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SF 984

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 1st Engrossment

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A bill for an act
relating to human services; modifying programs and
services for persons with disabilities; amending
Minnesota Statutes 2004, sections 256B.04, by adding a
subdivision; 256B.056, subdivisions 3, 5c; 256B.057,
subdivision 9; 256B.0575; 256B.0621, subdivisions 2,
3, 4, 5, 6, 7, by adding a subdivision; 256B.0622,
subdivision 2; 256B.0625, subdivision 9; 256B.0916, by
adding a subdivision; 256B.092, subdivision 4b;
256B.35, subdivision 1; 256B.49, subdivisions 13, 14,
16; 256B.5012, by adding a subdivision; 256B.69,
subdivision 23; 256B.765; 256D.03, subdivision 4;
256L.03, subdivisions 1, 5.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2004, section 256B.04, is
amended by adding a subdivision to read:


new text begin Subd. 20. new text end

new text begin Incentive for wellness visits. new text end

new text begin The
commissioner of human services shall consult with private sector
health plan companies and shall develop an incentive program to
encourage medical assistance enrollees with disabilities to have
regular wellness exams conducted by a primary care physician.
The commissioner shall implement the incentive program beginning
January 1, 2006.
new text end

Sec. 2.

Minnesota Statutes 2004, section 256B.056,
subdivision 3, is amended to read:


Subd. 3.

Asset limitations for deleted text begin individuals and
families
deleted text end new text begin the aged, blind, or disablednew text end .

To be eligible for
medical assistance, a person new text begin whose eligibility category is based
on blindness, disability, or age of 65 or more years
new text end must not
individually own more than deleted text begin $3,000 deleted text end new text begin $10,000 new text end in assets, or if a
member of a household with two deleted text begin family members, husband and wife,
or parent and child
deleted text end new text begin or more personsnew text end , the household must not own
more than deleted text begin $6,000 deleted text end new text begin $18,000 new text end in assetsdeleted text begin , plus $200 for each
additional legal dependent
deleted text end . In addition to these maximum
amounts, an eligible individual or family may accrue interest on
these amounts, but they must be reduced to the maximum at the
time of an eligibility redetermination. The accumulation of the
clothing and personal needs allowance according to section
256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not
considered in determining eligibility for medical assistance is
the value of those assets excluded under the supplemental
security income program for aged, blind, and disabled persons,
with the following exceptions:

(a) Household goods and personal effects are not considered.

(b) Capital and operating assets of a trade or business
that the local agency determines are necessary to the person's
ability to earn an income are not considered.

(c) Motor vehicles are excluded to the same extent excluded
by the supplemental security income program.

(d) Assets designated as burial expenses are excluded to
the same extent excluded by the supplemental security income
program. Burial expenses funded by annuity contracts or life
insurance policies must irrevocably designate the individual's
estate as contingent beneficiary to the extent proceeds are not
used for payment of selected burial expenses.

(e) Effective upon federal approval, for a person who no
longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical
assistance under section 256B.057, subdivision 9, are not
considered for 12 months, beginning with the first month of
ineligibility as an employed person with a disability, to the
extent that the person's total assets remain within the allowed
limits of section 256B.057, subdivision 9, paragraph (b).

new text begin (f) Assets owned by children are not considered.
new text end

Sec. 3.

Minnesota Statutes 2004, section 256B.056,
subdivision 5c, is amended to read:


Subd. 5c.

Excess income standard.

(a) The excess income
standard for families with children is the standard specified in
subdivision 4.

(b) The excess income standard for a person whose
eligibility is based on blindness, disability, or age of 65 or
more years is deleted text begin 70 deleted text end new text begin 100 new text end percent of the federal poverty guidelines
for the family size. deleted text begin Effective July 1, 2002, the excess income
standard for this paragraph shall equal 75 percent of the
federal poverty guidelines.
deleted text end

Sec. 4.

Minnesota Statutes 2004, section 256B.057,
subdivision 9, is amended to read:


Subd. 9.

Employed persons with disabilities.

(a) Medical
assistance may be paid for a person who is employed and who:

(1) meets the definition of disabled under the supplemental
security income program;

(2) is at least 16 but less than 65 years of age;

(3) meets the asset limits in paragraph (b); and

(4) effective November 1, 2003, pays a premium and other
obligations under paragraph (d).

Any spousal income or assets shall be disregarded for purposes
of eligibility and premium determinations.

After the month of enrollment, a person enrolled in medical
assistance under this subdivision who:

(1) is temporarily unable to work and without receipt of
earned income due to a medical condition, as verified by a
physician, may retain eligibility for up to four calendar
months; or

(2) effective January 1, 2004, loses employment for reasons
not attributable to the enrollee, may retain eligibility for up
to four consecutive months after the month of job loss. To
receive a four-month extension, enrollees must verify the
medical condition or provide notification of job loss. All
other eligibility requirements must be met and the enrollee must
pay all calculated premium costs for continued eligibility.

(b) For purposes of determining eligibility under this
subdivision, a person's assets must not exceed $20,000,
excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts,
401(k) plans, 403(b) plans, Keogh plans, and pension plans; and

(3) medical expense accounts set up through the person's
employer.

(c)(1) Effective January 1, 2004, for purposes of
eligibility, there will be a $65 earned income disregard. To be
eligible, a person applying for medical assistance under this
subdivision must have earned income above the disregard level.

(2) Effective January 1, 2004, to be considered earned
income, Medicare, Social Security, and applicable state and
federal income taxes must be withheld. To be eligible, a person
must document earned income tax withholding.

(d)(1) A person whose earned and unearned income is equal
to or greater than 100 percent of federal poverty guidelines for
the applicable family size must pay a premium to be eligible for
medical assistance under this subdivision. The premium shall be
based on the person's gross earned and unearned income and the
applicable family size using a sliding fee scale established by
the commissioner, which begins at one percent of income at 100
percent of the federal poverty guidelines and increases to 7.5
percent of income for those with incomes at or above 300 percent
of the federal poverty guidelines. Annual adjustments in the
premium schedule based upon changes in the federal poverty
guidelines shall be effective for premiums due in July of each
year.

(2) Effective January 1, 2004, all enrollees must pay a
premium to be eligible for medical assistance under this
subdivision. An enrollee shall pay the greater of a $35 premium
or the premium calculated in clause (1).

(3) Effective November 1, 2003, all enrollees who receive
unearned income must pay one-half of one percent of unearned
income in addition to the premium amount.

(4) Effective deleted text begin November 1, 2003 deleted text end new text begin July 1, 2005new text end , for
enrollees deleted text begin whose income does not exceed 200 percent of the
federal poverty guidelines and
deleted text end who are also enrolled in
Medicare, the commissioner must reimburse the enrollee for
Medicare Part B premiums under section 256B.0625, subdivision
15, paragraph (a).

new text begin (5) Increases in benefits under title II of the Social
Security Act shall not be counted as income for purposes of this
subdivision until July 1 of each year.
new text end

(e) A person's eligibility and premium shall be determined
by the local county agency. Premiums must be paid to the
commissioner. All premiums are dedicated to the commissioner.

(f) Any required premium shall be determined at application
and redetermined at the enrollee's six-month income review or
when a change in income or household size is reported.
Enrollees must report any change in income or household size
within ten days of when the change occurs. A decreased premium
resulting from a reported change in income or household size
shall be effective the first day of the next available billing
month after the change is reported. Except for changes
occurring from annual cost-of-living increases, a change
resulting in an increased premium shall not affect the premium
amount until the next six-month review.

(g) Premium payment is due upon notification from the
commissioner of the premium amount required. Premiums may be
paid in installments at the discretion of the commissioner.

(h) Nonpayment of the premium shall result in denial or
termination of medical assistance unless the person demonstrates
good cause for nonpayment. Good cause exists if the
requirements specified in Minnesota Rules, part 9506.0040,
subpart 7, items B to D, are met. Except when an installment
agreement is accepted by the commissioner, all persons
disenrolled for nonpayment of a premium must pay any past due
premiums as well as current premiums due prior to being
reenrolled. Nonpayment shall include payment with a returned,
refused, or dishonored instrument. The commissioner may require
a guaranteed form of payment as the only means to replace a
returned, refused, or dishonored instrument.

Sec. 5.

Minnesota Statutes 2004, section 256B.0575, is
amended to read:


256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
PERSONS.

When an institutionalized person is determined eligible for
medical assistance, the income that exceeds the deductions in
paragraphs (a) and (b) must be applied to the cost of
institutional care.

(a) The following amounts must be deducted from the
institutionalized person's income in the following order:

(1) the personal needs allowance under section 256B.35 or,
for a veteran who does not have a spouse or child, or a
surviving spouse of a veteran having no child, the amount of an
improved pension received from the veteran's administration not
exceeding $90 per month;

(2) the personal allowance for disabled individuals under
section 256B.36;

(3) if the institutionalized person has a legally appointed
guardian or conservator, five percent of the recipient's gross
monthly income up to $100 as reimbursement for guardianship or
conservatorship services;

(4) a monthly income allowance determined under section
256B.058, subdivision 2, but only to the extent income of the
institutionalized spouse is made available to the community
spouse;

(5) a monthly allowance for children under age 18 which,
together with the net income of the children, would provide
income equal to the medical assistance standard for families and
children according to section 256B.056, subdivision 4, for a
family size that includes only the minor children. This
deduction applies only if the children do not live with the
community spouse and only to the extent that the deduction is
not included in the personal needs allowance under section
256B.35, subdivision 1, as child support garnished under a court
order;

(6) a monthly family allowance for other family members,
equal to one-third of the difference between 122 percent of the
federal poverty guidelines and the monthly income for that
family member;

(7) reparations payments made by the Federal Republic of
Germany and reparations payments made by the Netherlands for
victims of Nazi persecution between 1940 and 1945;

(8) all other exclusions from income for institutionalized
persons as mandated by federal law; and

(9) amounts for reasonable expenses incurred for necessary
medical or remedial care for the institutionalized person that
are not medical assistance covered expenses and that are not
subject to payment by a third party.

For purposes of clause (6), "other family member" means a
person who resides with the community spouse and who is a minor
or dependent child, dependent parent, or dependent sibling of
either spouse. "Dependent" means a person who could be claimed
as a dependent for federal income tax purposes under the
Internal Revenue Code.

(b) Income shall be allocated to an institutionalized
person for a period of up to deleted text begin three deleted text end new text begin six new text end calendar months, in an
amount equal to new text begin 100 percent of new text end the deleted text begin medical assistance standard
deleted text end new text begin federal poverty guidelines new text end for a family size of one if:

(1) a physician certifies that the person is expected to
reside in the long-term care facility for deleted text begin three deleted text end new text begin six new text end calendar
months or less;

(2) if the person has expenses of maintaining a residence
in the community; and

(3) if one of the following circumstances apply:

(i) the person was not living together with a spouse or a
family member as defined in paragraph (a) when the person
entered a long-term care facility; or

(ii) the person and the person's spouse become
institutionalized on the same date, in which case the allocation
shall be applied to the income of one of the spouses.

For purposes of this paragraph, a person is determined to be
residing in a licensed nursing home, regional treatment center,
or medical institution if the person is expected to remain for a
period of one full calendar month or more.

Sec. 6.

Minnesota Statutes 2004, section 256B.0621,
subdivision 2, is amended to read:


Subd. 2.

Targeted case management; definitions.

For
purposes of subdivisions 3 to 10, the following terms have the
meanings given them:

(1) "home care service recipients" means those individuals
receiving the following services under section 256B.0627:
skilled nursing visits, home health aide visits, private duty
nursing, personal care assistants, or therapies provided through
a home health agency;

(2) "home care targeted case management" means the
provision of targeted case management services for the purpose
of assisting home care service recipients to gain access to
needed services and supports so that they may remain in the
community;

(3) "institutions" means hospitals, consistent with Code of
Federal Regulations, title 42, section 440.10; regional
treatment center inpatient services, consistent with section
245.474; nursing facilities; and intermediate care facilities
for persons with mental retardation;

(4) "relocation targeted case management" deleted text begin means deleted text end new text begin includes
new text end the provision of new text begin both county new text end targeted case management new text begin and
service coordination
new text end services for the purpose of assisting
recipients to gain access to needed services and supports if
they choose to move from an institution to the community.
Relocation targeted case management may be provided during the
last 180 consecutive days of an eligible recipient's
institutional stay; and

(5) "targeted case management" means case management
services provided to help recipients gain access to needed
medical, social, educational, and other services and supports.

Sec. 7.

Minnesota Statutes 2004, section 256B.0621,
subdivision 3, is amended to read:


Subd. 3.

Eligibility.

The following persons are eligible
for relocation targeted case management or home deleted text begin care-targeted
deleted text end new text begin care targeted new text end case management:

(1) medical assistance eligible persons residing in
institutions who choose to move into the community are eligible
for relocation targeted case management services; and

(2) medical assistance eligible persons receiving home care
services, who are not eligible for any other medical assistance
reimbursable case management service, are eligible for home
deleted text begin care-targeted deleted text end new text begin care targeted new text end case management services beginning
deleted text begin January 1, 2003 deleted text end new text begin July 1, 2005new text end .

Sec. 8.

Minnesota Statutes 2004, section 256B.0621,
subdivision 4, is amended to read:


Subd. 4.

Relocation targeted new text begin county new text end case management
provider qualifications.

(a) A relocation targeted new text begin county new text end case
management provider is an enrolled medical assistance provider
who is determined by the commissioner to have all of the
following characteristics:

(1) the legal authority to provide public welfare under
sections 393.01, subdivision 7; and 393.07; or a federally
recognized Indian tribe;

(2) the demonstrated capacity and experience to provide the
components of case management to coordinate and link community
resources needed by the eligible population;

(3) the administrative capacity and experience to serve the
target population for whom it will provide services and ensure
quality of services under state and federal requirements;

(4) the legal authority to provide complete investigative
and protective services under section 626.556, subdivision 10;
and child welfare and foster care services under section 393.07,
subdivisions 1 and 2; or a federally recognized Indian tribe;

(5) a financial management system that provides accurate
documentation of services and costs under state and federal
requirements; and

(6) the capacity to document and maintain individual case
records under state and federal requirements.

(b) A provider of targeted case management under section
256B.0625, subdivision 20, may be deemed a certified provider of
relocation targeted case management.

(c) A relocation targeted new text begin county new text end case management provider
may subcontract with another provider to deliver relocation
targeted case management services. Subcontracted providers must
demonstrate the ability to provide the services outlined in
subdivision 6, and have a procedure in place that notifies the
recipient and the recipient's legal representative of any
conflict of interest if the contracted targeted case management
provider also provides, or will provide, the recipient's
services and supports. new text begin Counties must require that new text end contracted
providers must provide information on all conflicts of interest
and obtain the recipient's informed consent or provide the
recipient with alternatives.

Sec. 9.

Minnesota Statutes 2004, section 256B.0621,
subdivision 5, is amended to read:


Subd. 5.

Home care targeted case management new text begin and
relocation service coordination
new text end provider qualifications.

deleted text begin The
following qualifications and certification standards must be met
by
deleted text end Providers of home care targeted case management new text begin and
relocation service coordination must meet the qualifications
under subdivision 4 or the following qualifications and
certification standards
new text end .

(a) The commissioner must certify each provider of home
care targeted case management new text begin and relocation service
coordination
new text end before enrollment. The certification process shall
examine the provider's ability to meet the requirements in this
subdivision and other state and federal requirements of this
service.

(b) deleted text begin A deleted text end new text begin Both new text end home care targeted case management deleted text begin provider is
an
deleted text end new text begin providers and relocation service coordination providers are
new text end enrolled medical assistance deleted text begin provider deleted text end new text begin providers new text end who deleted text begin has deleted text end new text begin have new text end a
minimum of a bachelor's degree or a license in a health or human
services fieldnew text begin , or comparable training and two years of
experience in human services
new text end , and deleted text begin is deleted text end new text begin have been new text end determined by the
commissioner to have all of the following characteristics:

(1) the demonstrated capacity and experience to provide the
components of case management to coordinate and link community
resources needed by the eligible population;

(2) the administrative capacity and experience to serve the
target population for whom it will provide services and ensure
quality of services under state and federal requirements;

(3) a financial management system that provides accurate
documentation of services and costs under state and federal
requirements;

(4) the capacity to document and maintain individual case
records under state and federal requirements; deleted text begin and
deleted text end

(5) the capacity to coordinate with county administrative
functionsnew text begin ;
new text end

new text begin (6) have no financial interest in the provision of
out-of-home residential services to persons for whom targeted
case management or relocation service coordination is provided;
and
new text end

new text begin (7) if a provider has a financial interest in services
other than out-of-home residential services provided to persons
for whom targeted case management or relocation service
coordination is also provided, the county must determine each
year that:
new text end

new text begin (i) any possible conflict of interest is explained annually
at a face-to-face meeting and in writing and the person provides
written informed consent consistent with section 256B.77,
subdivision 2, paragraph (p); and
new text end

new text begin (ii) information on a range of other feasible service
provider options has been provided
new text end .

Sec. 10.

Minnesota Statutes 2004, section 256B.0621,
subdivision 6, is amended to read:


Subd. 6.

Eligible services.

new text begin (a) new text end Services eligible for
medical assistance reimbursement as targeted case management
include:

(1) assessment of the recipient's need for targeted case
management services;

(2) development, completion, and regular review of a
written individual service plan, which is based upon the
assessment of the recipient's needs and choices, and which will
ensure access to medical, social, educational, and other related
services and supports;

(3) routine contact or communication with the recipient,
recipient's family, primary caregiver, legal representative,
substitute care provider, service providers, or other relevant
persons identified as necessary to the development or
implementation of the goals of the individual service plan;

(4) coordinating referrals for, and the provision of, case
management services for the recipient with appropriate service
providers, consistent with section 1902(a)(23) of the Social
Security Act;

(5) coordinating and monitoring the overall service
delivery new text begin and engaging in advocacy as needed new text end to ensure quality of
services, appropriateness, and continued need;

(6) completing and maintaining necessary documentation that
supports and verifies the activities in this subdivision;

(7) deleted text begin traveling deleted text end new text begin assisting individuals in order to access
needed services, including travel
new text end to conduct a visit with the
recipient or other relevant person necessary to develop or
implement the goals of the individual service plan; and

(8) coordinating with the institution discharge planner in
the 180-day period before the recipient's discharge.

new text begin (b) Relocation targeted county case management includes
services under paragraph (a), clauses (2) and (4). Relocation
service coordination includes services under paragraph (a),
clauses (1), (3), and (5) to (8). Home care targeted case
management includes services under paragraph (a), clauses (1) to
(8).
new text end

Sec. 11.

Minnesota Statutes 2004, section 256B.0621,
subdivision 7, is amended to read:


Subd. 7.

Time lines.

The following time lines must be
met for assigning a case manager:

(a) For relocation targeted case management, an eligible
recipient must be assigned a new text begin county new text end case manager who visits the
person within 20 working days of requesting a case manager from
their county of financial responsibility as determined under
chapter 256G.

(1) If a county agency, its contractor, or federally
recognized tribe does not provide case management services as
required, the recipient may obtain deleted text begin targeted relocation case
management services
deleted text end new text begin relocation service coordination new text end from deleted text begin an
alternative
deleted text end new text begin a new text end provider deleted text begin of targeted case management services
enrolled by the commissioner
deleted text end new text begin qualified under subdivision 5new text end .

(2) The commissioner may waive the provider requirements in
subdivision 4, paragraph (a), clauses (1) and (4), to ensure
recipient access to the assistance necessary to move from an
institution to the community. The recipient or the recipient's
legal guardian shall provide written notice to the county or
tribe of the decision to obtain services from an alternative
provider.

(3) Providers of relocation targeted case management
enrolled under this subdivision shall:

(i) meet the provider requirements under subdivision 4 that
are not waived by the commissioner;

(ii) be qualified to provide the services specified in
subdivision 6;

(iii) coordinate efforts with local social service agencies
and tribes; and

(iv) comply with the conflict of interest provisions
established under subdivision 4, paragraph (c).

(4) Local social service agencies and federally recognized
tribes shall cooperate with providers certified by the
commissioner under this subdivision to facilitate the
recipient's successful relocation from an institution to the
community.

(b) For home care targeted case management, an eligible
recipient must be assigned a case manager within 20 working days
of requesting a case manager from a home care targeted case
management provider, as defined in subdivision 5.

Sec. 12.

Minnesota Statutes 2004, section 256B.0621, is
amended by adding a subdivision to read:


new text begin Subd. 11. new text end

new text begin Data use agreement and notice of relocation
targeted case management availability.
new text end

new text begin (a) The commissioner
shall execute a data use agreement with the Center for Medicare
and Medicaid Services to obtain the long-term care minimum data
set data to assist residents of nursing facilities who have
indicated a desire to live in the community. The commissioner
shall in turn enter into agreements with the Centers for
Independent Living and other disability advocacy organizations
to assist persons who want help to move to the community.
new text end

new text begin (b) Upon admission and annually thereafter, the
commissioner shall provide notification to medical assistance
eligible persons who are residing in institutions of the
availability of relocation targeted case management services,
including contact information for the responsible county and
senior and disability organizations that provide assistance to
persons with disabilities.
new text end

Sec. 13.

Minnesota Statutes 2004, section 256B.0622,
subdivision 2, is amended to read:


Subd. 2.

Definitions.

For purposes of this section, the
following terms have the meanings given them.

(a) "Intensive nonresidential rehabilitative mental health
services" means adult rehabilitative mental health services as
defined in section 256B.0623, subdivision 2, paragraph (a),
except that these services are provided by a multidisciplinary
staff using a total team approach consistent with assertive
community treatment, the Fairweather Lodge treatment model, new text begin as
defined by the standards established by the National Coalition
for Community Living,
new text end and other evidence-based practices, and
directed to recipients with a serious mental illness who require
intensive services.

(b) "Intensive residential rehabilitative mental health
services" means short-term, time-limited services provided in a
residential setting to recipients who are in need of more
restrictive settings and are at risk of significant functional
deterioration if they do not receive these services. Services
are designed to develop and enhance psychiatric stability,
personal and emotional adjustment, self-sufficiency, and skills
to live in a more independent setting. Services must be
directed toward a targeted discharge date with specified client
outcomes and must be consistent with new text begin the Fairweather Lodge
treatment model as defined in paragraph (a), and other
new text end evidence-based practices.

(c) "Evidence-based practices" are nationally recognized
mental health services that are proven by substantial research
to be effective in helping individuals with serious mental
illness obtain specific treatment goals.

(d) "Overnight staff" means a member of the intensive
residential rehabilitative mental health treatment team who is
responsible during hours when recipients are typically asleep.

(e) "Treatment team" means all staff who provide services
under this section to recipients. At a minimum, this includes
the clinical supervisor, mental health professionals, mental
health practitioners, and mental health rehabilitation workers.

Sec. 14.

Minnesota Statutes 2004, section 256B.0625,
subdivision 9, is amended to read:


Subd. 9.

Dental services.

deleted text begin (a) deleted text end Medical assistance covers
dental services. Dental services include, with prior
authorization, fixed bridges that are cost-effective for persons
who cannot use removable dentures because of their medical
condition.

deleted text begin (b) Coverage of dental services for adults age 21 and over
who are not pregnant is subject to a $500 annual benefit limit
and covered services are limited to:
deleted text end

deleted text begin (1) diagnostic and preventative services;
deleted text end

deleted text begin (2) restorative services; and
deleted text end

deleted text begin (3) emergency services.
deleted text end

deleted text begin Emergency services, dentures, and extractions related to
dentures are not included in the $500 annual benefit limit.
deleted text end

Sec. 15.

Minnesota Statutes 2004, section 256B.0916, is
amended by adding a subdivision to read:


new text begin Subd. 10.new text end

new text begin Transitional supports allowance.new text end

new text begin A
transitional supports allowance shall be available to all
persons under a home and community-based waiver who are moving
from a licensed setting to a community setting. "Transitional
supports allowance" means a onetime payment of up to $3,000, to
cover the costs, not covered by other sources, associated with
moving from a licensed setting to a community setting. Covered
costs include:
new text end

new text begin (1) lease or rent deposits;
new text end

new text begin (2) security deposits;
new text end

new text begin (3) utilities set-up costs, including telephone;
new text end

new text begin (4) essential furnishings and supplies; and
new text end

new text begin (5) personal supports and transports needed to locate and
transition to community settings.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal
approval and to the extent approved as a federal waiver
amendment.
new text end

Sec. 16.

Minnesota Statutes 2004, section 256B.092,
subdivision 4b, is amended to read:


Subd. 4b.

new text begin county new text end case management new text begin and service coordination
new text end for persons receiving home and community-based services.

new text begin (a)
new text end Persons authorized for and receiving home and community-based
services may select from new text begin public new text end vendors of new text begin county new text end case
management which have provider agreements with the state to
provide home and community-based case management service
activities. deleted text begin This subdivision becomes effective July 1, 1992,
only if the state agency is unable to secure federal approval
for limiting choice of case management vendors to the county of
financial responsibility.
deleted text end

new text begin (b) The commissioner shall ensure that each eligible person
is given a choice between county and private agency service
coordination vendors consistent with the provisions of section
256B.49, subdivision 13.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
or, if a federal waiver is required, on the date the federal
waiver is granted.
new text end

Sec. 17.

Minnesota Statutes 2004, section 256B.35,
subdivision 1, is amended to read:


Subdivision 1.

Personal needs allowance.

(a)
Notwithstanding any law to the contrary, welfare allowances for
clothing and personal needs for individuals receiving medical
assistance while residing in any skilled nursing home,
intermediate care facility, or medical institution including
recipients of supplemental security income, in this state shall
not be less than deleted text begin $45 deleted text end new text begin $150 new text end per month from all sources. When
benefit amounts for Social Security or supplemental security
income recipients are increased pursuant to United States Code,
title 42, sections 415(i) and 1382f, the commissioner shall,
effective in the month in which the increase takes effect,
increase by the same percentage to the nearest whole dollar the
clothing and personal needs allowance for individuals receiving
medical assistance while residing in any skilled nursing home,
medical institution, or intermediate care facility. The
commissioner shall provide timely notice to local agencies,
providers, and recipients of increases under this provision.

(b) The personal needs allowance may be paid as part of the
Minnesota supplemental aid program, notwithstanding the
provisions of section 256D.37, subdivision 2, and payments to
recipients of Minnesota supplemental aid may be made once each
three months covering liabilities that accrued during the
preceding three months.

(c) The personal needs allowance shall be increased to
include income garnished for child support under a court order,
up to a maximum of $250 per month but only to the extent that
the amount garnished is not deducted as a monthly allowance for
children under section 256B.0575, paragraph (a), clause (5).

Sec. 18.

Minnesota Statutes 2004, section 256B.49,
subdivision 13, is amended to read:


Subd. 13.

new text begin county new text end case management new text begin and service coordination
services
new text end .

(a) Each recipient of a home and community-based
waiver shall be provided new text begin county new text end case management new text begin and service
coordination
new text end services by qualified vendors as described in the
federally approved waiver application new text begin and offered a choice
between county and private vendors for service coordination
services
new text end . The new text begin county new text end case management deleted text begin service
activities
deleted text end new text begin services to be new text end provided deleted text begin will deleted text end include:

(1) assessing the needs of the individual within 20 working
days of a recipient's request;

(2) developing the written individual service plan within
ten working days after the assessment is completednew text begin , including a
determination of resources needed to meet assessed needs
new text end ;

(3) informing the recipient or the recipient's legal
guardian or conservator of service options; new text begin and
new text end

(4) new text begin monitoring and evaluating the overall service plan
implementation to assure the recipient's health, safety,
welfare, and service outcomes.
new text end

new text begin (b) Each recipient shall be offered a choice of a service
coordination vendor among qualified public and private vendors
as described in the federally approved waiver application. The
service coordination activities include:
new text end

new text begin (1) assisting the recipient to provide medical and other
information to determine services needs;
new text end

new text begin (2) new text end assisting the recipient in the identification of
potential service providers;

deleted text begin (5) deleted text end new text begin (3) new text end assisting the recipient to access services;

deleted text begin (6) deleted text end new text begin (4) new text end coordinating, evaluating, and monitoring of the
new text begin recipient and the new text end services identified in the service plan new text begin to
assure that the ongoing needs of the recipient are met or
changes are made, if needed
new text end ;

deleted text begin (7) deleted text end new text begin (5) assisting the recipient to obtain all information
for
new text end completing the annual new text begin or other new text end reviews new text begin described in
subdivision 14
new text end of the service plan new text begin with the case managernew text end ; deleted text begin and
deleted text end

new text begin (6) participating in meetings and consultations and
advocating for the recipient with recipient's service providers,
medical providers, and county staff as needed;
new text end

new text begin (7) having no financial interest in out-of-home residential
services for persons for whom service coordination is provided;
and
new text end

(8) deleted text begin informing the recipient or legal representative of the
right to have assessments completed and service plans developed
within specified time periods, and to appeal county action or
inaction under section 256.045, subdivision 3
deleted text end new text begin if a provider has
a financial interest in services other than out-of-home
residential services provided to persons for whom targeted case
management or relocation service coordination is also provided,
the county must determine each year that:
new text end

new text begin (i) any possible conflict of interest is explained annually
at a face-to-face meeting and in writing and the person provides
written informed consent consistent with section 256B.77,
subdivision 2, paragraph (p); and
new text end

new text begin (ii) information on a range of other feasible service
provider options has been provided
new text end .

deleted text begin (b) deleted text end new text begin (c) new text end The deleted text begin case manager deleted text end new text begin county new text end may delegate certain
aspects of the new text begin county new text end case management new text begin or new text end service new text begin coordination
new text end activities to another individual provided there is oversight by
the case manager. The case manager may not delegate those
aspects which require professional judgment including
assessments, reassessments, and care plan development.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2005,
or, if a federal waiver is required, on the date the federal
waiver is granted.
new text end

Sec. 19.

Minnesota Statutes 2004, section 256B.49,
subdivision 14, is amended to read:


Subd. 14.

Assessment and reassessment.

(a) Assessments
of each recipient's strengths, informal support systems, and
need for services shall be completed new text begin by the county case manager
new text end within 20 working days of the recipient's request. Reassessment
of each recipient's strengths, support systems, and need for
services shall be conducted new text begin by the county case manager new text end at least
every 12 months and at other times when there has been a
significant change in the recipient's functioning.

(b) Persons with mental retardation or a related condition
who apply for services under the nursing facility level waiver
programs shall be screened for the appropriate level of care
according to section 256B.092.

(c) Recipients who are found eligible for home and
community-based services under this section before their 65th
birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.

Sec. 20.

Minnesota Statutes 2004, section 256B.49,
subdivision 16, is amended to read:


Subd. 16.

Services and supports.

(a) Services and
supports included in the home and community-based waivers for
persons with disabilities shall meet the requirements set out in
United States Code, title 42, section 1396n. The services and
supports, which are offered as alternatives to institutional
care, shall promote consumer choice, community inclusion,
self-sufficiency, and self-determination.

(b) Beginning January 1, 2003, the commissioner shall
simplify and improve access to home and community-based waivered
services, to the extent possible, through the establishment of a
common service menu that is available to eligible recipients
regardless of age, disability type, or waiver program.

(c) Consumer directed community support services shall be
offered as an option to all persons eligible for services under
subdivision 11, by January 1, 2002.

(d) Services and supports shall be arranged and provided
consistent with individualized written plans of care for
eligible waiver recipients.

(e) new text begin A transitional supports allowance shall be available to
all persons under a home and community-based waiver who are
moving from a licensed setting to a community setting.
"Transitional supports allowance" means a onetime payment of up
to $3,000, to cover the costs, not covered by other sources,
associated with moving from a licensed setting to a community
setting. Covered costs include:
new text end

new text begin (1) lease or rent deposits;
new text end

new text begin (2) security deposits;
new text end

new text begin (3) utilities set-up costs, including telephone;
new text end

new text begin (4) essential furnishings and supplies; and
new text end

new text begin (5) personal supports and transports needed to locate and
transition to community settings.
new text end

new text begin (f) new text end The state of Minnesota and county agencies that
administer home and community-based waivered services for
persons with disabilities, shall not be liable for damages,
injuries, or liabilities sustained through the purchase of
supports by the individual, the individual's family, legal
representative, or the authorized representative with funds
received through the consumer-directed community support service
under this section. Liabilities include but are not limited
to: workers' compensation liability, the Federal Insurance
Contributions Act (FICA), or the Federal Unemployment Tax Act
(FUTA).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal
approval and to the extent approved as a federal waiver
amendment.
new text end

Sec. 21.

Minnesota Statutes 2004, section 256B.5012, is
amended by adding a subdivision to read:


new text begin Subd. 6. new text end

new text begin Icf/mr rate increases beginning january 1, 2006,
and january 1, 2007.
new text end

new text begin For the rate years beginning January 1,
2006, and January 1, 2007, the commissioner shall provide
facilities reimbursed under this section an adjustment to the
total operating payment rate of ..... percent. At least
two-thirds of each year's adjustment must be used for increased
costs of employee salaries and benefits and associated costs for
FICA, the Medicare tax, workers' compensation premiums, and
federal and state unemployment insurance. Each facility
receiving an adjustment shall report to the commissioner, in the
form and manner specified by the commissioner, on how the
additional funding was used.
new text end

Sec. 22.

Minnesota Statutes 2004, section 256B.69,
subdivision 23, is amended to read:


Subd. 23.

Alternative integrated long-term care services;
elderly and disabled persons.

(a) The commissioner may
implement demonstration projects to create alternative
integrated delivery systems for acute and long-term care
services to elderly persons and persons with disabilities as
defined in section 256B.77, subdivision 7a, that provide
increased coordination, improve access to quality services, and
mitigate future cost increases. The commissioner may seek
federal authority to combine Medicare and Medicaid capitation
payments for the purpose of such demonstrations. Medicare funds
and services shall be administered according to the terms and
conditions of the federal waiver and demonstration provisions.
For the purpose of administering medical assistance funds,
demonstrations under this subdivision are subject to
subdivisions 1 to 22. The provisions of Minnesota Rules, parts
9500.1450 to 9500.1464, apply to these demonstrations, with the
exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
subpart 1, items B and C, which do not apply to persons
enrolling in demonstrations under this section. An initial open
enrollment period may be provided. Persons who disenroll from
demonstrations under this subdivision remain subject to
Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is
enrolled in a health plan under these demonstrations and the
health plan's participation is subsequently terminated for any
reason, the person shall be provided an opportunity to select a
new health plan and shall have the right to change health plans
within the first 60 days of enrollment in the second health
plan. Persons required to participate in health plans under
this section who fail to make a choice of health plan shall not
be randomly assigned to health plans under these demonstrations.
Notwithstanding section 256L.12, subdivision 5, and Minnesota
Rules, part 9505.5220, subpart 1, item A, if adopted, for the
purpose of demonstrations under this subdivision, the
commissioner may contract with managed care organizations,
including counties, to serve only elderly persons eligible for
medical assistance, elderly and disabled persons, or disabled
persons only. For persons with primary diagnoses of mental
retardation or a related condition, serious and persistent
mental illness, or serious emotional disturbance, the
commissioner must ensure that the county authority has approved
the demonstration and contracting design. Enrollment in these
projects for persons with disabilities shall be voluntary. The
commissioner shall not implement any demonstration project under
this subdivision for persons with primary diagnoses of mental
retardation or a related condition, serious and persistent
mental illness, or serious emotional disturbance, without
approval of the county board of the county in which the
demonstration is being implemented.

(b) Notwithstanding chapter 245B, sections 252.40 to
252.46, 256B.092, 256B.501 to 256B.5015, and Minnesota Rules,
parts 9525.0004 to 9525.0036, 9525.1200 to 9525.1330, 9525.1580,
and 9525.1800 to 9525.1930, the commissioner may implement under
this section projects for persons with developmental
disabilities. The commissioner may capitate payments for ICF/MR
services, waivered services for mental retardation or related
conditions, including case management services, day training and
habilitation and alternative active treatment services, and
other services as approved by the state and by the federal
government. Case management and active treatment must be
individualized and developed in accordance with a
person-centered plan. Costs under these projects may not exceed
costs that would have been incurred under fee-for-service.
Beginning July 1, 2003, and until two years after the pilot
project implementation date, subcontractor participation in the
long-term care developmental disability pilot is limited to a
nonprofit long-term care system providing ICF/MR services, home
and community-based waiver services, and in-home services to no
more than 120 consumers with developmental disabilities in
Carver, Hennepin, and Scott Counties. The commissioner shall
report to the legislature prior to expansion of the
developmental disability pilot project. This paragraph expires
two years after the implementation date of the pilot project.

(c) Before implementation of a demonstration project for
disabled persons, the commissioner must provide information to
appropriate committees of the house of representatives and
senate and must involve representatives of affected disability
groups in the design of the demonstration projects.

(d) A nursing facility reimbursed under the alternative
reimbursement methodology in section 256B.434 may, in
collaboration with a hospital, clinic, or other health care
entity provide services under paragraph (a). The commissioner
shall amend the state plan and seek any federal waivers
necessary to implement this paragraph.

new text begin (e) The commissioner shall seek federal approval to expand
the Minnesota disability health options (MnDHO) program
established under this subdivision in stages, first to regional
population centers outside the seven-county metro area and then
to all areas of the state.
new text end

Sec. 23.

Minnesota Statutes 2004, section 256B.765, is
amended to read:


256B.765 PROVIDER RATE INCREASES.

new text begin Subdivision 1. new text end

new text begin Annual inflation adjustments. new text end

(a)
Effective July 1, 2001, within the limits of appropriations
specifically for this purpose, the commissioner shall provide an
annual inflation adjustment for the providers listed
in deleted text begin paragraph (c) deleted text end new text begin subdivision 2new text end . The index for the inflation
adjustment must be based on the change in the Employment Cost
Index for Private Industry Workers - Total Compensation
forecasted by Data Resources, Inc., as forecasted in the fourth
quarter of the calendar year preceding the fiscal year. The
commissioner shall increase reimbursement or allocation rates by
the percentage of this adjustment, and county boards shall
adjust provider contracts as needed.

(b) The commissioner of finance shall include an annual
inflationary adjustment in reimbursement rates for the providers
listed in deleted text begin paragraph (c) deleted text end new text begin subdivision 2 new text end using the inflation factor
specified in paragraph (a) as a budget change request in each
biennial detailed expenditure budget submitted to the
legislature under section 16A.11.

deleted text begin (c) deleted text end new text begin Subd. 2.new text end [ELIGIBLE PROVIDERS.] The annual adjustment
under new text begin subdivision 1,new text end paragraph (a)new text begin ,new text end shall be provided for home
and community-based waiver services for persons with mental
retardation or related conditions under section 256B.501; home
and community-based waiver services for the elderly under
section 256B.0915; waivered services under community
alternatives for disabled individuals under section 256B.49;
community alternative care waivered services under section
256B.49; traumatic brain injury waivered services under section
256B.49; nursing services and home health services under section
256B.0625, subdivision 6a; personal care services and nursing
supervision of personal care services under section 256B.0625,
subdivision 19a; private duty nursing services under section
256B.0625, subdivision 7; day training and habilitation services
for adults with mental retardation or related conditions under
sections 252.40 to 252.46; physical therapy services under
sections 256B.0625, subdivision 8, and 256D.03, subdivision 4;
occupational therapy services under sections 256B.0625,
subdivision 8a, and 256D.03, subdivision 4; speech-language
therapy services under section 256D.03, subdivision 4, and
Minnesota Rules, part 9505.0390; respiratory therapy services
under section 256D.03, subdivision 4, and Minnesota Rules, part
9505.0295; alternative care services under section 256B.0913;
adult residential program grants under Minnesota Rules, parts
9535.2000 to 9535.3000; adult and family community support
grants under Minnesota Rules, parts 9535.1700 to 9535.1760;
semi-independent living services under section 252.275 including
SILS funding under county social services grants formerly funded
under chapter 256I; and community support services for deaf and
hard-of-hearing adults with mental illness who use or wish to
use sign language as their primary means of communication.

new text begin Subd. 3. new text end

new text begin Rate increase for biennium beginning july 1,
2005.
new text end

new text begin For the fiscal years beginning July 1, 2005, and July 1,
2006, the commissioner shall increase reimbursement rates for
the providers listed in subdivision 2 by ..... percent. At
least two-thirds of each year's adjustment must be used for
increased costs of employee salaries and benefits and associated
costs for FICA, the Medicare tax, workers' compensation
premiums, and federal and state unemployment insurance. Each
provider receiving an adjustment shall report to the
commissioner, in the form and manner specified by the
commissioner, on how the additional funding was used.
new text end

Sec. 24.

Minnesota Statutes 2004, section 256D.03,
subdivision 4, is amended to read:


Subd. 4.

General assistance medical care; services.

(a)(i) For a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):

(1) inpatient hospital services;

(2) outpatient hospital services;

(3) services provided by Medicare certified rehabilitation
agencies;

(4) prescription drugs and other products recommended
through the process established in section 256B.0625,
subdivision 13;

(5) equipment necessary to administer insulin and
diagnostic supplies and equipment for diabetics to monitor blood
sugar level;

(6) eyeglasses and eye examinations provided by a physician
or optometrist;

(7) hearing aids;

(8) prosthetic devices;

(9) laboratory and X-ray services;

(10) physician's services;

(11) medical transportation except special transportation;

(12) chiropractic services as covered under the medical
assistance program;

(13) podiatric services;

(14) dental services deleted text begin and dentures, subject to the
limitations specified in section 256B.0625, subdivision 9
deleted text end new text begin as
covered under the medical assistance program
new text end ;

(15) outpatient services provided by a mental health center
or clinic that is under contract with the county board and is
established under section 245.62;

(16) day treatment services for mental illness provided
under contract with the county board;

(17) prescribed medications for persons who have been
diagnosed as mentally ill as necessary to prevent more
restrictive institutionalization;

(18) psychological services, medical supplies and
equipment, and Medicare premiums, coinsurance and deductible
payments;

(19) medical equipment not specifically listed in this
paragraph when the use of the equipment will prevent the need
for costlier services that are reimbursable under this
subdivision;

(20) services performed by a certified pediatric nurse
practitioner, a certified family nurse practitioner, a certified
adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or
a certified geriatric nurse practitioner in independent
practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an
inpatient basis is not included as part of the cost for
inpatient services included in the operating payment rate, and
(3) the service is within the scope of practice of the nurse
practitioner's license as a registered nurse, as defined in
section 148.171;

(21) services of a certified public health nurse or a
registered nurse practicing in a public health nursing clinic
that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the
scope of practice of the public health nurse's license as a
registered nurse, as defined in section 148.171; and

(22) telemedicine consultations, to the extent they are
covered under section 256B.0625, subdivision 3b.

(ii) Effective October 1, 2003, for a person who is
eligible under subdivision 3, paragraph (a), clause (2), item
(ii), general assistance medical care coverage is limited to
inpatient hospital services, including physician services
provided during the inpatient hospital stay. A $1,000
deductible is required for each inpatient hospitalization.

(b) Gender reassignment surgery and related services are
not covered services under this subdivision unless the
individual began receiving gender reassignment services prior to
July 1, 1995.

(c) In order to contain costs, the commissioner of human
services shall select vendors of medical care who can provide
the most economical care consistent with high medical standards
and shall where possible contract with organizations on a
prepaid capitation basis to provide these services. The
commissioner shall consider proposals by counties and vendors
for prepaid health plans, competitive bidding programs, block
grants, or other vendor payment mechanisms designed to provide
services in an economical manner or to control utilization, with
safeguards to ensure that necessary services are provided.
Before implementing prepaid programs in counties with a county
operated or affiliated public teaching hospital or a hospital or
clinic operated by the University of Minnesota, the commissioner
shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to
participate in the program in a manner that reflects the risk of
adverse selection and the nature of the patients served by the
hospital, provided the terms of participation in the program are
competitive with the terms of other participants considering the
nature of the population served. Payment for services provided
pursuant to this subdivision shall be as provided to medical
assistance vendors of these services under sections 256B.02,
subdivision 8, and 256B.0625. For payments made during fiscal
year 1990 and later years, the commissioner shall consult with
an independent actuary in establishing prepayment rates, but
shall retain final control over the rate methodology.

(d) Recipients eligible under subdivision 3, paragraph (a),
clause (2), item (i), shall pay the following co-payments for
services provided on or after October 1, 2003:

(1) $3 per nonpreventive visit. For purposes of this
subdivision, a visit means an episode of service which is
required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory
setting by a physician or physician ancillary, chiropractor,
podiatrist, nurse midwife, advanced practice nurse, audiologist,
optician, or optometrist;

(2) $25 for eyeglasses;

(3) $25 for nonemergency visits to a hospital-based
emergency room; new text begin and
new text end

(4) $3 per brand-name drug prescription and $1 per generic
drug prescription, subject to a $20 per month maximum for
prescription drug co-payments. No co-payments shall apply to
antipsychotic drugs when used for the treatment of mental
illnessdeleted text begin ; and
deleted text end

deleted text begin (5) 50 percent coinsurance on restorative dental servicesdeleted text end .

(e) Co-payments shall be limited to one per day per
provider for nonpreventive visits, eyeglasses, and nonemergency
visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all
co-payments in this subdivision. The general assistance medical
care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for
prescription drugs shall not be reduced once a recipient has
reached the $20 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the
recipient. Providers may not deny services to recipients who
are unable to pay the co-payment, except as provided in
paragraph (f).

(f) If it is the routine business practice of a provider to
refuse service to an individual with uncollected debt, the
provider may include uncollected co-payments under this
section. A provider must give advance notice to a recipient
with uncollected debt before services can be denied.

(g) Any county may, from its own resources, provide medical
payments for which state payments are not made.

(h) Chemical dependency services that are reimbursed under
chapter 254B must not be reimbursed under general assistance
medical care.

(i) The maximum payment for new vendors enrolled in the
general assistance medical care program after the base year
shall be determined from the average usual and customary charge
of the same vendor type enrolled in the base year.

(j) The conditions of payment for services under this
subdivision are the same as the conditions specified in rules
adopted under chapter 256B governing the medical assistance
program, unless otherwise provided by statute or rule.

(k) Inpatient and outpatient payments shall be reduced by
five percent, effective July 1, 2003. This reduction is in
addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (i).

(l) Payments for all other health services except
inpatient, outpatient, and pharmacy services shall be reduced by
five percent, effective July 1, 2003.

(m) Payments to managed care plans shall be reduced by five
percent for services provided on or after October 1, 2003.

(n) A hospital receiving a reduced payment as a result of
this section may apply the unpaid balance toward satisfaction of
the hospital's bad debts.

Sec. 25.

Minnesota Statutes 2004, section 256L.03,
subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

For individuals
under section 256L.04, subdivision 7, with income no greater
than 75 percent of the federal poverty guidelines or for
families with children under section 256L.04, subdivision 1, all
subdivisions of this section apply. "Covered health services"
means the health services reimbursed under chapter 256B, with
the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care
services deleted text begin other than services deleted text end new text begin except as new text end covered under section
256B.0625, subdivision 9, deleted text begin paragraph (b), orthodontic services,
deleted text end nonemergency medical transportation services, personal care
assistant and case management services, nursing home or
intermediate care facilities services, inpatient mental health
services, and chemical dependency services. Outpatient mental
health services covered under the MinnesotaCare program are
limited to diagnostic assessments, psychological testing,
explanation of findings, medication management by a physician,
day treatment, partial hospitalization, and individual, family,
and group psychotherapy.

No public funds shall be used for coverage of abortion
under MinnesotaCare except where the life of the female would be
endangered or substantial and irreversible impairment of a major
bodily function would result if the fetus were carried to term;
or where the pregnancy is the result of rape or incest.

Covered health services shall be expanded as provided in
this section.

Sec. 26.

Minnesota Statutes 2004, section 256L.03,
subdivision 5, is amended to read:


Subd. 5.

Co-payments and coinsurance.

(a) Except as
provided in paragraphs (b) and (c), the MinnesotaCare benefit
plan shall include the following co-payments and coinsurance
requirements for all enrollees:

(1) ten percent of the paid charges for inpatient hospital
services for adult enrollees, subject to an annual inpatient
out-of-pocket maximum of $1,000 per individual and $3,000 per
family;

(2) $3 per prescription for adult enrollees; new text begin and
new text end

(3) $25 for eyeglasses for adult enrolleesdeleted text begin ; and
deleted text end

deleted text begin (4) 50 percent of the fee-for-service rate for adult dental
care services other than preventive care services for persons
eligible under section 256L.04, subdivisions 1 to 7, with income
equal to or less than 175 percent of the federal poverty
guidelines
deleted text end .

(b) Paragraph (a), clause (1), does not apply to parents
and relative caretakers of children under the age of 21 in
households with family income equal to or less than 175 percent
of the federal poverty guidelines. Paragraph (a), clause (1),
does not apply to parents and relative caretakers of children
under the age of 21 in households with family income greater
than 175 percent of the federal poverty guidelines for inpatient
hospital admissions occurring on or after January 1, 2001.

(c) Paragraph (a), clauses (1) to (4), do not apply to
pregnant women and children under the age of 21.

(d) Adult enrollees with family gross income that exceeds
175 percent of the federal poverty guidelines and who are not
pregnant shall be financially responsible for the coinsurance
amount, if applicable, and amounts which exceed the $10,000
inpatient hospital benefit limit.

(e) When a MinnesotaCare enrollee becomes a member of a
prepaid health plan, or changes from one prepaid health plan to
another during a calendar year, any charges submitted towards
the $10,000 annual inpatient benefit limit, and any
out-of-pocket expenses incurred by the enrollee for inpatient
services, that were submitted or incurred prior to enrollment,
or prior to the change in health plans, shall be disregarded.

Sec. 27. new text begin FEDERAL APPROVAL.
new text end

new text begin By August 1, 2005, the commissioner of human services shall
request any federal approval and plan amendments necessary to
implement (1) the transitional supports allowance under
Minnesota Statutes, sections 256B.0916, subdivision 10; and
256B.49, subdivision 16; and (2) the choice of case management
service coordination provisions under Minnesota Statutes,
sections 256B.0621, subdivision 4; 256B.092, subdivisions 2a and
4b; and 256B.49, subdivision 13.
new text end

Sec. 28. new text begin DENTAL ACCESS FOR PERSONS WITH DISABILITIES.
new text end

new text begin The commissioner of human services shall study access to
dental services for persons with disabilities, and shall present
recommendations for improving access to dental services to the
legislature by January 15, 2006. The study must examine
physical and geographic access, the willingness of dentists to
serve persons with disabilities enrolled in state health care
programs, reimbursement rates for dental service providers, and
other factors identified by the commissioner as potential
barriers to accessing dental services.
new text end

Sec. 29. new text begin DISABILITY SERVICES INTERAGENCY WORK GROUP.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment. new text end

new text begin The commissioners of human
services and housing finance and the Minnesota State Council on
Disability shall convene an interagency work group of interested
stakeholders, including other state agencies, counties, public
housing authorities, the Metropolitan Council, disability
service providers, and representatives from disability advocacy
organizations to identify barriers, strengthen coordination,
recommend policy and funding changes, and pursue federal
financing that will assist Minnesotans with disabilities who are
attempting to relocate from or avoid placement in institutional
settings.
new text end

new text begin Subd. 2. new text end

new text begin Work group activities. new text end

new text begin The work group shall
make recommendations to the state agencies and the legislature
related to:
new text end

new text begin (1) coordinating the availability of housing,
transportation, and support services needed to discharge persons
with disabilities from institutions;
new text end

new text begin (2) improving information and assistance needed to make an
informed choice about relocating from an institutional placement
to community-based services;
new text end

new text begin (3) identifying gaps in human services, transportation, and
housing access that are barriers to moving to community
services;
new text end

new text begin (4) identifying strategies that would result in earlier
identification of persons most at risk of institutional
placement in order to promote diversion to community services or
reduce lengths of stay in an institutional facility;
new text end

new text begin (5) identifying funding mechanisms and financial strategies
to assure a financially sustainable community support system
that diverts and relocates individuals from institutional
placement; and
new text end

new text begin (6) identifying state actions needed to address any federal
changes affecting policies, benefits, or funding used to support
persons with disabilities in avoiding institutional placement.
new text end

new text begin Subd. 3. new text end

new text begin Recommendations. new text end

new text begin Recommendations of the work
group must be submitted to each state agency and to the chairs
of the health and human services policy and finance committees
of the senate and house of representatives by October 15, 2006.
new text end