 years within the biennium for the state 417.61 residential facilities repairs and 417.62 betterments account and special 418.1 equipment. 418.2 Subd. 9. Continuing Care Grants 418.3 Summary by Fund 418.4 General 1,446,139 1,425,621 418.5 Lottery Prize Fund 1,158 1,158 418.6 The amounts that may be spent from this 418.7 appropriation for each purpose are as 418.8 follows: 418.9 (a) Aging and Adult Service Grant 418.10 General 7,201 7,969 418.11 (b) Deaf and Hard-of-hearing 418.12 Service Grants 418.13 General 1,702 1,468 418.14 (c) Mental Health Grants 418.15 General 53,744 34,955 418.16 Lottery Prize Fund 1,158 1,158 418.17 [RESTRUCTURING OF ADULT MENTAL HEALTH 418.18 SERVICES.] The commissioner may make 418.19 budget neutral transfers to effectively 418.20 implement the restructuring of adult 418.21 mental health services. "Budget 418.22 neutral transfers" means transfers 418.23 which do not increase the state share 418.24 of costs. 418.25 (d) Community Support Grants 418.26 General 11,725 8,794 418.27 (e) Medical Assistance Long-term 418.28 Care Waivers and Home Care Grants 418.29 General 643,530 694,967 418.30 [RATE AND ALLOCATION DECREASES FOR 418.31 CONTINUING CARE PROGRAMS.] 418.32 Notwithstanding any law or rule to the 418.33 contrary, the commissioner of human 418.34 services shall decrease reimbursement 418.35 rates or reduce allocations to assure 418.36 the necessary reductions in state 418.37 spending for the providers or programs 418.38 listed in (A) through (D). The 418.39 decreases are effective for services 418.40 rendered on or after July 1, 2003. 418.41 (A) Effective July 1, 2003, the 418.42 commissioner shall reduce payment rates 418.43 for services and individual or service 418.44 limits by four percent. The rate 418.45 decreases described in this section 418.46 must be applied to: 418.47 (1) home and community-based waivered 418.48 services for the elderly under 418.49 Minnesota Statutes, section 256B.0915; 418.50 (2) day training and habilitation 419.1 services for adults with mental 419.2 retardation or related conditions under 419.3 Minnesota Statutes, sections 252.40 to 419.4 252.46; 419.5 (3) the group residential housing 419.6 supplementary service rate under 419.7 Minnesota Statutes, section 256I.05, 419.8 subdivision 1a; 419.9 (4) chemical dependency residential and 419.10 nonresidential service rates under 419.11 Minnesota Statutes, section 245B.03; 419.12 (5) consumer support grants under 419.13 Minnesota Statutes, section 256.476; 419.14 and 419.15 (6) home and community-based services 419.16 for alternative care services under 419.17 Minnesota Statutes, section 256B.0913. 419.18 (B) Effective July 1, 2003, the 419.19 commissioner shall reduce payment rates 419.20 for services and individual or service 419.21 limits by two percent to: 419.22 (1) home health services under 419.23 Minnesota Statutes, section 256B.0625, 419.24 subdivision 6a; 419.25 (2) personal care services and nursing 419.26 supervision of personal care services 419.27 under Minnesota Statutes, section 419.28 256B.0625, subdivision 19a; and 419.29 (3) private duty nursing services under 419.30 Minnesota Statutes, section 256B.0625, 419.31 subdivision 7. 419.32 (C) The commissioner shall reduce 419.33 allocations made available to county 419.34 agencies for home and community-based 419.35 waivered services to assure a four 419.36 percent reduction in state spending for 419.37 services rendered on or after July 1, 419.38 2003. The commissioner shall apply the 419.39 allocation decreases described in this 419.40 section to: 419.41 (1) persons with mental retardation or 419.42 related conditions under Minnesota 419.43 Statutes, section 256B.501; 419.44 (2) waivered services under community 419.45 alternatives for disabled individuals 419.46 under Minnesota Statutes, section 419.47 256B.49; 419.48 (3) community alternative care waivered 419.49 services under Minnesota Statutes, 419.50 section 256B.49; and 419.51 (4) traumatic brain injury waivered 419.52 services under Minnesota Statutes, 419.53 section 256B.49. 419.54 County agencies will be responsible for 419.55 100 percent of any spending in excess 419.56 of the allocation made by the 419.57 commissioner. Nothing in this section 420.1 shall be construed as reducing the 420.2 county's responsibility to offer and 420.3 make available feasible home and 420.4 community-based options to eligible 420.5 waiver recipients within the resources 420.6 allocated to them for that purpose. 420.7 (D) The commissioner shall reduce deaf 420.8 and hard-of-hearing grants by four 420.9 percent on July 1, 2003. 420.10 [REDUCE GROWTH IN MR/RC WAIVER.] The 420.11 commissioner shall reduce the growth in 420.12 the MR/RC waiver by not allocating the 420.13 300 additional diversion allocations 420.14 that are included in the February 2003 420.15 forecast for the fiscal years that 420.16 begin on July 1, 2003, and July 1, 2004. 420.17 [MANAGE THE GROWTH IN THE TBI WAIVER.] 420.18 During the fiscal years beginning on 420.19 July 1, 2003, and July 1, 2004, the 420.20 commissioner shall allocate money for 420.21 this program in such a way so that the 420.22 caseload growth for this program does 420.23 not exceed 150 in each year of the 420.24 biennium. Priorities for the 420.25 allocation of funds shall be for 420.26 individuals anticipated to be 420.27 discharged from institutional settings 420.28 or who are at imminent risk of a 420.29 placement in an institutional setting. 420.30 [TARGETED CASE MANAGEMENT FOR HOME CARE 420.31 RECIPIENTS.] Implementation of the 420.32 targeted case management benefit for 420.33 home care recipients, according to 420.34 Minnesota Statutes, section 256B.0621, 420.35 subdivisions 2, 3, 5, 6, 7, 9, and 10, 420.36 will be delayed until July 1, 2005. 420.37 [COMMON SERVICE MENU.] Implementation 420.38 of the common service menu option 420.39 within the home and community-based 420.40 waivers, according to Minnesota 420.41 Statutes, section 256B.49, subdivision 420.42 16, will be delayed until July 1, 2005. 420.43 (f) Medical Assistance Long-term 420.44 Care Facilities Grants 420.45 General 514,710 485,543 420.46 (g) Alternative Care Grants 420.47 General 70,705 62,930 420.48 [ALTERNATIVE CARE TRANSFER.] Any money 420.49 allocated to the alternative care 420.50 program that is not spent for the 420.51 purposes indicated does not cancel but 420.52 shall be transferred to the medical 420.53 assistance account. 420.54 [ALTERNATIVE CARE APPROPRIATION.] The 420.55 commissioner may expend the money 420.56 appropriated for the alternative care 420.57 program for that purpose in either year 420.58 of the biennium. 420.59 [ALTERNATIVE CARE IMPLEMENTATION OF 421.1 CHANGES TO PREMIUMS AND ELIGIBILITY.] 421.2 Changes to Minnesota Statutes, section 421.3 256B.0913, subdivision 4, paragraph 421.4 (d), and subdivision 12, are effective 421.5 July 1, 2003, for all persons found 421.6 eligible for the alternative care 421.7 program on or after July 1, 2003. All 421.8 recipients of alternative care funding 421.9 as of June 30, 2003, shall be subject 421.10 to Minnesota Statutes, section 421.11 256B.0913, subdivision 4, paragraph 421.12 (d), and subdivision 12, on the annual 421.13 reassessment and review of their 421.14 eligibility after July 1, 2003, but no 421.15 later than January 1, 2004. 421.16 (h) Group Residential Housing Grants 421.17 General 94,150 80,092 421.18 [GROUP RESIDENTIAL HOUSING COSTS 421.19 REFINANCED.] Effective July 1, 2004, 421.20 the commissioner shall increase the 421.21 home and community-based service rates 421.22 and county allocations provided to 421.23 programs established under section 421.24 1915(c) of the Social Security Act to 421.25 the extent that these programs will be 421.26 paying for the costs above the rate 421.27 established in Minnesota Statutes, 421.28 section 256I.05, subdivision 1. 421.29 (i) Chemical Dependency 421.30 Entitlement Grants 421.31 General 47,617 47,848 421.32 (j) Chemical Dependency Nonentitlement 421.33 Grants 421.34 General 1,055 1,055 421.35 Subd. 10. Continuing Care Management 421.36 Summary by Fund 421.37 General 21,484 21,014 421.38 State Government 421.39 Special Revenue 119 119 421.40 Lottery Prize Fund 148 148 421.41 Subd. 11. Economic Support Grants 421.42 Summary by Fund 421.43 General 120,922 116,011 421.44 Federal TANF 205,949 199,980 421.45 The amounts that may be spent from this 421.46 appropriation for each purpose are as 421.47 follows: 421.48 (a) Minnesota Family Investment Program 421.49 General 50,947 44,938 421.50 Federal TANF 104,889 92,294 422.1 (b) Work Grants 422.2 General 8,666 8,678 422.3 Federal TANF 101,060 107,686 422.4 (c) Economic Support Grants - Other 422.5 Assistance 422.6 General 2,858 2,963 422.7 (d) Child Support Enforcement Grants 422.8 General 3,571 3,503 422.9 (e) General Assistance Grants 422.10 General 24,651 24,482 422.11 [GENERAL ASSISTANCE STANDARD.] The 422.12 commissioner shall set the monthly 422.13 standard of assistance for general 422.14 assistance units consisting of an adult 422.15 recipient who is childless and 422.16 unmarried or living apart from parents 422.17 or a legal guardian at $203. The 422.18 commissioner may reduce this amount 422.19 according to Laws 1997, chapter 85, 422.20 article 3, section 54. 422.21 (f) Minnesota Supplemental Aid Grants 422.22 General 30,229 31,447 422.23 Subd. 12. Economic Support 422.24 Management 422.25 Summary by Fund 422.26 General 39,028 39,303 422.27 Health Care Access 1,407 1,377 422.28 Federal TANF 368 368 422.29 The amounts that may be spent from this 422.30 appropriation for each purpose are as 422.31 follows: 422.32 (a) Economic Support 422.33 Policy Administration 422.34 General 5,360 5,587 422.35 Federal TANF 368 368 422.36 (b) Economic Support 422.37 Operations 422.38 General 33,668 33,716 422.39 Health Care Access 1,407 1,377 422.40 [CHILD SUPPORT PAYMENT CENTER.] 422.41 Payments to the commissioner from other 422.42 governmental units, private 422.43 enterprises, and individuals for 422.44 services performed by the child support 422.45 payment center must be deposited in the 422.46 state systems account authorized under 422.47 Minnesota Statutes, section 256.014. 423.1 These payments are appropriated to the 423.2 commissioner for the operation of the 423.3 child support payment center or system, 423.4 according to Minnesota Statutes, 423.5 section 256.014. 423.6 [CHILD SUPPORT COST RECOVERY FEES.] The 423.7 commissioner shall transfer $247,000 of 423.8 child support cost recovery fees 423.9 collected in fiscal year 2005 to the 423.10 PRISM special revenue account to offset 423.11 PRISM system costs of implementing the 423.12 fee. 423.13 [FINANCIAL INSTITUTION DATA MATCH AND 423.14 PAYMENT OF FEES.] The commissioner is 423.15 authorized to allocate up to $310,000 423.16 each year in fiscal year 2004 and 423.17 fiscal year 2005 from the PRISM special 423.18 revenue account to make payments to 423.19 financial institutions in exchange for 423.20 performing data matches between account 423.21 information held by financial 423.22 institutions and the public authority's 423.23 database of child support obligors as 423.24 authorized by Minnesota Statutes, 423.25 section 13B.06, subdivision 7. 423.26 Sec. 3. COMMISSIONER OF HEALTH 423.27 Subdivision 1. Total 423.28 Appropriation 104,875,000 104,292,000 423.29 Summary by Fund 423.30 General 59,722,000 59,402,000 423.31 State Government 423.32 Special Revenue 32,880,000 32,617,000 423.33 Health Care Access 6,273,000 6,273,000 423.34 Federal TANF 6,000,000 6,000,000 423.35 Subd. 2. Health Improvement 423.36 Summary by Fund 423.37 General 44,750,000 44,490,000 423.38 State Government 423.39 Special Revenue 1,987,000 1,987,000 423.40 Health Care Access 3,510,000 3,510,000 423.41 Federal TANF 6,000,000 6,000,000 423.42 [TOBACCO PREVENTION ENDOWMENT FUND 423.43 TRANSFERS.] (a) On July 1, 2003, the 423.44 commissioner of finance shall transfer 423.45 $4,000,000 from the tobacco use 423.46 prevention and local public health 423.47 endowment expendable trust fund to the 423.48 general fund. 423.49 (b) Notwithstanding Minnesota Statutes, 423.50 section 16A.62, any remaining 423.51 unexpended balance in the fund after 423.52 the transfer in paragraph (a) shall be 423.53 transferred to the miscellaneous 423.54 special revenue fund and dedicated to 424.1 the commissioner of health for a youth 424.2 tobacco prevention program. These 424.3 funds are available until expended. 424.4 [TANF APPROPRIATIONS.] TANF funds 424.5 appropriated to the commissioner are 424.6 available for home visiting and 424.7 nutritional activities listed under 424.8 Minnesota Statutes, section 145.882, 424.9 subdivisions 5, 6, and 7, and 424.10 eliminating health disparities 424.11 activities under Minnesota Statutes, 424.12 section 145.928, subdivision 10. 424.13 Funding shall be distributed to 424.14 community health boards and tribal 424.15 governments based on the formula in 424.16 Minnesota Statutes, section 145A.131, 424.17 subdivisions 1 and 2. 424.18 [TANF CARRYFORWARD.] Any unexpended 424.19 balance of the TANF appropriation in 424.20 the first year of the biennium does not 424.21 cancel but is available for the second 424.22 year. 424.23 Subd. 3. Health Quality and 424.24 Access 424.25 Summary by Fund 424.26 General 868,000 814,000 424.27 State Government 424.28 Special Revenue 8,888,000 8,888,000 424.29 Health Care Access 2,763,000 2,763,000 424.30 [STATE GOVERNMENT SPECIAL REVENUE FUND 424.31 TRANSFERS.] On July 1, 2003, the 424.32 commissioner of finance shall transfer 424.33 $3,000,000 from the state government 424.34 special revenue fund to the general 424.35 fund. 424.36 [MEDICAL EDUCATION ENDOWMENT FUND 424.37 TRANSFERS.] Notwithstanding Minnesota 424.38 Statutes, section 16A.62, any remaining 424.39 unexpended balances in the medical 424.40 education expendable trust fund shall 424.41 be transferred to the miscellaneous 424.42 special revenue fund and dedicated to 424.43 the commissioner for the purposes 424.44 identified in Minnesota Statutes, 424.45 section 62J.692. These funds are 424.46 available until expended. 424.47 Subd. 4. Health Protection 424.48 Summary by Fund 424.49 General 8,855,000 8,855,000 424.50 State Government 424.51 Special Revenue 22,005,000 21,742,000 424.52 Subd. 5. Management and Support 424.53 Services 424.54 General 5,249,000 5,243,000 424.55 Sec. 4. VETERANS HOME BOARD 425.1 General 30,030,000 30,030,000 425.2 Sec. 5. HEALTH-RELATED BOARDS 425.3 Subdivision 1. Total 425.4 Appropriation 11,266,000 11,266,000 425.5 [STATE GOVERNMENT SPECIAL REVENUE 425.6 FUND.] The appropriations in this 425.7 section are from the state government 425.8 special revenue fund, except where 425.9 noted. 425.10 [NO SPENDING IN EXCESS OF REVENUES.] 425.11 The commissioner of finance shall not 425.12 permit the allotment, encumbrance, or 425.13 expenditure of money appropriated in 425.14 this section in excess of the 425.15 anticipated biennial revenues or 425.16 accumulated surplus revenues from fees 425.17 collected by the boards. Neither this 425.18 provision nor Minnesota Statutes, 425.19 section 214.06, applies to transfers 425.20 from the general contingent account. 425.21 [STATE GOVERNMENT SPECIAL REVENUE FUND 425.22 TRANSFERS.] On July 1, 2003, the 425.23 commissioner of finance shall transfer 425.24 $7,500,000 from the state government 425.25 special revenue fund to the general 425.26 fund. 425.27 Subd. 2. Board of Chiropractic 425.28 Examiners 384,000 384,000 425.29 Subd. 3. Board of Dentistry 425.30 State Government Special 425.31 Revenue Fund 858,000 858,000 425.32 Health Care 425.33 Access Fund 64,000 64,000 425.34 Subd. 4. Board of Dietetic and 425.35 Nutrition Practice 101,000 101,000 425.36 Subd. 5. Board of Marriage and 425.37 Family Therapy 118,000 118,000 425.38 Subd. 6. Board of Medical 425.39 Practice 3,498,000 3,498,000 425.40 Subd. 7. Board of Nursing 2,405,000 2,405,000 425.41 Subd. 8. Board of Nursing 425.42 Home Administrators 198,000 198,000 425.43 Subd. 9. Board of Optometry 96,000 96,000 425.44 Subd. 10. Board of Pharmacy 1,386,000 1,386,000 425.45 [ADMINISTRATIVE SERVICES UNIT.] Of this 425.46 appropriation, $359,000 the first year 425.47 and $359,000 the second year are for 425.48 the health boards administrative 425.49 services unit. The administrative 425.50 services unit may receive and expend 425.51 reimbursements for services performed 425.52 for other agencies. 425.53 Subd. 11. Board of Physical 426.1 Therapy 197,000 197,000 426.2 Subd. 12. Board of Podiatry 45,000 45,000 426.3 Subd. 13. Board of Psychology 680,000 680,000 426.4 Subd. 14. Board of Social 426.5 Work 1,073,000 1,073,000 426.6 Subd. 15. Board of Veterinary 426.7 Medicine 163,000 163,000 426.8 Sec. 6. EMERGENCY MEDICAL SERVICES BOARD 426.9 Subdivision 1. Total 426.10 Appropriation 2,850,000 2,850,000 426.11 Summary by Fund 426.12 General 2,304,000 2,304,000 426.13 State Government 426.14 Special Revenue 546,000 546,000 426.15 [HEALTH PROFESSIONAL SERVICES 426.16 ACTIVITY.] $546,000 each year from the 426.17 state government special revenue fund 426.18 is for the health professional services 426.19 activity. 426.20 Sec. 7. OMBUDSMAN FOR MENTAL HEALTH 426.21 AND MENTAL RETARDATION 426.22 General 1,243,000 1,242,000 426.23 Sec. 8. OMBUDSMAN FOR 426.24 FAMILIES 426.25 General 170,000 170,000 426.26 Sec. 9. [TRANSFERS.] 426.27 Subdivision 1. [GRANTS.] The commissioner of human 426.28 services, with the approval of the commissioner of finance, and 426.29 after notification of the chair of the senate health, human 426.30 services and corrections budget division and the chair of the 426.31 house health and human services finance committee, may transfer 426.32 unencumbered appropriation balances for the biennium ending June 426.33 30, 2005, within fiscal years among the MFIP, general 426.34 assistance, general assistance medical care, medical assistance, 426.35 Minnesota supplemental aid, and group residential housing 426.36 programs, and the entitlement portion of the chemical dependency 426.37 consolidated treatment fund, and between fiscal years of the 426.38 biennium. 426.39 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 426.40 nonsalary administrative money may be transferred within the 426.41 departments of human services and health and within the programs 427.1 operated by the veterans nursing homes board as the 427.2 commissioners and the board consider necessary, with the advance 427.3 approval of the commissioner of finance. The commissioner or 427.4 the board shall inform the chairs of the house health and human 427.5 services finance committee and the senate health, human services 427.6 and corrections budget division quarterly about transfers made 427.7 under this provision. 427.8 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 427.9 transferred to operations within the departments of human 427.10 services and health and within the programs operated by the 427.11 veterans nursing homes board without the approval of the 427.12 legislature. 427.13 Sec. 10. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 427.14 The commissioners of health and of human services shall not 427.15 use indirect cost allocations to pay for the operational costs 427.16 of any program for which they are responsible. 427.17 Sec. 11. [CARRYOVER LIMITATION.] 427.18 The appropriations in this article which are allowed to be 427.19 carried forward from fiscal year 2004 to fiscal year 2005 shall 427.20 not become part of the base level funding for the 2006-2007 427.21 biennial budget, unless specifically directed by the legislature. 427.22 Sec. 12. [SUNSET OF UNCODIFIED LANGUAGE.] 427.23 All uncodified language contained in this article expires 427.24 on June 30, 2005, unless a different expiration date is explicit. 427.25 Sec. 13. [EFFECTIVE DATE.] 427.26 The provisions in this article are effective July 1, 2003, 427.27 unless a different effective date is specified.