SF 1532

as introduced - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am

A bill for an actrelating to state government; making changes to public assistance programs, health care programs, long-term care, continuing care for persons with disabilities, occupational licenses, children services, estate recovery provisions for medical assistance, adult mental health and alternative programs for offenders with mental illness; changing health department provisions; transferring programs and funding from the department of children, families, and learning; requiring certain correctional institutions to permit multiple occupancy of cells; providing juvenile court jurisdiction for juveniles alleged to have committed traffic offenses; authorizing the state public defender to investigate decisions of the department of corrections; authorizing the state public defender to recommend correctional agencies to take corrective actions upon complaints; requiring defendents with 180 days or less remaining on terms of imprisonment to serve those remaining terms in local correctional facilities; requiring law enforcement agencies to disclose certain information to community crime prevention groups; making forecast adjustments; appropriating money; amending Minnesota Statutes 2002, sections 13.461, by adding a subdivision; 13.69, subdivision 1; 62E.06, subdivision 1; 62J.17, subdivision 2; 62J.23, by adding a subdivision; 62J.692, subdivisions 1, 2, 3, 4, 5, 7, 8; 62J.694, by adding a subdivision; 62L.05, subdivision 4; 62Q.19, subdivision 2; 116J.70, subdivision 2a; 119B.011, subdivisions 5, 6, 15, 19, by adding a subdivision; 119B.02, subdivision 1; 119B.03, subdivision 9; 119B.05, subdivision 1; 119B.09, subdivision 7; 119B.11, subdivision 2a; 119B.12, subdivision 2; 119B.13, subdivisions 2, 6, by adding a subdivision; 119B.19, subdivision 7; 119B.21, subdivision 11; 124D.23, subdivision 1; 144.1222, by adding a subdivision; 144.125; 144.128; 144.1488, subdivision 4; 144.1491, subdivision 1; 144.1502, subdivision 4; 144.335, subdivision 1; 144.35; 144.395, by adding a subdivision; 144.396, subdivisions 7, 11, 12; 144.414, subdivision 3; 144.551, subdivision 1; 144.99, subdivision 1; 144A.4605, subdivision 4; 144E.29; 144E.50, subdivision 5; 147A.08; 148.5194, subdivisions 1, 2, 3, by adding a subdivision; 148.6445, subdivision 7; 148C.01, subdivisions 2, 12, by adding subdivisions; 148C.03, subdivision 1; 148C.0351, subdivision 1, by adding a subdivision; 148C.04; 148C.05, subdivision 1, by adding subdivisions; 148C.07; 148C.10, subdivisions 1, 2; 148C.11; 150A.05, subdivision 2; 151.47, subdivision 1; 153A.17; 171.06, subdivision 3; 171.07, by adding a subdivision; 243.53, subdivision 1; 245.4874; 245.493, subdivision 1a; 245A.035, subdivision 3; 245A.04, subdivisions 3b, 3d; 245A.10; 245A.11, subdivision 2a; 252.27, subdivision 2a; 252.32, subdivisions 1, 1a, 3, 3c; 253B.05, by adding a subdivision; 256.01, subdivision 2; 256.012; 256.046, subdivision 1; 256.0471, subdivision 1; 256.476, subdivisions 1, 3, 4, 5, 11; 256.955, subdivision 2a; 256.9657, subdivisions 1, 4, by adding a subdivision; 256.969, subdivisions 2b, 3a; 256.975, by adding a subdivision; 256.98, subdivision 8; 256.984, subdivision 1; 256B.056, subdivisions 1c, 6; 256B.057, subdivisions 2, 3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding subdivisions; 256B.061; 256B.0621, subdivision 4; 256B.0623, subdivisions 2, 4, 5, 6, 8; 256B.0625, subdivisions 9, 13, 17, 19c, by adding subdivisions; 256B.0627, subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2; 256B.064, subdivision 2; 256B.0911, subdivision 4d; 256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 256B.0915, subdivision 3, by adding a subdivision; 256B.092, subdivision 5, by adding a subdivision; 256B.0945, subdivisions 2, 4; 256B.15, subdivisions 1, 1a, 2, 3, 4, by adding subdivisions; 256B.19, by adding a subdivision; 256B.195, subdivisions 3, 5; 256B.32, subdivision 1; 256B.431, subdivisions 2r, 32, by adding subdivisions; 256B.434, subdivision 4; 256B.437, subdivisions 2, 6; 256B.47, subdivision 2; 256B.5012, by adding a subdivision; 256B.5013, by adding a subdivision; 256B.69, subdivisions 2, 4, 5, 5a, 5c, 5g, 6a, 6b, 8, by adding a subdivision; 256B.75; 256B.76; 256B.761; 256B.82; 256D.03, subdivisions 3, 3a; 256D.053, subdivision 1; 256I.02; 256I.04, subdivision 3; 256I.05, subdivisions 1, 1a, 7c; 256J.02, subdivision 2; 256J.021; 256J.08, by adding subdivisions; 256J.09, subdivisions 2, 3a, 10; 256J.21, subdivision 2; 256J.24, subdivision 3; 256J.37, subdivision 9; 256J.38, subdivision 3; 256J.40; 256J.42, subdivision 5; 256J.425, subdivisions 2, 3, 4, 6; 256J.50, subdivisions 1, 8; 256J.55, subdivision 2; 256J.56; 256J.751, subdivisions 2, 5; 256L.05, subdivisions 3a, 4; 256L.06, subdivision 3; 256L.07, subdivisions 1, 3, by adding a subdivision; 256L.12, subdivision 6; 256L.15, subdivision 3, by adding a subdivision; 257.0769; 259.21, subdivision 6; 259.67, subdivisions 4, 7; 260B.007, subdivisions 3, 6, 16; 260B.101, subdivision 1; 260B.103, subdivision 1; 260B.105, subdivision 3; 260B.157, subdivision 1; 260B.171, subdivision 5; 260B.176, subdivision 2; 260B.178, subdivision 1; 260B.193, subdivision 2; 260B.225, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9; 260B.235, subdivision 6; 260C.007, subdivision 11; 260C.141, subdivision 2; 295.53, subdivision 1; 297I.15, subdivisions 1, 4; 319B.40; 326.42; 357.021, subdivisions 6, 7; 393.07, subdivisions 5, 10; 514.981, subdivision 6; 518.551, subdivisions 12, 13; 524.3-805; 609.105, subdivision 1, by adding subdivisions; 609.145, by adding a subdivision; 609.2231, by adding a subdivision; Laws 1997, chapter 245, article 2, section 11; proposing coding for new law in Minnesota Statutes, chapters 62J; 62Q; 97A; 119B; 144; 144A; 148C; 150B; 243; 245; 246; 256B; 256J; 481; 514; 609; 611; 611A; repealing Minnesota Statutes 2002, sections 62J.15; 62J.152; 62J.451; 62J.452; 62J.66; 62J.68; 119B.061; 144.126; 144.1494; 144.1495; 144.1496; 144.1497; 144A.071, subdivision 5; 144A.35; 144A.36; 144A.38; 148.5194, subdivision 3a; 148.6445, subdivision 9; 148C.0351, subdivision 2; 148C.05, subdivisions 2, 3, 4; 148C.06; 148C.10, subdivision 1a; 241.41; 241.42; 241.43; 241.44; 241.441; 241.45; 252.32, subdivision 2; 256.482, subdivision 8; 256.955, subdivision 8; 256B.0625, subdivisions 5a, 35, 36; 256B.0917; 256B.0945, subdivision 10; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 256B.0955; 256B.437, subdivision 2; 256B.5013, subdivision 4; 256J.08, subdivision 70; 256J.425, subdivision 7; 256J.47; Laws 1997, chapter 203, article 9, section 21, as amended; Laws 1998, chapter 407, article 4, section 63; Laws 1998, chapter 407, article 6, section 111; Laws 2000, chapter 488, article 10, section 28; Laws 2000, chapter 488, article 10, section 29; Laws 2001, First Special Session chapter 3, article 1, section 16; Laws 2001, First Special Session chapter 9, article 10, section 62; Laws 2001, First Special Session chapter 9, article 13, section 24; Laws 2002, chapter 374, article 9, section 8; Minnesota Rules, parts 4747.0030, subparts 25, 28, 30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A, B, D; 4747.0070, subparts 4, 5; 4747.0080; 4747.0090; 4747.0100; 4747.0300; 4747.0400, subparts 2, 3; 4747.0500; 4747.0600; 4747.1000; 4747.1100, subpart 3; 4747.1600; 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 4763.0250; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; 9505.3700.

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

ARTICLE 1

WELFARE REFORM

Section 1.

Minnesota Statutes 2002, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of section 119B.10;

(2) persons who are members of transition year families under section 119B.011, subdivision 20 new text begin , and persons who are no longer receiving or eligible for diversionary work program supports new text end ;

(3) families who are participating in employment orientation or job search, or other employment or training activities that are included in an approved employability development plan under chapter 256K;

(4) MFIP families who are participating in work job search, job support, employment, or training activities as required in their job search support or employment plan, or in appeals, hearings, assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J or 256K as required in their employment plan approved according to chapter 256J or 256K; and

(6) families who are participating in programs as required in tribal contracts under section 119B.02, subdivision 2, or 256.01, subdivision 2.

Sec. 2.

Minnesota Statutes 2002, section 256.984, subdivision 1, is amended to read:

Subdivision 1.

Declaration.

Every application for public assistance under this chapter deleted text begin and/or deleted text end new text begin or new text end chapters 256B, 256D, deleted text begin 256K, MFIP program deleted text end new text begin 256J new text end , and food stamps new text begin or food support new text end under chapter 393 shall be in writing or reduced to writing as prescribed by the state agency and shall contain the following declaration which shall be signed by the applicant:

"I declare under the penalties of perjury that this application has been examined by me and to the best of my knowledge is a true and correct statement of every material point. I understand that a person convicted of perjury may be sentenced to imprisonment of not more than five years or to payment of a fine of not more than $10,000, or both."

Sec. 3.

Minnesota Statutes 2002, section 256D.053, subdivision 1, is amended to read:

Subdivision 1.

Program established.

The Minnesota food assistance program is established to provide food assistance to legal noncitizens residing in this state who are ineligible to participate in the federal Food Stamp Program solely due to the provisions of section 402 or 403 of Public Law deleted text begin Number deleted text end 104-193, as authorized by Title VII of the 1997 Emergency Supplemental Appropriations Act, Public Law deleted text begin Number deleted text end 105-18, and as amended by Public Law deleted text begin Number deleted text end 105-185.

deleted text begin Beginning July 1, 2003, the Minnesota food assistance program is limited to those noncitizens described in this subdivision who are 50 years of age or older. deleted text end

Sec. 4.

Minnesota Statutes 2002, section 256J.02, subdivision 2, is amended to read:

Subd. 2.

Use of money.

State money appropriated for purposes of this section and TANF block grant money must be used for:

(1) financial assistance to or on behalf of any minor child who is a resident of this state under section 256J.12;

(2) employment and training services under this chapter or chapter 256K;

(3) emergency financial assistance and services under section 256J.48;

(4) deleted text begin diversionary assistance under section 256J.47; deleted text end

deleted text begin (5) deleted text end the health care and human services training and retention program under chapter 116L, for costs associated with families with children with incomes below 200 percent of the federal poverty guidelines;

deleted text begin (6) deleted text end new text begin (5) new text end the pathways program under section 116L.04, subdivision 1a;

deleted text begin (7) deleted text end new text begin (6) new text end welfare-to-work extended employment services for MFIP participants with severe impairment to employment as defined in section 268A.15, subdivision 1a;

deleted text begin (8) deleted text end new text begin (7) new text end the family homeless prevention and assistance program under section 462A.204;

deleted text begin (9) deleted text end new text begin (8) new text end the rent assistance for family stabilization demonstration project under section 462A.205;

deleted text begin (10) deleted text end new text begin (9) new text end welfare to work transportation authorized under Public Law deleted text begin Number deleted text end 105-178;

deleted text begin (11) deleted text end new text begin (10) new text end reimbursements for the federal share of child support collections passed through to the custodial parent;

deleted text begin (12) deleted text end new text begin (11) new text end reimbursements for the working family credit under section 290.0671;

deleted text begin (13) deleted text end new text begin (12) new text end intensive ESL grants under Laws 2000, chapter 489, article 1;

deleted text begin (14) deleted text end new text begin (13) new text end transitional housing programs under section 119A.43;

deleted text begin (15) deleted text end new text begin (14) new text end programs and pilot projects under chapter 256K; deleted text begin and deleted text end

deleted text begin (16) deleted text end new text begin (15) new text end program administration under this chapter new text begin ; and new text end

new text begin (16) the diversionary work program under section 256J.95 new text end .

Sec. 5.

Minnesota Statutes 2002, section 256J.021, is amended to read:

256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.

Beginning October 1, 2001, and each year thereafter, the commissioner of human services must treat deleted text begin financial assistance deleted text end new text begin MFIP new text end expenditures made to or on behalf of any minor child under section 256J.02, subdivision 2, clause (1), who is a resident of this state under section 256J.12, and who is part of a two-parent eligible household as expenditures under a separately funded state program and report those expenditures to the federal Department of Health and Human Services as separate state program expenditures under Code of Federal Regulations, title 45, section 263.5.

Sec. 6.

Minnesota Statutes 2002, section 256J.08, is amended by adding a subdivision to read:

new text begin Subd. 24b. new text end

new text begin Diversionary work program or dwp. new text end

new text begin "Diversionary work program" or "DWP" has the meaning given in section 256J.95. new text end

Sec. 7.

Minnesota Statutes 2002, section 256J.08, is amended by adding a subdivision to read:

new text begin Subd. 73a. new text end

new text begin Qualified professional. new text end

new text begin (a) For physical illness, injury, or incapacity, a "qualified professional" means a licensed physician, a physician's assistant, a nurse practitioner, or in the case of spinal subluxation, a licensed chiropractor. new text end

new text begin (b) For mental retardation and intelligence testing, a "qualified professional" means an individual qualified by training and experience to administer the tests necessary to make determinations, such as tests of intellectual functioning, assessments of adaptive behavior, adaptive skills, and developmental functioning. These professionals include licensed psychologists, certified school psychologists, or certified psychometrists working under the supervision of a licensed psychologist. new text end

new text begin (c) For learning disabilities, a "qualified professional" means a licensed psychologist or school psychologist with experience determining learning disabilities. new text end

new text begin (d) For mental health, a "qualified professional" means a licensed physician or a qualified mental health professional. A "qualified mental health professional" means: new text end

new text begin (1) for children, in psychiatric nursing, a registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist in child and adolescent psychiatric or mental health nursing by a national nurse certification organization or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness; new text end

new text begin (2) for adults, in psychiatric nursing, a registered nurse who is licensed under sections 148.171 to 148.285, and who is certified as a clinical specialist in adult psychiatric and mental health nursing by a national nurse certification organization or who has a master's degree in nursing or one of the behavioral sciences or related fields from an accredited college or university or its equivalent, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness; new text end

new text begin (3) in clinical social work, a person licensed as an independent clinical social worker under section 148B.21, subdivision 6, or a person with a master's degree in social work from an accredited college or university, with at least 4,000 hours of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness; new text end

new text begin (4) in psychology, an individual licensed by the board of psychology under sections 148.88 to 148.98, who has stated to the board of psychology competencies in the diagnosis and treatment of mental illness; new text end

new text begin (5) in psychiatry, a physician licensed under chapter 147 and certified by the American Board of Psychiatry and Neurology or eligible for board certification in psychiatry; and new text end

new text begin (6) in marriage and family therapy, the mental health professional must be a marriage and family therapist licensed under sections 148B.29 to 148B.39, with at least two years of post-master's supervised experience in the delivery of clinical services in the treatment of mental illness. new text end

Sec. 8.

Minnesota Statutes 2002, section 256J.09, subdivision 2, is amended to read:

Subd. 2.

County agency responsibility to provide information.

When a person inquires about assistance, a county agency must:

(1) explain the eligibility requirements of, and how to apply for deleted text begin , diversionary assistance as provided in section 256J.47; deleted text end emergency assistance as provided in section 256J.48; MFIP as provided in section 256J.10; or any other assistance for which the person may be eligible; and

(2) offer the person brochures developed or approved by the commissioner that describe how to apply for assistance.

Sec. 9.

Minnesota Statutes 2002, section 256J.09, subdivision 3a, is amended to read:

Subd. 3a.

Screening.

The county agency, or at county option, the county's employment and training service provider as defined in section 256J.49, must screen each applicant to determine immediate needs and to determine if the applicant may be eligible for:

(1) another program that is not partially funded through the federal temporary assistance to needy families block grant under Title I of Public Law deleted text begin Number deleted text end 104-193, including the expedited issuance of food stamps under section 256J.28, subdivision 1. If the applicant may be eligible for another program, a county caseworker must provide the appropriate referral to the program;

deleted text begin (2) the diversionary assistance program under section 256J.47; deleted text end or

deleted text begin (3) deleted text end new text begin (2) new text end the emergency assistance program under section 256J.48.

Sec. 10.

Minnesota Statutes 2002, section 256J.09, subdivision 10, is amended to read:

Subd. 10.

Applicants who do not meet eligibility requirements for mfip new text begin or the diversionary work program new text end .

When an applicant is not eligible for MFIP new text begin or the diversionary work program under section 256J.95 new text end because the applicant does not meet eligibility requirements, the county agency must determine whether the applicant is eligible for food stamps, medical assistance, deleted text begin diversionary assistance, deleted text end or has a need for emergency assistance when the applicant meets the eligibility requirements for those programs.

Sec. 11.

Minnesota Statutes 2002, section 256J.21, subdivision 2, is amended to read:

Subd. 2.

Income exclusions.

The following must be excluded in determining a family's available income:

(1) payments for basic care, difficulty of care, and clothing allowances received for providing family foster care to children or adults under Minnesota Rules, parts 9545.0010 to 9545.0260 and 9555.5050 to 9555.6265, and payments received and used for care and maintenance of a third-party beneficiary who is not a household member;

(2) reimbursements for employment training received through the deleted text begin Job Training Partnership deleted text end new text begin Workforce Investment new text end Act new text begin of 1998 new text end , United States Code, title deleted text begin 29 deleted text end new text begin 20 new text end , chapter deleted text begin 19 deleted text end new text begin 73 new text end , deleted text begin sections 1501 to 1792b deleted text end new text begin section 9201 new text end ;

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer services, jury duty, employment, or informal carpooling arrangements directly related to employment;

(4) all educational assistance, except the county agency must count graduate student teaching assistantships, fellowships, and other similar paid work as earned income and, after allowing deductions for any unmet and necessary educational expenses, shall count scholarships or grants awarded to graduate students that do not require teaching or research as unearned income;

(5) loans, regardless of purpose, from public or private lending institutions, governmental lending institutions, or governmental agencies;

(6) loans from private individuals, regardless of purpose, provided an applicant or participant documents that the lender expects repayment;

(7)(i) state income tax refunds; and

(ii) federal income tax refunds;

(8)(i) federal earned income credits;

(ii) Minnesota working family credits;

(iii) state homeowners and renters credits under chapter 290A; and

(iv) federal or state tax rebates;

(9) funds received for reimbursement, replacement, or rebate of personal or real property when these payments are made by public agencies, awarded by a court, solicited through public appeal, or made as a grant by a federal agency, state or local government, or disaster assistance organizations, subsequent to a presidential declaration of disaster;

(10) the portion of an insurance settlement that is used to pay medical, funeral, and burial expenses, or to repair or replace insured property;

(11) reimbursements for medical expenses that cannot be paid by medical assistance;

(12) payments by a vocational rehabilitation program administered by the state under chapter 268A, except those payments that are for current living expenses;

(13) in-kind income, including any payments directly made by a third party to a provider of goods and services;

(14) assistance payments to correct underpayments, but only for the month in which the payment is received;

(15) emergency assistance payments;

(16) funeral and cemetery payments as provided by section 256.935;

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in a calendar month;

(18) any form of energy assistance payment made through Public Law deleted text begin Number deleted text end 97-35, Low-Income Home Energy Assistance Act of 1981, payments made directly to energy providers by other public and private agencies, and any form of credit or rebate payment issued by energy providers;

(19) Supplemental Security Income (SSI), including retroactive SSI payments and other income of an SSI recipient;

(20) Minnesota supplemental aid, including retroactive payments;

(21) proceeds from the sale of real or personal property;

(22) adoption assistance payments under section 259.67;

(23) state-funded family subsidy program payments made under section 252.32 to help families care for children with mental retardation or related conditions, consumer support grant funds under section 256.476, and resources and services for a disabled household member under one of the home and community-based waiver services programs under chapter 256B;

(24) interest payments and dividends from property that is not excluded from and that does not exceed the asset limit;

(25) rent rebates;

(26) income earned by a minor caregiver, minor child through age 6, or a minor child who is at least a half-time student in an approved elementary or secondary education program;

(27) income earned by a caregiver under age 20 who is at least a half-time student in an approved elementary or secondary education program;

(28) MFIP child care payments under section 119B.05;

(29) all other payments made through MFIP to support a caregiver's pursuit of greater self-support;

(30) income a participant receives related to shared living expenses;

(31) reverse mortgages;

(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title 42, chapter 13A, sections 1771 to 1790;

(33) benefits provided by the women, infants, and children (WIC) nutrition program, United States Code, title 42, chapter 13A, section 1786;

(34) benefits from the National School Lunch Act, United States Code, title 42, chapter 13, sections 1751 to 1769e;

(35) relocation assistance for displaced persons under the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title 42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States Code, title 12, chapter 13, sections 1701 to 1750jj;

(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter 12, part 2, sections 2271 to 2322;

(37) war reparations payments to Japanese Americans and Aleuts under United States Code, title 50, sections 1989 to 1989d;

(38) payments to veterans or their dependents as a result of legal settlements regarding Agent Orange or other chemical exposure under Public Law deleted text begin Number deleted text end 101-239, section 10405, paragraph (a)(2)(E);

(39) income that is otherwise specifically excluded from MFIP consideration in federal law, state law, or federal regulation;

(40) security and utility deposit refunds;

(41) American Indian tribal land settlements excluded under Public deleted text begin Law Numbers deleted text end new text begin Laws new text end 98-123, 98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs reservations and payments to members of the White Earth Band, under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;

(42) all income of the minor parent's parents and stepparents when determining the grant for the minor parent in households that include a minor parent living with parents or stepparents on MFIP with other children;

(43) income of the minor parent's parents and stepparents equal to 200 percent of the federal poverty guideline for a family size not including the minor parent and the minor parent's child in households that include a minor parent living with parents or stepparents not on MFIP when determining the grant for the minor parent. The remainder of income is deemed as specified in section 256J.37, subdivision 1b;

(44) payments made to children eligible for relative custody assistance under section 257.85;

(45) vendor payments for goods and services made on behalf of a client unless the client has the option of receiving the payment in cash; and

(46) the principal portion of a contract for deed payment.

Sec. 12.

Minnesota Statutes 2002, section 256J.24, subdivision 3, is amended to read:

Subd. 3.

Individuals who must be excluded from an assistance unit.

(a) The following individuals who are part of the assistance unit determined under subdivision 2 are ineligible to receive MFIP:

(1) individuals deleted text begin receiving deleted text end new text begin who are recipients of new text end Supplemental Security Income or Minnesota supplemental aid;

(2) individuals disqualified from the food stamp program or MFIP, until the disqualification ends;

(3) children on whose behalf federal, state or local foster care payments are made, except as provided in sections 256J.13, subdivision 2, and 256J.74, subdivision 2; and

(4) children receiving ongoing monthly adoption assistance payments under section 259.67.

(b) The exclusion of a person under this subdivision does not alter the mandatory assistance unit composition.

Sec. 13.

Minnesota Statutes 2002, section 256J.37, subdivision 9, is amended to read:

Subd. 9.

Unearned income.

deleted text begin (a) deleted text end The county agency must apply unearned income to the MFIP standard of need. When determining the amount of unearned income, the county agency must deduct the costs necessary to secure payments of unearned income. These costs include legal fees, medical fees, and mandatory deductions such as federal and state income taxes.

deleted text begin (b) Effective July 1, 2003, the county agency shall count $100 of the value of public and assisted rental subsidies provided through the Department of Housing and Urban Development (HUD) as unearned income. The full amount of the subsidy must be counted as unearned income when the subsidy is less than $100. deleted text end

deleted text begin (c) The provisions of paragraph (b) shall not apply to MFIP participants who are exempt from the employment and training services component because they are: deleted text end

deleted text begin (i) individuals who are age 60 or older; deleted text end

deleted text begin (ii) individuals who are suffering from a professionally certified permanent or temporary illness, injury, or incapacity which is expected to continue for more than 30 days and which prevents the person from obtaining or retaining employment; or deleted text end

deleted text begin (iii) caregivers whose presence in the home is required because of the professionally certified illness or incapacity of another member in the assistance unit, a relative in the household, or a foster child in the household. deleted text end

deleted text begin (d) The provisions of paragraph (b) shall not apply to an MFIP assistance unit where the parental caregiver receives supplemental security income. deleted text end

Sec. 14.

Minnesota Statutes 2002, section 256J.38, subdivision 3, is amended to read:

Subd. 3.

Recovering overpayments deleted text begin from former participants deleted text end .

A county agency must initiate efforts to recover overpayments paid to a former participant new text begin or caregiver new text end . deleted text begin Adults deleted text end new text begin Caregivers, both parental and nonparental, new text end and minor caregivers of an assistance unit at the time an overpayment occurs, whether receiving assistance or not, are jointly and individually liable for repayment of the overpayment. The county agency must request repayment from the former participants new text begin and caregivers new text end . When an agreement for repayment is not completed within six months of the date of discovery or when there is a default on an agreement for repayment after six months, the county agency must initiate recovery consistent with chapter 270A, or section 541.05. When a person has been convicted of fraud under section 256.98, recovery must be sought regardless of the amount of overpayment. When an overpayment is less than $35, and is not the result of a fraud conviction under section 256.98, the county agency must not seek recovery under this subdivision. The county agency must retain information about all overpayments regardless of the amount. When an adult new text begin , adult caregiver, new text end or minor caregiver reapplies for assistance, the overpayment must be recouped under subdivision 4.

Sec. 15.

Minnesota Statutes 2002, section 256J.40, is amended to read:

256J.40 FAIR HEARINGS.

Caregivers receiving a notice of intent to sanction or a notice of adverse action that includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or termination of benefits may request a fair hearing. A request for a fair hearing must be submitted in writing to the county agency or to the commissioner and must be mailed within 30 days after a participant or former participant receives written notice of the agency's action or within 90 days when a participant or former participant shows good cause for not submitting the request within 30 days. A former participant who receives a notice of adverse action due to an overpayment may appeal the adverse action according to the requirements in this section. Issues that may be appealed are:

(1) the amount of the assistance payment;

(2) a suspension, reduction, denial, or termination of assistance;

(3) the basis for an overpayment, the calculated amount of an overpayment, and the level of recoupment;

(4) the eligibility for an assistance payment; and

(5) the use of protective or vendor payments under section 256J.39, subdivision 2, clauses (1) to (3).

new text begin Except for benefits issued under section 256J.95, new text end a county agency must not reduce, suspend, or terminate payment when an aggrieved participant requests a fair hearing prior to the effective date of the adverse action or within ten days of the mailing of the notice of adverse action, whichever is later, unless the participant requests in writing not to receive continued assistance pending a hearing decision. new text begin An appeal request cannot extend benefits for the diversionary work program under section 256J.95 beyond the four-month time limit. new text end Assistance issued pending a fair hearing is subject to recovery under section 256J.38 when as a result of the fair hearing decision the participant is determined ineligible for assistance or the amount of the assistance received. A county agency may increase or reduce an assistance payment while an appeal is pending when the circumstances of the participant change and are not related to the issue on appeal. The commissioner's order is binding on a county agency. No additional notice is required to enforce the commissioner's order.

A county agency shall reimburse appellants for reasonable and necessary expenses of attendance at the hearing, such as child care and transportation costs and for the transportation expenses of the appellant's witnesses and representatives to and from the hearing. Reasonable and necessary expenses do not include legal fees. Fair hearings must be conducted at a reasonable time and date by an impartial referee employed by the department. The hearing may be conducted by telephone or at a site that is readily accessible to persons with disabilities.

The appellant may introduce new or additional evidence relevant to the issues on appeal. Recommendations of the appeals referee and decisions of the commissioner must be based on evidence in the hearing record and are not limited to a review of the county agency action.

Sec. 16.

Minnesota Statutes 2002, section 256J.42, subdivision 5, is amended to read:

Subd. 5.

Exemption for certain families.

(a) Any cash assistance received by an assistance unit does not count toward the 60-month limit on assistance during a month in which the caregiver is deleted text begin in the category in deleted text end new text begin age 60 or older, including months during which the caregiver was exempt under new text end section 256J.56, paragraph (a), clause (1).

(b) From July 1, 1997, until the date MFIP is operative in the caregiver's county of financial responsibility, any cash assistance received by a caregiver who is complying with Minnesota Statutes 1996, section 256.73, subdivision 5a, and Minnesota Statutes 1998, section 256.736, if applicable, does not count toward the 60-month limit on assistance. Thereafter, any cash assistance received by a minor caregiver who is complying with the requirements of sections 256J.14 and 256J.54, if applicable, does not count towards the 60-month limit on assistance.

(c) Any diversionary assistance or emergency assistance received does not count toward the 60-month limit.

(d) Any cash assistance received by an 18- or 19-year-old caregiver who is complying with the requirements of section 256J.54 does not count toward the 60-month limit.

new text begin (e) Diversionary work program benefits provided under section 256J.95 do not count toward the 60-month time limit. new text end

Sec. 17.

Minnesota Statutes 2002, section 256J.425, subdivision 2, is amended to read:

Subd. 2.

Ill or incapacitated.

(a) An assistance unit subject to the time limit in section 256J.42, subdivision 1, deleted text begin in which any participant has received 60 counted months of assistance, deleted text end is eligible to receive months of assistance under a hardship extension if the participant new text begin who reached the time limit new text end belongs to any of the following groups:

(1) participants who are suffering from deleted text begin a professionally certified deleted text end new text begin an new text end illness, injury, or incapacity which new text begin has been certified by a qualified professional when the illness, injury, or incapacity new text end is expected to continue for more than 30 days and deleted text begin which deleted text end prevents the person from obtaining or retaining employment deleted text begin and who are following deleted text end new text begin . These participants must follow new text end the treatment recommendations of the deleted text begin health care provider deleted text end new text begin qualified professional new text end certifying the illness, injury, or incapacity;

(2) participants whose presence in the home is required as a caregiver because of deleted text begin a professionally certified deleted text end new text begin the new text end illness or incapacity of another member in the assistance unit, a relative in the household, or a foster child in the household deleted text begin and deleted text end new text begin when new text end the illness or incapacity new text begin and the need for the participant's presence in the home has been certified by a qualified professional and new text end is expected to continue for more than 30 days; or

(3) caregivers with a child or an adult in the household who meets the disability or medical criteria for home care services under section 256B.0627, subdivision 1, paragraph (c), or a home and community-based waiver services program under chapter 256B, or meets the criteria for severe emotional disturbance under section 245.4871, subdivision 6, or for serious and persistent mental illness under section 245.462, subdivision 20, paragraph (c). Caregivers in this category are presumed to be prevented from obtaining or retaining employment.

(b) An assistance unit receiving assistance under a hardship extension under this subdivision may continue to receive assistance as long as the participant meets the criteria in paragraph (a), clause (1), (2), or (3).

Sec. 18.

Minnesota Statutes 2002, section 256J.425, subdivision 3, is amended to read:

Subd. 3.

Hard-to-employ participants.

An assistance unit subject to the time limit in section 256J.42, subdivision 1, deleted text begin in which any participant has received 60 counted months of assistance, deleted text end is eligible to receive months of assistance under a hardship extension if the participant new text begin who reached the time limit new text end belongs to any of the following groups:

(1) a person who is diagnosed by a licensed physician, psychological practitioner, or other qualified professional, as mentally retarded or mentally ill, and that condition prevents the person from obtaining or retaining unsubsidized employment;

(2) a person who:

(i) has been assessed by a vocational specialist or the county agency to be unemployable for purposes of this subdivision; or

(ii) has an IQ below 80 who has been assessed by a vocational specialist or a county agency to be employable, but not at a level that makes the participant eligible for an extension under subdivision 4 deleted text begin or, deleted text end new text begin . The determination of IQ level must be made by a qualified professional. new text end In the case of a non-English-speaking person for whom it is not possible to provide a determination due to language barriers or absence of culturally appropriate assessment tools, is determined by a qualified professional to have an IQ below 80. A person is considered employable if positions of employment in the local labor market exist, regardless of the current availability of openings for those positions, that the person is capable of performing;

(3) a person who is determined by deleted text begin the county agency deleted text end new text begin a qualified professional new text end to be learning disabled or, in the case of a non-English-speaking person for whom it is not possible to provide a medical diagnosis due to language barriers or absence of culturally appropriate assessment tools, is determined by a qualified professional to have a learning disability. If a rehabilitation plan for the person is developed or approved by the county agency, the plan must be incorporated into the employment plan. However, a rehabilitation plan does not replace the requirement to develop and comply with an employment plan under section 256J.52. For purposes of this section, "learning disabled" means the applicant or recipient has a disorder in one or more of the psychological processes involved in perceiving, understanding, or using concepts through verbal language or nonverbal means. The disability must severely limit the applicant or recipient in obtaining, performing, or maintaining suitable employment. Learning disabled does not include learning problems that are primarily the result of visual, hearing, or motor handicaps; mental retardation; emotional disturbance; or due to environmental, cultural, or economic disadvantage; or

(4) a person who is a victim of family violence as defined in section 256J.49, subdivision 2, and who is participating in an alternative employment plan under section 256J.49, subdivision 1a.

Sec. 19.

Minnesota Statutes 2002, section 256J.425, subdivision 4, is amended to read:

Subd. 4.

Employed participants.

(a) An assistance unit subject to the time limit under section 256J.42, subdivision 1, deleted text begin in which any participant has received 60 months of assistance, deleted text end is eligible to receive assistance under a hardship extension if the participant new text begin who reached the time limit new text end belongs to:

(1) a one-parent assistance unit in which the participant is participating in work activities for at least 30 hours per week, of which an average of at least 25 hours per week every month are spent participating in employment;

(2) a two-parent assistance unit in which the participants are participating in work activities for at least 55 hours per week, of which an average of at least 45 hours per week every month are spent participating in employment; or

(3) an assistance unit in which a participant is participating in employment for fewer hours than those specified in clause (1), and the participant submits verification from a deleted text begin health care provider deleted text end new text begin qualified professional new text end , in a form acceptable to the commissioner, stating that the number of hours the participant may work is limited due to illness or disability, as long as the participant is participating in employment for at least the number of hours specified by the deleted text begin health care provider deleted text end new text begin qualified professional new text end . The participant must be following the treatment recommendations of the deleted text begin health care provider deleted text end new text begin qualified professional new text end providing the verification. The commissioner shall develop a form to be completed and signed by the deleted text begin health care provider deleted text end new text begin qualified professional new text end , documenting the diagnosis and any additional information necessary to document the functional limitations of the participant that limit work hours. If the participant is part of a two-parent assistance unit, the other parent must be treated as a one-parent assistance unit for purposes of meeting the work requirements under this subdivision.

(b) For purposes of this section, employment means:

(1) unsubsidized employment under section 256J.49, subdivision 13, clause (1);

(2) subsidized employment under section 256J.49, subdivision 13, clause (2);

(3) on-the-job training under section 256J.49, subdivision 13, clause (4);

(4) an apprenticeship under section 256J.49, subdivision 13, clause (19);

(5) supported work. For purposes of this section, "supported work" means services supporting a participant on the job which include, but are not limited to, supervision, job coaching, and subsidized wages;

(6) a combination of new text begin clauses new text end (1) to (5); or

(7) child care under section 256J.49, subdivision 13, clause (25), if it is in combination with paid employment.

(c) If a participant is complying with a child protection plan under chapter 260C, the number of hours required under the child protection plan count toward the number of hours required under this subdivision.

(d) The county shall provide the opportunity for subsidized employment to participants needing that type of employment within available appropriations.

(e) To be eligible for a hardship extension for employed participants under this subdivision, a participant in a one-parent assistance unit or both parents in a two-parent assistance unit must be in compliance for at least ten out of the 12 months immediately preceding the participant's 61st month on assistance. If only one parent in a two-parent assistance unit fails to be in compliance ten out of the 12 months immediately preceding the participant's 61st month, the county shall give the assistance unit the option of disqualifying the noncompliant parent. If the noncompliant participant is disqualified, the assistance unit must be treated as a one-parent assistance unit for the purposes of meeting the work requirements under this subdivision and the assistance unit's MFIP grant shall be calculated using the shared household standard under section 256J.08, subdivision 82a.

(f) The employment plan developed under section 256J.52, subdivision 5, for participants under this subdivision must contain the number of hours specified in paragraph (a) related to employment and work activities. The job counselor and the participant must sign the employment plan to indicate agreement between the job counselor and the participant on the contents of the plan.

(g) Participants who fail to meet the requirements in paragraph (a), without good cause under section 256J.57, shall be sanctioned or permanently disqualified under subdivision 6. Good cause may only be granted for that portion of the month for which the good cause reason applies. Participants must meet all remaining requirements in the approved employment plan or be subject to sanction or permanent disqualification.

(h) If the noncompliance with an employment plan is due to the involuntary loss of employment, the participant is exempt from the hourly employment requirement under this subdivision for one month. Participants must meet all remaining requirements in the approved employment plan or be subject to sanction or permanent disqualification. This exemption is available to one-parent assistance units two times in a 12-month period, and two-parent assistance units, two times per parent in a 12-month period.

deleted text begin (i) This subdivision expires on June 30, 2004. deleted text end

Sec. 20.

Minnesota Statutes 2002, section 256J.425, subdivision 6, is amended to read:

Subd. 6.

Sanctions for extended cases.

(a) If one or both participants in an assistance unit receiving assistance under subdivision 3 or 4 are not in compliance with the employment and training service requirements in sections 256J.52 to 256J.55, the sanctions under this subdivision apply. For a first occurrence of noncompliance, an assistance unit must be sanctioned under section 256J.46, subdivision 1, paragraph (d), clause (1). For a second or deleted text begin third deleted text end new text begin subsequent new text end occurrence of noncompliance, the assistance unit must be sanctioned under section 256J.46, subdivision 1, paragraph (d), clause (2). deleted text begin For a fourth occurrence of noncompliance, the assistance unit is disqualified from MFIP. If a participant is determined to be out of compliance, the participant may claim a good cause exception under section 256J.57, however, the participant may not claim an exemption under section 256J.56. deleted text end

(b) If both participants in a two-parent assistance unit are out of compliance at the same time, it is considered one occurrence of noncompliance.

Sec. 21.

Minnesota Statutes 2002, section 256J.50, subdivision 1, is amended to read:

Subdivision 1.

Employment and training services component of mfip.

(a) deleted text begin By January 1, 1998, deleted text end Each county must develop and deleted text begin implement deleted text end new text begin provide new text end an employment and training services component deleted text begin of MFIP deleted text end which is designed to put participants on the most direct path to unsubsidized employment. Participation in these services is mandatory for all MFIP caregivers, unless the caregiver is exempt under section 256J.56.

(b) A county must provide employment and training services under sections 256J.515 to 256J.74 within 30 days after the deleted text begin caregiver's participation becomes mandatory under subdivision 5 or within 30 days of receipt of a request for services from a caregiver who under section 256J.42 is no longer eligible to receive MFIP but whose income is below 120 percent of the federal poverty guidelines for a family of the same size. The request must be made within 12 months of the date the caregivers' MFIP case was closed deleted text end new text begin caregiver is determined eligible for MFIP, or within five days when the caregiver participated in the diversionary work program under section 256J.95 within the past 12 months new text end .

Sec. 22.

Minnesota Statutes 2002, section 256J.50, subdivision 8, is amended to read:

Subd. 8.

County duty to ensure employment and training choices for participants.

Each county, or group of counties working cooperatively, shall make available to participants the choice of at least two employment and training service providers as defined under section 256J.49, subdivision 4, except in counties utilizing workforce centers that use multiple employment and training services, offer multiple services options under a collaborative effort and can document that participants have choice among employment and training services designed to meet specialized needs. new text begin The requirements of this subdivision do not apply to the diversionary work program under section 256J.95. new text end

Sec. 23.

Minnesota Statutes 2002, section 256J.55, subdivision 2, is amended to read:

Subd. 2.

Duty to report.

The participant must inform the job counselor within deleted text begin three deleted text end new text begin ten new text end working days regarding any changes related to the participant's employment status.

Sec. 24.

Minnesota Statutes 2002, section 256J.56, is amended to read:

256J.56 EMPLOYMENT AND TRAINING SERVICES COMPONENT; EXEMPTIONS.

(a) An MFIP participant is exempt from the requirements of sections 256J.52 to 256J.55 if the participant belongs to any of the following groups:

(1) participants who are age 60 or older;

(2) participants who are suffering from a deleted text begin professionally certified deleted text end permanent or temporary illness, injury, or incapacity which new text begin has been certified by a qualified professional when the illness, injury, or incapacity new text end is expected to continue for more than 30 days and deleted text begin which deleted text end prevents the person from obtaining or retaining employment. Persons in this category with a temporary illness, injury, or incapacity must be reevaluated at least quarterly;

(3) participants whose presence in the home is required as a caregiver because of deleted text begin a professionally certified deleted text end new text begin the new text end illness or incapacity of another member in the assistance unit, a relative in the household, or a foster child in the household deleted text begin and deleted text end new text begin when new text end the illness or incapacity new text begin and the need for the participant's presence in the home has been certified by a qualified professional and new text end is expected to continue for more than 30 days;

(4) women who are pregnant, if the pregnancy has resulted in deleted text begin a professionally certified deleted text end new text begin an new text end incapacity that prevents the woman from obtaining or retaining employment new text begin , and the incapacity has been certified by a qualified professional new text end ;

(5) caregivers of a child under the age of one year who personally provide full-time care for the child. This exemption may be used for only 12 months in a lifetime. In two-parent households, only one parent or other relative may qualify for this exemption;

(6) participants experiencing a personal or family crisis that makes them incapable of participating in the program, as determined by the county agency. If the participant does not agree with the county agency's determination, the participant may seek deleted text begin professional deleted text end certification new text begin from a qualified professional new text end , as defined in section 256J.08, that the participant is incapable of participating in the program.

Persons in this exemption category must be reevaluated every 60 days. A personal or family crisis related to family violence, as determined by the county or a job counselor with the assistance of a person trained in domestic violence, should not result in an exemption, but should be addressed through the development or revision of an alternative employment plan under section 256J.52, subdivision 6; or

(7) caregivers with a child or an adult in the household who meets the disability or medical criteria for home care services under section 256B.0627, subdivision 1, paragraph (c), or a home and community-based waiver services program under chapter 256B, or meets the criteria for severe emotional disturbance under section 245.4871, subdivision 6, or for serious and persistent mental illness under section 245.462, subdivision 20, paragraph (c). Caregivers in this exemption category are presumed to be prevented from obtaining or retaining employment.

A caregiver who is exempt under clause (5) must enroll in and attend an early childhood and family education class, a parenting class, or some similar activity, if available, during the period of time the caregiver is exempt under this section. Notwithstanding section 256J.46, failure to attend the required activity shall not result in the imposition of a sanction.

(b) The county agency must provide employment and training services to MFIP participants who are exempt under this section, but who volunteer to participate. Exempt volunteers may request approval for any work activity under section 256J.49, subdivision 13. The hourly participation requirements for nonexempt participants under section 256J.50, subdivision 5, do not apply to exempt participants who volunteer to participate.

Sec. 25.

Minnesota Statutes 2002, section 256J.751, subdivision 2, is amended to read:

Subd. 2.

Quarterly comparison report.

The commissioner shall report quarterly to all counties on each county's performance on the following measures:

(1) percent of MFIP caseload working in paid employment;

(2) percent of MFIP caseload receiving only the food portion of assistance;

(3) number of MFIP cases that have left assistance;

(4) federal participation requirements as specified in Title 1 of Public Law deleted text begin Number deleted text end 104-193;

(5) median placement wage rate; and

(6) caseload by months of TANF assistance.

Sec. 26.

Minnesota Statutes 2002, section 256J.751, subdivision 5, is amended to read:

Subd. 5.

Failure to meet federal performance standards.

(a) If sanctions occur for failure to meet the performance standards specified in title 1 of Public Law deleted text begin Number deleted text end 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, the state shall pay 88 percent of the sanction. The remaining 12 percent of the sanction will be paid by the counties. The county portion of the sanction will be distributed across all counties in proportion to each county's percentage of the MFIP average monthly caseload during the period for which the sanction was applied.

(b) If a county fails to meet the performance standards specified in title 1 of Public Law deleted text begin Number deleted text end 104-193 of the Personal Responsibility and Work Opportunity Act of 1996 for any year, the commissioner shall work with counties to organize a joint state-county technical assistance team to work with the county. The commissioner shall coordinate any technical assistance with other departments and agencies including the departments of economic security and children, families, and learning as necessary to achieve the purpose of this paragraph.

Sec. 27.

new text begin [256J.95] DIVERSIONARY WORK PROGRAM. new text end

new text begin Subdivision 1. new text end [ESTABLISHING A DIVERSIONARY WORK PROGRAM (DWP).] new text begin (a) The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public Law 104-193, establishes block grants to states for temporary assistance for needy families (TANF). TANF provisions allow states to use TANF dollars for nonrecurrent, short-term diversionary benefits. The diversionary work program established on July 1, 2003, is Minnesota's TANF program to provide short-term diversionary benefits to eligible recipients of the diversionary work program. new text end

new text begin (b) The goal of the diversionary work program is to provide short-term, necessary services and supports to families which will lead to unsubsidized employment, increase economic stability, and reduce the risk of those families needing longer term assistance, under the Minnesota family investment program (MFIP). new text end

new text begin (c) When a family unit meets the eligibility criteria in this section, the family must receive a diversionary work program grant and is not eligible for MFIP. new text end

new text begin (d) A family unit is eligible for the diversionary work program for a maximum of four months only once in a 12-month period. The 12-month period begins at the date of application or the date eligibility is met, whichever is later. Counties may provide supportive and other allowable services funded by section 256J.62, including $75 for transportation-related expenses, to eligible participants during the four-month diversionary period. new text end

new text begin Subd. 2. new text end [DEFINITIONS.] new text begin The terms used in this section have the following meanings. new text end

new text begin (a) "Diversionary Work Program (DWP)" means the program established under this section. new text end

new text begin (b) "Employment plan" means a plan developed by the job counselor and the participant which identifies the participant's most direct path to unsubsidized employment, lists the specific steps that the caregiver will take on that path, and includes a timetable for the completion of each step. For participants who request and qualify for a family violence waiver in section 256J.521, subdivision 3, an employment plan must be developed by the job counselor, the participant and a person trained in domestic violence and follow the employment plan provisions in section 256J.521, subdivision 3. Employment plans under this section shall be written for a period of time not to exceed four months. new text end

new text begin (c) "Employment services" means programs, activities, and services in this section that are designed to assist participants in obtaining and retaining employment. new text end

new text begin (d) "Family maintenance needs" means current housing costs including rent, manufactured home lot rental costs, or monthly principal, interest, insurance premiums, and property taxes due for mortgages or contracts for deed, association fees required for homeownership, utility costs for current month expenses of gas and electric, garbage, water and sewer, and a flat rate of $35 for a telephone. new text end

new text begin (e) "Family unit" means a group of people applying for or receiving DWP benefits together. For the purposes of determining eligibility for this program, the unit includes the relationships in section 256J.24, subdivisions 2 and 4. new text end

new text begin (f) "Minnesota family investment program (MFIP)" means the assistance program as defined in section 256J.08, subdivision 57. new text end

new text begin (g) "Personal needs allowance" means an allowance of $70 per month per DWP unit member to pay for expenses such as household products and personal products, to the extent such amounts are available when calculating the diversionary work program grant under subdivision 10. new text end

new text begin (h) "Work activities" means allowable work activities as defined in section 256J.49, subdivision 13. new text end

new text begin Subd. 3. new text end [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] new text begin (a) Individuals who apply for cash benefits and who meet MFIP eligibility under sections 256J.11 to 256J.15, and have a high school diploma or its equivalent and have participated in either employment for 30 or more hours per week in four of the previous 12 months or are currently working at least 30 hours per week must participate in the diversionary work program. new text end

new text begin (b) Family units who are not eligible for the diversionary work programs include: new text end

new text begin (1) individuals who have no full-time work experience, which equals at least 30 hours per week, in any of the past 12 months; new text end

new text begin (2) child-only cases; new text end

new text begin (3) a caregiver age 60 or older; new text end

new text begin (4) a caregiver who has experienced a family crisis, including domestic violence, which prevents employment; new text end

new text begin (5) a minor caregiver or a caregiver 18 or 19 years of age who is cooperating with an employment plan under section 256J.54; and new text end

new text begin (6) a caregiver who has an eligible child six months old or younger. new text end

new text begin (c) Caregivers who do not fall under paragraph (a) or (b), who meet MFIP eligibility, may volunteer to participate in the diversionary work program. new text end

new text begin Subd. 4. new text end [SUBMITTING APPLICATION FORM.] new text begin The eligibility date for the diversionary work program begins with the date the signed combined application form (CAF) is received by the county agency or the date diversionary work program eligibility criteria are met, whichever is later. The county agency must inform the applicant that any delay in submitting the application will reduce the benefits paid for the month of application. The county agency must inform a person that an application may be submitted before the person has an interview appointment. Upon receipt of a signed application, the county agency must stamp the date of receipt on the face of the application. The applicant may withdraw the application at any time prior to approval by giving written or oral notice to the county agency. The county agency must follow the notice requirements in section 256J.09, subdivision 3, when issuing a notice confirming the withdrawal. new text end

new text begin Subd. 5. new text end [INITIAL SCREENING OF APPLICATIONS.] new text begin Upon receipt of the application, the county agency must determine if the applicant may be eligible for other benefits as required in sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 and 5. The county must also follow the provisions in section 256J.09, subdivision 3b, clause (2). new text end

new text begin Subd. 6. new text end [PROGRAM AND PROCESSING STANDARDS.] new text begin (a) The interview to determine financial eligibility for the diversionary work program must be conducted within five working days of the receipt of the cash application form. During the intake interview the financial worker must discuss: new text end

new text begin (1) the goals, requirements, and services of the diversionary work program; new text end

new text begin (2) the availability of child care assistance. If child care is needed, the worker must obtain a completed application for child care from the applicant before the interview is terminated. The same day the application for child care is received, the application must be forwarded to the appropriate child care worker. For purposes of eligibility for child care assistance under chapter 119B, DWP participants shall be eligible for the same benefits as MFIP recipients; and new text end

new text begin (3) if the applicant has not requested food support and health care assistance on the application, the county agency shall, during the interview process, talk with the applicant about the availability of these benefits and inquire whether the applicant wants to apply for these benefits. If the applicant does want to apply, the county agency shall assist the applicant in completing the applicable application form or forms. new text end

new text begin (b) The county shall follow section 256J.74, subdivision 2, paragraph (b), clauses (1) and (2), when an applicant or a recipient of DWP has a person who is a member of more than one assistance unit in a given payment month. new text end

new text begin (c) The county agency must determine eligibility for the diversionary work program according to the provisions in section 256J.09, subdivisions 5 and 6. A family unit whose application is denied is eligible for a fair hearing under section 256J.40. new text end

new text begin Subd. 7. new text end [VERIFICATION REQUIREMENTS.] new text begin (a) A county agency must only require verification of information necessary to determine DWP eligibility and the amount of the payment. The applicant or participant must document the information required or authorize the county agency to verify the information. The applicant or participant has the burden of providing documentary evidence to verify eligibility. The county agency shall assist the applicant or participant in obtaining required documents when the applicant or participant is unable to do so. new text end

new text begin (b) A county agency must not request information about an applicant or participant that is not a matter of public record from a source other than county agencies, the department of human services, or the United States Department of Health and Human Services without the person's prior written consent. An applicant's signature on an application form constitutes consent for contact with the sources specified on the application. A county agency may use a single consent form to contact a group of similar sources, but the sources to be contacted must be identified by the county agency prior to requesting an applicant's consent. new text end

new text begin (c) Factors to be verified shall follow section 256J.32, subdivision 4. Family maintenance needs must be verified before the expense can be allowed in the calculation of the DWP grant. new text end

new text begin Subd. 8. new text end [PROPERTY AND INCOME LIMITATIONS.] new text begin The asset limits and exclusions in section 256J.20, apply to applicants and recipients of DWP. All payments, unless excluded in section 256J.21, must be counted as income to determine eligibility for the diversionary work program. The county shall treat income as outlined in section 256J.37, except for subdivision 3a. The initial income test and the disregards in section 256J.21, subdivision 3, shall be followed for determining eligibility for the diversionary work program. new text end

new text begin Subd. 9. new text end [COOPERATION WITH PROGRAM REQUIREMENTS.] new text begin (a) To be eligible for DWP, an applicant must comply with the requirements of paragraphs (b) to (d). new text end

new text begin (b) Applicants and participants must cooperate with the requirements of the child support enforcement program, but will not be charged a fee under section 518.551, subdivision 7. new text end

new text begin (c) The applicant must provide each member of the family unit's social security number to the county agency. This requirement is satisfied when each member of the family unit cooperates with the procedures for verification of numbers, issuance of duplicate cards, and issuance of new numbers which have been established jointly between the Social Security Administration and the commissioner. new text end

new text begin (d) Before DWP benefits can be issued to a family unit, the caregiver must, in conjunction with a job counselor, develop and sign an employment plan. In two-parent family units, both parents must develop and sign employment plans before benefits can be issued. Food support and health care benefits are not contingent on the requirement for a signed employment plan. new text end

new text begin Subd. 10. new text end [DIVERSIONARY WORK PROGRAM GRANT.] new text begin (a) To determine the amount of cash benefits that a family unit is eligible for, the county agency shall evaluate the income of the family unit that is requesting payments under the diversionary work program. Countable income means gross earned and unearned income not excluded or disregarded under MFIP. The same disregards for earned income that are allowed under MFIP are allowed for the diversionary work program. new text end

new text begin (b) The DWP grant is the difference between (1) the family unit's family maintenance needs plus the personal needs allowance for each member of the family unit and (2) the family unit's countable income, not to exceed the cash portion of the MFIP standard of need as defined in section 256J.08, subdivision 55a, for the family unit's size. For a family unit with earned income, the DWP grant as calculated this in subdivision shall not exceed the family wage level as defined in section 256J.08, subdivision 35. new text end

new text begin (c) Housing and utilities may be vendor paid. Unless otherwise stated in this section, actual housing and utility expenses shall be used when determining the amount of the DWP grant. new text end

new text begin (d) Once the county has determined a grant amount, the DWP grant amount will not be decreased if the determination is based on the best information available at the time of approval and shall not be decreased because of any additional income to the family unit. The grant can be increased if a participant later verifies an increase in family maintenance needs or family unit size. The minimum cash benefit amount, if income and asset tests are met, is $10. Benefits of $10 shall not be vendor paid. new text end

new text begin (e) When all criteria are met, including the development of an employment plan as described in subdivision 14 and eligibility exists for the month of application, the amount of benefits for the diversionary work program retroactive to the date of application is as specified in section 256J.35, paragraph (a). new text end

new text begin (f) Any month during the four-month DWP period that a person receives a DWP benefit directly or through a vendor payment made on the person's behalf, that person is ineligible for MFIP or any other TANF cash program except for benefits defined in section 256.48. new text end

new text begin If during the four-month DWP period a family unit that receives diversionary work program benefits moves to a county that has not established a diversionary work program, the family unit may be eligible for MFIP the month following the last month of the issuance of the DWP benefit. new text end

new text begin Subd. 11. new text end [CONVERSION OR REFERRAL TO MFIP.] new text begin (a) If at any time during the DWP application process or during the four-month DWP eligibility period, it is determined that a participant is unlikely to benefit from the diversionary work program, the county shall convert or refer the participant to MFIP as specified in paragraph (d). Participants who meet the criteria in paragraph (b) shall be considered to be unlikely to benefit from DWP, provided the necessary documentation is available to support the determination. new text end

new text begin (b) A participant who: new text end

new text begin (1) has been determined by a qualified professional as being unable to obtain or retain employment due to an illness, injury, or incapacity that is expected to last at least 30 days; new text end

new text begin (2) is determined by a qualified professional as being needed in the home to care for a family member due to an illness, injury, or incapacity that is expected to last at least 30 days; new text end

new text begin (3) is determined by a qualified professional as being needed in the home to care for a child or an adult in the household meeting the special medical criteria in section 256J.425, subdivision 2, clause (3); new text end

new text begin (4) is pregnant and is determined by a qualified professional as being unable to obtain or retain employment due to the pregnancy; or new text end

new text begin (5) has applied for SSI or RSDI. new text end

new text begin (c) In a two-parent family unit, both parents must be determined to be unlikely to benefit from the diversionary work program before the family unit can be converted or referred to MFIP. new text end

new text begin (d) A participant who is determined to be unlikely to benefit from the diversionary work program shall be converted to MFIP. If the determination is made within 30 days of the initial application for benefits, a new combined application form will not be required. If the determination is made more than 30 days after the initial application, the participant must submit a new combined application form. The county agency shall process the combined application form by the first of the following month to ensure that no gap in benefits is due to delayed action by the county agency. In processing the combined application form, the county must follow section 256J.32, subdivision 1, except that the county agency shall not require additional verification of the information in the case file from the diversionary work program application unless the information in the case file is inaccurate, questionable, or no longer current. new text end

new text begin Subd. 12. new text end [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] new text begin Within one working day of determination that the applicant is eligible for the diversionary work program, but before benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to employment services. The referral to the DWP employment services must be in writing and must contain the following information: new text end

new text begin (1) notification that, as part of the application process, applicants are required to develop an employment plan or the DWP application will be denied; new text end

new text begin (2) the employment services provider name and phone number; new text end

new text begin (3) the date, time, and location of the scheduled employment services interview; new text end

new text begin (4) the immediate availability of supportive services, including, but not limited to, child care, transportation, and other work-related aid; and new text end

new text begin (5) the rights, responsibilities, and obligations of participants in the program, including, but not limited to, the grounds for converting or referring a participant to MFIP under subdivision 12,, the consequences of refusing or failing to participate fully with program requirements, the grounds for good cause for failing to comply with program requirements as defined in sections 256.741 and 256J.57, and the appeal process. new text end

new text begin Subd. 13. new text end [EMPLOYMENT PLAN; DWP BENEFITS.] new text begin Within five working days of being notified that a participant is financially eligible for the diversionary work program, the employment services provider and participant shall meet to develop an employment plan. Once the employment plan has been developed and signed by the participant and the job counselor, the employment services provider shall notify the county within one working day that the employment plan has been signed. The county shall issue DWP benefits within one working day after receiving notice that the employment plan has been signed. new text end

new text begin Subd. 14. new text end [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] new text begin (a) Except as specified in paragraphs (b) to (d), employment activities listed in section 256J.49, subdivision 13, are allowable under the diversionary work program. new text end

new text begin (b) Work activities under section 256J.49, subdivision 13, clause (5), shall be allowable only when in combination with approved work activities under section 256J.49, subdivision 13, clauses (1) to (4), and shall be limited to no more than one-half of the hours required in the employment plan. new text end

new text begin (c) In order for an English as a second language (ESL) class to be an approved work activity, a participant must: new text end

new text begin (1) be below a spoken language proficiency level of SPL6 or its equivalent, as measured by a nationally recognized test; and new text end

new text begin (2) not have been enrolled in ESL for more than 24 months while previously participating in MFIP or DWP. A participant who has been enrolled in ESL for 20 or more months may be approved for ESL until the participant has received 24 total months. new text end

new text begin (d) Work activities under section 256J.49, subdivision 13, clause (6), shall be allowable only when the training or education program will be completed within the four-month DWP period. Training or education programs that will not be completed within the four-month DWP period shall not be approved. new text end

new text begin Subd. 15. new text end [FAILURE TO COMPLY WITH REQUIREMENTS.] new text begin A family unit that includes a participant who fails to comply with DWP employment service or child support enforcement requirements, without good cause as defined in sections 256.741 and 256J.57, shall be disqualified from the diversionary work program. The county shall provide written notice as specified in section 256J.31 to the participant prior to disqualifying the family unit due to noncompliance with employment service or child support. The disqualification does not apply to food support or health care benefits. new text end

new text begin Subd. 16. new text end [GOOD CAUSE FOR NOT COMPLYING WITH REQUIREMENTS.] new text begin A participant who fails to comply with the requirements of the diversionary work program may claim good cause for reasons listed in sections 256.741 and 256J.57, subdivision 1. The county shall not impose a disqualification if good cause exists. new text end

new text begin Subd. 17. new text end [REINSTATEMENT FOLLOWING DISQUALIFICATION.] new text begin A participant who has been disqualified from the diversionary work program due to noncompliance with employment services may regain eligibility for the diversionary work program by complying with program requirements. A participant who has been disqualified from the diversionary work program due to noncooperation with child support enforcement requirements may regain eligibility by complying with child support requirements under section 256J.741. Once a participant has been reinstated, the county shall issue prorated benefits for the remaining portion of the month. A family unit that has been disqualified from the diversionary work program due to noncompliance shall not be eligible for MFIP or any other TANF cash program during the period of time the participant remains noncompliant. In a two-parent family, both parents must be in compliance before the family unit can regain eligibility for benefits. new text end

new text begin Subd. 18. new text end [RECOVERY OF OVERPAYMENTS.] new text begin When an overpayment or an ATM error is determined, the overpayment shall be recouped or recovered as specified in section 256J.38. new text end

new text begin Subd. 19. new text end [IMPLEMENTATION OF DWP.] new text begin Counties may establish a diversionary work program according to this section any time on or after July 1, 2003. Prior to establishing a diversionary work program, the county must notify the commissioner. All counties must implement the provisions of this section no later than July 1, 2004. new text end

Sec. 28.

Minnesota Statutes 2002, section 393.07, subdivision 10, is amended to read:

Subd. 10.

Federal food stamp program and the maternal and child nutrition act.

(a) The local social services agency shall establish and administer the food stamp new text begin or support new text end program according to rules of the commissioner of human services, the supervision of the commissioner as specified in section 256.01, and all federal laws and regulations. The commissioner of human services shall monitor food stamp new text begin or support new text end program delivery on an ongoing basis to ensure that each county complies with federal laws and regulations. Program requirements to be monitored include, but are not limited to, number of applications, number of approvals, number of cases pending, length of time required to process each application and deliver benefits, number of applicants eligible for expedited issuance, length of time required to process and deliver expedited issuance, number of terminations and reasons for terminations, client profiles by age, household composition and income level and sources, and the use of phone certification and home visits. The commissioner shall determine the county-by-county and statewide participation rate.

(b) On July 1 of each year, the commissioner of human services shall determine a statewide and county-by-county food stamp program participation rate. The commissioner may designate a different agency to administer the food stamp program in a county if the agency administering the program fails to increase the food stamp program participation rate among families or eligible individuals, or comply with all federal laws and regulations governing the food stamp program. The commissioner shall review agency performance annually to determine compliance with this paragraph.

(c) A person who commits any of the following acts has violated section 256.98 or 609.821, or both, and is subject to both the criminal and civil penalties provided under those sections:

(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a willful statement or misrepresentation, or intentional concealment of a material fact, food stamps or vouchers issued according to sections 145.891 to 145.897 to which the person is not entitled or in an amount greater than that to which that person is entitled or which specify nutritional supplements to which that person is not entitled; or

(2) presents or causes to be presented, coupons or vouchers issued according to sections 145.891 to 145.897 for payment or redemption knowing them to have been received, transferred or used in a manner contrary to existing state or federal law; or

(3) willfully uses, possesses, or transfers food stamp coupons, authorization to purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner contrary to existing state or federal law, rules, or regulations; or

(4) buys or sells food stamp coupons, authorization to purchase cards, other assistance transaction devices, vouchers issued according to sections 145.891 to 145.897, or any food obtained through the redemption of vouchers issued according to sections 145.891 to 145.897 for cash or consideration other than eligible food.

(d) A peace officer or welfare fraud investigator may confiscate food stamps, authorization to purchase cards, or other assistance transaction devices found in the possession of any person who is neither a recipient of the food stamp program nor otherwise authorized to possess and use such materials. Confiscated property shall be disposed of as the commissioner may direct and consistent with state and federal food stamp law. The confiscated property must be retained for a period of not less than 30 days to allow any affected person to appeal the confiscation under section 256.045.

(e) Food stamp overpayment claims which are due in whole or in part to client error shall be established by the county agency for a period of six years from the date of any resultant overpayment.

(f) With regard to the federal tax revenue offset program only, recovery incentives authorized by the federal food and consumer service shall be retained at the rate of 50 percent by the state agency and 50 percent by the certifying county agency.

(g) A peace officer, welfare fraud investigator, federal law enforcement official, or the commissioner of health may confiscate vouchers found in the possession of any person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise authorized to possess and use such vouchers. Confiscated property shall be disposed of as the commissioner of health may direct and consistent with state and federal law. The confiscated property must be retained for a period of not less than 30 days.

Sec. 29. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 256J.08, subdivision 70; 256J.425, subdivision 7; and 256J.47, are repealed. new text end

new text begin (b) Laws 1997, chapter 203, article 9, section 21, as amended by Laws 1998, chapter 407, article 6, section 111, Laws 2000, chapter 488, article 10, section 28, and Laws 2001, First Special Session chapter 9, article 10, section 62; and Laws 2000, chapter 488, article 10, section 29, are repealed. new text end

ARTICLE 2

HEALTH CARE

Section 1.

Minnesota Statutes 2002, section 13.461, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Wholesale drug distributor reports. new text end

new text begin Pricing information reported to the commissioner of human services is defined as trade secret information under section 151.47, subdivision 1, paragraph (g). new text end

Sec. 2.

Minnesota Statutes 2002, section 62J.692, subdivision 8, is amended to read:

Subd. 8.

Federal financial participation.

new text begin (a) new text end The commissioner of human services shall seek to maximize federal financial participation in payments for medical education and research costs. If the commissioner of human services determines that federal financial participation is available for the medical education and research, the commissioner of health shall transfer to the commissioner of human services the amount of state funds necessary to maximize the federal funds available. The amount transferred to the commissioner of human services, plus the amount of federal financial participation, shall be distributed to medical assistance providers in accordance with the distribution methodology described in subdivision 4.

new text begin (b) For the purposes of paragraph (a), the commissioner shall use physician clinic rates where possible to maximize federal financial participation. new text end

Sec. 3.

Minnesota Statutes 2002, section 151.47, subdivision 1, is amended to read:

Subdivision 1.

Requirements.

All wholesale drug distributors are subject to the requirements in paragraphs (a) to deleted text begin (f) deleted text end new text begin (g) new text end .

(a) No person or distribution outlet shall act as a wholesale drug distributor without first obtaining a license from the board and paying the required fee.

(b) No license shall be issued or renewed for a wholesale drug distributor to operate unless the applicant agrees to operate in a manner prescribed by federal and state law and according to the rules adopted by the board.

(c) The board may require a separate license for each facility directly or indirectly owned or operated by the same business entity within the state, or for a parent entity with divisions, subsidiaries, or affiliate companies within the state, when operations are conducted at more than one location and joint ownership and control exists among all the entities.

(d) As a condition for receiving and retaining a wholesale drug distributor license issued under sections 151.42 to 151.51, an applicant shall satisfy the board that it has new text begin complied with paragraph (g) and that it has new text end and will continuously maintain:

(1) adequate storage conditions and facilities;

(2) minimum liability and other insurance as may be required under any applicable federal or state law;

(3) a viable security system that includes an after hours central alarm, or comparable entry detection capability; restricted access to the premises; comprehensive employment applicant screening; and safeguards against all forms of employee theft;

(4) a system of records describing all wholesale drug distributor activities set forth in section 151.44 for at least the most recent two-year period, which shall be reasonably accessible as defined by board regulations in any inspection authorized by the board;

(5) principals and persons, including officers, directors, primary shareholders, and key management executives, who must at all times demonstrate and maintain their capability of conducting business in conformity with sound financial practices as well as state and federal law;

(6) complete, updated information, to be provided to the board as a condition for obtaining and retaining a license, about each wholesale drug distributor to be licensed, including all pertinent corporate licensee information, if applicable, or other ownership, principal, key personnel, and facilities information found to be necessary by the board;

(7) written policies and procedures that assure reasonable wholesale drug distributor preparation for, protection against, and handling of any facility security or operation problems, including, but not limited to, those caused by natural disaster or government emergency, inventory inaccuracies or product shipping and receiving, outdated product or other unauthorized product control, appropriate disposition of returned goods, and product recalls;

(8) sufficient inspection procedures for all incoming and outgoing product shipments; and

(9) operations in compliance with all federal requirements applicable to wholesale drug distribution.

(e) An agent or employee of any licensed wholesale drug distributor need not seek licensure under this section.

(f) A wholesale drug distributor shall file with the board an annual report, in a form and on the date prescribed by the board, identifying all payments, honoraria, reimbursement or other compensation authorized under section 151.461, clauses (3) to (5), paid to practitioners in Minnesota during the preceding calendar year. The report shall identify the nature and value of any payments totaling $100 or more, to a particular practitioner during the year, and shall identify the practitioner. Reports filed under this provision are public data.

new text begin (g) Manufacturers shall, on a quarterly basis, report by National Drug Code the following pharmaceutical pricing criteria to the board and the commissioner of human services for each of their drugs: average wholesale price, wholesale acquisition cost, average manufacturer price as defined in United States Code, title 42, chapter 7, subchapter XIX, section 1396r-8(k), and best price as defined in United States Code, title 42, chapter 7, subchapter XIX, section 1396r-8(c)(1)(C). The calculation of average wholesale price and wholesale acquisition cost shall be the net of all volume discounts, prompt payment discounts, chargebacks, short-dated product discounts, cash discounts, free goods, rebates, and all other price concessions or incentives provided to a purchaser that result in a reduction in the ultimate cost to the purchaser. When reporting average wholesale price, wholesale acquisition cost, average manufacturer price, and best price, manufacturers shall also include a detailed description of the methodology by which the prices were calculated. When a manufacturer reports average wholesale price, wholesale acquisition cost, average manufacturer price, or best price, the president or chief executive officer of the manufacturer shall certify to the Medicaid program, on a form provided by the commissioner of human services, that the reported prices are accurate. Information reported under this paragraph is trade secret information for purposes of section 13.37. new text end

Sec. 4.

Minnesota Statutes 2002, section 256.01, subdivision 2, is amended to read:

Subd. 2.

Specific powers.

Subject to the provisions of section 241.021, subdivision 2, the commissioner of human services shall:

(1) Administer and supervise all forms of public assistance provided for by state law and other welfare activities or services as are vested in the commissioner. Administration and supervision of human services activities or services includes, but is not limited to, assuring timely and accurate distribution of benefits, completeness of service, and quality program management. In addition to administering and supervising human services activities vested by law in the department, the commissioner shall have the authority to:

(a) require county agency participation in training and technical assistance programs to promote compliance with statutes, rules, federal laws, regulations, and policies governing human services;

(b) monitor, on an ongoing basis, the performance of county agencies in the operation and administration of human services, enforce compliance with statutes, rules, federal laws, regulations, and policies governing welfare services and promote excellence of administration and program operation;

(c) develop a quality control program or other monitoring program to review county performance and accuracy of benefit determinations;

(d) require county agencies to make an adjustment to the public assistance benefits issued to any individual consistent with federal law and regulation and state law and rule and to issue or recover benefits as appropriate;

(e) delay or deny payment of all or part of the state and federal share of benefits and administrative reimbursement according to the procedures set forth in section 256.017;

(f) make contracts with and grants to public and private agencies and organizations, both profit and nonprofit, and individuals, using appropriated funds; and

(g) enter into contractual agreements with federally recognized Indian tribes with a reservation in Minnesota to the extent necessary for the tribe to operate a federally approved family assistance program or any other program under the supervision of the commissioner. The commissioner shall consult with the affected county or counties in the contractual agreement negotiations, if the county or counties wish to be included, in order to avoid the duplication of county and tribal assistance program services. The commissioner may establish necessary accounts for the purposes of receiving and disbursing funds as necessary for the operation of the programs.

(2) Inform county agencies, on a timely basis, of changes in statute, rule, federal law, regulation, and policy necessary to county agency administration of the programs.

(3) Administer and supervise all child welfare activities; promote the enforcement of laws protecting handicapped, dependent, neglected and delinquent children, and children born to mothers who were not married to the children's fathers at the times of the conception nor at the births of the children; license and supervise child-caring and child-placing agencies and institutions; supervise the care of children in boarding and foster homes or in private institutions; and generally perform all functions relating to the field of child welfare now vested in the state board of control.

(4) Administer and supervise all noninstitutional service to handicapped persons, including those who are visually impaired, hearing impaired, or physically impaired or otherwise handicapped. The commissioner may provide and contract for the care and treatment of qualified indigent children in facilities other than those located and available at state hospitals when it is not feasible to provide the service in state hospitals.

(5) Assist and actively cooperate with other departments, agencies and institutions, local, state, and federal, by performing services in conformity with the purposes of Laws 1939, chapter 431.

(6) Act as the agent of and cooperate with the federal government in matters of mutual concern relative to and in conformity with the provisions of Laws 1939, chapter 431, including the administration of any federal funds granted to the state to aid in the performance of any functions of the commissioner as specified in Laws 1939, chapter 431, and including the promulgation of rules making uniformly available medical care benefits to all recipients of public assistance, at such times as the federal government increases its participation in assistance expenditures for medical care to recipients of public assistance, the cost thereof to be borne in the same proportion as are grants of aid to said recipients.

(7) Establish and maintain any administrative units reasonably necessary for the performance of administrative functions common to all divisions of the department.

(8) Act as designated guardian of both the estate and the person of all the wards of the state of Minnesota, whether by operation of law or by an order of court, without any further act or proceeding whatever, except as to persons committed as mentally retarded. For children under the guardianship of the commissioner whose interests would be best served by adoptive placement, the commissioner may contract with a licensed child-placing agency or a Minnesota tribal social services agency to provide adoption services. A contract with a licensed child-placing agency must be designed to supplement existing county efforts and may not replace existing county programs, unless the replacement is agreed to by the county board and the appropriate exclusive bargaining representative or the commissioner has evidence that child placements of the county continue to be substantially below that of other counties. Funds encumbered and obligated under an agreement for a specific child shall remain available until the terms of the agreement are fulfilled or the agreement is terminated.

(9) Act as coordinating referral and informational center on requests for service for newly arrived immigrants coming to Minnesota.

(10) The specific enumeration of powers and duties as hereinabove set forth shall in no way be construed to be a limitation upon the general transfer of powers herein contained.

(11) Establish county, regional, or statewide schedules of maximum fees and charges which may be paid by county agencies for medical, dental, surgical, hospital, nursing and nursing home care and medicine and medical supplies under all programs of medical care provided by the state and for congregate living care under the income maintenance programs.

(12) Have the authority to conduct and administer experimental projects to test methods and procedures of administering assistance and services to recipients or potential recipients of public welfare. To carry out such experimental projects, it is further provided that the commissioner of human services is authorized to waive the enforcement of existing specific statutory program requirements, rules, and standards in one or more counties. The order establishing the waiver shall provide alternative methods and procedures of administration, shall not be in conflict with the basic purposes, coverage, or benefits provided by law, and in no event shall the duration of a project exceed four years. It is further provided that no order establishing an experimental project as authorized by the provisions of this section shall become effective until the following conditions have been met:

(a) The secretary of health and human services of the United States has agreed, for the same project, to waive state plan requirements relative to statewide uniformity.

(b) A comprehensive plan, including estimated project costs, shall be approved by the legislative advisory commission and filed with the commissioner of administration.

(13) According to federal requirements, establish procedures to be followed by local welfare boards in creating citizen advisory committees, including procedures for selection of committee members.

(14) Allocate federal fiscal disallowances or sanctions which are based on quality control error rates for the aid to families with dependent children program formerly codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the following manner:

(a) One-half of the total amount of the disallowance shall be borne by the county boards responsible for administering the programs. For the medical assistance and the AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be shared by each county board in the same proportion as that county's expenditures for the sanctioned program are to the total of all counties' expenditures for the AFDC program formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the food stamp program, sanctions shall be shared by each county board, with 50 percent of the sanction being distributed to each county in the same proportion as that county's administrative costs for food stamps are to the total of all food stamp administrative costs for all counties, and 50 percent of the sanctions being distributed to each county in the same proportion as that county's value of food stamp benefits issued are to the total of all benefits issued for all counties. Each county shall pay its share of the disallowance to the state of Minnesota. When a county fails to pay the amount due hereunder, the commissioner may deduct the amount from reimbursement otherwise due the county, or the attorney general, upon the request of the commissioner, may institute civil action to recover the amount due.

(b) Notwithstanding the provisions of paragraph (a), if the disallowance results from knowing noncompliance by one or more counties with a specific program instruction, and that knowing noncompliance is a matter of official county board record, the commissioner may require payment or recover from the county or counties, in the manner prescribed in paragraph (a), an amount equal to the portion of the total disallowance which resulted from the noncompliance, and may distribute the balance of the disallowance according to paragraph (a).

(15) Develop and implement special projects that maximize reimbursements and result in the recovery of money to the state. For the purpose of recovering state money, the commissioner may enter into contracts with third parties. Any recoveries that result from projects or contracts entered into under this paragraph shall be deposited in the state treasury and credited to a special account until the balance in the account reaches $1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be transferred and credited to the general fund. All money in the account is appropriated to the commissioner for the purposes of this paragraph.

(16) Have the authority to make direct payments to facilities providing shelter to women and their children according to section 256D.05, subdivision 3. Upon the written request of a shelter facility that has been denied payments under section 256D.05, subdivision 3, the commissioner shall review all relevant evidence and make a determination within 30 days of the request for review regarding issuance of direct payments to the shelter facility. Failure to act within 30 days shall be considered a determination not to issue direct payments.

(17) Have the authority to establish and enforce the following county reporting requirements:

(a) The commissioner shall establish fiscal and statistical reporting requirements necessary to account for the expenditure of funds allocated to counties for human services programs. When establishing financial and statistical reporting requirements, the commissioner shall evaluate all reports, in consultation with the counties, to determine if the reports can be simplified or the number of reports can be reduced.

(b) The county board shall submit monthly or quarterly reports to the department as required by the commissioner. Monthly reports are due no later than 15 working days after the end of the month. Quarterly reports are due no later than 30 calendar days after the end of the quarter, unless the commissioner determines that the deadline must be shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines or risking a loss of federal funding. Only reports that are complete, legible, and in the required format shall be accepted by the commissioner.

(c) If the required reports are not received by the deadlines established in clause (b), the commissioner may delay payments and withhold funds from the county board until the next reporting period. When the report is needed to account for the use of federal funds and the late report results in a reduction in federal funding, the commissioner shall withhold from the county boards with late reports an amount equal to the reduction in federal funding until full federal funding is received.

(d) A county board that submits reports that are late, illegible, incomplete, or not in the required format for two out of three consecutive reporting periods is considered noncompliant. When a county board is found to be noncompliant, the commissioner shall notify the county board of the reason the county board is considered noncompliant and request that the county board develop a corrective action plan stating how the county board plans to correct the problem. The corrective action plan must be submitted to the commissioner within 45 days after the date the county board received notice of noncompliance.

(e) The final deadline for fiscal reports or amendments to fiscal reports is one year after the date the report was originally due. If the commissioner does not receive a report by the final deadline, the county board forfeits the funding associated with the report for that reporting period and the county board must repay any funds associated with the report received for that reporting period.

(f) The commissioner may not delay payments, withhold funds, or require repayment under paragraph (c) or (e) if the county demonstrates that the commissioner failed to provide appropriate forms, guidelines, and technical assistance to enable the county to comply with the requirements. If the county board disagrees with an action taken by the commissioner under paragraph (c) or (e), the county board may appeal the action according to sections 14.57 to 14.69.

(g) Counties subject to withholding of funds under paragraph (c) or forfeiture or repayment of funds under paragraph (e) shall not reduce or withhold benefits or services to clients to cover costs incurred due to actions taken by the commissioner under paragraph (c) or (e).

(18) Allocate federal fiscal disallowances or sanctions for audit exceptions when federal fiscal disallowances or sanctions are based on a statewide random sample for the foster care program under title IV-E of the Social Security Act, United States Code, title 42, in direct proportion to each county's title IV-E foster care maintenance claim for that period.

(19) Be responsible for ensuring the detection, prevention, investigation, and resolution of fraudulent activities or behavior by applicants, recipients, and other participants in the human services programs administered by the department.

(20) Require county agencies to identify overpayments, establish claims, and utilize all available and cost-beneficial methodologies to collect and recover these overpayments in the human services programs administered by the department.

(21) Have the authority to administer a drug rebate program for drugs purchased pursuant to the prescription drug program established under section 256.955 after the beneficiary's satisfaction of any deductible established in the program. The commissioner shall require a rebate agreement from all manufacturers of covered drugs as defined in section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on or after July 1, 2002, must include rebates for individuals covered under the prescription drug program who are under 65 years of age. For each drug, the amount of the rebate shall be equal to the deleted text begin basic deleted text end rebate as defined for purposes of the federal rebate program in United States Code, title 42, section 1396r-8(c)(1). deleted text begin This basic rebate shall be applied to single-source and multiple-source drugs. deleted text end The manufacturers must provide full payment within 30 days of receipt of the state invoice for the rebate within the terms and conditions used for the federal rebate program established pursuant to section 1927 of title XIX of the Social Security Act. The manufacturers must provide the commissioner with any information necessary to verify the rebate determined per drug. The rebate program shall utilize the terms and conditions used for the federal rebate program established pursuant to section 1927 of title XIX of the Social Security Act.

(22) Have the authority to administer the federal drug rebate program for drugs purchased under the medical assistance program as allowed by section 1927 of title XIX of the Social Security Act and according to the terms and conditions of section 1927. Rebates shall be collected for all drugs that have been dispensed or administered in an outpatient setting and that are from manufacturers who have signed a rebate agreement with the United States Department of Health and Human Services.

(23) Have the authority to administer a supplemental drug rebate program for drugs purchased under the medical assistance program. The commissioner may enter into supplemental rebate contracts with pharmaceutical manufacturers and may require prior authorization for drugs that are from manufacturers that have not signed a supplemental rebate contract. Prior authorization of drugs shall be subject to the provisions of section 256B.0625, subdivision 13. new text begin The commissioner shall evaluate whether participation in a multistate preferred drug list and supplemental rebate program reduces costs or improves the operations of the medical assistance program. The commissioner may enter into a contract with a vendor or other states for the purposes of participating in a multistate preferred drug list and supplemental rebate program. new text end

(24) Operate the department's communication systems account established in Laws 1993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared communication costs necessary for the operation of the programs the commissioner supervises. A communications account may also be established for each regional treatment center which operates communications systems. Each account must be used to manage shared communication costs necessary for the operations of the programs the commissioner supervises. The commissioner may distribute the costs of operating and maintaining communication systems to participants in a manner that reflects actual usage. Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and other costs as determined by the commissioner. Nonprofit organizations and state, county, and local government agencies involved in the operation of programs the commissioner supervises may participate in the use of the department's communications technology and share in the cost of operation. The commissioner may accept on behalf of the state any gift, bequest, devise or personal property of any kind, or money tendered to the state for any lawful purpose pertaining to the communication activities of the department. Any money received for this purpose must be deposited in the department's communication systems accounts. Money collected by the commissioner for the use of communication systems must be deposited in the state communication systems account and is appropriated to the commissioner for purposes of this section.

(25) Receive any federal matching money that is made available through the medical assistance program for the consumer satisfaction survey. Any federal money received for the survey is appropriated to the commissioner for this purpose. The commissioner may expend the federal money received for the consumer satisfaction survey in either year of the biennium.

(26) Incorporate cost reimbursement claims from First Call Minnesota and Greater Twin Cities United Way into the federal cost reimbursement claiming processes of the department according to federal law, rule, and regulations. Any reimbursement received is appropriated to the commissioner and shall be disbursed to First Call Minnesota and Greater Twin Cities United Way according to normal department payment schedules.

(27) Develop recommended standards for foster care homes that address the components of specialized therapeutic services to be provided by foster care homes with those services.

Sec. 5.

Minnesota Statutes 2002, section 256.955, subdivision 2a, is amended to read:

Subd. 2a.

Eligibility.

An individual satisfying the following requirements and the requirements described in subdivision 2, paragraph (d), is eligible for the prescription drug program:

(1) is at least 65 years of age or older; and

(2) is eligible as a qualified Medicare beneficiary according to section 256B.057, subdivision 3 deleted text begin , deleted text end new text begin or new text end 3a, deleted text begin or 3b, clause (1), deleted text end or is eligible under section 256B.057, subdivision 3 deleted text begin , deleted text end new text begin or new text end 3a, deleted text begin or 3b, clause (1), deleted text end and is also eligible for medical assistance or general assistance medical care with a spenddown as defined in section 256B.056, subdivision 5.

Sec. 6.

Minnesota Statutes 2002, section 256.969, subdivision 2b, is amended to read:

Subd. 2b.

Operating payment rates.

new text begin (a) new text end In determining operating payment rates for admissions occurring on or after the rate year beginning January 1, 1991, and every two years after, or more frequently as determined by the commissioner, the commissioner shall obtain operating data from an updated base year and establish operating payment rates per admission for each hospital based on the cost-finding methods and allowable costs of the Medicare program in effect during the base year. Rates under the general assistance medical care, medical assistance, and MinnesotaCare programs shall not be rebased to more current data on January 1, 1997. The base year operating payment rate per admission is standardized by the case mix index and adjusted by the hospital cost index, relative values, and disproportionate population adjustment. The cost and charge data used to establish operating rates shall only reflect inpatient services covered by medical assistance and shall not include property cost information and costs recognized in outlier payments.

new text begin (b) The rebasing of rates scheduled to occur on January 1, 2005, shall be postponed until January 1, 2006. The rebasing of rates scheduled to occur on January 1, 2007, shall be implemented as scheduled. new text end

Sec. 7.

Minnesota Statutes 2002, section 256.969, subdivision 3a, is amended to read:

Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical assistance program must not be submitted until the recipient is discharged. However, the commissioner shall establish monthly interim payments for inpatient hospitals that have individual patient lengths of stay over 30 days regardless of diagnostic category. Except as provided in section 256.9693, medical assistance reimbursement for treatment of mental illness shall be reimbursed based on diagnostic classifications. Individual hospital payments established under this section and sections 256.9685, 256.9686, and 256.9695, in addition to third party and recipient liability, for discharges occurring during the rate year shall not exceed, in aggregate, the charges for the medical assistance covered inpatient services paid for the same period of time to the hospital. This payment limitation shall be calculated separately for medical assistance and general assistance medical care services. The limitation on general assistance medical care shall be effective for admissions occurring on or after July 1, 1991. Services that have rates established under subdivision 11 or 12, must be limited separately from other services. After consulting with the affected hospitals, the commissioner may consider related hospitals one entity and may merge the payment rates while maintaining separate provider numbers. The operating and property base rates per admission or per day shall be derived from the best Medicare and claims data available when rates are established. The commissioner shall determine the best Medicare and claims data, taking into consideration variables of recency of the data, audit disposition, settlement status, and the ability to set rates in a timely manner. The commissioner shall notify hospitals of payment rates by December 1 of the year preceding the rate year. The rate setting data must reflect the admissions data used to establish relative values. Base year changes from 1981 to the base year established for the rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited to the limits ending June 30, 1987, on the maximum rate of increase under subdivision 1. The commissioner may adjust base year cost, relative value, and case mix index data to exclude the costs of services that have been discontinued by the October 1 of the year preceding the rate year or that are paid separately from inpatient services. Inpatient stays that encompass portions of two or more rate years shall have payments established based on payment rates in effect at the time of admission unless the date of admission preceded the rate year in effect by six months or more. In this case, operating payment rates for services rendered during the rate year in effect and established based on the date of admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for inpatient services is reduced by .5 percent from the current statutory rates.

new text begin (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service admissions occurring on or after July 1, 2003, made to hospitals for inpatient services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Mental health services within diagnosis related groups 424 to 432, and facilities defined under subdivision 16 are excluded from this paragraph. new text end

Sec. 8.

Minnesota Statutes 2002, section 256.975, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Prescription drug assistance. new text end

new text begin The Minnesota board on aging shall establish and administer a prescription drug assistance program to assist individuals in accessing programs offered by pharmaceutical manufacturers that provide free or discounted prescription drugs or provide coverage for prescription drugs. The board shall use computer software programs to: new text end

new text begin (1) list eligibility requirements for pharmaceutical assistance programs offered by manufacturers; new text end

new text begin (2) list drugs that are included in a supplemental rebate contract between the commissioner and a pharmaceutical manufacturer under section 256.01, subdivision 2, clause (23); and new text end

new text begin (3) link individuals with the pharmaceutical assistance programs most appropriate for the individual. The board shall make information on the prescription drug assistance program available to interested individuals and health care providers and shall coordinate the program with the statewide information and assistance service provided through the Senior LinkAge Line under subdivision 7. new text end

Sec. 9.

Minnesota Statutes 2002, section 256B.056, subdivision 1c, is amended to read:

Subd. 1c.

Families with children income methodology.

(a) new text begin (1) new text end For children ages one to five whose eligibility is determined under section 256B.057, subdivision 2, 21 percent of countable earned income shall be disregarded for up to four months.

new text begin (2) For children ages one through 18 whose eligibility is determined under section 256B.057, subdivision 2, the following deductions shall be applied to income counted toward the child's eligibility as allowed under the state's AFDC plan in effect as of July 16, 1996; $90 work expense, dependent care, and child support paid under court order. This clause is effective July 1, 2003. new text end

(b) For families with children whose eligibility is determined using the standard specified in section 256B.056, subdivision 4, paragraph (c), 17 percent of countable earned income shall be disregarded for up to four months.

(c) If the disregard has been applied to the wage earner's income for four months, the disregard shall not be applied again until the wage earner's income has not been considered in determining medical assistance eligibility for 12 consecutive months.

Sec. 10.

Minnesota Statutes 2002, section 256B.057, subdivision 2, is amended to read:

Subd. 2.

Children.

Except as specified in subdivision 1b, effective July 1, deleted text begin 2002 deleted text end new text begin 2003 new text end , a child one through 18 years of age in a family whose countable income is no greater than deleted text begin 170 deleted text end new text begin 150 new text end percent of the federal poverty guidelines for the same family size, is eligible for medical assistance.

Sec. 11.

Minnesota Statutes 2002, section 256B.057, subdivision 3b, is amended to read:

Subd. 3b.

Qualifying individuals.

Beginning July 1, 1998, deleted text begin to the extent of the federal allocation to Minnesota deleted text end new text begin contingent upon federal funding new text end , a person who would otherwise be eligible as a qualified Medicare beneficiary under subdivision 3, except that the person's income is in excess of the limit, is eligible as a qualifying individual according to the following criteria:

(1) if the person's income is greater than 120 percent, but less than 135 percent of the official federal poverty guidelines for the applicable family size, the person is eligible for medical assistance reimbursement of Medicare Part B premiums; or

(2) if the person's income is equal to or greater than 135 percent but less than 175 percent of the official federal poverty guidelines for the applicable family size, the person is eligible for medical assistance reimbursement of that portion of the Medicare Part B premium attributable to an increase in Part B expenditures which resulted from the shift of home care services from Medicare Part A to Medicare Part B under Public Law deleted text begin Number deleted text end 105-33, section 4732, the Balanced Budget Act of 1997.

The commissioner shall limit enrollment of qualifying individuals under this subdivision according to the requirements of Public Law deleted text begin Number deleted text end 105-33, section 4732.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 12.

Minnesota Statutes 2002, 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) new text begin effective November 1, 2003, new text end pays a premium, deleted text begin if deleted text end new text begin as new text end required, under paragraph deleted text begin (c) deleted text end new text begin (d) new text end .

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 new text begin : new text end

new text begin (1) new text end 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 new text begin ; or new text end

new text begin (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 new text end .

(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) new text begin (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. new text end

new text begin (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. new text end

new text begin (d)(1) new text end 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.

new text begin (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). new text end

deleted text begin (d) deleted text end new text begin (e) new text end 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.

deleted text begin (e) deleted text end new text begin (f) new text end Any required premium shall be determined at application and redetermined deleted text begin annually at recertification deleted text end new text begin at the enrollee's six-month income review new text end or when a change in income or deleted text begin family deleted text end new text begin household new text end size deleted text begin occurs deleted text end new text begin 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 or verification of income under section 256B.061, paragraph (b), a change resulting in an increased premium shall not affect the premium amount until the next six-month review new text end .

deleted text begin (f) deleted text end new text begin (g) new text end 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.

deleted text begin (g) deleted text end new text begin (h) new text end 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. new text begin 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. new text end 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.

[EFFECTIVE DATE.] new text begin This section is effective November 1, 2003, except the amendments to Minnesota Statutes 2002, section 256B.057, subdivision 9, paragraphs (f) and (h), are effective July 1, 2003. new text end

Sec. 13.

Minnesota Statutes 2002, section 256B.061, is amended to read:

256B.061 ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.

deleted text begin (a) deleted text end If any individual has been determined to be eligible for medical assistance, it will be made available for care and services included under the plan and furnished in or after the third month before the month in which the individual made application for such assistance, if such individual was, or upon application would have been, eligible for medical assistance at the time the care and services were furnished. The commissioner may limit, restrict, or suspend the eligibility of an individual for up to one year upon that individual's conviction of a criminal offense related to application for or receipt of medical assistance benefits.

deleted text begin (b) On the basis of information provided on the completed application, an applicant who meets the following criteria shall be determined eligible beginning in the month of application: deleted text end

deleted text begin (1) whose gross income is less than 90 percent of the applicable income standard; deleted text end

deleted text begin (2) whose total liquid assets are less than 90 percent of the asset limit; deleted text end

deleted text begin (3) does not reside in a long-term care facility; and deleted text end

deleted text begin (4) meets all other eligibility requirements. deleted text end

deleted text begin The applicant must provide all required verifications within 30 days' notice of the eligibility determination or eligibility shall be terminated. deleted text end

[EFFECTIVE DATE.] new text begin This section is repealed April 1, 2005, if the HealthMatch system is operational. If the HealthMatch system is not operational, this section is effective July 1, 2005. new text end

Sec. 14.

Minnesota Statutes 2002, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

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. new text begin Payments for dental services covered under medical assistance that are provided by a licensed denturist shall be 80 percent of the rate paid to a licensed dentist. A licensed denturist may only provide services that are within the scope of practice of the denturist's license as defined in chapter 150B. new text end

Sec. 15.

Minnesota Statutes 2002, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed by a licensed pharmacist, by a physician enrolled in the medical assistance program as a dispensing physician, or by a physician or a nurse practitioner employed by or under contract with a community health board as defined in section 145A.02, subdivision 5, for the purposes of communicable disease control.

new text begin (b) new text end The commissioner, after receiving recommendations from professional medical associations and professional deleted text begin pharmacist deleted text end new text begin pharmacy new text end associations, shall designate a formulary committee to deleted text begin advise the commissioner on the names of drugs for which payment is made, recommend a system for reimbursing providers on a set fee or charge basis rather than the present system, and develop methods encouraging use of generic drugs when they are less expensive and equally effective as trademark drugs. The formulary committee shall consist of nine members, four of whom shall be physicians who are not employed by the department of human services, and a majority of whose practice is for persons paying privately or through health insurance, three of whom shall be pharmacists who are not employed by the department of human services, and a majority of whose practice is for persons paying privately or through health insurance, a consumer representative, and a nursing home representative deleted text end new text begin carry out duties as described in this subdivision. The formulary committee shall be comprised of four licensed physicians actively engaged in the practice of medicine in Minnesota one of whom must be actively engaged in the treatment of persons with mental illness; at least three licensed pharmacists actively engaged in the practice of pharmacy in Minnesota; and one consumer representative; the remainder to be made up of health care professionals who are licensed in their field and have recognized knowledge in the clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs. Members of the formulary committee shall not be employed by the department of human services new text end . Committee members shall serve three-year terms and deleted text begin shall serve without compensation. Members deleted text end may be reappointed deleted text begin once deleted text end new text begin by the commissioner. The formulary committee shall meet at least quarterly. The commissioner may require more frequent formulary committee meetings as needed. An honorarium of $100 per meeting and reimbursement for mileage shall be paid to each committee member in attendance new text end .

deleted text begin (b) deleted text end new text begin (c) new text end The commissioner shall establish a drug formulary. Its establishment and publication shall not be subject to the requirements of the Administrative Procedure Act, but the formulary committee shall review and comment on the formulary contents.

The formulary shall not include:

(i) drugs or products for which there is no federal funding;

(ii) over-the-counter drugs, except deleted text begin for antacids, acetaminophen, family planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults with documented vitamin deficiencies, vitamins for children under the age of seven and pregnant or nursing women, and any other over-the-counter drug identified by the commissioner, in consultation with the drug formulary committee, as necessary, appropriate, and cost-effective for the treatment of certain specified chronic diseases, conditions or disorders, and this determination shall not be subject to the requirements of chapter 14 deleted text end new text begin as provided in paragraph (g) new text end ;

(iii) deleted text begin anorectics, except that medically necessary anorectics shall be covered for a recipient previously diagnosed as having pickwickian syndrome and currently diagnosed as having diabetes and being morbidly obese deleted text end new text begin drugs used for weight loss new text end ;

(iv) drugs for which medical value has not been established; and

(v) drugs from manufacturers who have not signed a rebate agreement with the Department of Health and Human Services pursuant to section 1927 of title XIX of the Social Security Act.

The commissioner shall publish conditions for prohibiting payment for specific drugs after considering the formulary committee's recommendations. deleted text begin An honorarium of $100 per meeting and reimbursement for mileage shall be paid to each committee member in attendance. deleted text end

new text begin (d) Prior authorization may be required by the commissioner before certain formulary drugs are eligible for payment. The formulary committee may recommend drugs for prior authorization directly to the commissioner. The commissioner may also request that the formulary committee review a drug for prior authorization. Before the commissioner may require prior authorization for a drug: new text end

new text begin (1) the commissioner must provide information to the formulary committee on the impact that placing the drug on prior authorization may have on the quality of patient care and on program costs, information regarding whether the drug is subject to clinical abuse or misuse, and relevant data from the state Medicaid program if such data is available; new text end

new text begin (2) the formulary committee must review the drug, taking into account medical and clinical data and the information provided by the commissioner; and new text end

new text begin (3) the formulary committee must hold a public forum and receive public comment for an additional 15 days. new text end

new text begin The commissioner must provide a 15-day notice period before implementing the prior authorization. new text end

deleted text begin (c) deleted text end new text begin (e) The dispensed quantity of a prescribed drug must not exceed a 30-day supply. new text end The basis for determining the amount of payment shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee; the maximum allowable cost set by the federal government or by the commissioner plus the fixed dispensing fee; or the usual and customary price charged to the public. The amount of payment basis must be reduced to reflect all discount amounts applied to the charge by any provider/insurer agreement or contract for submitted charges to medical assistance programs. The net submitted charge may not be greater than the patient liability for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee for intravenous solutions which must be compounded by the pharmacist shall be $8 per bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral nutritional products dispensed in quantities greater than one liter. Actual acquisition cost includes quantity and other special discounts except time and cash discounts. The actual acquisition cost of a drug shall be estimated by the commissioner, at average price minus deleted text begin nine deleted text end new text begin 14 new text end percent, except that where a drug has had its wholesale price reduced as a result of the actions of the National Association of Medicaid Fraud Control Units, the estimated actual acquisition cost shall be the reduced average wholesale price, without the deleted text begin nine deleted text end new text begin 14 new text end percent deduction. The maximum allowable cost of a multisource drug may be set by the commissioner and it shall be comparable to, but no higher than, the maximum amount paid by other third-party payors in this state who have maximum allowable cost programs. deleted text begin The commissioner shall set maximum allowable costs for multisource drugs that are not on the federal upper limit list as described in United States Code, title 42, chapter 7, section 1396r-8(e), the Social Security Act, and Code of Federal Regulations, title 42, part 447, section 447.332. deleted text end Establishment of the amount of payment for drugs shall not be subject to the requirements of the Administrative Procedure Act. An additional dispensing fee of $.30 may be added to the dispensing fee paid to pharmacists for legend drug prescriptions dispensed to residents of long-term care facilities when a unit dose blister card system, approved by the department, is used. Under this type of dispensing system, the pharmacist must dispense a 30-day supply of drug. The National Drug Code (NDC) from the drug container used to fill the blister card must be identified on the claim to the department. The unit dose blister card containing the drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700, that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider will be required to credit the department for the actual acquisition cost of all unused drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the manufacturer's unopened package. The commissioner may permit the drug clozapine to be dispensed in a quantity that is less than a 30-day supply. Whenever a generically equivalent product is available, payment shall be on the basis of the actual acquisition cost of the generic drug deleted text begin , unless the prescriber specifically indicates "dispense as written - brand necessary" on the prescription as required by section 151.21, subdivision 2. deleted text end

deleted text begin (d) For purposes of this subdivision, "multisource drugs" means covered outpatient drugs, excluding innovator multisource drugs for which there are two or more drug products, which: deleted text end

deleted text begin (1) are related as therapeutically equivalent under the Food and Drug Administration's most recent publication of "Approved Drug Products with Therapeutic Equivalence Evaluations"; deleted text end new text begin or on the maximum allowable cost established by the commissioner. The commissioner may require prior authorization for brand-name drugs whenever a generically equivalent product is available even if the prescriber specifically indicates "dispense as written - brand necessary" on the prescription as required by section 151.21, subdivision 2. The formulary committee shall establish general criteria to be used for the prior authorization of brand-name drugs for which generically equivalent drugs are available, but formulary committee review of each brand-name drug for which a generically equivalent drug is available shall not be required. new text end

deleted text begin (2) are pharmaceutically equivalent and bioequivalent as determined by the Food and Drug Administration; and deleted text end

deleted text begin (3) are sold or marketed in Minnesota. deleted text end

deleted text begin "Innovator multisource drug" means a multisource drug that was originally marketed under an original new drug application approved by the Food and Drug Administration. deleted text end

deleted text begin (e) The formulary committee shall review and recommend drugs which require prior authorization. The formulary committee may recommend drugs for prior authorization directly to the commissioner, as long as opportunity for public input is provided. Prior authorization may be requested by the commissioner based on medical and clinical criteria and on cost before certain drugs are eligible for payment. Before a drug may be considered for prior authorization at the request of the commissioner: deleted text end

deleted text begin (1) the drug formulary committee must develop criteria to be used for identifying drugs; the development of these criteria is not subject to the requirements of chapter 14, but the formulary committee shall provide opportunity for public input in developing criteria; deleted text end

deleted text begin (2) the drug formulary committee must hold a public forum and receive public comment for an additional 15 days; deleted text end

deleted text begin (3) the drug formulary committee must consider data from the state Medicaid program if such data is available; and deleted text end

deleted text begin (4) the commissioner must provide information to the formulary committee on the impact that placing the drug on prior authorization will have on the quality of patient care and on program costs, and information regarding whether the drug is subject to clinical abuse or misuse. deleted text end

deleted text begin Prior authorization may be required by the commissioner before certain formulary drugs are eligible for payment. If prior authorization of a drug is required by the commissioner, the commissioner must provide a 30-day notice period before implementing the prior authorization. If a prior authorization request is denied by the department, the recipient may appeal the denial in accordance with section 256.045. If an appeal is filed, the drug must be provided without prior authorization until a decision is made on the appeal. deleted text end

(f) The basis for determining the amount of payment for drugs administered in an outpatient setting shall be the lower of the usual and customary cost submitted by the provider; the average wholesale price minus five percent; or the maximum allowable cost set by the federal government under United States Code, title 42, chapter 7, section 1396r-8(e), and Code of Federal Regulations, title 42, section 447.332, or by the commissioner under paragraph deleted text begin (c) deleted text end new text begin (e) new text end .

(g) deleted text begin Prior authorization shall not be required or utilized for any antipsychotic drug prescribed for the treatment of mental illness where there is no generically equivalent drug available unless the commissioner determines that prior authorization is necessary for patient safety. This paragraph applies to any supplemental drug rebate program established or administered by the commissioner. deleted text end new text begin Medical assistance covers the following over-the-counter drugs when prescribed by a licensed practitioner, or when authorized by a licensed pharmacist who meets standards established by the commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults with documented vitamin deficiencies, vitamins for children under the age of seven and pregnant or nursing women, and any other over-the-counter drug identified by the commissioner, in consultation with the formulary committee, as necessary, appropriate, and cost effective for the treatment of certain specified chronic diseases, conditions, or disorders, and this determination shall not be subject to the requirements of chapter 14. When authorizing over-the-counter drugs under this paragraph, licensed pharmacists must consult with the recipient to determine necessity, provide drug counseling, review drug therapy for potential adverse interactions, and make referrals as needed to other health care professionals. new text end

(h) Prior authorization shall not be required or utilized for any antihemophilic factor drug prescribed for the treatment of hemophilia and blood disorders where there is no generically equivalent drug available deleted text begin unless the commissioner determines that prior authorization is necessary for patient safety. This paragraph applies to deleted text end new text begin if the prior authorization is used in conjunction with new text end any supplemental drug rebate program new text begin or multistate preferred drug list new text end established or administered by the commissioner. This paragraph expires July 1, deleted text begin 2003 deleted text end new text begin 2005 new text end .

new text begin (i) Prior authorization shall not be required or utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness if: new text end

new text begin (1) there is no generically equivalent drug available; and new text end

new text begin (2) the drug was initially prescribed for the recipient prior to July 1, 2003; or new text end

new text begin (3) the drug is part of the recipient's current course of treatment. new text end

new text begin This paragraph applies to any multistate preferred drug list or supplemental drug rebate program established or administered by the commissioner. new text end

Sec. 16.

Minnesota Statutes 2002, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 13c. new text end

new text begin Pharmaceutical care demonstration project. new text end

new text begin (a) The commissioner shall develop, upon federal approval, a demonstration project to provide culturally specific pharmaceutical care to American Indian medical assistance recipients who are age 55 and older. In developing the demonstration project, the commissioner shall consult with organizations and health care providers experienced in developing and implementing culturally competent intervention strategies to manage the use of prescription drugs, over-the-counter drugs, other drug products, and native therapies by American Indian elders. The commissioner shall seek federal approval to implement the demonstration project. new text end

new text begin (b) For purposes of this subdivision, "pharmaceutical care" means the provision of drug therapy and native therapy for the purpose of improving a patient's quality of life by: (1) curing a disease; (2) eliminating or reducing a patient's symptoms; (3) arresting or slowing a disease process; or (4) preventing a disease or a symptom. Pharmaceutical care involves the documented process through which a pharmacist cooperates with a patient and other professionals in designing, implementing, and monitoring a therapeutic plan that is expected to produce specific therapeutic outcomes, through the identification, resolution, and prevention of drug-related problems. Nothing in this subdivision shall be construed to expand or modify the scope of practice of the pharmacist as defined in section 151.01, subdivision 27. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, or upon federal approval, whichever is later. new text end

Sec. 17.

Minnesota Statutes 2002, section 256B.0625, subdivision 17, is amended to read:

Subd. 17.

Transportation costs.

(a) Medical assistance covers transportation costs incurred solely for obtaining emergency medical care or transportation costs incurred by deleted text begin nonambulatory deleted text end new text begin eligible new text end persons in obtaining emergency or nonemergency medical care when paid directly to an ambulance company, common carrier, or other recognized providers of transportation services. For the purpose of this subdivision, a person who deleted text begin is incapable of transport by taxicab or bus deleted text end new text begin has been certified by a physician under paragraph (b) new text end shall be deleted text begin considered to be nonambulatory deleted text end new text begin eligible for special transportation services new text end .

(b) Medical assistance covers special transportation, as defined in Minnesota Rules, part 9505.0315, subpart 1, item F, if the provider receives and maintains a current physician's order by the recipient's attending physician certifying that the recipient has a physical or mental impairment that would prohibit the recipient from safely accessing and using a bus, taxi, other commercial transportation, or private automobile. Special transportation includes driver-assisted service to eligible individuals. Driver-assisted service includes passenger pickup at and return to the individual's residence or place of business, assistance with admittance of the individual to the medical facility, and assistance in passenger securement or in securing of wheelchairs or stretchers in the vehicle. deleted text begin The commissioner shall establish maximum medical assistance reimbursement rates for special transportation services for persons who need a wheelchair-accessible van or stretcher-accessible vehicle and for those who do not need a wheelchair-accessible van or stretcher-accessible vehicle. The average of these two rates per trip must not exceed $15 for the base rate and $1.40 per mile. Special transportation provided to nonambulatory persons who do not need a wheelchair-accessible van or stretcher-accessible vehicle, may be reimbursed at a lower rate than special transportation provided to persons who need a wheelchair-accessible van or stretcher-accessible vehicle. deleted text end new text begin The maximum medical assistance reimbursement rates for special transportation services are: new text end

new text begin (1) for trips originating within a major metropolitan area, a flat rate of $28.50 per trip for nonambulatory persons who need a wheelchair-accessible van and a flat rate of $21 per trip for eligible persons who do not need a wheelchair-accessible van or a stretcher-accessible vehicle; new text end

new text begin (2) for trips originating outside of a major metropolitan area, a base rate of $18 per trip and $1.20 per mile for eligible persons who need a wheelchair-accessible van and a base rate of $12 per trip and $1.20 per mile for eligible persons who do not need a wheelchair-accessible van or a stretcher-accessible vehicle; and new text end

new text begin (3) for all trips, a base rate of $36 and $1.40 per mile, and an attendant rate of $9 per trip, for eligible persons who need a stretcher-accessible vehicle. new text end

new text begin For purposes of the determining rates under clauses (1) and (2), major metropolitan area means a standard metropolitan statistical area with a population of more than 2,000,000 people. new text end

Sec. 18.

Minnesota Statutes 2002, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 45. new text end

new text begin List of health care services not eligible for coverage. new text end

new text begin (a) The commissioner of human services, in consultation with the commissioner of health, shall biennially establish a list of diagnosis/treatment pairings that are not eligible for reimbursement under chapters 256B, 256D, and 256L, effective for services provided on or after July 1, 2005. The commissioner shall review the list in effect for the prior biennium and shall make any additions or deletions from the list as appropriate taking into consideration the following: new text end

new text begin (1) scientific and medical information; new text end

new text begin (2) clinical assessment; new text end

new text begin (3) cost-effectiveness of treatment; new text end

new text begin (4) prevention of future costs; and new text end

new text begin (5) medical ineffectiveness. new text end

new text begin (b) The commissioner may appoint an ad hoc advisory panel made up of physicians, consumers, nurses, dentists, chiropractors, and other experts to assist the commissioner in reviewing and establishing the list. The commissioner shall solicit comments and recommendations from any interested persons and organizations and shall schedule at least one public hearing. new text end

new text begin (c) The list must be established by October 1 of the even-numbered years beginning October 1, 2004. The commissioner shall publish the list in the State Register by November 1 of the even-numbered years beginning November 1, 2004. The list shall be submitted to the legislature by January 15 of the odd-numbered years beginning January 15, 2005. new text end

Sec. 19.

Minnesota Statutes 2002, section 256B.0635, subdivision 1, is amended to read:

Subdivision 1.

Increased employment.

(a) Until June 30, 2002, medical assistance may be paid for persons who received MFIP or medical assistance for families and children in at least three of six months preceding the month in which the person became ineligible for MFIP or medical assistance, if the ineligibility was due to an increase in hours of employment or employment income or due to the loss of an earned income disregard. In addition, to receive continued assistance under this section, persons who received medical assistance for families and children but did not receive MFIP must have had income less than or equal to the assistance standard for their family size under the state's AFDC plan in effect as of July 16, 1996, increased by three percent effective July 1, 2000, at the time medical assistance eligibility began. A person who is eligible for extended medical assistance is entitled to six months of assistance without reapplication, unless the assistance unit ceases to include a dependent child. For a person under 21 years of age, medical assistance may not be discontinued within the six-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance. Medical assistance may be continued for an additional six months if the person meets all requirements for the additional six months, according to title XIX of the Social Security Act, as amended by section 303 of the Family Support Act of 1988, Public Law deleted text begin Number deleted text end 100-485.

(b) Beginning July 1, 2002, new text begin contingent upon federal funding, new text end medical assistance for families and children may be paid for persons who were eligible under section 256B.055, subdivision 3a, in at least three of six months preceding the month in which the person became ineligible under that section if the ineligibility was due to an increase in hours of employment or employment income or due to the loss of an earned income disregard. A person who is eligible for extended medical assistance is entitled to six months of assistance without reapplication, unless the assistance unit ceases to include a dependent child, except medical assistance may not be discontinued for that dependent child under 21 years of age within the six-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance. Medical assistance may be continued for an additional six months if the person meets all requirements for the additional six months, according to title XIX of the Social Security Act, as amended by section 303 of the Family Support Act of 1988, Public Law deleted text begin Number deleted text end 100-485.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 20.

Minnesota Statutes 2002, section 256B.0635, subdivision 2, is amended to read:

Subd. 2.

Increased child or spousal support.

(a) Until June 30, 2002, medical assistance may be paid for persons who received MFIP or medical assistance for families and children in at least three of the six months preceding the month in which the person became ineligible for MFIP or medical assistance, if the ineligibility was the result of the collection of child or spousal support under part D of title IV of the Social Security Act. In addition, to receive continued assistance under this section, persons who received medical assistance for families and children but did not receive MFIP must have had income less than or equal to the assistance standard for their family size under the state's AFDC plan in effect as of July 16, 1996, increased by three percent effective July 1, 2000, at the time medical assistance eligibility began. A person who is eligible for extended medical assistance under this subdivision is entitled to four months of assistance without reapplication, unless the assistance unit ceases to include a dependent child, except medical assistance may not be discontinued for that dependent child under 21 years of age within the four-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance.

(b) Beginning July 1, 2002, new text begin contingent upon federal funding, new text end medical assistance for families and children may be paid for persons who were eligible under section 256B.055, subdivision 3a, in at least three of the six months preceding the month in which the person became ineligible under that section if the ineligibility was the result of the collection of child or spousal support under part D of title IV of the Social Security Act. A person who is eligible for extended medical assistance under this subdivision is entitled to four months of assistance without reapplication, unless the assistance unit ceases to include a dependent child, except medical assistance may not be discontinued for that dependent child under 21 years of age within the four-month period of extended eligibility until it has been determined that the person is not otherwise eligible for medical assistance.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 21.

Minnesota Statutes 2002, section 256B.19, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Temporary county share of medical assistance costs. new text end

new text begin (a) Except as otherwise provided in this chapter, for the period January 1, 2005, to June 30, 2005, the county share of medical assistance costs shall be 3.9 percent county funds. new text end

new text begin (b) The county shall pay by the 20th of each month the county portion of medical assistance costs under the temporary share provided in this subdivision based upon billings from the state agency to the county agency for expenditures for the succeeding month. Payment shall be made monthly by the county to the state for expenditures for each month. new text end

new text begin (c) On or before July 31, 2005, the state shall reimburse each county for the medical assistance payments made by that county to the state under paragraph (b). new text end

Sec. 22.

Minnesota Statutes 2002, section 256B.195, subdivision 3, is amended to read:

Subd. 3.

Payments to certain safety net providers.

(a) Effective July 15, 2001, the commissioner shall make the following payments to the hospitals indicated after noon on the 15th of each month:

(1) to Hennepin County Medical Center, any federal matching funds available to match the payments received by the medical center under subdivision 2, to increase payments for medical assistance admissions and to recognize higher medical assistance costs in institutions that provide high levels of charity care; and

(2) to Regions hospital, any federal matching funds available to match the payments received by the hospital under subdivision 2, to increase payments for medical assistance admissions and to recognize higher medical assistance costs in institutions that provide high levels of charity care.

(b) Effective July 15, 2001, the following percentages of the transfers under subdivision 2 shall be retained by the commissioner for deposit each month into the general fund:

(1) 18 percent, plus any federal matching funds, shall be allocated for the following purposes:

(i) during the fiscal year beginning July 1, 2001, of the amount available under this clause, 39.7 percent shall be allocated to make increased hospital payments under section 256.969, subdivision 26; 34.2 percent shall be allocated to fund the amounts due from small rural hospitals, as defined in section 144.148, for overpayments under section 256.969, subdivision 5a, resulting from a determination that medical assistance and general assistance payments exceeded the charge limit during the period from 1994 to 1997; and 26.1 percent shall be allocated to the commissioner of health for rural hospital capital improvement grants under section 144.148; and

(ii) during fiscal years beginning on or after July 1, 2002, of the amount available under this clause, 55 percent shall be allocated to make increased hospital payments under section 256.969, subdivision 26, and 45 percent shall be allocated to the commissioner of health for rural hospital capital improvement grants under section 144.148; and

(2) 11 percent shall be allocated to the commissioner of health to fund community clinic grants under section 145.9268.

(c) This subdivision shall apply to fee-for-service payments only and shall not increase capitation payments or payments made based on average rates.

(d) Medical assistance rate or payment changes, including those required to obtain federal financial participation under section 62J.692, subdivision 8, shall precede the determination of intergovernmental transfer amounts determined in this subdivision. Participation in the intergovernmental transfer program shall not result in the offset of any health care provider's receipt of medical assistance payment increases other than limits resulting from hospital-specific charge limits and limits on disproportionate share hospital payments.

new text begin (e) Effective July 1, 2003, if the amount available for allocation under paragraph (b) is greater than the amounts available during March 2003, any additional amounts available under this subdivision after reimbursement of the transfers under subdivision 2, as a result of sections 62J.692, subdivision 8, and 256.969, subdivision 3a; or from any other source, shall be allocated to increase medical assistance payments, subject to hospital-specific charge limits and limits on disproportionate share hospital payments, as follows: new text end

new text begin (1) if the payments under subdivision 5 have been approved, 67 percent shall be allocated to Hennepin County Medical Center and 33 percent to Regions hospital; or new text end

new text begin (2) if the payments under subdivision 5 have not been approved, 51 percent shall be allocated to Hennepin County Medical Center, 27 percent to Regions hospital, and 22 percent to Fairview University Medical Center. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 23.

Minnesota Statutes 2002, section 256B.195, subdivision 5, is amended to read:

Subd. 5.

Inclusion of fairview university medical center.

(a) Upon federal approval of the deleted text begin inclusion of Fairview University Medical Center in the nonstate government category deleted text end new text begin payments in paragraph (b) new text end , the commissioner shall establish an intergovernmental transfer with the University of Minnesota in an amount determined by the commissioner based on the deleted text begin increase in the deleted text end new text begin amount of new text end Medicare upper payment limit deleted text begin due solely to the inclusion of Fairview University Medical Center as a nonstate government hospital and limited deleted text end new text begin available for nongovernment hospitals adjusted new text end by hospital-specific charge limits and the amount available under the hospital-specific disproportionate share limit.

(b) The commissioner shall increase payments for medical assistance admissions at Fairview University Medical Center by deleted text begin 71 percent deleted text end new text begin the amount new text end of the transfer plus any federal matching payments on that amount, to increase payments for medical assistance admissions and to recognize higher medical assistance costs in institutions that provide high levels of charity care. deleted text begin From this payment, Fairview University Medical Center shall pay to the University of Minnesota the cost of the transfer, on the same day the payment is received. Eighteen percent of the transfer plus any federal matching payments shall be used as specified in subdivision 3, paragraph (b), clause (1). Payments under section 256.969, subdivision 26, may be increased above the 90 percent level specified in that subdivision within the limits of additional funding available under this subdivision. Eleven percent of the transfer shall be used to increase the grants under section 145.9268. deleted text end

Sec. 24.

Minnesota Statutes 2002, section 256B.32, subdivision 1, is amended to read:

Subdivision 1.

Facility fee payment.

(a) The commissioner shall establish a facility fee payment mechanism that will pay a facility fee to all enrolled outpatient hospitals for each emergency room or outpatient clinic visit provided on or after July 1, 1989. This payment mechanism may not result in an overall increase in outpatient payment rates. This section does not apply to federally mandated maximum payment limits, department approved program packages, or services billed using a nonoutpatient hospital provider number.

(b) For fee-for-service services provided on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for outpatient hospital facility services is reduced by .5 percent from the current statutory rates.

new text begin (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from this paragraph. new text end

Sec. 25.

Minnesota Statutes 2002, section 256B.69, subdivision 2, is amended to read:

Subd. 2.

Definitions.

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

(a) "Commissioner" means the commissioner of human services. For the remainder of this section, the commissioner's responsibilities for methods and policies for implementing the project will be proposed by the project advisory committees and approved by the commissioner.

(b) "Demonstration provider" means a health maintenance organization, community integrated service network, or accountable provider network authorized and operating under chapter 62D, 62N, or 62T that participates in the demonstration project according to criteria, standards, methods, and other requirements established for the project and approved by the commissioner. For purposes of this section, a county board, or group of county boards operating under a joint powers agreement, is considered a demonstration provider if the county or group of county boards meets the requirements of section 256B.692. Notwithstanding the above, Itasca county may continue to participate as a demonstration provider until July 1, 2004.

(c) "Eligible individuals" means those persons eligible for medical assistance benefits as defined in sections 256B.055, 256B.056, and 256B.06.

(d) "Limitation of choice" means suspending freedom of choice while allowing eligible individuals to choose among the demonstration providers.

deleted text begin (e) This paragraph supersedes paragraph (c) as long as the Minnesota health care reform waiver remains in effect. When the waiver expires, this paragraph expires and the commissioner of human services shall publish a notice in the State Register and notify the revisor of statutes. "Eligible individuals" means those persons eligible for medical assistance benefits as defined in sections 256B.055, 256B.056, and 256B.06. Notwithstanding sections 256B.055, 256B.056, and 256B.06, an individual who becomes ineligible for the program because of failure to submit income reports or recertification forms in a timely manner, shall remain enrolled in the prepaid health plan and shall remain eligible to receive medical assistance coverage through the last day of the month following the month in which the enrollee became ineligible for the medical assistance program. deleted text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 26.

Minnesota Statutes 2002, section 256B.69, subdivision 4, is amended to read:

Subd. 4.

Limitation of choice.

(a) The commissioner shall develop criteria to determine when limitation of choice may be implemented in the experimental counties. The criteria shall ensure that all eligible individuals in the county have continuing access to the full range of medical assistance services as specified in subdivision 6.

(b) The commissioner shall exempt the following persons from participation in the project, in addition to those who do not meet the criteria for limitation of choice:

(1) persons eligible for medical assistance according to section 256B.055, subdivision 1;

(2) persons eligible for medical assistance due to blindness or disability as determined by the social security administration or the state medical review team, unless:

(i) they are 65 years of age or older; or

(ii) they reside in Itasca county or they reside in a county in which the commissioner conducts a pilot project under a waiver granted pursuant to section 1115 of the Social Security Act;

(3) recipients who currently have private coverage through a health maintenance organization;

(4) recipients who are eligible for medical assistance by spending down excess income for medical expenses other than the nursing facility per diem expense;

(5) recipients who receive benefits under the Refugee Assistance Program, established under United States Code, title 8, section 1522(e);

(6) children who are both determined to be severely emotionally disturbed and receiving case management services according to section 256B.0625, subdivision 20;

(7) adults who are both determined to be seriously and persistently mentally ill and received case management services according to section 256B.0625, subdivision 20; deleted text begin and deleted text end

(8) persons eligible for medical assistance according to section 256B.057, subdivision 10 new text begin ; and new text end

new text begin (9) persons with access to cost-effective employer-sponsored private health insurance or persons enrolled in an individual health plan determined to be cost-effective according to section 256B.0625, subdivision 15 new text end .

Children under age 21 who are in foster placement may enroll in the project on an elective basis. Individuals excluded under clauses (6) and (7) may choose to enroll on an elective basis. new text begin The commissioner may enroll recipients in the prepaid medical assistance program for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending down excess income. new text end

(c) The commissioner may allow persons with a one-month spenddown who are otherwise eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly spenddown to the state.

(d) The commissioner may require those individuals to enroll in the prepaid medical assistance program who otherwise would have been excluded under paragraph (b), clauses (1), (3), and (8), and under Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.

(e) Before limitation of choice is implemented, eligible individuals shall be notified and after notification, shall be allowed to choose only among demonstration providers. The commissioner may assign an individual with private coverage through a health maintenance organization, to the same health maintenance organization for medical assistance coverage, if the health maintenance organization is under contract for medical assistance in the individual's county of residence. After initially choosing a provider, the recipient is allowed to change that choice only at specified times as allowed by the commissioner. If a demonstration provider ends participation in the project for any reason, a recipient enrolled with that provider must select a new provider but may change providers without cause once more within the first 60 days after enrollment with the second provider.

Sec. 27.

Minnesota Statutes 2002, section 256B.69, subdivision 5, is amended to read:

Subd. 5.

Prospective per capita payment.

The commissioner shall establish the method and amount of payments for services. The commissioner shall annually contract with demonstration providers to provide services consistent with these established methods and amounts for payment.

If allowed by the commissioner, a demonstration provider may contract with an insurer, health care provider, nonprofit health service plan corporation, or the commissioner, to provide insurance or similar protection against the cost of care provided by the demonstration provider or to provide coverage against the risks incurred by demonstration providers under this section. The recipients enrolled with a demonstration provider are a permissible group under group insurance laws and chapter 62C, the Nonprofit Health Service Plan Corporations Act. Under this type of contract, the insurer or corporation may make benefit payments to a demonstration provider for services rendered or to be rendered to a recipient. Any insurer or nonprofit health service plan corporation licensed to do business in this state is authorized to provide this insurance or similar protection.

Payments to providers participating in the project are exempt from the requirements of sections 256.966 and 256B.03, subdivision 2. The commissioner shall complete development of capitation rates for payments before delivery of services under this section is begun. For payments made during calendar year 1990 and later years, the commissioner shall contract with an independent actuary to establish prepayment rates.

By January 15, 1996, the commissioner shall report to the legislature on the methodology used to allocate to participating counties available administrative reimbursement for advocacy and enrollment costs. The report shall reflect the commissioner's judgment as to the adequacy of the funds made available and of the methodology for equitable distribution of the funds. The commissioner must involve participating counties in the development of the report.

new text begin Beginning July 1, 2004, the commissioner may include payments for elderly waiver services and 180 days of nursing home care in capitation payments for the prepaid medical assistance program for seniors. Payments for elderly waiver services shall be made no earlier than the month following the month in which services were received. new text end

Sec. 28.

Minnesota Statutes 2002, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year basis beginning January 1, 1996. Managed care contracts which were in effect on June 30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995 through December 31, 1995 at the same terms that were in effect on June 30, 1995. new text begin The commissioner may issue separate contracts with requirements specific to services to medical assistance recipients age 65 and older. new text end

(b) A prepaid health plan providing covered health services for eligible persons pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms of its contract with the commissioner. Requirements applicable to managed care programs under chapters 256B, 256D, and 256L, established after the effective date of a contract with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner shall withhold five percent of managed care plan payments under this section for the prepaid medical assistance and general assistance medical care programs pending completion of performance targets. The withheld funds must be returned no sooner than July of the following year if performance targets in the contract are achieved. The commissioner may exclude special demonstration projects under subdivision 23. A managed care plan may include as admitted assets under section 62D.044 any amount withheld under this paragraph that is reasonably expected to be returned.

Sec. 29.

Minnesota Statutes 2002, section 256B.69, subdivision 5c, is amended to read:

Subd. 5c.

Medical education and research fund.

(a) new text begin Except as provided in paragraph (c), new text end the commissioner of human services shall transfer each year to the medical education and research fund established under section 62J.692, the following:

(1) an amount equal to the reduction in the prepaid medical assistance and prepaid general assistance medical care payments as specified in this clause. Until January 1, 2002, the county medical assistance and general assistance medical care capitation base rate prior to plan specific adjustments and after the regional rate adjustments under section 256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin county, two percent for the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota counties; and after January 1, 2002, the county medical assistance and general assistance medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent for Hennepin county, two percent for the remaining metropolitan counties, and 1.6 percent for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments and demonstration project payments operating under subdivision 23 are excluded from this reduction. The amount calculated under this clause shall not be adjusted for periods already paid due to subsequent changes to the capitation payments;

(2) beginning July 1, deleted text begin 2001, $2,537,000 deleted text end new text begin 2003, $2,157,000 new text end from the capitation rates paid under this section plus any federal matching funds on this amount;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which allows federal financial participation in the medical education and research fund.

new text begin (c) Effective July 1, 2003, the amount reduced from the prepaid general assistance medical care payments under paragraph (a), clause (1), shall be transferred to the general fund. new text end

Sec. 30.

Minnesota Statutes 2002, section 256B.69, subdivision 5g, is amended to read:

Subd. 5g.

Payment for covered services.

new text begin (a) new text end For services rendered on or after January 1, 2003, the total payment made to managed care plans for providing covered services under the medical assistance and general assistance medical care programs is reduced by .5 percent from their current statutory rates.

new text begin (b) In addition to the reduction in paragraph (a), the total payment made to managed care plans under the medical assistance and general assistance medical care programs is reduced by one percent for services rendered on or after October 1, 2003. new text end

new text begin (c) new text end This deleted text begin provision excludes deleted text end new text begin subdivision does not apply to new text end payments for nursing home services, home and community-based waivers, and payments to demonstration projects for persons with disabilities.

Sec. 31.

Minnesota Statutes 2002, section 256B.69, subdivision 6a, is amended to read:

Subd. 6a.

Nursing home services.

(a) Notwithstanding Minnesota Rules, part 9500.1457, subpart 1, item B, up to deleted text begin 90 deleted text end new text begin 180 new text end days of nursing facility services as defined in section 256B.0625, subdivision 2, which are provided in a nursing facility certified by the Minnesota department of health for services provided and eligible for payment under Medicaid, shall be covered under the prepaid medical assistance program for individuals who are not residing in a nursing facility at the time of enrollment in the prepaid medical assistance program. new text begin The commissioner may develop a schedule to phase in implementation of the 180-day provision. new text end

(b) For individuals enrolled in the Minnesota senior health options project authorized under subdivision 23, nursing facility services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project.

Sec. 32.

Minnesota Statutes 2002, section 256B.69, subdivision 6b, is amended to read:

Subd. 6b.

Home and community-based waiver services.

(a) For individuals enrolled in the Minnesota senior health options project authorized under subdivision 23, elderly waiver services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project.

(b) For individuals under age 65 enrolled in demonstrations authorized under subdivision 23, home and community-based waiver services shall be covered according to the terms and conditions of the federal agreement governing that demonstration project.

new text begin (c) Notwithstanding Minnesota Rules, part 9500.1457, subpart 1, item C, elderly waiver services shall be covered under the prepaid medical assistance program for all individuals who are eligible according to section 256B.0915. The commissioner may develop a schedule to phase in implementation of these waiver services. new text end

Sec. 33.

Minnesota Statutes 2002, section 256B.69, is amended by adding a subdivision to read:

new text begin Subd. 6d. new text end

new text begin Prescription drugs. new text end

new text begin Effective January 1, 2004, the commissioner may exclude or modify coverage for prescription drugs from the prepaid managed care contracts entered into under this section in order to increase savings to the state by collecting additional prescription drug rebates. The contracts must maintain incentives for the managed care plan to manage drug costs and utilization and may require that the managed care plans maintain an open drug formulary. In order to manage drug costs and utilization, the contracts may authorize the managed care plans to use preferred drug lists and prior authorization. This subdivision is contingent on federal approval of the managed care contract changes and the collection of additional prescription drug rebates. new text end

Sec. 34.

Minnesota Statutes 2002, section 256B.69, subdivision 8, is amended to read:

Subd. 8.

Preadmission screening waiver.

Except as applicable to the project's operation, the provisions of section 256B.0911 are waived for the purposes of this section for recipients enrolled with demonstration providers new text begin or in the prepaid medical assistance program for seniors new text end .

Sec. 35.

Minnesota Statutes 2002, section 256B.75, is amended to read:

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for which there is a federal maximum allowable payment. Effective for services rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and emergency room facility fees shall be increased by eight percent over the rates in effect on December 31, 1999, except for those services for which there is a federal maximum allowable payment. Services for which there is a federal maximum allowable payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare upper limit. If it is determined that a provision of this section conflicts with existing or future requirements of the United States government with respect to federal financial participation in medical assistance, the federal requirements prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory surgery hospital facility fee services for critical access hospitals designated under section 144.1483, clause (11), shall be paid on a cost-based payment system that is based on the cost-finding methods and allowable costs of the Medicare program.

(c) Effective for services provided on or after July 1, 2003, rates that are based on the Medicare outpatient prospective payment system shall be replaced by a budget neutral prospective payment system that is derived using medical assistance data. The commissioner shall provide a proposal to the 2003 legislature to define and implement this provision.

(d) For fee-for-service services provided on or after July 1, 2002, the total payment, before third-party liability and spenddown, made to hospitals for outpatient hospital facility services is reduced by .5 percent from the current statutory rate.

new text begin (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility services before third-party liability and spenddown, is reduced five percent from the current statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from this paragraph. new text end

Sec. 36.

Minnesota Statutes 2002, section 256B.76, is amended to read:

256B.76 PHYSICIAN deleted text begin AND deleted text end new text begin , new text end DENTAL new text begin , AND OTHER PROVIDER new text end REIMBURSEMENT.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common procedural coding system codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery, antepartum, and postpartum care," "critical care," cesarean delivery and pharmacologic management provided to psychiatric patients, and level three codes for enhanced services for prenatal high risk, shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within these categories is different than the rate that would have been paid under the methodology in section 256B.74, subdivision 2, then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect on June 30, 1992;

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases except that payment rates for home health agency services shall be the rates in effect on September 30, 1992;

(4) effective for services rendered on or after January 1, 2000, payment rates for physician and professional services shall be increased by three percent over the rates in effect on December 31, 1999, except for home health agency and family planning agency services; and

(5) the increases in clause (4) shall be implemented January 1, 2000, for managed care.

(b) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases;

(3) effective for services rendered on or after January 1, 2000, payment rates for dental services shall be increased by three percent over the rates in effect on December 31, 1999;

(4) the commissioner shall award grants to community clinics or other nonprofit community organizations, political subdivisions, professional associations, or other organizations that demonstrate the ability to provide dental services effectively to public program recipients. Grants may be used to fund the costs related to coordinating access for recipients, developing and implementing patient care criteria, upgrading or establishing new facilities, acquiring furnishings or equipment, recruiting new providers, or other development costs that will improve access to dental care in a region. In awarding grants, the commissioner shall give priority to applicants that plan to serve areas of the state in which the number of dental providers is not currently sufficient to meet the needs of recipients of public programs or uninsured individuals. The commissioner shall consider the following in awarding the grants:

(i) potential to successfully increase access to an underserved population;

(ii) the ability to raise matching funds;

(iii) the long-term viability of the project to improve access beyond the period of initial funding;

(iv) the efficiency in the use of the funding; and

(v) the experience of the proposers in providing services to the target population.

The commissioner shall monitor the grants and may terminate a grant if the grantee does not increase dental access for public program recipients. The commissioner shall consider grants for the following:

deleted text begin (i) deleted text end new text begin (A) new text end implementation of new programs or continued expansion of current access programs that have demonstrated success in providing dental services in underserved areas;

deleted text begin (ii) deleted text end new text begin (B) new text end a pilot program for utilizing hygienists outside of a traditional dental office to provide dental hygiene services; and

deleted text begin (iii) deleted text end new text begin (C) new text end a program that organizes a network of volunteer dentists, establishes a system to refer eligible individuals to volunteer dentists, and through that network provides donated dental care services to public program recipients or uninsured individuals;

(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;

(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, for managed care; and

(7) effective for services provided on or after January 1, 2002, payment for diagnostic examinations and dental x-rays provided to children under age 21 shall be the lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.

(c) Effective for dental services rendered on or after January 1, 2002, the commissioner may, within the limits of available appropriation, increase reimbursements to dentists and dental clinics deemed by the commissioner to be critical access dental providers. Reimbursement to a critical access dental provider may be increased by not more than 50 percent above the reimbursement rate that would otherwise be paid to the provider. Payments to health plan companies shall be adjusted to reflect increased reimbursements to critical access dental providers as approved by the commissioner. In determining which dentists and dental clinics shall be deemed critical access dental providers, the commissioner shall review:

(1) the utilization rate in the service area in which the dentist or dental clinic operates for dental services to patients covered by medical assistance, general assistance medical care, or MinnesotaCare as their primary source of coverage;

(2) the level of services provided by the dentist or dental clinic to patients covered by medical assistance, general assistance medical care, or MinnesotaCare as their primary source of coverage; and

(3) whether the level of services provided by the dentist or dental clinic is critical to maintaining adequate levels of patient access within the service area.

In the absence of a critical access dental provider in a service area, the commissioner may designate a dentist or dental clinic as a critical access dental provider if the dentist or dental clinic is willing to provide care to patients covered by medical assistance, general assistance medical care, or MinnesotaCare at a level which significantly increases access to dental care in the service area.

(d) Effective July 1, 2001, the medical assistance rates for outpatient mental health services provided by an entity that operates:

(1) a Medicare-certified comprehensive outpatient rehabilitation facility; and

(2) a facility that was certified prior to January 1, 1993, with at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year who are medical assistance recipients, will be increased by 38 percent, when those services are provided within the comprehensive outpatient rehabilitation facility and provided to residents of nursing facilities owned by the entity.

(e) An entity that operates both a Medicare certified comprehensive outpatient rehabilitation facility and a facility which was certified prior to January 1, 1993, that is licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year are medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation services at rates that are 38 percent greater than the maximum reimbursement rate allowed under paragraph (a), clause (2), when those services are (1) provided within the comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing facilities owned by the entity.

new text begin (f) Effective for services rendered on or after January 1, 2007, the commissioner shall make payments for physician and professional services based on the Medicare relative value units (RVUs). This change shall be budget neutral and the cost of implementing RVUs will be incorporated in the established conversion factor. new text end

new text begin (g) An entity that operates a Medicare certified rehabilitation facility that was designated by the commissioner of health as an essential community provider under section 62Q.19 as of January 1, 2000, and for whom at least 25 percent of the clients receiving rehabilitation services at the facility or in their homes in the most recent calendar year are medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation services provided on or after July 1, 2003, at rates that are 50 percent greater than the maximum reimbursement rate that would otherwise be allowed for rehabilitation services provided by a Medicare certified rehabilitation facility. For purposes of this paragraph, "rehabilitation services" means physical therapy, occupational therapy, speech-language pathology, and audiology services. In order to qualify for the reimbursement rate authorized by this paragraph, a facility must annually certify, in the time and manner specified by the commissioner, that the medical assistance percentage of caseload requirement was satisfied in the most recent calendar year. new text end

Sec. 37.

Minnesota Statutes 2002, section 256D.03, subdivision 3, is amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance medical care may be paid for any person who is not eligible for medical assistance under chapter 256B, including eligibility for medical assistance based on a spenddown of excess income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in paragraph (b), except as provided in paragraph (c); and:

(1) who is receiving assistance under section 256D.05, except for families with children who are eligible under Minnesota family investment program (MFIP), who is having a payment made on the person's behalf under sections 256I.01 to 256I.06, or who resides in group residential housing as defined in chapter 256I and can meet a spenddown using the cost of remedial services received through group residential housing; or

(2)(i) who is a resident of Minnesota; and whose equity in assets is not in excess of $1,000 per assistance unit. Exempt assets, the reduction of excess assets, and the waiver of excess assets must conform to the medical assistance program in chapter 256B, with the following exception: the maximum amount of undistributed funds in a trust that could be distributed to or on behalf of the beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the terms of the trust, must be applied toward the asset maximum; and

(ii) who has countable income not in excess of the assistance standards established in section 256B.056, subdivision 5c, paragraph (b), or whose excess income is spent down to that standard using a six-month budget period. The method for calculating earned income disregards and deductions for a person who resides with a dependent child under age 21 shall follow the AFDC income disregard and deductions in effect under the July 16, 1996, AFDC state plan. The earned income and work expense deductions for a person who does not reside with a dependent child under age 21 shall be the same as the method used to determine eligibility for a person under section 256D.06, subdivision 1, except the disregard of the first $50 of earned income is not allowed;

(3) who would be eligible for medical assistance except that the person resides in a facility that is determined by the commissioner or the federal Centers for Medicare and Medicaid Services to be an institution for mental diseases; or

(4) who is ineligible for medical assistance under chapter 256B or general assistance medical care under any other provision of this section, and is receiving care and rehabilitation services from a nonprofit center established to serve victims of torture. These individuals are eligible for general assistance medical care only for the period during which they are receiving services from the center. During this period of eligibility, individuals eligible under this clause shall not be required to participate in prepaid general assistance medical care.

(b) Beginning January 1, 2000, applicants or recipients who meet all eligibility requirements of MinnesotaCare as defined in sections 256L.01 to 256L.16, and are:

(i) adults with dependent children under 21 whose gross family income is equal to or less than 275 percent of the federal poverty guidelines; or

(ii) adults without children with earned income and whose family gross income is between 75 percent of the federal poverty guidelines and the amount set by section 256L.04, subdivision 7, shall be terminated from general assistance medical care upon enrollment in MinnesotaCare. Earned income is deemed available to family members as defined in section 256D.02, subdivision 8.

(c) For services rendered on or after July 1, 1997, eligibility is limited to one month prior to application if the person is determined eligible in the prior month. A redetermination of eligibility must occur every 12 months. Beginning January 1, 2000, Minnesota health care program applications completed by recipients and applicants who are persons described in paragraph (b), may be returned to the county agency to be forwarded to the department of human services or sent directly to the department of human services for enrollment in MinnesotaCare. If all other eligibility requirements of this subdivision are met, eligibility for general assistance medical care shall be available in any month during which a MinnesotaCare eligibility determination and enrollment are pending. Upon notification of eligibility for MinnesotaCare, notice of termination for eligibility for general assistance medical care shall be sent to an applicant or recipient. If all other eligibility requirements of this subdivision are met, eligibility for general assistance medical care shall be available until enrollment in MinnesotaCare subject to the provisions of paragraph (e).

(d) The date of an initial Minnesota health care program application necessary to begin a determination of eligibility shall be the date the applicant has provided a name, address, and social security number, signed and dated, to the county agency or the department of human services. If the applicant is unable to provide an initial application when health care is delivered due to a medical condition or disability, a health care provider may act on the person's behalf to complete the initial application. The applicant must complete the remainder of the application and provide necessary verification before eligibility can be determined. The county agency must assist the applicant in obtaining verification if necessary. deleted text begin On the basis of information provided on the completed application, an applicant who meets the following criteria shall be determined eligible beginning in the month of application: deleted text end

deleted text begin (1) has gross income less than 90 percent of the applicable income standard; deleted text end

deleted text begin (2) has liquid assets that total within $300 of the asset standard; deleted text end

deleted text begin (3) does not reside in a long-term care facility; and deleted text end

deleted text begin (4) meets all other eligibility requirements. deleted text end

deleted text begin The applicant must provide all required verifications within 30 days' notice of the eligibility determination or eligibility shall be terminated. deleted text end

(e) County agencies are authorized to use all automated databases containing information regarding recipients' or applicants' income in order to determine eligibility for general assistance medical care or MinnesotaCare. Such use shall be considered sufficient in order to determine eligibility and premium payments by the county agency.

(f) General assistance medical care is not available for a person in a correctional facility unless the person is detained by law for less than one year in a county correctional or detention facility as a person accused or convicted of a crime, or admitted as an inpatient to a hospital on a criminal hold order, and the person is a recipient of general assistance medical care at the time the person is detained by law or admitted on a criminal hold order and as long as the person continues to meet other eligibility requirements of this subdivision.

(g) General assistance medical care is not available for applicants or recipients who do not cooperate with the county agency to meet the requirements of medical assistance. General assistance medical care is limited to payment of emergency services only for applicants or recipients as described in paragraph (b), whose MinnesotaCare coverage is denied or terminated for nonpayment of premiums as required by sections 256L.06 and 256L.07.

(h) In determining the amount of assets of an individual, there shall be included any asset or interest in an asset, including an asset excluded under paragraph (a), that was given away, sold, or disposed of for less than fair market value within the 60 months preceding application for general assistance medical care or during the period of eligibility. Any transfer described in this paragraph shall be presumed to have been for the purpose of establishing eligibility for general assistance medical care, unless the individual furnishes convincing evidence to establish that the transaction was exclusively for another purpose. For purposes of this paragraph, the value of the asset or interest shall be the fair market value at the time it was given away, sold, or disposed of, less the amount of compensation received. For any uncompensated transfer, the number of months of ineligibility, including partial months, shall be calculated by dividing the uncompensated transfer amount by the average monthly per person payment made by the medical assistance program to skilled nursing facilities for the previous calendar year. The individual shall remain ineligible until this fixed period has expired. The period of ineligibility may exceed 30 months, and a reapplication for benefits after 30 months from the date of the transfer shall not result in eligibility unless and until the period of ineligibility has expired. The period of ineligibility begins in the month the transfer was reported to the county agency, or if the transfer was not reported, the month in which the county agency discovered the transfer, whichever comes first. For applicants, the period of ineligibility begins on the date of the first approved application.

(i) When determining eligibility for any state benefits under this subdivision, the income and resources of all noncitizens shall be deemed to include their sponsor's income and resources as defined in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, title IV, Public Law deleted text begin Number deleted text end 104-193, sections 421 and 422, and subsequently set out in federal rules.

(j)(1) An undocumented noncitizen or a nonimmigrant is ineligible for general assistance medical care other than emergency services. For purposes of this subdivision, a nonimmigrant is an individual in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and an undocumented noncitizen is an individual who resides in the United States without the approval or acquiescence of the Immigration and Naturalization Service.

(2) This paragraph does not apply to a child under age 18, to a Cuban or Haitian entrant as defined in Public Law deleted text begin Number deleted text end 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is aged, blind, or disabled as defined in Code of Federal Regulations, title 42, sections 435.520, 435.530, 435.531, 435.540, and 435.541, or effective October 1, 1998, to an individual eligible for general assistance medical care under paragraph (a), clause (4), who cooperates with the Immigration and Naturalization Service to pursue any applicable immigration status, including citizenship, that would qualify the individual for medical assistance with federal financial participation.

(k) For purposes of paragraphs (g) and (j), "emergency services" has the meaning given in Code of Federal Regulations, title 42, section 440.255(b)(1), except that it also means services rendered because of suspected or actual pesticide poisoning.

(l) Notwithstanding any other provision of law, a noncitizen who is ineligible for medical assistance due to the deeming of a sponsor's income and resources, is ineligible for general assistance medical care.

[EFFECTIVE DATE.] new text begin This section is repealed April 1, 2005, if the HealthMatch system is operational. If the HealthMatch system is not operational, this section is effective July 1, 2005. new text end

Sec. 38.

Minnesota Statutes 2002, section 256L.05, subdivision 3a, is amended to read:

Subd. 3a.

Renewal of eligibility.

new text begin (a) new text end Beginning January 1, 1999, an enrollee's eligibility must be renewed every 12 months. The 12-month period begins in the month after the month the application is approved.

new text begin (b) Beginning October 1, 2004, an enrollee's eligibility must be renewed every six months. The first six-month period of eligibility begins in the month after the month the application is approved. Each new period of eligibility must take into account any changes in circumstances that impact eligibility and premium amount. An enrollee must provide all the information needed to redetermine eligibility by the first day of the month that ends the eligibility period. The premium for the new period of eligibility must be received as provided in section 256L.06 in order for eligibility to continue. new text end

Sec. 39.

Minnesota Statutes 2002, section 256L.05, subdivision 4, is amended to read:

Subd. 4.

Application processing.

The commissioner of human services shall determine an applicant's eligibility for MinnesotaCare no more than 30 days from the date that the application is received by the department of human services. Beginning January 1, 2000, this requirement also applies to local county human services agencies that determine eligibility for MinnesotaCare. deleted text begin Once annually at application or reenrollment, to prevent processing delays, applicants or enrollees who, from the information provided on the application, appear to meet eligibility requirements shall be enrolled upon timely payment of premiums. The enrollee must provide all required verifications within 30 days of notification of the eligibility determination or coverage from the program shall be terminated. Enrollees who are determined to be ineligible when verifications are provided shall be disenrolled from the program. deleted text end

[EFFECTIVE DATE.] new text begin This section is effective April 1, 2005, if the HealthMatch system is operational. If the HealthMatch system is not operational on April 1, 2005, then this section is effective July 1, 2005. new text end

Sec. 40.

Minnesota Statutes 2002, section 256L.06, subdivision 3, is amended to read:

Subd. 3.

Commissioner's duties and payment.

(a) Premiums are dedicated to the commissioner for MinnesotaCare.

(b) The commissioner shall develop and implement procedures to: (1) require enrollees to report changes in income; (2) adjust sliding scale premium payments, based upon changes in enrollee income; deleted text begin and deleted text end (3) disenroll enrollees from MinnesotaCare for failure to pay required premiums new text begin ; and (4) collect the premiums from employers choosing to participate in the employer-subsidized coverage exemption as described in section 256L.15, subdivision 4 new text end . Failure to pay includes payment with a dishonored check, a returned automatic bank withdrawal, or a refused credit card or debit card payment. The commissioner may demand a guaranteed form of payment, including a cashier's check or a money order, as the only means to replace a dishonored, returned, or refused payment.

(c) Premiums are calculated on a calendar month basis and may be paid on a monthly, quarterly, or deleted text begin annual deleted text end new text begin semiannual new text end basis, with the first payment due upon notice from the commissioner of the premium amount required. The commissioner shall inform applicants and enrollees of these premium payment options. Premium payment is required before enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments received before noon are credited the same day. Premium payments received after noon are credited on the next working day.

(d) Nonpayment of the premium will result in disenrollment from the plan effective for the calendar month for which the premium was due. Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll until four calendar months have elapsed. Persons disenrolled for nonpayment who pay all past due premiums as well as current premiums due, including premiums due for the period of disenrollment, within 20 days of disenrollment, shall be reenrolled retroactively to the first day of disenrollment. Persons disenrolled for nonpayment or who voluntarily terminate coverage from the program may not reenroll for four calendar months unless the person demonstrates good cause for nonpayment. Good cause does not exist if a person chooses to pay other family expenses instead of the premium. The commissioner shall define good cause in rule.

[EFFECTIVE DATE.] new text begin Subdivision 3, paragraph (c), is effective October 1, 2004. new text end

Sec. 41.

Minnesota Statutes 2002, section 256L.07, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

(a) Children enrolled in the original children's health plan as of September 30, 1992, children who enrolled in the MinnesotaCare program after September 30, 1992, pursuant to Laws 1992, chapter 549, article 4, section 17, and children who have family gross incomes that are equal to or less than deleted text begin 175 deleted text end new text begin 150 new text end percent of the federal poverty guidelines are eligible without meeting the requirements of subdivision 2 new text begin or 3 new text end , as long as they maintain continuous coverage in the MinnesotaCare program or medical assistance new text begin or they meet the requirements of subdivision 5 new text end . deleted text begin Children who apply for MinnesotaCare on or after the implementation date of the employer-subsidized health coverage program as described in Laws 1998, chapter 407, article 5, section 45, who have family gross incomes that are equal to or less than 175 percent of the federal poverty guidelines, must meet the requirements of subdivision 2 to be eligible for MinnesotaCare. deleted text end

(b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose income increases above 275 percent of the federal poverty guidelines, are no longer eligible for the program and shall be disenrolled by the commissioner. Individuals enrolled in MinnesotaCare under section 256L.04, subdivision 7, whose income increases above 175 percent of the federal poverty guidelines are no longer eligible for the program and shall be disenrolled by the commissioner. For persons disenrolled under this subdivision, MinnesotaCare coverage terminates the last day of the calendar month following the month in which the commissioner determines that the income of a family or individual exceeds program income limits.

(c) Notwithstanding paragraph (b), individuals and families may remain enrolled in MinnesotaCare if ten percent of their annual income is less than the annual premium for a policy with a $500 deductible available through the Minnesota comprehensive health association. Individuals and families who are no longer eligible for MinnesotaCare under this subdivision shall be given an 18-month notice period from the date that ineligibility is determined before disenrollment.

Sec. 42.

Minnesota Statutes 2002, section 256L.07, subdivision 3, is amended to read:

Subd. 3.

Other health coverage.

(a) Families and individuals enrolled in the MinnesotaCare program must have no health coverage while enrolled or for at least four months prior to application and renewal. Children enrolled in the original children's health plan and children in families with income equal to or less than deleted text begin 175 deleted text end new text begin 150 new text end percent of the federal poverty guidelines, who have other health insurance, are eligible if the coverage:

(1) lacks two or more of the following:

(i) basic hospital insurance;

(ii) medical-surgical insurance;

(iii) prescription drug coverage;

(iv) dental coverage; or

(v) vision coverage;

(2) requires a deductible of $100 or more per person per year; or

(3) lacks coverage because the child has exceeded the maximum coverage for a particular diagnosis or the policy excludes a particular diagnosis.

The commissioner may change this eligibility criterion for sliding scale premiums in order to remain within the limits of available appropriations. The requirement of no health coverage does not apply to newborns.

(b) Medical assistance, general assistance medical care, and the Civilian Health and Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A, part II, chapter 55, are not considered insurance or health coverage for purposes of the four-month requirement described in this subdivision.

(c) For purposes of this subdivision, Medicare Part A or B coverage under title XVIII of the Social Security Act, United States Code, title 42, sections 1395c to 1395w-4, is considered health coverage. An applicant or enrollee may not refuse Medicare coverage to establish eligibility for MinnesotaCare.

(d) Applicants who were recipients of medical assistance or general assistance medical care within one month of application must meet the provisions of this subdivision and subdivision 2.

new text begin (e) Effective October 1, 2003, applicants who were recipients of medical assistance and had cost-effective health insurance which was paid for by medical assistance are exempt from the four-month requirement under this subdivision. new text end

Sec. 43.

Minnesota Statutes 2002, section 256L.07, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Employer-subsidized coverage exemption. new text end

new text begin Children in families with family gross income equal to or less than 170 percent of the federal poverty guidelines who have access to employer-subsidized coverage as defined in subdivision 2 are eligible for MinnesotaCare without meeting the requirements of subdivision 2 if the following requirements are met: new text end

new text begin (1) all eligibility requirements except for the requirements of subdivision 2 are met by the child; new text end

new text begin (2) any premiums owed as determined under section 256L.15 are paid in accordance with section 256L.06; and new text end

new text begin (3) the employer meets the requirements described in section 256L.15, subdivision 4. new text end

Sec. 44.

Minnesota Statutes 2002, section 256L.15, subdivision 3, is amended to read:

Subd. 3.

Exceptions to sliding scale.

An annual premium of $48 is required for all children in families with income at or less than deleted text begin 175 deleted text end new text begin 150 new text end percent of federal poverty guidelines.

Sec. 45.

Minnesota Statutes 2002, section 256L.15, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Employer-subsidized insurance exception. new text end

new text begin Any employer of a parent of a child who may be eligible for MinnesotaCare under section 256L.07, subdivision 5, must choose to contribute 25 percent of the total cost of the coverage as calculated under subdivision 2 for the child to be eligible for MinnesotaCare under section 256L.07, subdivision 5. Any employer who chooses to participate must pay the premium owed to the commissioner in accordance with section 256L.06. new text end

Sec. 46.

Minnesota Statutes 2002, section 295.53, subdivision 1, is amended to read:

Subdivision 1.

Exemptions.

(a) The following payments are excluded from the gross revenues subject to the hospital, surgical center, or health care provider taxes under sections 295.50 to 295.57:

(1) payments received for services provided under the Medicare program, including payments received from the government, and organizations governed by sections 1833 and 1876 of title XVIII of the federal Social Security Act, United States Code, title 42, section 1395, and enrollee deductibles, coinsurance, and co new text begin - new text end payments, whether paid by the Medicare enrollee or by a Medicare supplemental coverage as defined in section 62A.011, subdivision 3, clause (10). Payments for services not covered by Medicare are taxable;

(2) deleted text begin medical assistance payments including payments received directly from the government or from a prepaid plan; deleted text end

deleted text begin (3) deleted text end payments received for home health care services;

deleted text begin (4) deleted text end new text begin (3) new text end payments received from hospitals or surgical centers for goods and services on which liability for tax is imposed under section 295.52 or the source of funds for the payment is exempt under clause (1), deleted text begin (2), (7), (8), (10) deleted text end new text begin (7) new text end , deleted text begin (13) deleted text end new text begin (10) new text end , or deleted text begin (20) deleted text end new text begin (17) new text end ;

deleted text begin (5) deleted text end new text begin (4) new text end payments received from health care providers for goods and services on which liability for tax is imposed under this chapter or the source of funds for the payment is exempt under clause (1), deleted text begin (2), (7), (8), (10) deleted text end new text begin (7) new text end , deleted text begin (13) deleted text end new text begin (10) new text end , or deleted text begin (20) deleted text end new text begin (17) new text end ;

deleted text begin (6) deleted text end new text begin (5) new text end amounts paid for legend drugs, other than nutritional products, to a wholesale drug distributor who is subject to tax under section 295.52, subdivision 3, reduced by reimbursements received for legend drugs otherwise exempt under this chapter;

deleted text begin (7) payments received under the general assistance medical care program including payments received directly from the government or from a prepaid plan; deleted text end

deleted text begin (8) payments received for providing services under the MinnesotaCare program including payments received directly from the government or from a prepaid plan and enrollee deductibles, coinsurance, and copayments. For purposes of this clause, coinsurance means the portion of payment that the enrollee is required to pay for the covered service; deleted text end

deleted text begin (9) deleted text end new text begin (6) new text end payments received by a health care provider or the wholly owned subsidiary of a health care provider for care provided outside Minnesota;

deleted text begin (10) deleted text end new text begin (7) new text end payments received from the chemical dependency fund under chapter 254B;

deleted text begin (11) deleted text end new text begin (8) new text end payments received in the nature of charitable donations that are not designated for providing patient services to a specific individual or group;

deleted text begin (12) deleted text end new text begin (9) new text end payments received for providing patient services incurred through a formal program of health care research conducted in conformity with federal regulations governing research on human subjects. Payments received from patients or from other persons paying on behalf of the patients are subject to tax;

deleted text begin (13) deleted text end new text begin (10) new text end payments received from any governmental agency for services benefiting the public, not including payments made by the government in its capacity as an employer or insurer new text begin or payments made by the government for services provided under medical assistance, general assistance medical care, or the MinnesotaCare program new text end ;

deleted text begin (14) deleted text end new text begin (11) new text end payments received for services provided by community residential mental health facilities licensed under Minnesota Rules, parts 9520.0500 to 9520.0690, community support programs and family community support programs approved under Minnesota Rules, parts 9535.1700 to 9535.1760, and community mental health centers as defined in section 245.62, subdivision 2;

deleted text begin (15) deleted text end new text begin (12) new text end government payments received by a regional treatment center;

deleted text begin (16) deleted text end new text begin (13) new text end payments received for hospice care services;

deleted text begin (17) deleted text end new text begin (14) new text end payments received by a health care provider for hearing aids and related equipment or prescription eyewear delivered outside of Minnesota;

deleted text begin (18) deleted text end new text begin (15) new text end payments received by an educational institution from student tuition, student activity fees, health care service fees, government appropriations, donations, or grants. Fee for service payments and payments for extended coverage are taxable;

deleted text begin (19) deleted text end new text begin (16) new text end payments received for services provided by: assisted living programs and congregate housing programs; and

deleted text begin (20) deleted text end new text begin (17) new text end payments received under the federal Employees Health Benefits Act, United States Code, title 5, section 8909(f), as amended by the Omnibus Reconciliation Act of 1990.

(b) Payments received by wholesale drug distributors for legend drugs sold directly to veterinarians or veterinary bulk purchasing organizations are excluded from the gross revenues subject to the wholesale drug distributor tax under sections 295.50 to 295.59.

Sec. 47.

Minnesota Statutes 2002, section 297I.15, subdivision 1, is amended to read:

Subdivision 1.

Government payments.

Premiums under deleted text begin medical assistance, general assistance medical care, the MinnesotaCare program, and deleted text end the Minnesota comprehensive health insurance plan and all payments, revenues, and reimbursements received from the federal government for Medicare-related coverage as defined in section 62A.31, subdivision 3, are not subject to tax under this chapter.

Sec. 48.

Minnesota Statutes 2002, section 297I.15, subdivision 4, is amended to read:

Subd. 4.

Premiums paid to health carriers by state.

A health carrier as defined in section 62A.011 is exempt from the taxes imposed under this chapter on premiums paid to it by the state. new text begin Premiums paid by the state under medical assistance, general assistance medical care, and the MinnesotaCare program are not exempt under this subdivision. new text end

Sec. 49. new text begin REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY CRITERIA AND POTENTIAL COST SAVINGS. new text end

new text begin The commissioner of human services, in consultation with the commissioner of transportation and special transportation service providers, shall review eligibility criteria for medical assistance special transportation services and shall evaluate whether the level of special transportation services provided should be based on the degree of impairment of the client, as well as the medical diagnosis. The commissioner shall also evaluate methods for reducing the cost of special transportation services, including, but not limited to: new text end

new text begin (1) requiring providers to maintain a daily log book confirming delivery of clients to medical facilities; new text end

new text begin (2) requiring providers to implement commercially available computer mapping programs to calculate mileage for purposes of reimbursement; new text end

new text begin (3) restricting special transportation service from being provided solely for trips to pharmacies; new text end

new text begin (4)modifying eligibility for special transportation; new text end

new text begin (5) expanding alternatives to the use of special transportation services; new text end

new text begin (6) improving the process of certifying persons as eligible for special transportation services; and new text end

new text begin (7) examining the feasibility and benefits of licensing special transportation providers. new text end

new text begin The commissioner shall present recommendations for changes in the eligibility criteria and potential cost-savings for special transportation services to the chairs and ranking minority members of the house and senate committees having jurisdiction over health and human services spending by January 15, 2004. The commissioner is prohibited from using a broker or coordinator to manage special transportation services until recommendations are presented to the chairs and ranking minority members. new text end

Sec. 50. new text begin WITHHOLD EXEMPTION. new text end

new text begin The commissioner of human services may exempt from the five percent withhold in Minnesota Statutes, section 256B.69, subdivision 5a, paragraph (c), and the .5 percent withhold in Minnesota Statutes, section 256L.12, subdivision 9, paragraph (b), a managed care plan that has entered into a managed care contract with the commissioner in accordance with Minnesota Statutes, section 256B.69 or 256L.12, if the contract was the initial contract between the managed care plan and the commissioner, and it was entered into after January 1, 2000. new text end

new text begin If an exemption is given, the exemption shall only apply for the first five years of operation of the managed care plan. new text end

Sec. 51. new text begin PHARMACY PLUS WAIVER. new text end

new text begin (a) The commissioner of human services shall seek a pharmacy plus federal waiver for the prescription drug program in Minnesota Statutes, section 256.955. If the waiver is approved and federal funds are received for the prescription drug program, the commissioner shall expand eligibility for the program in the following order: new text end

new text begin (1) increase income eligibility up to 135 percent of the federal poverty guidelines for individuals eligible under Minnesota Statutes, section 256.955, subdivision 2a; and new text end

new text begin (2) increase income eligibility up to 135 percent of the federal poverty guidelines for individuals eligible under Minnesota Statutes, section 256.955, subdivision 2b. new text end

new text begin (b) If eligibility is increased, the commissioner shall publish the new income eligibility levels for the program in the State Register and shall inform the agencies and organizations serving senior citizens and persons with disabilities. new text end

Sec. 52. new text begin DRUG PURCHASING PROGRAM. new text end

new text begin The commissioner of human services, in consultation with other state agencies, shall evaluate whether participation in a multistate or multiagency drug purchasing program can reduce costs or improve the operations of the drug benefit programs administered by the commissioner and other state agencies. The commissioner shall also evaluate the possibility of contracting with a vendor or other states for purposes of participating in a multistate or multiagency drug purchasing program. The commissioner shall submit the recommendations to the legislature by January 15, 2004. new text end

Sec. 53. new text begin MAIL ORDER DISPENSING OF PRESCRIPTION DRUGS. new text end

new text begin The commissioner of human services shall publish a request for proposal for mail order pharmacy providers for recipients in medical assistance, general assistance medical care, and the prescription drug program. The request for proposal must establish criteria for evaluating potential vendors and require respondents to propose a payment level for this service that is less than the payments available under Minnesota Statutes, section 256B.0625, subdivision 13f. The commissioner shall report to the chairs and ranking minority members of the health and human services finance committees by January 7, 2004, on the availability of mail order pharmacy vendors for state public programs and the savings that could be generated by contracting with one or more vendors. new text end

Sec. 54. new text begin LIMITING COVERAGE OF HEALTH CARE SERVICES FOR MEDICAL ASSISTANCE, GENERAL ASSISTANCE MEDICAL CARE, AND MINNESOTACARE PROGRAMS. new text end

new text begin Subdivision 1. new text end [GENERAL ASSISTANCE MEDICAL CARE AND MINNESOTACARE.] new text begin (a) Effective July 1, 2003, the diagnosis/treatment pairings described in subdivision 3 shall not be covered under the general assistance medical care program and under the MinnesotaCare program for persons eligible under Minnesota Statutes, section 256L.04, subdivision 7. new text end

new text begin (b) This subdivision expires July 1, 2005. new text end

new text begin Subd. 2. new text end [PRIOR AUTHORIZATION OF SERVICES FOR MEDICAL ASSISTANCE.] new text begin (a) Effective July 1, 2003, prior authorization shall be required for the diagnosis/treatment pairings described in subdivision 3 for reimbursement under Minnesota Statutes, chapter 256B, and under the MinnesotaCare program for persons eligible under Minnesota Statutes, section 256L.04, subdivision 1. new text end

new text begin (b) This subdivision expires July 1, 2005. new text end

new text begin Subd. 3. new text end [LIST OF DIAGNOSIS/TREATMENT PAIRINGS.] new text begin (a)(1) Diagnosis: TRIGEMINAL AND OTHER NERVE DISORDERS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 350,352 new text end

new text begin (2) Diagnosis: DISRUPTIONS OF THE LIGAMENTS AND TENDONS OF THE ARMS AND LEGS, EXCLUDING THE KNEE, GRADE II AND III new text end

new text begin Treatment: REPAIR new text end

new text begin ICD-9: 726.5, 727.59, 727.62-727.65, 727.68-727.69, 728.83, 728.89, 840.0-840.3, 840.5-840.9, 841-843, 845.0 new text end

new text begin (3) Diagnosis: DISORDERS OF SHOULDER new text end

new text begin Treatment: REPAIR/RECONSTRUCTION new text end

new text begin ICD-9: 718.01, 718.11, 718.21, 718.31, 718.41, 718.51, 718.81, 726.0, 726.10-726.11, 726.19, 726.2, 727.61, 840.4, 840.7 new text end

new text begin (4) Diagnosis: INTERNAL DERANGEMENT OF KNEE AND LIGAMENTOUS DISRUPTIONS OF THE KNEE, GRADE II AND III new text end

new text begin Treatment: REPAIR, MEDICAL THERAPY new text end

new text begin ICD-9: 717.0-717.4, 717.6-717.8, 718.26, 718.36, 718.46, 718.56, 727.66, 836.0-836.2, 844 new text end

new text begin (5) Diagnosis: MALUNION AND NONUNION OF FRACTURE new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 733.8 new text end

new text begin (6) Diagnosis: FOREIGN BODY IN UTERUS, VULVA AND VAGINA new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 939.1-939.2 new text end

new text begin (7) Diagnosis: UTERINE PROLAPSE; CYSTOCELE new text end

new text begin Treatment: SURGICAL REPAIR new text end

new text begin ICD-9: 618 new text end

new text begin (8) Diagnosis: OSTEOARTHRITIS AND ALLIED DISORDERS new text end

new text begin Treatment: MEDICAL THERAPY, INJECTIONS new text end

new text begin ICD-9: 713.5, 715, 716.0-716.1, 716.5-716.6 new text end

new text begin (9) Diagnosis: METABOLIC BONE DISEASE new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 731.0, 733.0 new text end

new text begin (10) Diagnosis: SYMPTOMATIC IMPACTED TEETH new text end

new text begin Treatment: SURGERY new text end

new text begin ICD-9: 520.6, 524.3-524.4 new text end

new text begin (11) Diagnosis: UNSPECIFIED DISEASE OF HARD TISSUES OF TEETH (AVULSION) new text end

new text begin Treatment: INTERDENTAL WIRING new text end

new text begin ICD-9: 525.9 new text end

new text begin (12) Diagnosis: ABSCESSES AND CYSTS OF BARTHOLIN'S GLAND AND VULVA new text end

new text begin Treatment: INCISION AND DRAINAGE, MEDICAL THERAPY new text end

new text begin ICD-9: 616.2-616.9 new text end

new text begin (13) Diagnosis: CERVICITIS, ENDOCERVICITIS, HEMATOMA OF VULVA, AND NONINFLAMMATORY DISORDERS OF THE VAGINA new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 616.0, 623.6, 623.8-623.9, 624.5 new text end

new text begin (14) Diagnosis: DENTAL CONDITIONS (e.g,. TOOTH LOSS) new text end

new text begin Treatment: SPACE MAINTENANCE AND PERIODONTAL MAINTENANCE new text end

new text begin ICD-9: V72.2 new text end

new text begin (15) Diagnosis: URINARY INCONTINENCE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 599.81, 625.6, 788.31-788.33 new text end

new text begin (16) Diagnosis: HYPOSPADIAS AND EPISPADIAS new text end

new text begin Treatment: REPAIR new text end

new text begin ICD-9: 752.6 new text end

new text begin (17) Diagnosis: RESIDUAL FOREIGN BODY IN SOFT TISSUE new text end

new text begin Treatment: REMOVAL new text end

new text begin ICD-9: 374.86, 729.6, 883.1-883.2 new text end

new text begin (18) Diagnosis: BRANCHIAL CLEFT CYST new text end

new text begin Treatment: EXCISION, MEDICAL THERAPY new text end

new text begin ICD-9: 744.41-744.46, 744.49, 759.2 new text end

new text begin (19) Diagnosis: EXFOLIATION OF TEETH DUE TO SYSTEMIC CAUSES; SPECIFIC DISORDERS OF THE TEETH AND SUPPORTING STRUCTURES new text end

new text begin Treatment: EXCISION OF DENTOALVEOLAR STRUCTURE new text end

new text begin ICD-9: 525.0, 525.8, 525.11 new text end

new text begin (20) Diagnosis: PTOSIS (ACQUIRED) WITH VISION IMPAIRMENT new text end

new text begin Treatment: PTOSIS REPAIR new text end

new text begin ICD-9: 374.2-374.3, 374.41, 374.43, 374.46 new text end

new text begin (21) Diagnosis: SIMPLE AND SOCIAL PHOBIAS new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 300.23, 300.29 new text end

new text begin (22) Diagnosis: RETAINED DENTAL ROOT new text end

new text begin Treatment: EXCISION OF DENTOALVEOLAR STRUCTURE new text end

new text begin ICD-9: 525.3 new text end

new text begin (23) Diagnosis: PERIPHERAL NERVE ENTRAPMENT new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 354.0, 354.2, 355.5, 723.3, 728.6 new text end

new text begin (24) Diagnosis: INCONTINENCE OF FECES new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 787.6 new text end

new text begin (25) Diagnosis: RECTAL PROLAPSE new text end

new text begin Treatment: PARTIAL COLECTOMY new text end

new text begin ICD-9: 569.1-569.2 new text end

new text begin (26) Diagnosis: BENIGN NEOPLASM OF KIDNEY AND OTHER URINARY ORGANS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 223 new text end

new text begin (27) Diagnosis: URETHRAL FISTULA new text end

new text begin Treatment: EXCISION, MEDICAL THERAPY new text end

new text begin ICD-9: 599.1-599.2, 599.4 new text end

new text begin (28) Diagnosis: THROMBOSED AND COMPLICATED HEMORRHOIDS new text end

new text begin Treatment: HEMORRHOIDECTOMY, INCISION new text end

new text begin ICD-9: 455.1-455.2, 455.4-455.5, 455.7-455.8 new text end

new text begin (29) Diagnosis: VAGINITIS, TRICHOMONIASIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 112.1, 131, 616.1, 623.5 new text end

new text begin (30) Diagnosis: BALANOPOSTHITIS AND OTHER DISORDERS OF PENIS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 607.1, 607.81-607.83, 607.89 new text end

new text begin (31) Diagnosis: CHRONIC ANAL FISSURE; ANAL FISTULA new text end

new text begin Treatment: SPHINCTEROTOMY, FISSURECTOMY, FISTULECTOMY, MEDICAL THERAPY new text end

new text begin ICD-9: 565.0-565.1 new text end

new text begin (32) Diagnosis: CHRONIC OTITIS MEDIA new text end

new text begin Treatment: PE TUBES/ADENOIDECTOMY/TYMPANOPLASTY, MEDICAL THERAPY new text end

new text begin ICD-9: 380.5, 381.1-381.8, 382.1-382.3, 382.9, 383.1-383.2, 383.30-383.31, 383.9, 384.2, 384.8-384.9 new text end

new text begin (33) Diagnosis: ACUTE CONJUNCTIVITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 077, 372.00 new text end

new text begin (34) Diagnosis: CERUMEN IMPACTION, FOREIGN BODY IN EAR & NOSE new text end

new text begin Treatment: REMOVAL OF FOREIGN BODY new text end

new text begin ICD-9: 380.4, 931-932 new text end

new text begin (35) Diagnosis: VERTIGINOUS SYNDROMES AND OTHER DISORDERS OF VESTIBULAR SYSTEM new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 379.54, 386.1-386.2, 386.4-386.9, 438.6-438.7, 438.83-438.85 new text end

new text begin (36) Diagnosis: UNSPECIFIED URINARY OBSTRUCTION AND BENIGN PROSTATIC HYPERPLASIA WITHOUT OBSTRUCTION new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 599.6, 600 new text end

new text begin (37) Diagnosis: PHIMOSIS new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 605 new text end

new text begin (38) Diagnosis: CONTACT DERMATITIS, ATOPIC DERMATITIS AND OTHER ECZEMA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 691.8, 692.0-692.6, 692.70-692.74, 692.79, 692.8-692.9 new text end

new text begin (39) Diagnosis: PSORIASIS AND SIMILAR DISORDERS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 696.1-696.2, 696.8 new text end

new text begin (40) Diagnosis: CYSTIC ACNE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 705.83, 706.0-706.1 new text end

new text begin (41) Diagnosis: CLOSED FRACTURE OF GREAT TOE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 826.0 new text end

new text begin (42) Diagnosis: SYMPTOMATIC URTICARIA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 708.0-708.1, 708.5, 708.8, 995.7 new text end

new text begin (43) Diagnosis: PERIPHERAL NERVE DISORDERS new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 355.4, 355.7-355.8, 723.2 new text end

new text begin (44) Diagnosis: DYSFUNCTION OF NASOLACRIMAL SYSTEM; LACRIMAL SYSTEM LACERATION new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT; CLOSURE new text end

new text begin ICD-9: 370.33, 375, 870.2 new text end

new text begin (45) Diagnosis: NASAL POLYPS, OTHER DISORDERS OF NASAL CAVITY AND SINUSES new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 471, 478.1, 993.1 new text end

new text begin (46) Diagnosis: SIALOLITHIASIS, MUCOCELE, DISTURBANCE OF SALIVARY SECRETION, OTHER AND UNSPECIFIED DISEASES OF SALIVARY GLANDS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 527.5-527.9 new text end

new text begin (47) Diagnosis: DENTAL CONDITIONS (e.g., BROKEN APPLIANCES) new text end

new text begin Treatment: PERIODONTICS AND COMPLEX PROSTHETICS new text end

new text begin ICD-9: 522.6, 522.8, V72.2 new text end

new text begin (48) Diagnosis: IMPULSE DISORDERS new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 312.31-312.39 new text end

new text begin (49) Diagnosis: BENIGN NEOPLASM BONE AND ARTICULAR CARTILAGE, INCLUDING OSTEOID OSTEOMAS; BENIGN NEOPLASM OF CONNECTIVE AND OTHER SOFT TISSUE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 213, 215, 526.0-526.1, 526.81, 719.2, 733.2 new text end

new text begin (50) Diagnosis: SEXUAL DYSFUNCTION new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT, PSYCHOTHERAPY new text end

new text begin ICD-9: 302.7, 607.84 new text end

new text begin (51) Diagnosis: STOMATITIS AND DISEASES OF LIPS new text end

new text begin Treatment: INCISION AND DRAINAGE/MEDICAL THERAPY new text end

new text begin ICD-9: 528.0, 528.5, 528.9, 529.0 new text end

new text begin (52) Diagnosis: BELL'S PALSY, EXPOSURE KERATOCONJUNCTIVITIS new text end

new text begin Treatment: TARSORRHAPHY new text end

new text begin ICD-9: 351.0-351.1, 351.8-351.9, 370.34, 374.44, 374.45, 374.89 new text end

new text begin (53) Diagnosis: HORDEOLUM AND OTHER DEEP INFLAMMATION OF EYELID; CHALAZION new text end

new text begin Treatment: INCISION AND DRAINAGE/MEDICAL THERAPY new text end

new text begin ICD-9: 373.11-373.12, 373.2, 374.50, 374.54, 374.56, 374.84 new text end

new text begin (54) Diagnosis: ECTROPION, TRICHIASIS OF EYELID, BENIGN NEOPLASM OF EYELID new text end

new text begin Treatment: ECTROPION REPAIR new text end

new text begin ICD-9: 216.1, 224, 372.63, 374.1, 374.85 new text end

new text begin (55) Diagnosis: CHONDROMALACIA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 733.92 new text end

new text begin (56) Diagnosis: DYSMENORRHEA new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 625.3 new text end

new text begin (57) Diagnosis: SPASTIC DIPLEGIA new text end

new text begin Treatment: RHIZOTOMY new text end

new text begin ICD-9: 343.0 new text end

new text begin (58) Diagnosis: ATROPHY OF EDENTULOUS ALVEOLAR RIDGE new text end

new text begin Treatment: VESTIBULOPLASTY, GRAFTS, IMPLANTS new text end

new text begin ICD-9: 525.2 new text end

new text begin (59) Diagnosis: DEFORMITIES OF UPPER BODY AND ALL LIMBS new text end

new text begin Treatment: REPAIR/REVISION/RECONSTRUCTION/RELOCATION/MEDICAL THERAPY new text end

new text begin ICD-9: 718.02-718.05, 718.13-718.15, 718.42-718.46, 718.52-718.56, 718.65, 718.82-718.86, 728.79, 732.3, 732.6, 732.8-732.9, 733.90-733.91, 736.00-736.04, 736.07, 736.09, 736.1, 736.20, 736.29, 736.30, 736.39, 736.4, 736.6, 736.76, 736.79, 736.89, 736.9, 738.6, 738.8, 754.42-754.44, 754.61, 754.8, 755.50-755.53, 755.56-755.57, 755.59, 755.60, 755.63-755.64, 755.69, 755.8, 756.82-756.83, 756.89 new text end

new text begin (60) Diagnosis: DEFORMITIES OF FOOT new text end

new text begin Treatment: FASCIOTOMY/INCISION/REPAIR/ARTHRODESIS new text end

new text begin ICD-9: 718.07, 718.47, 718.57, 718.87, 727.1, 732.5, 735.0-735.2, 735.3-735.9, 736.70-736.72, 754.50, 754.59, 754.60, 754.69, 754.70, 754.79, 755.65-755.67 new text end

new text begin (61) Diagnosis: PERITONEAL ADHESION new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 568.0, 568.82-568.89, 568.9 new text end

new text begin (62) Diagnosis: PELVIC PAIN SYNDROME, DYSPAREUNIA new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 300.81, 614.1, 614.6, 620.6, 625.0-625.2, 625.5, 625.8-625.9 new text end

new text begin (63) Diagnosis: TENSION HEADACHES new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 307.81, 784.0 new text end

new text begin (64) Diagnosis: CHRONIC BRONCHITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 490, 491.0, 491.8-491.9 new text end

new text begin (65) Diagnosis: DISORDERS OF FUNCTION OF STOMACH AND OTHER FUNCTIONAL DIGESTIVE DISORDERS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 536.0-536.3, 536.8-536.9, 537.1-537.2, 537.5-537.6, 537.89, 537.9, 564.0-564.7, 564.9 new text end

new text begin (66) Diagnosis: TMJ DISORDER new text end

new text begin Treatment: TMJ SPLINTS new text end

new text begin ICD-9: 524.6, 848.1 new text end

new text begin (67) Diagnosis: URETHRITIS, NONSEXUALLY TRANSMITTED new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 597.8, 599.3-599.5, 599.9 new text end

new text begin (68) Diagnosis: LESION OF PLANTAR NERVE; PLANTAR FASCIAL FIBROMATOSIS new text end

new text begin Treatment: MEDICAL THERAPY, EXCISION new text end

new text begin ICD-9: 355.6, 728.71 new text end

new text begin (69) Diagnosis: GRANULOMA OF MUSCLE, GRANULOMA OF SKIN AND SUBCUTANEOUS TISSUE new text end

new text begin Treatment: REMOVAL OF GRANULOMA new text end

new text begin ICD-9: 709.4, 728.82 new text end

new text begin (70) Diagnosis: DERMATOPHYTOSIS OF NAIL, GROIN, AND FOOT AND OTHER DERMATOMYCOSIS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 110.0-110.6, 110.8-110.9, 111 new text end

new text begin (71) Diagnosis: INTERNAL DERANGEMENT OF JOINT OTHER THAN KNEE new text end

new text begin Treatment: REPAIR, MEDICAL THERAPY new text end

new text begin ICD-9: 718.09, 718.19, 718.29, 718.48, 718.59, 718.88-718.89, 719.81-719.85, 719.87-719.89 new text end

new text begin (72) Diagnosis: STENOSIS OF NASOLACRIMAL DUCT (ACQUIRED) new text end

new text begin Treatment: DACRYOCYSTORHINOSTOMY new text end

new text begin ICD-9: 375.02, 375.30, 375.32, 375.4, 375.56-375.57, 375.61, 771.6 new text end

new text begin (73) Diagnosis: PERIPHERAL NERVE DISORDERS new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 355.4, 355.7-355.8, 723.2 new text end

new text begin (74) Diagnosis: CAVUS DEFORMITY OF FOOT; FLAT FOOT; POLYDACTYLY AND SYNDACTYLY OF TOES new text end

new text begin Treatment: MEDICAL THERAPY, ORTHOTIC new text end

new text begin ICD-9: 734, 736.73, 755.00, 755.02, 755.10, 755.13-755.14 new text end

new text begin (75) Diagnosis: PERIPHERAL ENTHESOPATHIES new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 726.12, 726.3-726.9, 728.81 new text end

new text begin (76) Diagnosis: PERIPHERAL ENTHESOPATHIES new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 726.12, 726.3-726.4, 726.6-726.9, 728.81 new text end

new text begin (77) Diagnosis: DISORDERS OF SOFT TISSUE new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 729.0-729.2, 729.31-729.39, 729.4-729.9 new text end

new text begin (78) Diagnosis: ENOPHTHALMOS new text end

new text begin Treatment: ORBITAL IMPLANT new text end

new text begin ICD-9: 372.64, 376.5 new text end

new text begin (79) Diagnosis: MACROMASTIA new text end

new text begin Treatment: SUBCUTANEOUS TOTAL MASTECTOMY, BREAST REDUCTION new text end

new text begin ICD-9: 611.1 new text end

new text begin (80) Diagnosis: GALACTORRHEA, MASTODYNIA, ATROPHY, BENIGN NEOPLASMS AND UNSPECIFIED DISORDERS OF THE BREAST new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 217, 611.3, 611.4, 611.6, 611.71, 611.9, 757.6 new text end

new text begin (81) Diagnosis: ACUTE AND CHRONIC DISORDERS OF SPINE WITHOUT NEUROLOGIC IMPAIRMENT new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 721.0, 721.2-721.3, 721.7-721.8, 721.90, 722.0-722.6, 722.8-722.9, 723.1, 723.5-723.9, 724.1-724.2, 724.5-724.9, 739, 839.2, 847 new text end

new text begin (82) Diagnosis: CYSTS OF ORAL SOFT TISSUES new text end

new text begin Treatment: INCISION AND DRAINAGE new text end

new text begin ICD-9: 527.1, 528.4, 528.8 new text end

new text begin (83) Diagnosis: FEMALE INFERTILITY, MALE INFERTILITY new text end

new text begin Treatment: ARTIFICIAL INSEMINATION, MEDICAL THERAPY new text end

new text begin ICD-9: 606, 628.4-628.9, 629.9, V26.1-V26.2, V26.8-V26.9 new text end

new text begin (84) Diagnosis: INFERTILITY DUE TO ANNOVULATION new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 626.0-626.1, 628.0, 628.1 new text end

new text begin (85) Diagnosis: POSTCONCUSSION SYNDROME new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 310.2 new text end

new text begin (86) Diagnosis: SIMPLE AND UNSPECIFIED GOITER, NONTOXIC NODULAR GOITER new text end

new text begin Treatment: MEDICAL THERAPY, THYROIDECTOMY new text end

new text begin ICD-9: 240-241 new text end

new text begin (87) Diagnosis: CONDUCTIVE HEARING LOSS new text end

new text begin Treatment: AUDIANT BONE CONDUCTORS new text end

new text begin ICD-9: 389.0, 389.2 new text end

new text begin (88) Diagnosis: CANCER OF LIVER AND INTRAHEPATIC BILE DUCTS new text end

new text begin Treatment: LIVER TRANSPLANT new text end

new text begin ICD-9: 155.0-155.1, 996.82 new text end

new text begin (89) Diagnosis: HYPOTENSION new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 458 new text end

new text begin (90) Diagnosis: VIRAL HEPATITIS, EXCLUDING CHRONIC VIRAL HEPATITIS B AND VIRAL HEPATITIS C WITHOUT HEPATIC COMA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 070.0-070.2, 070.30-070.31, 070.33, 070.4, 070.52-070.53, 070.59, 070.6-070.9 new text end

new text begin (91) Diagnosis: BENIGN NEOPLASMS OF SKIN AND OTHER SOFT TISSUES new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 210, 214, 216, 221, 222.1, 222.4, 228.00-228.01, 228.1, 229, 686.1, 686.9 new text end

new text begin (92) Diagnosis: REDUNDANT PREPUCE new text end

new text begin Treatment: ELECTIVE CIRCUMCISION new text end

new text begin ICD-9: 605, V50.2 new text end

new text begin (93) Diagnosis: BENIGN NEOPLASMS OF DIGESTIVE SYSTEM new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 211.0-211.2, 211.5-211.6, 211.8-211.9 new text end

new text begin (94) Diagnosis: OTHER NONINFECTIOUS GASTROENTERITIS AND COLITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 558 new text end

new text begin (95) Diagnosis: FACTITIOUS DISORDERS new text end

new text begin Treatment: CONSULTATION new text end

new text begin ICD-9: 300.10, 300.16, 300.19, 301.51 new text end

new text begin (96) Diagnosis: HYPOCHONDRIASIS; SOMATOFORM DISORDER, NOS AND UNDIFFERENTIATED new text end

new text begin Treatment: CONSULTATION new text end

new text begin ICD-9: 300.7, 300.9, 306 new text end

new text begin (97) Diagnosis: CONVERSION DISORDER, ADULT new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 300.11 new text end

new text begin (98) Diagnosis: SPINAL DEFORMITY, NOT CLINICALLY SIGNIFICANT new text end

new text begin Treatment: ARTHRODESIS/REPAIR/RECONSTRUCTION, MEDICAL THERAPY new text end

new text begin ICD-9: 721.5-721.6, 723.0, 724.0, 731.0, 737.0-737.3, 737.8-737.9, 738.4-738.5, 754.1-754.2, 756.10-756.12, 756.13-756.17, 756.19, 756.3 new text end

new text begin (99) Diagnosis: ASYMPTOMATIC URTICARIA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 708.2-708.4, 708.9 new text end

new text begin (100) Diagnosis: CIRCUMSCRIBED SCLERODERMA; SENILE PURPURA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 287.2, 287.8-287.9, 701.0 new text end

new text begin (101) Diagnosis: DERMATITIS DUE TO SUBSTANCES TAKEN INTERNALLY new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 693 new text end

new text begin (102) Diagnosis: ALLERGIC RHINITIS AND CONJUNCTIVITIS, CHRONIC RHINITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 372.01-372.05, 372.14, 372.54, 372.56, 472, 477, 955.3, V07.1 new text end

new text begin (103) Diagnosis: PLEURISY new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 511.0, 511.9 new text end

new text begin (104) Diagnosis: CONJUNCTIVAL CYST new text end

new text begin Treatment: EXCISION OF CONJUNCTIVAL CYST new text end

new text begin ICD-9: 372.61-372.62, 372.71-372.72, 372.74-372.75 new text end

new text begin (105) Diagnosis: HEMATOMA OF AURICLE OR PINNA AND HEMATOMA OF EXTERNAL EAR new text end

new text begin Treatment: DRAINAGE new text end

new text begin ICD-9: 380.3, 380.8, 738.7 new text end

new text begin (106) Diagnosis: ACUTE NONSUPPURATIVE LABYRINTHITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 386.30-386.32, 386.34-386.35 new text end

new text begin (107) Diagnosis: INFECTIOUS MONONUCLEOSIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 075 new text end

new text begin (108) Diagnosis: ASEPTIC MENINGITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 047-049 new text end

new text begin (109) Diagnosis: CONGENITAL ANOMALIES OF FEMALE GENITAL ORGANS, EXCLUDING VAGINA new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 752.0-752.3, 752.41 new text end

new text begin (110) Diagnosis: CONGENITAL DEFORMITIES OF KNEE new text end

new text begin Treatment: ARTHROSCOPIC REPAIR new text end

new text begin ICD-9: 755.64, 727.83 new text end

new text begin (111) Diagnosis: UNCOMPLICATED HERNIA IN ADULTS AGE 18 OR OVER new text end

new text begin Treatment: REPAIR new text end

new text begin ICD-9: 550.9, 553.0-553.2, 553.8-553.9 new text end

new text begin (112) Diagnosis: ACUTE ANAL FISSURE new text end

new text begin Treatment: FISSURECTOMY, MEDICAL THERAPY new text end

new text begin ICD-9: 565.0 new text end

new text begin (113) Diagnosis: CYST OF KIDNEY, ACQUIRED new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 593.2 new text end

new text begin (114) Diagnosis: PICA new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 307.52 new text end

new text begin (115) Diagnosis: DISORDERS OF SLEEP WITHOUT SLEEP APNEA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 307.41-307.45, 307.47-307.49, 780.50, 780.52, 780.54-780.56, 780.59 new text end

new text begin (116) Diagnosis: CYST, HEMORRHAGE, AND INFARCTION OF THYROID new text end

new text begin Treatment: SURGERY - EXCISION new text end

new text begin ICD-9: 246.2, 246.3, 246.9 new text end

new text begin (117) Diagnosis: DEVIATED NASAL SEPTUM, ACQUIRED DEFORMITY OF NOSE, OTHER DISEASES OF UPPER RESPIRATORY TRACT new text end

new text begin Treatment: EXCISION OF CYST/RHINECTOMY/PROSTHESIS new text end

new text begin ICD-9: 470, 478.0, 738.0, 754.0 new text end

new text begin (118) Diagnosis: ERYTHEMA MULTIFORM new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 695.1 new text end

new text begin (119) Diagnosis: HERPES SIMPLEX WITHOUT COMPLICATIONS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 054.2, 054.6, 054.73, 054.9 new text end

new text begin (120) Diagnosis: CONGENITAL ANOMALIES OF THE EAR WITHOUT IMPAIRMENT OF HEARING; UNILATERAL ANOMALIES OF THE EAR new text end

new text begin Treatment: OTOPLASTY, REPAIR AND AMPUTATION new text end

new text begin ICD-9: 744.00-744.04, 744.09, 744.1-744.3 new text end

new text begin (121) Diagnosis: BLEPHARITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 373.0, 373.8-373.9, 374.87 new text end

new text begin (122) Diagnosis: HYPERTELORISM OF ORBIT new text end

new text begin Treatment: ORBITOTOMY new text end

new text begin ICD-9: 376.41 new text end

new text begin (123) Diagnosis: INFERTILITY DUE TO TUBAL DISEASE new text end

new text begin Treatment: MICROSURGERY new text end

new text begin ICD-9: 608.85, 622.5, 628.2-628.3, 629.9, V26.0 new text end

new text begin (124) Diagnosis: KERATODERMA, ACANTHOSIS NIGRICANS, STRIAE ATROPHICAE, AND OTHER HYPERTROPHIC OR ATROPHIC CONDITIONS OF SKIN new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 373.3, 690, 698, 701.1-701.3, 701.8, 701.9 new text end

new text begin (125) Diagnosis: LICHEN PLANUS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 697 new text end

new text begin (126) Diagnosis: OBESITY new text end

new text begin Treatment: NUTRITIONAL AND LIFE STYLE COUNSELING new text end

new text begin ICD-9: 278.0 new text end

new text begin (127) Diagnosis: MORBID OBESITY new text end

new text begin Treatment: GASTROPLASTY new text end

new text begin ICD-9: 278.01 new text end

new text begin (128) Diagnosis: CHRONIC DISEASE OF TONSILS AND ADENOIDS new text end

new text begin Treatment: TONSILLECTOMY AND ADENOIDECTOMY new text end

new text begin ICD-9: 474.0, 474.1-474.2, 474.9 new text end

new text begin (129) Diagnosis: HYDROCELE new text end

new text begin Treatment: MEDICAL THERAPY, EXCISION new text end

new text begin ICD-9: 603, 608.84, 629.1, 778.6 new text end

new text begin (130) Diagnosis: KELOID SCAR; OTHER ABNORMAL GRANULATION TISSUE new text end

new text begin Treatment: INTRALESIONAL INJECTIONS/DESTRUCTION/EXCISION, RADIATION THERAPY new text end

new text begin ICD-9: 701.4-701.5 new text end

new text begin (131) Diagnosis: NONINFLAMMATORY DISORDERS OF CERVIX; HYPERTROPHY OF LABIA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 622.4, 622.6-622.9, 623.4, 624.2-624.3, 624.6-624.9 new text end

new text begin (132) Diagnosis: SPRAINS OF JOINTS AND ADJACENT MUSCLES, GRADE I new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 355.1-355.3, 355.9, 717, 718.26, 718.36, 718.46, 718.56, 836.0-836.2, 840-843, 844.0-844.3, 844.8-844.9, 845.00-845.03, 845.1, 846, 848.3, 848.40-848.42, 848.49, 848.5, 848.8-848.9, 905.7 new text end

new text begin (133) Diagnosis: SYNOVITIS AND TENOSYNOVITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 726.12, 727.00, 727.03-727.09 new text end

new text begin (134) Diagnosis: OTHER DISORDERS OF SYNOVIUM, TENDON AND BURSA, COSTOCHONDRITIS, AND CHONDRODYSTROPHY new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 719.5-719.6, 719.80, 719.86, 727.2-727.3, 727.50, 727.60, 727.82, 727.9, 733.5-733.7, 756.4 new text end

new text begin (135) Diagnosis: DISEASE OF NAILS, HAIR, AND HAIR FOLLICLES new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 703.8-703.9, 704.0, 704.1-704.9, 706.3, 706.9, 757.4-757.5, V50.0 new text end

new text begin (136) Diagnosis: CANDIDIASIS OF MOUTH, SKIN, AND NAILS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 112.0, 112.3, 112.9 new text end

new text begin (137) Diagnosis: BENIGN LESIONS OF TONGUE new text end

new text begin Treatment: EXCISION new text end

new text begin ICD-9: 529.1-529.6, 529.8-529.9 new text end

new text begin (138) Diagnosis: MINOR BURNS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 692.76, 941.0-941.2, 942.0-942.2, 943.0-943.2, 944.0-944.2, 945.0-945.2, 946.0-946.2, 949.0-949.1 new text end

new text begin (139) Diagnosis: MINOR HEAD INJURY: HEMATOMA/EDEMA WITH NO LOSS OF CONSCIOUSNESS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 800.00-800.01, 801.00-801.01, 803.00-803.01, 850.0, 850.9, 851.00-851.01, 851.09, 851.20-851.21, 851.29, 851.40-851.41, 851.49, 851.60-851.61, 851.69, 851.80-851.81, 851.89 new text end

new text begin (140) Diagnosis: CONGENITAL DEFORMITY OF KNEE new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 755.64 new text end

new text begin (141) Diagnosis: PHLEBITIS AND THROMBOPHLEBITIS, SUPERFICIAL new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 451.0, 451.2, 451.82, 451.84, 451.89, 451.9 new text end

new text begin (142) Diagnosis: PROLAPSED URETHRAL MUCOSA new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 599.3, 599.5 new text end

new text begin (143) Diagnosis: RUPTURE OF SYNOVIUM new text end

new text begin Treatment: REMOVAL OF BAKER'S CYST new text end

new text begin ICD-9: 727.51 new text end

new text begin (144) Diagnosis: PERSONALITY DISORDERS, EXCLUDING BORDERLINE, SCHIZOTYPAL AND ANTISOCIAL new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 301.0, 301.10-301.12, 301.20-301.21, 301.3-301.4, 301.50, 301.59, 301.6, 301.81-301.82, 301.84, 301.89, 301.9 new text end

new text begin (145) Diagnosis: GENDER IDENTIFICATION DISORDER, PARAPHILIAS AND OTHER PSYCHOSEXUAL DISORDERS new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 302.0-302.4, 302.50, 302.6, 302.85, 302.9 new text end

new text begin (146) Diagnosis: FINGERTIP AVULSION new text end

new text begin Treatment: REPAIR WITHOUT PEDICLE GRAFT new text end

new text begin ICD-9: 883.0 new text end

new text begin (147) Diagnosis: ANOMALIES OF RELATIONSHIP OF JAW TO CRANIAL BASE, MAJOR ANOMALIES OF JAW SIZE, OTHER SPECIFIED AND UNSPECIFIED DENTOFACIAL ANOMALIES new text end

new text begin Treatment: OSTEOPLASTY, MAXILLA/MANDIBLE new text end

new text begin ICD-9: 524.0-524.2, 524.5, 524.7-524.8, 524.9 new text end

new text begin (148) Diagnosis: CERVICAL RIB new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 756.2 new text end

new text begin (149) Diagnosis: GYNECOMASTIA new text end

new text begin Treatment: MASTECTOMY new text end

new text begin ICD-9: 611.1 new text end

new text begin (150) Diagnosis: VIRAL, SELF-LIMITING ENCEPHALITIS, MYELITIS AND ENCEPHALOMYELITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 056.0, 056.71, 323.8-323.9 new text end

new text begin (151) Diagnosis: GALLSTONES WITHOUT CHOLECYSTITIS new text end

new text begin Treatment: MEDICAL THERAPY, CHOLECYSTECTOMY new text end

new text begin ICD-9: 574.2, 575.8 new text end

new text begin (152) Diagnosis: BENIGN NEOPLASM OF NASAL CAVITIES, MIDDLE EAR AND ACCESSORY SINUSES new text end

new text begin Treatment: EXCISION, RECONSTRUCTION new text end

new text begin ICD-9: 212.0 new text end

new text begin (153) Diagnosis: ACUTE TONSILLITIS OTHER THAN BETA-STREPTOCOCCAL new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 463 new text end

new text begin (154) Diagnosis: EDEMA AND OTHER CONDITIONS INVOLVING THE INTEGUMENT OF THE FETUS AND NEWBORN new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 778.5, 778.7-778.9 new text end

new text begin (155) Diagnosis: ACUTE UPPER RESPIRATORY INFECTIONS AND COMMON COLD new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 460, 465 new text end

new text begin (156) Diagnosis: DIAPER RASH new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 691.0 new text end

new text begin (157) Diagnosis: DISORDERS OF SWEAT GLANDS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 705.0-705.1, 705.81-705.83, 705.89, 705.9, 780.8 new text end

new text begin (158) Diagnosis: OTHER VIRAL INFECTIONS, EXCLUDING PNEUMONIA DUE TO RESPIRATORY SYNCYTIAL VIRUS IN PERSONS UNDER AGE 3 new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 052, 055, 056.79, 056.8-056.9, 057, 072, 074, 078.0, 078.2, 078.4-078.8, 079.0-079.6, 079.88-079.89, 079.9, 480, 487 new text end

new text begin (159) Diagnosis: PHARYNGITIS AND LARYNGITIS AND OTHER DISEASES OF VOCAL CORDS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 462, 464.00, 464.50, 476, 478.5 new text end

new text begin (160) Diagnosis: CORNS AND CALLUSES new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 700 new text end

new text begin (161) Diagnosis: VIRAL WARTS, EXCLUDING VENEREAL WARTS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT, CRYOSURGERY new text end

new text begin ICD-9: 078.0, 078.10, 078.19 new text end

new text begin (162) Diagnosis: OLD LACERATION OF CERVIX AND VAGINA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 621.5, 622.3, 624.4 new text end

new text begin (163) Diagnosis: TONGUE TIE AND OTHER ANOMALIES OF TONGUE new text end

new text begin Treatment: FRENOTOMY, TONGUE TIE new text end

new text begin ICD-9: 529.5, 750.0-750.1 new text end

new text begin (164) Diagnosis: OPEN WOUND OF INTERNAL STRUCTURES OF MOUTH WITHOUT COMPLICATION new text end

new text begin Treatment: REPAIR SOFT TISSUES new text end

new text begin ICD-9: 525.10, 525.12, 525.13, 525.19, 873.6 new text end

new text begin (165) Diagnosis: CENTRAL SEROUS RETINOPATHY new text end

new text begin Treatment: LASER SURGERY new text end

new text begin ICD-9: 362.40-362.41, 362.6-362.7 new text end

new text begin (166) Diagnosis: SEBORRHEIC KERATOSIS, DYSCHROMIA, AND VASCULAR DISORDERS, SCAR CONDITIONS, AND FIBROSIS OF SKIN new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 278.1, 702.1-702.8, 709.1-709.3, 709.8-709.9 new text end

new text begin (167) Diagnosis: UNCOMPLICATED HEMORRHOIDS new text end

new text begin Treatment: HEMORRHOIDECTOMY, MEDICAL THERAPY new text end

new text begin ICD-9: 455.0, 455.3, 455.6, 455.9 new text end

new text begin (168) Diagnosis: GANGLION new text end

new text begin Treatment: EXCISION new text end

new text begin ICD-9: 727.02, 727.4 new text end

new text begin (169) Diagnosis: CHRONIC CONJUNCTIVITIS, BLEPHAROCONJUNCTIVITIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 372.10-372.13, 372.2-372.3, 372.53, 372.73, 374.55 new text end

new text begin (170) Diagnosis: TOXIC ERYTHEMA, ACNE ROSACEA, DISCOID LUPUS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 695.0, 695.2-695.9 new text end

new text begin (171) Diagnosis: PERIPHERAL NERVE DISORDERS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 355.7-355.8, 357.5-357.9, 723.2 new text end

new text begin (172) Diagnosis: OTHER COMPLICATIONS OF A PROCEDURE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 371.82, 457.0, 998.81, 998.9 new text end

new text begin (173) Diagnosis: RAYNAUD'S SYNDROME new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 443.0, 443.89, 443.9 new text end

new text begin (174) Diagnosis: TMJ DISORDERS new text end

new text begin Treatment: TMJ SURGERY new text end

new text begin ICD-9: 524.5, 524.6, 718.08, 718.18, 718.28, 718.38, 718.58 new text end

new text begin (175) Diagnosis: VARICOSE VEINS OF LOWER EXTREMITIES WITHOUT ULCER OR INFLAMMATION new text end

new text begin Treatment: STRIPPING/SCLEROTHERAPY new text end

new text begin ICD-9: 454.9, 459, 607.82 new text end

new text begin (176) Diagnosis: VULVAL VARICES new text end

new text begin Treatment: VASCULAR SURGERY new text end

new text begin ICD-9: 456.6 new text end

new text begin (177) Diagnosis: CHRONIC PANCREATITIS new text end

new text begin Treatment: SURGICAL TREATMENT new text end

new text begin ICD-9: 577.1 new text end

new text begin (178) Diagnosis: CHRONIC PROSTATITIS, OTHER DISORDERS OF PROSTATE new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 601.1, 601.3, 601.9, 602 new text end

new text begin (179) Diagnosis: MUSCULAR CALCIFICATION AND OSSIFICATION new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 728.1 new text end

new text begin (180) Diagnosis: CANCER OF VARIOUS SITES WHERE TREATMENT WILL NOT RESULT IN A FIVE PERCENT FIVE-YEAR SURVIVAL new text end

new text begin Treatment: CURATIVE MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 140-208 new text end

new text begin (181) Diagnosis: AGENESIS OF LUNG new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 748.5 new text end

new text begin (182) Diagnosis: DISEASE OF CAPILLARIES new text end

new text begin Treatment: EXCISION new text end

new text begin ICD-9: 448.1-448.9 new text end

new text begin (183) Diagnosis: BENIGN POLYPS OF VOCAL CORDS new text end

new text begin Treatment: MEDICAL THERAPY, STRIPPING new text end

new text begin ICD-9: 478.4 new text end

new text begin (184) Diagnosis: FRACTURES OF RIBS AND STERNUM, CLOSED new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 807.0, 807.2, 805.6, 839.41 new text end

new text begin (185) Diagnosis: CLOSED FRACTURE OF ONE OR MORE PHALANGES OF THE FOOT, NOT INCLUDING THE GREAT TOE new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 826.0 new text end

new text begin (186) Diagnosis: DISEASES OF THYMUS GLAND new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 254 new text end

new text begin (187) Diagnosis: DENTAL CONDITIONS WHERE TREATMENT RESULTS IN MARGINAL IMPROVEMENT new text end

new text begin Treatment: ELECTIVE DENTAL SERVICES new text end

new text begin ICD-9: 520.7, V72.2 new text end

new text begin (188) Diagnosis: ANTISOCIAL PERSONALITY DISORDER new text end

new text begin Treatment: MEDICAL/PSYCHOTHERAPY new text end

new text begin ICD-9: 301.7 new text end

new text begin (189) Diagnosis: SEBACEOUS CYST new text end

new text begin Treatment: MEDICAL AND SURGICAL THERAPY new text end

new text begin ICD-9: 685.1, 706.2, 744.47 new text end

new text begin (190) Diagnosis: CENTRAL RETINAL ARTERY OCCLUSION new text end

new text begin Treatment: PARACENTESIS OF AQUEOUS new text end

new text begin ICD-9: 362.31-362.33 new text end

new text begin (191) Diagnosis: ORAL APHTHAE new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 528.2 new text end

new text begin (192) Diagnosis: SUBLINGUAL, SCROTAL, AND PELVIC VARICES new text end

new text begin Treatment: VENOUS INJECTION, VASCULAR SURGERY new text end

new text begin ICD-9: 456.3-456.5 new text end

new text begin (193) Diagnosis: SUPERFICIAL WOUNDS WITHOUT INFECTION AND CONTUSIONS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 910.0, 910.2, 910.4, 910.6, 910.8, 911.0, 911.2, 911.4, 91.6, 911.8, 912.0, 912.2, 912.4, 912.6, 912.8, 913.0, 913.2, 913.4, 913.6, 913.8, 914.0, 914.2, 914.4, 914.6, 914.8, 915.0, 915.2, 915.4, 915.6, 915.8, 916.0, 916.2, 916.4, 916.6, 916.8, 917.0, 917.2, 917.4, 917.6, 917.8, 919.0, 919.2, 919.4, 919.6, 919.8, 920-924, 959.0-959.8 new text end

new text begin (194) Diagnosis: UNSPECIFIED RETINAL VASCULAR OCCLUSION new text end

new text begin Treatment: LASER SURGERY new text end

new text begin ICD-9: 362.30 new text end

new text begin (195) Diagnosis: BENIGN NEOPLASM OF EXTERNAL FEMALE GENITAL ORGANS new text end

new text begin Treatment: EXCISION new text end

new text begin ICD-9: 221.1-221.9 new text end

new text begin (196) Diagnosis: BENIGN NEOPLASM OF MALE GENITAL ORGANS: TESTIS, PROSTATE, EPIDIDYMIS new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 222.0, 222.2, 222.3, 222.8, 222.9 new text end

new text begin (197) Diagnosis: XEROSIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 706.8 new text end

new text begin (198) Diagnosis: CONGENITAL CYSTIC LUNG - SEVERE new text end

new text begin Treatment: LUNG RESECTION new text end

new text begin ICD-9: 748.4 new text end

new text begin (199) Diagnosis: ICHTHYOSIS new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 757.1 new text end

new text begin (200) Diagnosis: LYMPHEDEMA new text end

new text begin Treatment: MEDICAL THERAPY, OTHER OPERATION ON LYMPH CHANNEL new text end

new text begin ICD-9: 457.1-457.9, 757.0 new text end

new text begin (201) Diagnosis: DERMATOLOGICAL CONDITIONS WITH NO EFFECTIVE TREATMENT OR NO TREATMENT NECESSARY new text end

new text begin Treatment: MEDICAL AND SURGICAL TREATMENT new text end

new text begin ICD-9: 696.3-696.5, 709.0, 757.2-757.3, 757.8-757.9 new text end

new text begin (202) Diagnosis: INFECTIOUS DISEASES WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 071, 136.0, 136.9 new text end

new text begin (203) Diagnosis: RESPIRATORY CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 519.3, 519.9, 748.60, 748.69, 748.9 new text end

new text begin (204) Diagnosis: GENITOURINARY CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 593.0-593.1, 593.6, 607.9, 608.3, 608.9, 621.6, 621.8-621.9, 626.9, 629.8, 752.9 new text end

new text begin (205) Diagnosis: CARDIOVASCULAR CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 429.3, 429.81-429.82, 429.89, 429.9, 747.9 new text end

new text begin (206) Diagnosis: MUSCULOSKELETAL CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 716.9, 718.00, 718.10, 718.20, 718.40, 718.50, 718.60, 718.80, 718.9, 719.7, 719.9, 728.5, 728.84, 728.9, 731.2, 738.2-738.3, 738.9, 744.5-744.9, 748.1, 755.9, 756.9 new text end

new text begin (207) Diagnosis: INTRACRANIAL CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 348.2, 377.01, 377.02, 377.2, 377.3, 377.5, 377.7, 437.7-437.8 new text end

new text begin (208) Diagnosis: SENSORY ORGAN CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 360.30-360.31, 360.33, 362.37, 362.42-362.43, 362.8-362.9, 363.21, 364.5, 364.60, 364.9, 371.20, 371.22, 371.24, 371.3, 371.81, 371.89, 371.9, 372.40-372.42, 372.44-372.45, 372.50-372.52, 372.55, 372.8-372.9, 374.52-374.53, 374.81-374.83, 374.9, 376.82, 376.89, 376.9, 377.03, 377.1, 377.4, 377.6, 379.24, 379.29, 379.4-379.8, 380.9, 747.47 new text end

new text begin (209) Diagnosis: ENDOCRINE AND METABOLIC CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 251.1-251.2, 259.4, 259.8-259.9, 277.3, 759.1 new text end

new text begin (210) Diagnosis: GASTROINTESTINAL CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 527.0, 569.9, 573.9 new text end

new text begin (211) Diagnosis: MENTAL DISORDERS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 313.1, 313.3, 313.83 new text end

new text begin (212) Diagnosis: NEUROLOGIC CONDITIONS WITH NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY new text end

new text begin Treatment: EVALUATION new text end

new text begin ICD-9: 333.82, 333.84, 333.91, 333.93 new text end

new text begin (213) Diagnosis: DENTAL CONDITIONS (e.g., ORTHODONTICS) new text end

new text begin Treatment: COSMETIC DENTAL SERVICES new text end

new text begin ICD-9: 520.0-520.5, 520.8-520.9, 521.1-521.9, 522.3, V72.2 new text end

new text begin (214) Diagnosis: TUBAL DYSFUNCTION AND OTHER CAUSES OF INFERTILITY new text end

new text begin Treatment: IN-VITRO FERTILIZATION, GIFT new text end

new text begin ICD-9: 256 new text end

new text begin (215) Diagnosis: HEPATORENAL SYNDROME new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 572.4 new text end

new text begin (216) Diagnosis: SPASTIC DYSPHONIA new text end

new text begin Treatment: MEDICAL THERAPY new text end

new text begin ICD-9: 478.79 new text end

new text begin (217) Diagnosis: DISORDERS OF REFRACTION AND ACCOMMODATION new text end

new text begin Treatment: RADIAL KERATOTOMY new text end

new text begin ICD-9: 367, 368.1-368.9 new text end

new text begin (b) The commissioner of human services shall identify the related CPT codes that correspond with the diagnosis/treatment pairings described in this section. The identification of the related CPT codes is not subject to the requirements of Minnesota Statutes, chapter 14. new text end

new text begin Subd. 4. new text end [FEDERAL APPROVAL.] new text begin The commissioner of human services shall seek federal approval to eliminate medical assistance coverage for the diagnosis/treatment pairings described in subdivision 3. new text end

new text begin Subd. 5. new text end [NONEXPANSION OF COVERED SERVICES.] new text begin Nothing in this section shall be construed to expand medical assistance coverage to services that are not currently covered under the medical assistance program as of June 30, 2003. new text end

Sec. 55. new text begin REPEALER. new text end

new text begin Minnesota Statutes 2002, sections 256.955, subdivision 8; and 256B.0625, subdivision 5a, are repealed July 1, 2003. new text end

ARTICLE 3

HEALTH MISCELLANEOUS

Section 1.

Minnesota Statutes 2002, section 62E.06, subdivision 1, is amended to read:

Subdivision 1.

Number three plan.

A plan of health coverage shall be certified as a number three qualified plan if it otherwise meets the requirements established by chapters 62A, 62C, and 62Q, and the other laws of this state, whether or not the policy is issued in Minnesota, and meets or exceeds the following minimum standards:

(a) The minimum benefits for a covered individual shall, subject to the other provisions of this subdivision, be equal to at least 80 percent of the cost of covered services in excess of an annual deductible which does not exceed $150 per person. The coverage shall include a limitation of $3,000 per person on total annual out-of-pocket expenses for services covered under this subdivision. The coverage shall be subject to a maximum lifetime benefit of not less than $1,000,000.

The $3,000 limitation on total annual out-of-pocket expenses and the $1,000,000 maximum lifetime benefit shall not be subject to change or substitution by use of an actuarially equivalent benefit.

(b) Covered expenses shall be the usual and customary charges for the following services and articles when prescribed by a physician:

(1) hospital services;

(2) professional services for the diagnosis or treatment of injuries, illnesses, or conditions, other than dental, which are rendered by a physician or at the physician's direction;

(3) drugs requiring a physician's prescription;

(4) services of a nursing home for not more than 120 days in a year if the services would qualify as reimbursable services under Medicare;

(5) services of a home health agency if the services would qualify as reimbursable services under Medicare;

(6) use of radium or other radioactive materials;

(7) oxygen;

(8) anesthetics;

(9) prostheses other than dental but including scalp hair prostheses worn for hair loss suffered as a result of alopecia areata;

(10) rental or purchase, as appropriate, of durable medical equipment other than eyeglasses and hearing aids new text begin , unless coverage is required under section 62Q.675 new text end ;

(11) diagnostic x-rays and laboratory tests;

(12) oral surgery for partially or completely unerupted impacted teeth, a tooth root without the extraction of the entire tooth, or the gums and tissues of the mouth when not performed in connection with the extraction or repair of teeth;

(13) services of a physical therapist;

(14) transportation provided by licensed ambulance service to the nearest facility qualified to treat the condition; or a reasonable mileage rate for transportation to a kidney dialysis center for treatment; and

(15) services of an occupational therapist.

(c) Covered expenses for the services and articles specified in this subdivision do not include the following:

(1) any charge for care for injury or disease either (i) arising out of an injury in the course of employment and subject to a workers' compensation or similar law, (ii) for which benefits are payable without regard to fault under coverage statutorily required to be contained in any motor vehicle, or other liability insurance policy or equivalent self-insurance, or (iii) for which benefits are payable under another policy of accident and health insurance, Medicare, or any other governmental program except as otherwise provided by section 62A.04, subdivision 3, clause (4);

(2) any charge for treatment for cosmetic purposes other than for reconstructive surgery when such service is incidental to or follows surgery resulting from injury, sickness, or other diseases of the involved part or when such service is performed on a covered dependent child because of congenital disease or anomaly which has resulted in a functional defect as determined by the attending physician;

(3) care which is primarily for custodial or domiciliary purposes which would not qualify as eligible services under Medicare;

(4) any charge for confinement in a private room to the extent it is in excess of the institution's charge for its most common semiprivate room, unless a private room is prescribed as medically necessary by a physician, provided, however, that if the institution does not have semiprivate rooms, its most common semiprivate room charge shall be considered to be 90 percent of its lowest private room charge;

(5) that part of any charge for services or articles rendered or prescribed by a physician, dentist, or other health care personnel which exceeds the prevailing charge in the locality where the service is provided; and

(6) any charge for services or articles the provision of which is not within the scope of authorized practice of the institution or individual rendering the services or articles.

(d) The minimum benefits for a qualified plan shall include, in addition to those benefits specified in clauses (a) and (e), benefits for well baby care, effective July 1, 1980, subject to applicable deductibles, coinsurance provisions, and maximum lifetime benefit limitations.

(e) Effective July 1, 1979, the minimum benefits of a qualified plan shall include, in addition to those benefits specified in clause (a), a second opinion from a physician on all surgical procedures expected to cost a total of $500 or more in physician, laboratory, and hospital fees, provided that the coverage need not include the repetition of any diagnostic tests.

(f) Effective August 1, 1985, the minimum benefits of a qualified plan must include, in addition to the benefits specified in clauses (a), (d), and (e), coverage for special dietary treatment for phenylketonuria when recommended by a physician.

(g) Outpatient mental health coverage is subject to section 62A.152, subdivision 2.

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to policies and plans issued or renewed to provide coverage to Minnesota residents on or after that date. new text end

Sec. 2.

Minnesota Statutes 2002, section 62J.17, subdivision 2, is amended to read:

Subd. 2.

Definitions.

For purposes of this section, the terms defined in this subdivision have the meanings given.

(a) "Access" means the financial, temporal, and geographic availability of health care to individuals who need it.

(b) "Capital expenditure" means an expenditure which, under generally accepted accounting principles, is not properly chargeable as an expense of operation and maintenance.

(c) "Cost" means the amount paid by consumers or third party payers for health care services or products.

(d) "Date of the major spending commitment" means the date the provider formally obligated itself to the major spending commitment. The obligation may be incurred by entering into a contract, making a down payment, issuing bonds or entering a loan agreement to provide financing for the major spending commitment, or taking some other formal, tangible action evidencing the provider's intention to make the major spending commitment.

(e) "Health care service" means:

(1) a service or item that would be covered by the medical assistance program under chapter 256B if provided in accordance with medical assistance requirements to an eligible medical assistance recipient; and

(2) a service or item that would be covered by medical assistance except that it is characterized as experimental, cosmetic, or voluntary.

"Health care service" does not include retail, over-the-counter sales of nonprescription drugs and other retail sales of health-related products that are not generally paid for by medical assistance and other third-party coverage.

(f) "Major spending commitment" means an expenditure in excess of $500,000 new text begin , but less than or equal to $2,000,000, new text end for:

(1) acquisition of a unit of medical equipment;

(2) a capital expenditure for a single project for the purposes of providing health care services, other than for the acquisition of medical equipment;

(3) offering a new specialized service not offered before;

(4) planning for an activity that would qualify as a major spending commitment under this paragraph; or

(5) a project involving a combination of two or more of the activities in clauses (1) to (4).

The cost of acquisition of medical equipment, and the amount of a capital expenditure, is the total cost to the provider regardless of whether the cost is distributed over time through a lease arrangement or other financing or payment mechanism.

(g) "Medical equipment" means fixed and movable equipment that is used by a provider in the provision of a health care service. "Medical equipment" includes, but is not limited to, the following:

(1) an extracorporeal shock wave lithotripter;

(2) a computerized axial tomography (CAT) scanner;

(3) a magnetic resonance imaging (MRI) unit;

(4) a positron emission tomography (PET) scanner; and

(5) emergency and nonemergency medical transportation equipment and vehicles.

(h) "New specialized service" means a specialized health care procedure or treatment regimen offered by a provider that was not previously offered by the provider, including, but not limited to:

(1) cardiac catheterization services involving high-risk patients as defined in the Guidelines for Coronary Angiography established by the American Heart Association and the American College of Cardiology;

(2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or any other service for transplantation of any other organ;

(3) megavoltage radiation therapy;

(4) open heart surgery;

(5) neonatal intensive care services; and

(6) any new medical technology for which premarket approval has been granted by the United States Food and Drug Administration, excluding implantable and wearable devices.

Sec. 3.

new text begin [62J.18] PROVIDER REPORTING IN EXCESS OF $2,000,000. new text end

new text begin Subdivision 1. new text end [APPLICABILITY; DEFINITIONS.] new text begin (a) This section applies to providers and to persons who would become providers after making the expenditures described in subdivision 2. new text end

new text begin (b) For purposes of this section, the terms used have the meanings given in section 62J.17, subdivision 2, except that "major spending commitment" means an expenditure in excess of $2,000,000. new text end

new text begin Subd. 2. new text end [REPORTING REQUIREMENT.] new text begin (a) A provider that intends to make a major spending commitment in excess of $2,000,000 for the acquisition, by purchase or lease, of a unit of medical equipment or in excess of $2,000,000 for a single capital project for the purposes of providing health care services must file a report with the commissioner at least 60 days before committing to make the expenditure. The report must contain the information described in section 62J.17, subdivision 4a, paragraphs (b) and (c). new text end

new text begin (b) The commissioner shall maintain a database to track expenditures reported under this subdivision. new text end

new text begin (c) The commissioner shall maintain a list of all persons who have registered with the commissioner for the purpose of receiving notice by electronic mail of a report filed under this subdivision. The commissioner shall, within 15 days of receiving an expenditure report, provide notice of such report by electronic mail to all persons on its list, and by publication in the State Register. The notice must include either a copy of the report or an easily understandable description of the proposed expenditure in the report. The notice in the State Register must include a copy of the report, along with an easily understandable description of the proposed expenditure in the report. In addition, the commissioner shall make reasonable efforts to notify persons or classes of persons who may be significantly affected by the proposed expenditure in the report. The commissioner may recover the reasonable costs incurred in providing notice provided in this paragraph through costs paid by third parties involved in proceedings provided in this section. new text end

new text begin (d) No provider may commit to making the expenditure until the procedures described in this section are completed. new text end

new text begin Subd. 3. new text end [PUBLIC MEETING.] new text begin (a) Within 30 days from the date the notice requirements of subdivision 2, paragraph (c), are satisfied, a third party may request a public meeting on expenditures that exceed $2,000,000. The public meeting shall serve as an informational forum for the provider to answer inquiries of interested third parties. new text end

new text begin (b) The commissioner shall arrange for and coordinate the meeting on an expedited basis. The party requesting the meeting shall pay the commissioner for the commissioner's cost of the meeting, as determined by the commissioner. Money received by the commissioner for reimbursement under this section is appropriated to the commissioner for the purpose of administering this section. new text end

new text begin Subd. 4. new text end [PUBLIC MEETING EXCEPTIONS.] new text begin (a) Subdivisions 3, 5, and 6 do not apply to an expenditure: new text end

new text begin (1) to replace existing equipment with comparable equipment used for direct patient care. Upgrades of equipment beyond the current model or comparable model are subject to subdivisions 3, 5, and 6; new text end

new text begin (2) made by a research and teaching institution for purposes of conducting medical education, medical research supported or sponsored by a medical school or by a federal or foundation grant, or clinical trials; new text end

new text begin (3) to repair, remodel, or replace existing buildings or fixtures if, in the judgment of the commissioner, the project does not involve a substantial expansion of service capacity or a substantial change in the nature of health care services provided; new text end

new text begin (4) for building maintenance including heating, water, electricity, and other maintenance-related expenditures; new text end

new text begin (5) for activities not directly related to the delivery of patient care services, including food service, laundry, housekeeping, and other service-related activities; and new text end

new text begin (6) for computer equipment or data systems not directly related to the delivery of patient care services, including computer equipment or data systems related to medical record automation. new text end

new text begin (b) In addition to the exceptions listed in paragraph (a), subdivisions 3, 5, and 6 do not apply to mergers, acquisitions, and other changes in ownership or control that, in the judgment of the commissioner, do not involve a substantial expansion of service capacity or a substantial change in the nature of health care services provided. new text end

new text begin Subd. 5. new text end [HEARING.] new text begin (a) Within 30 days from the date of a public meeting under subdivision 3, a third party may request that the planned expenditure be subject to a hearing before the commissioner. The hearing and review of the planned expenditure shall be according to the relevant provisions of the Administrative Procedure Act, except as otherwise provided in this subdivision. new text end

new text begin (b) A hearing under this subdivision shall be a public proceeding. new text end

new text begin (c) A party to the hearing must pay for the party's representation before the commissioner. The party requesting the hearing must pay the commissioner for the commissioner's cost of the hearing, as determined by the commissioner. Costs of the hearing shall include, but not be limited to, the cost of the hearing and costs related to the commissioner's findings and order as provided in this section. Money received by the commissioner for reimbursement under this section is appropriated to the commissioner for the purpose of administering this section. Reimbursement by the party shall not be contingent upon and shall not affect the commissioner's findings and order under this section. new text end

new text begin (d) A hearing requested under this subdivision must proceed on an expedited basis. new text end

new text begin Subd. 6. new text end [HEARING CRITERIA; DECISION; RULES.] new text begin (a) The commissioner shall consider the following criteria: new text end

new text begin (1) need and access, including but not limited to: new text end

new text begin (i) the need of the population served or to be served by the proposed health services for those services; new text end

new text begin (ii) the project's contribution to meeting the needs of the medically underserved, including persons in rural areas, low-income persons, racial and ethnic minorities, persons with disabilities, and the elderly, as well as the extent to which medically underserved residents in the provider's service area are likely to have access to the proposed health service; and new text end

new text begin (iii) the distance, convenience, cost of transportation, and accessibility to health services for those to be served by the proposed health services; new text end

new text begin (2) quality of health care, including but not limited to: new text end

new text begin (i) the impact of the proposed service on the quality of health services available to those proposed to be served by the project; and new text end

new text begin (ii) the impact of the proposed service on the quality of health services offered by other providers; new text end

new text begin (3) cost of health care, including but not limited to: new text end

new text begin (i) the financial feasibility of the proposal; new text end

new text begin (ii) probable impact of the proposal on the costs of and charges for providing health services by the person proposing the service; new text end

new text begin (iii) probable impact of the proposal on the costs of and charges for health services provided by other providers; new text end

new text begin (iv) probable impact of the proposal on reimbursement for the proposed services; and new text end

new text begin (v) the relationship, including the organizational relationship, of the proposed health services to ancillary or support services; new text end

new text begin (4) alternatives available to the provider, including but not limited to: new text end

new text begin (i) the availability of alternative, less costly, or more effective methods of providing the proposed health services; new text end

new text begin (ii) the relationship of the proposed project to the long-range development plan, if any, of the person or entity providing or proposing the services; and new text end

new text begin (iii) possible sharing or cooperative arrangements among existing facilities and providers; and new text end

new text begin (5) other considerations, including but not limited to: new text end

new text begin (i) the best interests of the patients, including conflicts of interest that may be present in influencing the utilization of the services, facility, or equipment relating to the expenditures; new text end

new text begin (ii) special needs and circumstances of those entities that provide a substantial portion of their services or resources, or both, to individuals not residing in the immediate geographic area in which the entities are located, which entities may include but are not limited to medical and other health professional schools, multidisciplinary clinics, and specialty centers; new text end

new text begin (iii) the special needs and circumstances of biomedical and behavioral research projects designed to meet a national need and for which local conditions offer special advantages; and new text end

new text begin (iv) the impact of the proposed project on fostering competition between providers. new text end

new text begin (b) The commissioner may adopt rules to establish additional hearing criteria. new text end

new text begin (c) After applying the criteria under this subdivision, the commissioner shall make findings of fact as to whether the planned expenditure is needed to ensure quality health care. If the commissioner finds that the planned expenditure is not needed to ensure quality health care, the commissioner shall obtain an injunction prohibiting the provider from making the planned expenditure. The order of the commissioner constitutes the final decision in the case as applicable under section 14.62. A final decision in the case is entitled to judicial review under the provisions of sections 14.63 to 14.69. In an event of an appeal, each party must pay the party's respective costs, except that the party bringing the appeal must pay all costs if the appeal is unsuccessful. new text end

new text begin Subd. 7. new text end [ENFORCEMENT.] new text begin The commissioner may enforce this section by denying or refusing to reissue the permit, license, registration, or certificate of a provider that does not comply with this section, according to section 144.99, subdivision 8. Compliance with this section is a condition of medical assistance reimbursement. The commissioner of employee relations shall not permit a provider that does not comply with this section to provide services to state employees. In addition, the commissioner may assess fines against a provider that incurs an expenditure that is found by the commissioner as not needed to ensure quality health care pursuant to the provisions of this section in an amount up to triple the amount of the expenditure. new text end

new text begin Subd. 8. new text end [RETROSPECTIVE REVIEW.] new text begin Nothing in this section or in section 62J.17 shall be construed to prohibit the commissioner from conducting a retrospective review of an expenditure in excess of $2,000,000 in accordance with section 62J.17, subdivision 5a. new text end

Sec. 4.

Minnesota Statutes 2002, section 62J.23, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Audits of exempt providers. new text end

new text begin The commissioner may audit the referral patterns of providers that qualify for exceptions under the federal Stark Law, United States Code, title 42, section 1395nn. The commissioner has access to provider records according to section 144.99, subdivision 2. The commissioner shall report to the legislature any audit results that reveal a pattern of referrals by a provider for the furnishing of health services to an entity with which the provider has a direct or indirect financial relationship. new text end

Sec. 5.

Minnesota Statutes 2002, section 62J.692, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Accredited clinical training" means the clinical training provided by a medical education program that is accredited through an organization recognized by the department of education, the Centers for Medicare and Medicaid Services, or another national body who reviews the accrediting organizations for multiple disciplines and whose standards for recognizing accrediting organizations are reviewed and approved by the commissioner of health in consultation with the medical education and research advisory committee.

(b) "Commissioner" means the commissioner of health.

(c) "Clinical medical education program" means the accredited clinical training of physicians (medical students and residents), doctor of pharmacy practitioners, deleted text begin doctors of chiropractic, deleted text end dentists, advanced practice nurses (clinical nurse specialists, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and physician assistants.

(d) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota that sponsors and maintains primary organizational and financial responsibility for a clinical medical education program in Minnesota and which is accountable to the accrediting body.

(e) "Teaching institution" means a hospital, medical center, clinic, or other organization that conducts a clinical medical education program in Minnesota.

(f) "Trainee" means a student or resident involved in a clinical medical education program.

(g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time equivalent counts, that are at training sites located in Minnesota with a medical assistance provider number where training occurs in either an inpatient or ambulatory patient care setting and where the training is funded, in part, by patient care revenues.

Sec. 6.

Minnesota Statutes 2002, section 62J.692, subdivision 2, is amended to read:

Subd. 2.

Medical education and research advisory committee.

The commissioner shall appoint an advisory committee to provide advice and oversight on the distribution of funds appropriated for distribution under this section. In appointing the members, the commissioner shall:

(1) consider the interest of all stakeholders;

(2) appoint members that represent both urban and rural interests; and

(3) appoint members that represent ambulatory care as well as inpatient perspectives.

The commissioner shall appoint to the advisory committee representatives of the following groups to ensure appropriate representation of all eligible provider groups and other stakeholders: public and private medical researchers; public and private academic medical centers, including representatives from academic centers offering accredited training programs for physicians, pharmacists, deleted text begin chiropractors, deleted text end dentists, nurses, and physician assistants; managed care organizations; employers; consumers and other relevant stakeholders. The advisory committee is governed by section 15.059.

Sec. 7.

Minnesota Statutes 2002, section 62J.692, subdivision 3, is amended to read:

Subd. 3.

Application process.

(a) A clinical medical education program conducted in Minnesota by a teaching institution new text begin to train physicians, doctor of pharmacy practitioners, dentists, or physician assistants new text end is eligible for funds under subdivision 4 if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result of competition with nonteaching patient care entities; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

(b) new text begin A clinical medical education program for advanced practice nursing is eligible for funds under subdivision 4 if the program meets the eligibility requirements in paragraph (a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health Center, the Mayo Foundation, or institutions that are part of the Minnesota state colleges and universities system. new text end

new text begin (c) new text end Applications must be submitted to the commissioner by a sponsoring institution on behalf of an eligible clinical medical education program and must be received by October 31 of each year for distribution in the following year. An application for funds must contain the following information:

(1) the official name and address of the sponsoring institution and the official name and site address of the clinical medical education programs on whose behalf the sponsoring institution is applying;

(2) the name, title, and business address of those persons responsible for administering the funds;

(3) for each clinical medical education program for which funds are being sought; the type and specialty orientation of trainees in the program; the name, site address, and medical assistance provider number of each training site used in the program; the total number of trainees at each training site; and the total number of eligible trainee FTEs at each site new text begin . Only those training sites that host 0.5 FTE or more eligible trainees for a program may be included in the program's application new text end ; and

(4) other supporting information the commissioner deems necessary to determine program eligibility based on the criteria in deleted text begin paragraph deleted text end new text begin paragraphs new text end (a) new text begin and (b) new text end and to ensure the equitable distribution of funds.

deleted text begin (c) deleted text end new text begin (d) new text end An application must include the information specified in clauses (1) to (3) for each clinical medical education program on an annual basis for three consecutive years. After that time, an application must include the information specified in clauses (1) to (3) in the first year of each biennium:

(1) audited clinical training costs per trainee for each clinical medical education program when available or estimates of clinical training costs based on audited financial data;

(2) a description of current sources of funding for clinical medical education costs, including a description and dollar amount of all state and federal financial support, including Medicare direct and indirect payments; and

(3) other revenue received for the purposes of clinical training.

deleted text begin (d) deleted text end new text begin (e) new text end An applicant that does not provide information requested by the commissioner shall not be eligible for funds for the current funding cycle.

Sec. 8.

Minnesota Statutes 2002, section 62J.692, subdivision 4, is amended to read:

Subd. 4.

Distribution of funds.

(a) The commissioner shall annually distribute new text begin 90 percent of available new text end medical education funds to all qualifying applicants based on deleted text begin the following criteria deleted text end new text begin a distribution formula that reflects a summation of two factors new text end :

(1) deleted text begin total medical education funds available for distribution; deleted text end new text begin an education factor, which is determined by the total number of eligible trainee FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical medical education program new text end ; new text begin and new text end

(2) deleted text begin total number of eligible trainee FTEs in each clinical medical education program; and deleted text end

deleted text begin (3) the statewide average cost per trainee as determined by the application information provided in the first year of the biennium, by type of trainee, in each clinical medical education program. deleted text end new text begin a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool. new text end

new text begin In this formula, the education factor is weighted at 67 percent and the public program volume factor is weighted at 33 percent. new text end

new text begin Public program revenue for the distribution formula includes revenue from medical assistance, prepaid medical assistance, general assistance medical care, and prepaid general assistance medical care. Training sites that receive no public program revenue are ineligible for funds available under this paragraph. Total statewide average costs per trainee for medical residents is based on audited clinical training costs per trainee in primary care clinical medical education programs for medical residents. Total statewide average costs per trainee for dental residents is based on audited clinical training costs per trainee in clinical medical education programs for dental students. Total statewide average costs per trainee for pharmacy residents is based on audited clinical training costs per trainee in clinical medical education programs for pharmacy students. new text end

(b) new text begin The commissioner shall annually distribute ten percent of total available medical education funds to all qualifying applicants based on the percentage received by each applicant under paragraph (a). These funds are to be used to offset clinical education costs at eligible clinical training sites based on criteria developed by the clinical medical education program. Applicants may choose to distribute funds allocated under this paragraph based on the distribution formula described in paragraph (a). new text end

new text begin (c) new text end Funds distributed shall not be used to displace current funding appropriations from federal or state sources.

deleted text begin (c) deleted text end new text begin (d) new text end Funds shall be distributed to the sponsoring institutions indicating the amount to be distributed to each of the sponsor's clinical medical education programs based on the criteria in this subdivision and in accordance with the commissioner's approval letter. Each clinical medical education program must distribute funds new text begin allocated under paragraph (a) new text end to the training sites as specified in the commissioner's approval letter. Sponsoring institutions, which are accredited through an organization recognized by the department of education or the Centers for Medicare and Medicaid Services, may contract directly with training sites to provide clinical training. To ensure the quality of clinical training, those accredited sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may include the withholding of payments under this section or the removal of students from the site.

deleted text begin (d) deleted text end new text begin (e) new text end Any funds not distributed in accordance with the commissioner's approval letter must be returned to the medical education and research fund within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

deleted text begin (e) The commissioner shall distribute by June 30 of each year an amount equal to the funds transferred under section 62J.694, subdivision 2a, paragraph (b), plus five percent interest to the University of Minnesota board of regents for the costs of the academic health center as specified under section 62J.694, subdivision 2a, paragraph (a). deleted text end

Sec. 9.

Minnesota Statutes 2002, section 62J.692, subdivision 5, is amended to read:

Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must sign and submit a medical education grant verification report (GVR) to verify that the correct grant amount was forwarded to each eligible training site. If the sponsoring institution fails to submit the GVR by the stated deadline, or to request and meet the deadline for an extension, the sponsoring institution is required to return the full amount of funds received to the commissioner within 30 days of receiving notice from the commissioner. The commissioner shall distribute returned funds to the appropriate training sites in accordance with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must include:

(1) the total number of eligible trainee FTEs in each clinical medical education program;

(2) the name of each funded program and, for each program, the dollar amount distributed to each training site;

(3) documentation of any discrepancies between the initial grant distribution notice included in the commissioner's approval letter and the actual distribution;

(4) new text begin a statement by the sponsoring institution describing the distribution of funds allocated under subdivision 4, paragraph (b), including information on which clinical training sites received funding and the rationale used for determining funding priorities; new text end

new text begin (5) new text end a statement by the sponsoring institution stating that the completed grant verification report is valid and accurate; and

deleted text begin (5) deleted text end new text begin (6) new text end other information the commissioner, with advice from the advisory committee, deems appropriate to evaluate the effectiveness of the use of funds for medical education.

(c) By February 15 of each year, the commissioner, with advice from the advisory committee, shall provide an annual summary report to the legislature on the implementation of this section.

Sec. 10.

Minnesota Statutes 2002, section 62J.692, subdivision 7, is amended to read:

Subd. 7.

Transfers from the commissioner of human services.

(a) The amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall be distributed by the commissioner new text begin annually new text end to clinical medical education programs that meet the qualifications of subdivision 3 based on deleted text begin a distribution formula that reflects a summation of two factors: deleted text end new text begin the formula in subdivision 4, paragraph (a). new text end

deleted text begin (1) an education factor, which is determined by the total number of eligible trainee FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical medical education program; and deleted text end

deleted text begin (2) a public program volume factor, which is determined by the total volume of public program revenue received by each training site as a percentage of all public program revenue received by all training sites in the fund pool created under this subdivision. deleted text end

deleted text begin In this formula, the education factor shall be weighted at 50 percent and the public program volume factor shall be weighted at 50 percent. deleted text end

deleted text begin Public program revenue for the distribution formula shall include revenue from medical assistance, prepaid medical assistance, general assistance medical care, and prepaid general assistance medical care. Training sites that receive no public program revenue shall be ineligible for funds available under this paragraph. deleted text end

(b) Fifty percent of the amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (2), shall be distributed by the commissioner to the University of Minnesota board of regents for the purposes described in sections 137.38 to 137.40. Of the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (2), 24 percent of the amount shall be distributed by the commissioner to the Hennepin County Medical Center for clinical medical education. The remaining 26 percent of the amount transferred shall be distributed by the commissioner in accordance with subdivision 7a. If the federal approval is not obtained for the matching funds under section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount transferred under this paragraph shall be distributed by the commissioner to the University of Minnesota board of regents for the purposes described in sections 137.38 to 137.40.

(c) The amount transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (3), shall be distributed by the commissioner upon receipt to the University of Minnesota board of regents for the purposes of clinical graduate medical education.

Sec. 11.

Minnesota Statutes 2002, section 62J.694, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Effective date. new text end

new text begin This section is only in effect if there are funds available in the medical education endowment fund. new text end

Sec. 12.

Minnesota Statutes 2002, section 62L.05, subdivision 4, is amended to read:

Subd. 4.

Benefits.

The medical services and supplies listed in this subdivision are the benefits that must be covered by the small employer plans described in subdivisions 2 and 3. Benefits under this subdivision may be provided through the managed care procedures practiced by health carriers:

(1) inpatient and outpatient hospital services, excluding services provided for the diagnosis, care, or treatment of chemical dependency or a mental illness or condition, other than those conditions specified in clauses (10), (11), and (12). The health care services required to be covered under this clause must also be covered if rendered in a nonhospital environment, on the same basis as coverage provided for those same treatments or services if rendered in a hospital, provided, however, that this sentence must not be interpreted as expanding the types or extent of services covered;

(2) physician, chiropractor, and nurse practitioner services for the diagnosis or treatment of illnesses, injuries, or conditions;

(3) diagnostic x-rays and laboratory tests;

(4) ground transportation provided by a licensed ambulance service to the nearest facility qualified to treat the condition, or as otherwise required by the health carrier;

(5) services of a home health agency if the services qualify as reimbursable services under Medicare;

(6) services of a private duty registered nurse if medically necessary, as determined by the health carrier;

(7) the rental or purchase, as appropriate, of durable medical equipment, other than eyeglasses and hearing aids new text begin , unless coverage is required under section 62Q.675 new text end ;

(8) child health supervision services up to age 18, as defined in section 62A.047;

(9) maternity and prenatal care services, as defined in sections 62A.041 and 62A.047;

(10) inpatient hospital and outpatient services for the diagnosis and treatment of certain mental illnesses or conditions, as defined by the International Classification of Diseases-Clinical Modification (ICD-9-CM), seventh edition (1990) and as classified as ICD-9 codes 295 to 299;

(11) ten hours per year of outpatient mental health diagnosis or treatment for illnesses or conditions not described in clause (10);

(12) 60 hours per year of outpatient treatment of chemical dependency; and

(13) 50 percent of eligible charges for prescription drugs, up to a separate annual maximum out-of-pocket expense of $1,000 per individual for prescription drugs, and 100 percent of eligible charges thereafter.

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to policies and plans issued or renewed to provide coverage to Minnesota residents on or after that date. new text end

Sec. 13.

Minnesota Statutes 2002, section 62Q.19, subdivision 2, is amended to read:

Subd. 2.

Application.

(a) Any provider may apply to the commissioner for designation as an essential community provider by submitting an application form developed by the commissioner. Except as provided in deleted text begin paragraph deleted text end new text begin paragraphs new text end (d) new text begin and (e) new text end , applications must be accepted within two years after the effective date of the rules adopted by the commissioner to implement this section.

(b) Each application submitted must be accompanied by an application fee in an amount determined by the commissioner. The fee shall be no more than what is needed to cover the administrative costs of processing the application.

(c) The name, address, contact person, and the date by which the commissioner's decision is expected to be made shall be classified as public data under section 13.41. All other information contained in the application form shall be classified as private data under section 13.41 until the application has been approved, approved as modified, or denied by the commissioner. Once the decision has been made, all information shall be classified as public data unless the applicant designates and the commissioner determines that the information contains trade secret information.

(d) The commissioner shall accept an application for designation as an essential community provider until June 30, 2001, from:

(1) one applicant that is a nonprofit community health care facility, certified as a medical assistance provider effective April 1, 1998, that provides culturally competent health care to an underserved Southeast Asian immigrant and refugee population residing in the immediate neighborhood of the facility;

(2) one applicant that is a nonprofit home health care provider, certified as a Medicare and a medical assistance provider that provides culturally competent home health care services to a low-income culturally diverse population;

(3) up to five applicants that are nonprofit community mental health centers certified as medical assistance providers that provide mental health services to children with serious emotional disturbance and their families or to adults with serious and persistent mental illness; and

(4) one applicant that is a nonprofit provider certified as a medical assistance provider that provides mental health, child development, and family services to children with physical and mental health disorders and their families.

new text begin (e) The commissioner shall accept an application for designation as an essential community provider until June 30, 2003, from one applicant that is a nonprofit community clinic located in Hennepin county that provides health care to an underserved American Indian population and that is collaborating with other neighboring organizations on a community diabetes project and an immunization project. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 14.

new text begin [62Q.675] COMMUNICATION DEVICES; PERSONS 18 OR YOUNGER. new text end

new text begin A health plan must cover communication aids or devices, including hearing aids, for individuals 18 years of age or younger for hearing loss due to functional congenital malformation of the ears that is not correctable by other covered procedures. No special deductible, coinsurance, copayment, or other limitation on the coverage under this section that is not generally applicable to other coverages under the plan may be imposed. new text end

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to policies and plans issued or renewed to provide coverage to Minnesota residents on or after that date. new text end

Sec. 15.

Minnesota Statutes 2002, section 144.1222, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Fees. new text end

new text begin All plans and specifications for public swimming pool and spa construction, installation, or alteration or requests for a variance that are submitted to the commissioner according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate fees. If the commissioner determines, upon review of the plans, that inadequate fees were paid, the necessary additional fees shall be paid before plan approval. For purposes of determining fees, a project is defined as a proposal to construct or install a public pool, spa, special purpose pool, or wading pool and all associated water treatment equipment and drains, gutters, decks, water recreation features, spray pads, and those design and safety features that are within five feet of any pool or spa. The commissioner shall charge the following fees for plan review and inspection of public pools and spas and for requests for variance from the public pool and spa rules: new text end

new text begin (1) each spa pool, $500; new text end

new text begin (2) projects valued at $250,000 or less, a minimum of $800 plus: new text end

new text begin (i) for each slide, an additional $400; and new text end

new text begin (ii) for each spa pool, an additional $500; new text end

new text begin (3) projects valued at $250,000 or more, 0.5 percent of documented estimated project cost to a maximum fee of $10,000; new text end

new text begin (4) alterations to an existing pool without changing the size or configuration of the pool, $400; new text end

new text begin (5) removal or replacement of pool disinfection equipment only, $75; and new text end

new text begin (6) request for variance from the public pool and spa rules, $500. new text end

Sec. 16.

Minnesota Statutes 2002, section 144.125, is amended to read:

144.125 TESTS OF INFANTS FOR deleted text begin INBORN METABOLIC ERRORS deleted text end new text begin HERITABLE AND CONGENITAL DISORDERS new text end .

new text begin Subdivision 1. new text end [DUTY TO PERFORM TESTING.] It is the duty of (1) the administrative officer or other person in charge of each institution caring for infants 28 days or less of age, (2) the person required in pursuance of the provisions of section 144.215, to register the birth of a child, or (3) the nurse midwife or midwife in attendance at the birth, to arrange to have administered to every infant or child in its care tests for deleted text begin inborn errors of metabolism in accordance with deleted text end new text begin heritable and congenital disorders according to subdivision 2 and new text end rules prescribed by the state commissioner of health. deleted text begin In determining which tests must be administered, the commissioner shall take into consideration the adequacy of laboratory methods to detect the inborn metabolic error, the ability to treat or prevent medical conditions caused by the inborn metabolic error, and the severity of the medical conditions caused by the inborn metabolic error. deleted text end Testing and the recording and reporting of test results shall be performed at the times and in the manner prescribed by the commissioner of health. The commissioner shall charge laboratory service fees so that the total of fees collected will approximate the costs of conducting the tests and implementing and maintaining a system to follow-up infants with deleted text begin inborn metabolic errors deleted text end new text begin heritable or congenital disorders. The laboratory service fee is $61 per specimen except for recipients of medical assistance, general assistance medical care, or MinnesotaCare in which the laboratory service fee is $21 per specimen new text end . Costs associated with capital expenditures and the development of new procedures may be prorated over a three-year period when calculating the amount of the fees.

new text begin Subd. 2. new text end [DETERMINATION OF TESTS TO BE ADMINISTERED.] new text begin The commissioner shall periodically revise the list of tests to be administered for determining the presence of a heritable or congenital disorder. Revisions to the list shall reflect advances in medical science, new and improved testing methods, or other factors that will improve the public health. In determining whether a test must be administered, the commissioner shall take into consideration the adequacy of laboratory methods to detect the heritable or congenital disorder, the ability to treat or prevent medical conditions caused by the heritable or congenital disorder, and the severity of the medical conditions caused by the heritable or congenital disorder. The list of tests to be performed may be revised if the changes are recommended by the advisory committee established under section 144.1255, approved by the commissioner, and published in the State Register. The revision is exempt from the rulemaking requirements in chapter 14 and sections 14.385 and 14.386 do not apply. new text end

new text begin Subd. 3. new text end [OBJECTION OF PARENTS TO TEST.] new text begin If the parents of an infant object in writing to testing for heritable and congenital disorders as being in conflict with their personal beliefs or religious tenets and practice, the objection shall be recorded on a form that is signed by a parent or legal guardian and made part of the infant's medical record. A written objection exempts an infant from the requirements of this section and section 144.128. new text end

Sec. 17.

new text begin [144.1255] ADVISORY COMMITTEE ON HERITABLE AND CONGENITAL DISORDERS. new text end

new text begin Subdivision 1. new text end [CREATION AND MEMBERSHIP.] new text begin (a) By July 1, 2003, the commissioner of health shall appoint an advisory committee to provide advice and recommendations to the commissioner concerning tests and treatments for heritable and congenital disorders found in newborn children. Membership of the committee shall include, but not be limited to, at least one member from each of the following representative groups: new text end

new text begin (1) parents and other consumers; new text end

new text begin (2) primary care providers; new text end

new text begin (3) clinicians and researchers specializing in newborn diseases and disorders; new text end

new text begin (4) genetic counselors; new text end

new text begin (5) birth hospital representatives; new text end

new text begin (6) newborn screening laboratory professionals; new text end

new text begin (7) nutritionists; and new text end

new text begin (8) other experts as needed representing related fields such as emerging technologies and health insurance. new text end

new text begin (b) The terms and removal of members are governed by section 15.059. Members shall not receive per diems but shall be compensated for expenses. Notwithstanding section 15.059, subdivision 5, the advisory committee does not expire. new text end

new text begin Subd. 2. new text end [FUNCTION AND OBJECTIVES.] new text begin The committee's activities include, but are not limited to: new text end

new text begin (1) collection of information on the efficacy and reliability of various tests for heritable and congenital disorders; new text end

new text begin (2) collection of information on the availability and efficacy of treatments for heritable and congenital disorders; new text end

new text begin (3) collection of information on the severity of medical conditions caused by heritable and congenital disorders; new text end

new text begin (4) discussion and assessment of the benefits of performing tests for heritable or congenital disorders as compared to the costs, treatment limitations, or other potential disadvantages of requiring the tests; new text end

new text begin (5) discussion and assessment of ethical considerations surrounding the testing, treatment, and handling of data and specimens generated by the testing requirements of sections 144.125 to 144.128; and new text end

new text begin (6) providing advice and recommendations to the commissioner concerning tests and treatments for heritable and congenital disorders found in newborn children. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 18.

Minnesota Statutes 2002, section 144.128, is amended to read:

144.128 deleted text begin TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF CASES deleted text end new text begin COMMISSIONER'S DUTIES new text end .

The commissioner shall:

(1) make deleted text begin arrangements deleted text end new text begin referrals new text end for the necessary treatment of diagnosed cases of deleted text begin hemoglobinopathy, phenylketonuria, and other inborn errors of metabolism deleted text end new text begin heritable or congenital disorders new text end when treatment is indicated deleted text begin and the family is uninsured and, because of a lack of available income, is unable to pay the cost of the treatment deleted text end ;

(2) maintain a registry of new text begin the new text end cases of deleted text begin hemoglobinopathy, phenylketonuria, and other inborn errors of metabolism deleted text end new text begin heritable and congenital disorders detected by the screening program new text end for the purpose of follow-up services; and

(3) adopt rules to carry out deleted text begin section 144.126 and this section deleted text end new text begin sections 144.125 to 144.128 new text end .

Sec. 19.

Minnesota Statutes 2002, section 144.1488, subdivision 4, is amended to read:

Subd. 4.

Eligible health professionals.

(a) To be eligible to apply to the commissioner for the loan repayment program, health professionals must be citizens or nationals of the United States, must not have any unserved obligations for service to a federal, state, or local government, or other entity, must have a current and unrestricted Minnesota license to practice, and must be ready to begin full-time clinical practice upon signing a contract for obligated service.

(b) Eligible providers are those specified by the federal Bureau of deleted text begin Primary Health Care deleted text end new text begin Health Professionals new text end in the policy information notice for the state's current federal grant application. A health professional selected for participation is not eligible for loan repayment until the health professional has an employment agreement or contract with an eligible loan repayment site and has signed a contract for obligated service with the commissioner.

Sec. 20.

Minnesota Statutes 2002, section 144.1491, subdivision 1, is amended to read:

Subdivision 1.

Penalties for breach of contract.

A program participant who fails to complete deleted text begin two deleted text end new text begin the required new text end years of obligated service shall repay the amount paid, as well as a financial penalty deleted text begin based upon the length of the service obligation not fulfilled. If the participant has served at least one year, the financial penalty is the number of unserved months multiplied by $1,000. If the participant has served less than one year, the financial penalty is the total number of obligated months multiplied by $1,000 deleted text end new text begin specified by the federal Bureau of Health Professionals in the policy information notice for the state's current federal grant application new text end . The commissioner shall report to the appropriate health-related licensing board a participant who fails to complete the service obligation and fails to repay the amount paid or fails to pay any financial penalty owed under this subdivision.

Sec. 21.

new text begin [144.1501] HEALTH PROFESSIONAL EDUCATION LOAN FORGIVENESS PROGRAM. new text end

new text begin Subdivision 1. new text end [DEFINITIONS.] new text begin (a) For purposes of this section, the following definitions apply. new text end

new text begin (b) "Designated rural area" means: new text end

new text begin (1) an area in Minnesota outside the counties of Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or new text end

new text begin (2) a municipal corporation, as defined under section 471.634, that is physically located, in whole or in part, in an area defined as a designated rural area under clause (1). new text end

new text begin (c) "Emergency circumstances" means those conditions that make it impossible for the participant to fulfill the service commitment, including death, total and permanent disability, or temporary disability lasting more than two years. new text end

new text begin (d) "Medical resident" means an individual participating in a medical residency in family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry. new text end

new text begin (e) "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse anesthetist, advanced clinical nurse specialist, or physician assistant. new text end

new text begin (f) "Nurse" means an individual who has completed training and received all licensing or certification necessary to perform duties as a licensed practical nurse or registered nurse. new text end

new text begin (g) "Nurse-midwife" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse-midwives. new text end

new text begin (h) "Nurse practitioner" means a registered nurse who has graduated from a program of study designed to prepare registered nurses for advanced practice as nurse practitioners. new text end

new text begin (i) "Physician" means an individual who is licensed to practice medicine in the areas of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry. new text end

new text begin (j) "Physician assistant" means a person registered under chapter 147A. new text end

new text begin (k) "Qualified educational loan" means a government, commercial, or foundation loan for actual costs paid for tuition, reasonable education expenses, and reasonable living expenses related to the graduate or undergraduate education of a health care professional. new text end

new text begin (l) "Underserved urban community" means a Minnesota urban area or population included in the list of designated primary medical care health professional shortage areas (HPSAs), medically underserved areas (MUAs), or medically underserved populations (MUPs) maintained and updated by the United States Department of Health and Human Services. new text end

new text begin Subd. 2. new text end [CREATION OF ACCOUNT.] new text begin A health professional education loan forgiveness program account is established. The commissioner of health shall use money from the account to establish a loan forgiveness program for medical residents agreeing to practice in designated rural areas or underserved urban communities, for midlevel practitioners agreeing to practice in designated rural areas, and for nurses who agree to practice in a Minnesota nursing home or intermediate care facility for persons with mental retardation or related conditions. Appropriations made to the account do not cancel and are available until expended, except that at the end of each biennium, any remaining balance in the account that is not committed by contract and not needed to fulfill existing obligations shall cancel to the fund. new text end

new text begin Subd. 3. new text end [ELIGIBILITY.] new text begin (a) To be eligible to participate in the loan forgiveness program, an individual must: new text end

new text begin (1) be a medical resident or be enrolled in a midlevel practitioner, registered nurse, or a licensed practical nurse training program; and new text end

new text begin (2) submit an application to the commissioner of health. new text end

new text begin (b) An applicant selected to participate must sign a contract to agree to serve a minimum three-year full-time service obligation according to subdivision 2, which shall begin no later than March 31 following completion of required training. new text end

new text begin Subd. 4. new text end [LOAN FORGIVENESS.] new text begin The commissioner of health may select applicants each year for participation in the loan forgiveness program, within the limits of available funding. The commissioner shall distribute available funds for loan forgiveness proportionally among the eligible professions according to the vacancy rate for each profession in the required geographic area or facility type specified in subdivision 2. The commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the funds available are used for rural physician loan forgiveness and 25 percent of the funds available are used for underserved urban communities loan forgiveness. If the commissioner does not receive enough qualified applicants each year to use the entire allocation of funds for urban underserved communities, the remaining funds may be allocated for rural physician loan forgiveness. Applicants are responsible for securing their own qualified educational loans. The commissioner shall select participants based on their suitability for practice serving the required geographic area or facility type specified in subdivision 2, as indicated by experience or training. The commissioner shall give preference to applicants closest to completing their training. For each year that a participant meets the service obligation required under subdivision 3, up to a maximum of four years, the commissioner shall make annual disbursements directly to the participant equivalent to 15 percent of the average educational debt for indebted graduates in their profession in the year closest to the applicant's selection for which information is available, not to exceed the balance of the participant's qualifying educational loans. Before receiving loan repayment disbursements and as requested, the participant must complete and return to the commissioner an affidavit of practice form provided by the commissioner verifying that the participant is practicing as required under subdivisions 2 and 3. The participant must provide the commissioner with verification that the full amount of loan repayment disbursement received by the participant has been applied toward the designated loans. After each disbursement, verification must be received by the commissioner and approved before the next loan repayment disbursement is made. Participants who move their practice remain eligible for loan repayment as long as they practice as required under subdivision 2. new text end

new text begin Subd. 5. new text end [PENALTY FOR NONFULFILLMENT.] new text begin If a participant does not fulfill the required minimum commitment of service according to subdivision 3, the commissioner of health shall collect from the participant the total amount paid to the participant under the loan forgiveness program plus interest at a rate established according to section 270.75. The commissioner shall deposit the money collected in the health care access fund to be credited to the health professional education loan forgiveness program account established in subdivision 2. The commissioner shall allow waivers of all or part of the money owed the commissioner as a result of a nonfulfillment penalty if emergency circumstances prevented fulfillment of the minimum service commitment. new text end

new text begin Subd. 6. new text end [RULES.] new text begin The commissioner may adopt rules to implement this section. new text end

Sec. 22.

Minnesota Statutes 2002, section 144.1502, subdivision 4, is amended to read:

Subd. 4.

Loan forgiveness.

The commissioner of health may accept deleted text begin up to 14 deleted text end applicants deleted text begin per deleted text end new text begin each new text end year for participation in the loan forgiveness program new text begin , within the limits of available funding new text end . Applicants are responsible for securing their own loans. The commissioner shall select participants based on their suitability for practice serving public program patients, as indicated by experience or training. The commissioner shall give preference to applicants who have attended a Minnesota dentistry educational institution and to applicants closest to completing their training. For each year that a participant meets the service obligation required under subdivision 3, up to a maximum of four years, the commissioner shall make annual disbursements directly to the participant equivalent to deleted text begin $10,000 per year of service, not to exceed $40,000 deleted text end new text begin 15 percent of the average educational debt for indebted dental school graduates in the year closest to the applicant's selection for which information is available new text end or the balance of the qualifying educational loans, whichever is less. Before receiving loan repayment disbursements and as requested, the participant must complete and return to the commissioner an affidavit of practice form provided by the commissioner verifying that the participant is practicing as required under subdivision 3. The participant must provide the commissioner with verification that the full amount of loan repayment disbursement received by the participant has been applied toward the designated loans. After each disbursement, verification must be received by the commissioner and approved before the next loan repayment disbursement is made. Participants who move their practice remain eligible for loan repayment as long as they practice as required under subdivision 3.

Sec. 23.

Minnesota Statutes 2002, section 144.35, is amended to read:

144.35 POLLUTION OF WATER.

new text begin (a) new text end No sewage or other matter that will impair the healthfulness of water shall be deposited where it will fall deleted text begin or deleted text end new text begin , new text end drain new text begin , or leach new text end into any pond deleted text begin or deleted text end new text begin , new text end stream new text begin , or groundwater new text end used as a source of water supply for domestic use. The commissioner shall have general charge of all springs, wells, ponds, and streams so used and take all necessary and proper steps to preserve the same from such pollution as may endanger the public health. In case of violation of any of the provisions of this section, the commissioner may, with or without a hearing, order any person to desist from causing such pollution and to comply with such direction as the commissioner may deem proper and expedient in the premises. Such order shall be served forthwith upon the person found to have violated such provisions.

new text begin (b) For purposes of enforcing this section, the commissioner has access to any record maintained under section 18B.37, subdivision 2. Section 18B.37, subdivision 5, applies to the inspection, classification, and release of the records by the commissioner, except that the commissioner may release information to a licensed health care provider for the limited purpose of determining appropriate medical care for an individual who may have been exposed to a pesticide or for evaluating a possible public health threat. A health care provider who receives this information shall maintain the information in accordance with chapter 13 and the information must not be disclosed by the provider, except for the purposes described in this paragraph. A health care provider who violates this requirement is subject to the remedies and penalties in sections 13.08 and 13.09. new text end

Sec. 24.

Minnesota Statutes 2002, section 144.395, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Effective date. new text end

new text begin This section is only in effect if there are funds available in the tobacco use prevention and local public health endowment fund. new text end

Sec. 25.

Minnesota Statutes 2002, section 144.396, subdivision 7, is amended to read:

Subd. 7.

Local public health promotion and protection.

The commissioner shall distribute deleted text begin the deleted text end funds deleted text begin available under section 144.395, subdivision 2, paragraph (c), clause (3) deleted text end new text begin appropriated for the purpose of local health promotion and protection activities new text end to community health boards deleted text begin for local health promotion and protection activities deleted text end for local health initiatives other than tobacco prevention aimed at high risk health behaviors among youth. The commissioner shall distribute these funds to the community health boards based on demographics and other need-based factors relating to health.

Sec. 26.

Minnesota Statutes 2002, section 144.396, subdivision 11, is amended to read:

Subd. 11.

Audits.

The legislative auditor deleted text begin shall deleted text end new text begin may new text end audit tobacco use prevention and local public health deleted text begin endowment fund deleted text end expenditures to ensure that the money is spent for tobacco use prevention measures and public health initiatives.

Sec. 27.

Minnesota Statutes 2002, section 144.396, subdivision 12, is amended to read:

Subd. 12.

deleted text begin endowment fund deleted text end new text begin funds new text end not to supplant existing funding.

deleted text begin Appropriations from the tobacco use prevention and local public health endowment fund deleted text end new text begin Funds appropriated to the statewide tobacco prevention grants, local tobacco prevention grants, or the local public health promotion and prevention new text end must not be used as a substitute for traditional sources of funding tobacco use prevention activities or public health initiatives. Any local unit of government receiving money under this section must ensure that existing local financial efforts remain in place.

Sec. 28.

Minnesota Statutes 2002, section 144.414, subdivision 3, is amended to read:

Subd. 3.

Health care facilities and clinics.

(a) Smoking is prohibited in any area of a hospital, health care clinic, doctor's office, or other health care-related facility, other than a nursing home, boarding care facility, or licensed residential facility, except as allowed in this subdivision.

(b) deleted text begin Smoking by patients in a chemical dependency treatment program or mental health program may be allowed in a separated well-ventilated area pursuant to a policy established by the administrator of the program that identifies circumstances in which prohibiting smoking would interfere with the treatment of persons recovering from chemical dependency or mental illness. deleted text end

deleted text begin (c) deleted text end Smoking by participants in peer reviewed scientific studies related to the health effects of smoking may be allowed in a separated room ventilated at a rate of 60 cubic feet per minute per person pursuant to a policy that is approved by the commissioner and is established by the administrator of the program to minimize exposure of nonsmokers to smoke.

[EFFECTIVE DATE.] new text begin This section is effective January 1, 2004. new text end

Sec. 29.

Minnesota Statutes 2002, section 144.99, subdivision 1, is amended to read:

Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and sections new text begin 62J.18; 62J.23; new text end 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all rules, orders, stipulation agreements, settlements, compliance agreements, licenses, registrations, certificates, and permits adopted or issued by the department or under any other law now in force or later enacted for the preservation of public health may, in addition to provisions in other statutes, be enforced under this section.

Sec. 30.

Minnesota Statutes 2002, section 144E.29, is amended to read:

144E.29 FEES.

(a) The board shall charge the following fees:

(1) initial application for and renewal of an ambulance service license, deleted text begin $150 deleted text end new text begin $200 new text end ;

(2) each ambulance operated by a licensee, deleted text begin $96 deleted text end new text begin $125 new text end . The licensee shall pay an additional deleted text begin $96 deleted text end new text begin $125 new text end fee for the full licensing period or deleted text begin $4 deleted text end new text begin $10 new text end per month for any fraction of the period for each ambulance added to the ambulance service during the licensing period;

(3) initial application for and renewal of approval for a training program, deleted text begin $100 deleted text end new text begin $150 new text end ; and

(4) duplicate of an original license, certification, or approval, $25.

(b) With the exception of paragraph (a), clause (4), all fees are for a two-year period. All fees are nonrefundable.

(c) Fees collected by the board shall be deposited as nondedicated receipts in the general fund.

Sec. 31.

Minnesota Statutes 2002, section 144E.50, subdivision 5, is amended to read:

Subd. 5.

Distribution.

Money from the fund shall be distributed according to this subdivision. deleted text begin Ninety-three and one-third deleted text end new text begin Ninety-five new text end percent of the fund shall be distributed annually on a contract for services basis with each of the eight regional emergency medical services systems designated by the board. The systems shall be governed by a body consisting of appointed representatives from each of the counties in that region and shall also include representatives from emergency medical services organizations. The board shall contract with a regional entity only if the contract proposal satisfactorily addresses proposed emergency medical services activities in the following areas: personnel training, transportation coordination, public safety agency cooperation, communications systems maintenance and development, public involvement, health care facilities involvement, and system management. If each of the regional emergency medical services systems submits a satisfactory contract proposal, then this part of the fund shall be distributed evenly among the regions. If one or more of the regions does not contract for the full amount of its even share or if its proposal is unsatisfactory, then the board may reallocate the unused funds to the remaining regions on a pro rata basis. deleted text begin Six and two-thirds deleted text end new text begin Five new text end percent of the fund shall be used by the board to support regionwide reporting systems and to provide other regional administration and technical assistance.

Sec. 32.

Minnesota Statutes 2002, section 147A.08, is amended to read:

147A.08 EXEMPTIONS.

(a) This chapter does not apply to, control, prevent, or restrict the practice, service, or activities of persons listed in section 147.09, clauses (1) to (6) and (8) to (13), persons regulated under section 214.01, subdivision 2, or persons defined in section deleted text begin 144.1495 deleted text end new text begin 144.1501 new text end , subdivision 1, paragraphs deleted text begin (a) to (d) deleted text end new text begin (e), (g), and (h) new text end .

(b) Nothing in this chapter shall be construed to require registration of:

(1) a physician assistant student enrolled in a physician assistant or surgeon assistant educational program accredited by the Committee on Allied Health Education and Accreditation or by its successor agency approved by the board;

(2) a physician assistant employed in the service of the federal government while performing duties incident to that employment; or

(3) technicians, other assistants, or employees of physicians who perform delegated tasks in the office of a physician but who do not identify themselves as a physician assistant.

Sec. 33.

Minnesota Statutes 2002, section 148.5194, subdivision 1, is amended to read:

Subdivision 1.

Fee proration.

The commissioner shall prorate the registration fee for new text begin clinical fellowship, temporary, and new text end first time registrants according to the number of months that have elapsed between the date registration is issued and the date registration new text begin expires or new text end must be renewed under section 148.5191, subdivision 4.

Sec. 34.

Minnesota Statutes 2002, section 148.5194, subdivision 2, is amended to read:

Subd. 2.

Biennial registration fee.

The fee for initial registration and biennial registration, new text begin clinical fellowship registration, new text end temporary registration, or renewal is $200.

Sec. 35.

Minnesota Statutes 2002, section 148.5194, subdivision 3, is amended to read:

Subd. 3.

Biennial registration fee for dual registration.

The fee for initial registration and biennial registration, new text begin clinical fellowship registration, new text end temporary registration, or renewal is $200.

Sec. 36.

Minnesota Statutes 2002, section 148.5194, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Verification of credential. new text end

new text begin The fee for written verification of credentialed status is $25. new text end

Sec. 37.

Minnesota Statutes 2002, section 148.6445, subdivision 7, is amended to read:

Subd. 7.

deleted text begin certification deleted text end new text begin verification new text end to other states.

The fee for deleted text begin certification deleted text end new text begin verification new text end of licensure to other states is $25.

Sec. 38.

Minnesota Statutes 2002, section 153A.17, is amended to read:

153A.17 EXPENSES; FEES.

The expenses for administering the certification requirements including the complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15 and the consumer information center under section 153A.18 must be paid from initial application and examination fees, renewal fees, penalties, and fines. All fees are nonrefundable. The certificate application fee is deleted text begin $165 for audiologists registered under section 148.511 and $490 for all others deleted text end new text begin $350 new text end , the examination fee is deleted text begin $200 deleted text end new text begin $250 new text end for the written portion and deleted text begin $200 deleted text end new text begin $250 new text end for the practical portion each time one or the other is taken, and the trainee application fee is deleted text begin $100 deleted text end new text begin $200 new text end . deleted text begin Notwithstanding the policy set forth in section 16A.1285, subdivision 2, a surcharge of $165 for audiologists registered under section 148.511 and $330 for all others shall be paid at the time of application or renewal until June 30, 2003, to recover the commissioner's accumulated direct expenditures for administering the requirements of this chapter. deleted text end The penalty fee for late submission of a renewal application is $200. new text begin The fee for verification of certification to other jurisdictions or entities is $25. new text end All fees, penalties, and fines received must be deposited in the state government special revenue fund. The commissioner may prorate the certification fee for new applicants based on the number of quarters remaining in the annual certification period.

Sec. 39.

new text begin [246.0141] TOBACCO USE PROHIBITED. new text end

new text begin No patient, staff, guest, or visitor on the grounds or in a state regional treatment center, the Minnesota security hospital, the Minnesota sex offender program, or the Minnesota extended treatment options program may possess or use tobacco or a tobacco related device. For the purposes of this section, "tobacco" and "tobacco related device" have the meanings given in section 609.685, subdivision 1. This section does not prohibit the possession or use of tobacco or a tobacco related device by an adult as part of a traditional Indian spiritual or cultural ceremony. For purposes of this section, an Indian is a person who is a member of an Indian tribe as defined in section 260.755, subdivision 12. new text end

[EFFECTIVE DATE.] new text begin This section is effective January 1, 2004. new text end

Sec. 40.

Minnesota Statutes 2002, section 326.42, is amended to read:

326.42 APPLICATIONS, FEES.

new text begin Subdivision 1. new text end [APPLICATION.] Applications for plumber's license shall be made to the state commissioner of health, with fee. Unless the applicant is entitled to a renewal, the applicant shall be licensed by the state commissioner of health only after passing a satisfactory examination by the examiners showing fitness. Examination fees for both journeyman and master plumbers shall be in an amount prescribed by the state commissioner of health pursuant to section 144.122. Upon being notified that of having successfully passed the examination for original license the applicant shall submit an application, with the license fee herein provided. License fees shall be in an amount prescribed by the state commissioner of health pursuant to section 144.122. Licenses shall expire and be renewed as prescribed by the commissioner pursuant to section 144.122.

new text begin Subd. 2. new text end [FEES.] new text begin Plumbing system plans and specifications that are submitted to the commissioner for review shall be accompanied by the appropriate plan examination fees. If the commissioner determines, upon review of the plans, that inadequate fees were paid, the necessary additional fees shall be paid prior to plan approval. The commissioner shall charge the following fees for plan reviews and audits of plumbing installations for public, commercial, and industrial buildings: new text end

new text begin (1) systems with both water distribution and drain, waste, and vent systems and having: new text end

new text begin (i) 25 or fewer drainage fixture units, $150; new text end

new text begin (ii) 26 to 50 drainage fixture units, $250; new text end

new text begin (iii) 51 to 150 drainage fixture units, $350; new text end

new text begin (iv) 151 to 249 drainage fixture units, $500; new text end

new text begin (v) 250 or more drainage fixture units, $3 per drainage fixture unit to a maximum of $4,000; and new text end

new text begin (vi) interceptors, separators, or catch basins, $70 per interceptor, separator, or catch basin; new text end

new text begin (2) building sewer service only, $150; new text end

new text begin (3) building water service only, $150; new text end

new text begin (4) building water distribution system only, no drainage system, $5 per supply fixture unit or $150, whichever is greater; new text end

new text begin (5) storm drainage system, a minimum fee of $150 or: new text end

new text begin (i) $50 per drain opening, up to a maximum of $500; and new text end

new text begin (ii) $70 per interceptor, separator, or catch basin; new text end

new text begin (6) manufactured home park or campground, 1 to 25 sites, $300; new text end

new text begin (7) manufactured home park or campground, 26 to 50 sites, $350; new text end

new text begin (8) manufactured home park or campground, 51 to 125 sites, $400; new text end

new text begin (9) manufactured home park or campground, more than 125 sites, $500; new text end

new text begin (10) accelerated review, double the regular fee, one-half to be refunded if no response from the commissioner within 15 business days; and new text end

new text begin (11) revision to previously reviewed or incomplete plans: new text end

new text begin (i) review of plans for which commissioner has issued two or more requests for additional information, per review, $100 or ten percent of the original fee, whichever is greater; new text end

new text begin (ii) proposer-requested revision with no increase in project scope, $50 or ten percent of original fee, whichever is greater; and new text end

new text begin (iii) proposer-requested revision with an increase in project scope, $50 plus the difference between the original project fee and the revised project fee. new text end

Sec. 41. new text begin AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED. new text end

new text begin (a) The commissioner's authority to collect the certificate application fee from hearing instrument dispensers under Minnesota Statutes, section 153A.17, is suspended for certified hearing instrument dispensers renewing certification in fiscal year 2004. new text end

new text begin (b) The commissioner's authority to collect the license renewal fee from occupational therapy practitioners under Minnesota Statutes, section 148.6445, subdivision 2, is suspended for fiscal years 2004 and 2005. new text end

Sec. 42. new text begin REVISOR'S INSTRUCTION. new text end

new text begin (a) The revisor of statutes shall delete the reference to "144.1495" in Minnesota Statutes, section 62Q.145, and insert "144.1501." new text end

new text begin (b) For sections in Minnesota Statutes and Minnesota Rules affected by the repealed sections in this article, the revisor shall delete internal cross-references where appropriate and make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning. new text end

Sec. 43. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 62J.15; 62J.152; 62J.451; 62J.452; 144.126; 144.1494; 144.1495; 144.1496; 144.1497; 144A.36; 144A.38; 148.5194, subdivision 3a; and 148.6445, subdivision 9, are repealed. new text end

new text begin (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 4763.0250, are repealed. new text end

ARTICLE 4

LONG-TERM CARE

Section 1.

Minnesota Statutes 2002, section 144A.4605, subdivision 4, is amended to read:

Subd. 4.

License required.

(a) A housing with services establishment registered under chapter 144D that is required to obtain a home care license must obtain an assisted living home care license according to this section or a class A or class E license according to rule. A housing with services establishment that obtains a class E license under this subdivision remains subject to the payment limitations in sections 256B.0913, subdivision deleted text begin 5 deleted text end new text begin 5f new text end , paragraph deleted text begin (h) deleted text end new text begin (b) new text end , and 256B.0915, subdivision deleted text begin 3, paragraph (g) deleted text end new text begin 3d new text end .

(b) A board and lodging establishment registered for special services as of December 31, 1996, and also registered as a housing with services establishment under chapter 144D, must deliver home care services according to sections 144A.43 to 144A.47, and may apply for a waiver from requirements under Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a licensed agency under the standards of section 157.17. Such waivers as may be granted by the department will expire upon promulgation of home care rules implementing section 144A.4605.

(c) An adult foster care provider licensed by the department of human services and registered under chapter 144D may continue to provide health-related services under its foster care license until the promulgation of home care rules implementing this section.

(d) An assisted living home care provider licensed under this section must comply with the disclosure provisions of section 325F.72 to the extent they are applicable.

Sec. 2.

Minnesota Statutes 2002, section 256.9657, subdivision 1, is amended to read:

Subdivision 1.

Nursing home license surcharge.

(a) Effective July 1, 1993, each non-state-operated nursing home licensed under chapter 144A shall pay to the commissioner an annual surcharge according to the schedule in subdivision 4. The surcharge shall be calculated as $620 per licensed bed. If the number of licensed beds is reduced, the surcharge shall be based on the number of remaining licensed beds the second month following the receipt of timely notice by the commissioner of human services that beds have been delicensed. The nursing home must notify the commissioner of health in writing when beds are delicensed. The commissioner of health must notify the commissioner of human services within ten working days after receiving written notification. If the notification is received by the commissioner of human services by the 15th of the month, the invoice for the second following month must be reduced to recognize the delicensing of beds. Beds on layaway status continue to be subject to the surcharge. The commissioner of human services must acknowledge a medical care surcharge appeal within 30 days of receipt of the written appeal from the provider.

(b) Effective July 1, 1994, the surcharge in paragraph (a) shall be increased to $625.

(c) Effective August 15, 2002, the surcharge under paragraph (b) shall be increased to $990.

(d) new text begin Effective July 15, 2003, the surcharge under paragraph (c) shall be increased to $2,700. new text end

new text begin (e) The commissioner may reduce, and may subsequently restore, the surcharge under paragraph (d) based on the commissioner's determination of a permissible surcharge. new text end

new text begin (f) new text end Between April 1, 2002, and August 15, deleted text begin 2003 deleted text end new text begin 2004 new text end , a facility governed by this subdivision may elect to assume full participation in the medical assistance program by agreeing to comply with all of the requirements of the medical assistance program, including the rate equalization law in section 256B.48, subdivision 1, paragraph (a), and all other requirements established in law or rule, and to begin intake of new medical assistance recipients. Rates will be determined under Minnesota Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 256B.431, subdivision 27, paragraph (i), rate calculations will be subject to limits as prescribed in rule and law. Other than the adjustments in sections 256B.431, subdivisions 30 and 32; 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 9549.0057, and any other applicable legislation enacted prior to the finalization of rates, facilities assuming full participation in medical assistance under this paragraph are not eligible for any rate adjustments until the July 1 following their settle-up period.

[EFFECTIVE DATE.] new text begin This section is effective June 30, 2003. new text end

Sec. 3.

Minnesota Statutes 2002, section 256B.0913, subdivision 2, is amended to read:

Subd. 2.

Eligibility for services.

Alternative care services are available to Minnesotans age 65 or older deleted text begin who are not eligible for medical assistance without a spenddown or waiver obligation but deleted text end who would be eligible for medical assistance within 180 days of admission to a nursing facility and subject to subdivisions 4 to 13.

Sec. 4.

Minnesota Statutes 2002, section 256B.0913, subdivision 4, is amended to read:

Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a) Funding for services under the alternative care program is available to persons who meet the following criteria:

(1) the person has been determined by a community assessment under section 256B.0911 to be a person who would require the level of care provided in a nursing facility, but for the provision of services under the alternative care program;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 180 days of admission to a nursing facility;

(4) the person is not ineligible for the medical assistance program due to an asset transfer penalty;

(5) the person needs services that are not funded through other state or federal funding; and

(6) the monthly cost of the alternative care services funded by the program for this person does not exceed 75 percent of the deleted text begin statewide weighted average monthly nursing facility rate of the case mix resident class to which the individual alternative care client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in section 256B.0915, subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment system, under section 256B.437, for nursing home rate determination is implemented. Effective on the first day of the state fiscal year in which a resident assessment system, under section 256B.437, for nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the monthly cost of alternative care services for this person shall not exceed the alternative care monthly cap for the case mix resident class to which the alternative care client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, which was in effect on the last day of the previous state fiscal year, and adjusted by the greater of any legislatively adopted home and community-based services cost-of-living percentage increase or any legislatively adopted statewide percent rate increase for nursing facilities deleted text end new text begin monthly limit described under section 256B.0915, subdivision 3a new text end . This monthly limit does not prohibit the alternative care client from payment for additional services, but in no case may the cost of additional services purchased under this section exceed the difference between the client's monthly service limit defined under section 256B.0915, subdivision 3, and the alternative care program monthly service limit defined in this paragraph. If medical supplies and equipment or environmental modifications are or will be purchased for an alternative care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's other alternative care services exceeds the monthly limit established in this paragraph, the annual cost of the alternative care services shall be determined. In this event, the annual cost of alternative care services shall not exceed 12 times the monthly limit described in this paragraph.

(b) Alternative care funding under this subdivision is not available for a person who is a medical assistance recipient or who would be eligible for medical assistance without a spenddown or waiver obligation. A person whose initial application for medical assistance new text begin and the elderly waiver program new text end is being processed may be served under the alternative care program for a period up to 60 days. If the individual is found to be eligible for medical assistance, medical assistance must be billed for services payable under the federally approved elderly waiver plan and delivered from the date the individual was found eligible for the federally approved elderly waiver plan. Notwithstanding this provision, deleted text begin upon federal approval, deleted text end alternative care funds may not be used to pay for any service the cost of which new text begin (i) new text end is payable by medical assistance deleted text begin or which deleted text end new text begin , (ii) new text end is used by a recipient to meet a deleted text begin medical assistance income spenddown or deleted text end waiver obligation new text begin , or (iii) is used to pay a medical assistance income spenddown for a person who is eligible to participate in the federally approved elderly waiver program under the special income standard provisions new text end .

(c) Alternative care funding is not available for a person who resides in a licensed nursing home, certified boarding care home, hospital, or intermediate care facility, except for case management services which are provided in support of the discharge planning process deleted text begin to deleted text end new text begin for new text end a nursing home resident or certified boarding care home resident new text begin to assist with a relocation process to a community-based setting new text end .

new text begin (d) Alternative care funding is not available for a person whose income is greater than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal to or less than 120 percent of the federal poverty guideline effective July 1, in the year for which alternative care eligibility is determined, who would be eligible for the elderly waiver with a waiver obligation. new text end

Sec. 5.

Minnesota Statutes 2002, section 256B.0913, subdivision 5, is amended to read:

Subd. 5.

Services covered under alternative care.

deleted text begin (a) deleted text end Alternative care funding may be used for payment of costs of:

(1) adult foster care;

(2) adult day care;

(3) home health aide;

(4) homemaker services;

(5) personal care;

(6) case management;

(7) respite care;

(8) assisted living;

(9) residential care services;

(10) care-related supplies and equipment;

(11) meals delivered to the home;

(12) transportation;

(13) nursing services;

(14) chore services;

(15) companion services;

(16) nutrition services;

(17) training for direct informal caregivers;

(18) telehome care deleted text begin devices deleted text end to deleted text begin monitor recipients deleted text end new text begin provide services new text end in their own homes deleted text begin as an alternative to hospital care, nursing home care, or home deleted text end new text begin in conjunction with in-home new text end visits;

(19) deleted text begin other services which includes deleted text end discretionary deleted text begin funds and direct cash payments to clients, deleted text end new text begin services, for which counties may make payment from their alternative care program allocation or services not otherwise defined in this section or section 256B.0625, new text end following approval by the commissioner deleted text begin , subject to the provisions of paragraph (j). Total annual payments for "other services" for all clients within a county may not exceed 25 percent of that county's annual alternative care program base allocation deleted text end ; deleted text begin and deleted text end

(20) environmental modifications deleted text begin . deleted text end new text begin ; and new text end

new text begin (21) direct cash payments for which counties may make payment from their alternative care program allocation to clients for the purpose of purchasing services, following approval by the commissioner, and subject to the provisions of subdivision 5h, until approval and implementation of consumer-directed services through the federally approved elderly waiver plan. Upon implementation, consumer-directed services under the alternative care program are available statewide and limited to the average monthly expenditures representative of all alternative care program participants for the same case mix resident class assigned in the most recent fiscal year for which complete expenditure data is available. new text end

new text begin Total annual payments for discretionary services and direct cash payments, until the federally approved consumer-directed service option is implemented statewide, for all clients within a county may not exceed 25 percent of that county's annual alternative care program base allocation. Thereafter, discretionary services are limited to 25 percent of the county's annual alternative care program base allocation. new text end

new text begin Subd. 5a. new text end [SERVICES; SERVICE DEFINITIONS; SERVICE STANDARDS.] new text begin (a) Unless specified in statute, the services, service definitions, and standards for alternative care services shall be the same as the services, service definitions, and standards specified in the federally approved elderly waiver plan, except for transitional support services. new text end

(b) The county agency must ensure that the funds are not used to supplant services available through other public assistance or services programs.

deleted text begin (c) Unless specified in statute, the services, service definitions, and standards for alternative care services shall be the same as the services, service definitions, and standards specified in the federally approved elderly waiver plan. Except for the county agencies' approval of direct cash payments to clients as described in paragraph (j) or deleted text end For a provider of supplies and equipment when the monthly cost of the supplies and equipment is less than $250, persons or agencies must be employed by or under a contract with the county agency or the public health nursing agency of the local board of health in order to receive funding under the alternative care program. Supplies and equipment may be purchased from a vendor not certified to participate in the Medicaid program if the cost for the item is less than that of a Medicaid vendor.

new text begin (c) Personal care services must meet the service standards defined in the federally approved elderly waiver plan, except that a county agency may contract with a client's relative who meets the relative hardship waiver requirements or a relative who meets the criteria and is also the responsible party under an individual service plan that ensures the client's health and safety and supervision of the personal care services by a qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship is established by the county when the client's care causes a relative caregiver to do any of the following: resign from a paying job, reduce work hours resulting in lost wages, obtain a leave of absence resulting in lost wages, incur substantial client-related expenses, provide services to address authorized, unstaffed direct care time, or meet special needs of the client unmet in the formal service plan. new text end

deleted text begin (d) deleted text end new text begin Subd. 5b. new text end [ADULT FOSTER CARE RATE.] The adult foster care rate shall be considered a difficulty of care payment and shall not include room and board. The adult foster care rate shall be negotiated between the county agency and the foster care provider. The alternative care payment for the foster care service in combination with the payment for other alternative care services, including case management, must not exceed the limit specified in subdivision 4, paragraph (a), clause (6).

deleted text begin (e) Personal care services must meet the service standards defined in the federally approved elderly waiver plan, except that a county agency may contract with a client's relative who meets the relative hardship waiver requirement as defined in section 256B.0627, subdivision 4, paragraph (b), clause (10), to provide personal care services if the county agency ensures supervision of this service by a qualified professional as defined in section 256B.0625, subdivision 19c. deleted text end

deleted text begin (f) deleted text end new text begin Subd. 5c. new text end [RESIDENTIAL CARE SERVICES; SUPPORTIVE SERVICES; HEALTH-RELATED SERVICES.] For purposes of this section, residential care services are services which are provided to individuals living in residential care homes. Residential care homes are currently licensed as board and lodging establishments new text begin under section 157.16, new text end and are registered with the department of health as providing special services under section 157.17 deleted text begin and are not subject to registration deleted text end new text begin except settings that are currently registered new text end under chapter 144D. Residential care services are defined as "supportive services" and "health-related services." "Supportive services" means deleted text begin the provision of up to 24-hour supervision and oversight. Supportive services includes: (1) transportation, when provided by the residential care home only; (2) socialization, when socialization is part of the plan of care, has specific goals and outcomes established, and is not diversional or recreational in nature; (3) assisting clients in setting up meetings and appointments; (4) assisting clients in setting up medical and social services; (5) providing assistance with personal laundry, such as carrying the client's laundry to the laundry room. Assistance with personal laundry does not include any laundry, such as bed linen, that is included in the room and board rate deleted text end new text begin services as defined in section 157.17, subdivision 1, paragraph (a) new text end . "Health-related services" deleted text begin are limited to minimal assistance with dressing, grooming, and bathing and providing reminders to residents to take medications that are self-administered or providing storage for medications, if requested deleted text end new text begin means services covered in section 157.17, subdivision 1, paragraph (b) new text end . Individuals receiving residential care services cannot receive homemaking services funded under this section.

deleted text begin (g) deleted text end new text begin Subd. 5d. new text end [ASSISTED LIVING SERVICES.] For the purposes of this section, "assisted living" refers to supportive services provided by a single vendor to clients who reside in the same apartment building of three or more units which are not subject to registration under chapter 144D and are licensed by the department of health as a class A home care provider or a class E home care provider. Assisted living services are defined as up to 24-hour supervision, deleted text begin and deleted text end oversight, new text begin and new text end supportive services as defined in deleted text begin clause (1) deleted text end new text begin section 157.17, subdivision 1, paragraph (a) new text end , individualized home care aide tasks as defined in deleted text begin clause (2) deleted text end new text begin Minnesota Rules, part 4668.0110 new text end , and individualized home management tasks as defined in deleted text begin clause (3) deleted text end new text begin Minnesota Rules, part 4668.0120 new text end provided to residents of a residential center living in their units or apartments with a full kitchen and bathroom. A full kitchen includes a stove, oven, refrigerator, food preparation counter space, and a kitchen utensil storage compartment. Assisted living services must be provided by the management of the residential center or by providers under contract with the management or with the county.

deleted text begin (1) Supportive services include: deleted text end

deleted text begin (i) socialization, when socialization is part of the plan of care, has specific goals and outcomes established, and is not diversional or recreational in nature; deleted text end

deleted text begin (ii) assisting clients in setting up meetings and appointments; and deleted text end

deleted text begin (iii) providing transportation, when provided by the residential center only. deleted text end

deleted text begin (2) Home care aide tasks means: deleted text end

deleted text begin (i) preparing modified diets, such as diabetic or low sodium diets; deleted text end

deleted text begin (ii) reminding residents to take regularly scheduled medications or to perform exercises; deleted text end

deleted text begin (iii) household chores in the presence of technically sophisticated medical equipment or episodes of acute illness or infectious disease; deleted text end

deleted text begin (iv) household chores when the resident's care requires the prevention of exposure to infectious disease or containment of infectious disease; and deleted text end

deleted text begin (v) assisting with dressing, oral hygiene, hair care, grooming, and bathing, if the resident is ambulatory, and if the resident has no serious acute illness or infectious disease. Oral hygiene means care of teeth, gums, and oral prosthetic devices. deleted text end

deleted text begin (3) Home management tasks means: deleted text end

deleted text begin (i) housekeeping; deleted text end

deleted text begin (ii) laundry; deleted text end

deleted text begin (iii) preparation of regular snacks and meals; and deleted text end

deleted text begin (iv) shopping. deleted text end

new text begin Subd. 5e. new text end [FURTHER ASSISTED LIVING REQUIREMENTS.] new text begin (a) new text end Individuals receiving assisted living services shall not receive both assisted living services and homemaking services. Individualized means services are chosen and designed specifically for each resident's needs, rather than provided or offered to all residents regardless of their illnesses, disabilities, or physical conditions. Assisted living services as defined in this section shall not be authorized in boarding and lodging establishments licensed according to sections 157.011 and 157.15 to 157.22.

deleted text begin (h) deleted text end new text begin (b) new text end For establishments registered under chapter 144D, assisted living services under this section means either the services described in deleted text begin paragraph (g) deleted text end new text begin subdivision 5d new text end and delivered by a class E home care provider licensed by the department of health or the services described under section 144A.4605 and delivered by an assisted living home care provider or a class A home care provider licensed by the commissioner of health.

deleted text begin (i) deleted text end new text begin Subd. 5f. new text end [PAYMENT RATES FOR ASSISTED LIVING SERVICES AND RESIDENTIAL CARE.] new text begin (a) new text end Payment for assisted living services and residential care services shall be a monthly rate negotiated and authorized by the county agency based on an individualized service plan for each resident and may not cover direct rent or food costs.

deleted text begin (1) deleted text end new text begin (b) new text end The individualized monthly negotiated payment for assisted living services as described in deleted text begin paragraph (g) deleted text end new text begin subdivision 5d new text end or deleted text begin (h) deleted text end new text begin 5e, paragraph (b) new text end , and residential care services as described in deleted text begin paragraph (f) deleted text end new text begin subdivision 5c new text end , shall not exceed the nonfederal share in effect on July 1 of the state fiscal year for which the rate limit is being calculated of the greater of either the statewide or any of the geographic deleted text begin groups' weighted average monthly nursing facility payment rate of the case mix resident class to which the alternative care eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in section 256B.0915, subdivision 1d, paragraph (a), until the first day of the state fiscal year in which a resident assessment system, under section 256B.437, of nursing home rate determination is implemented. Effective on the first day of the state fiscal year in which a resident assessment system, under section 256B.437, of nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the individualized monthly negotiated payment for the services described in this clause shall not exceed the limit described in this clause which was in effect on the last day of the previous state fiscal year and which has been adjusted by the greater of any legislatively adopted home and community-based services cost-of-living percentage increase or any legislatively adopted statewide percent rate increase for nursing facilities deleted text end new text begin groups according to subdivision 4, paragraph (a), clause (6) new text end .

deleted text begin (2) deleted text end new text begin (c) new text end The individualized monthly negotiated payment for assisted living services described under section 144A.4605 and delivered by a provider licensed by the department of health as a class A home care provider or an assisted living home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D and that provides 24-hour supervision in combination with the payment for other alternative care services, including case management, must not exceed the limit specified in subdivision 4, paragraph (a), clause (6).

deleted text begin (j) deleted text end new text begin Subd. 5g. new text end [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] A county agency may make payment from their alternative care program allocation for deleted text begin "other services" which include use of "discretionary funds" for services that are not otherwise defined in this section and deleted text end direct cash payments to the client for the purpose of purchasing the services. The following provisions apply to payments under this deleted text begin paragraph deleted text end new text begin subdivision new text end :

(1) a cash payment to a client under this provision cannot exceed the monthly payment limit for that client as specified in subdivision 4, paragraph (a), clause (6); new text begin and new text end

(2) a county may not approve any cash payment for a client who meets either of the following:

(i) has been assessed as having a dependency in orientation, unless the client has an authorized representative. An "authorized representative" means an individual who is at least 18 years of age and is designated by the person or the person's legal representative to act on the person's behalf. This individual may be a family member, guardian, representative payee, or other individual designated by the person or the person's legal representative, if any, to assist in purchasing and arranging for supports; or

(ii) is concurrently receiving adult foster care, residential care, or assisted living services deleted text begin ; deleted text end new text begin . new text end

deleted text begin (3) deleted text end new text begin Subd. 5h. new text end [CASH PAYMENTS TO PERSONS.] new text begin (a) new text end Cash payments to a person or a person's family will be provided through a monthly payment and be in the form of cash, voucher, or direct county payment to a vendor. Fees or premiums assessed to the person for eligibility for health and human services are not reimbursable through this service option. Services and goods purchased through cash payments must be identified in the person's individualized care plan and must meet all of the following criteria:

deleted text begin (i) deleted text end new text begin (1) new text end they must be over and above the normal cost of caring for the person if the person did not have functional limitations;

deleted text begin (ii) deleted text end new text begin (2) new text end they must be directly attributable to the person's functional limitations;

deleted text begin (iii) deleted text end new text begin (3) new text end they must have the potential to be effective at meeting the goals of the program; new text begin and new text end

deleted text begin (iv) deleted text end new text begin (4) new text end they must be consistent with the needs identified in the individualized service plan. The service plan shall specify the needs of the person and family, the form and amount of payment, the items and services to be reimbursed, and the arrangements for management of the individual grant deleted text begin ; and deleted text end new text begin . new text end

deleted text begin (v) deleted text end new text begin (b) new text end The person, the person's family, or the legal representative shall be provided sufficient information to ensure an informed choice of alternatives. The local agency shall document this information in the person's care plan, including the type and level of expenditures to be reimbursed deleted text begin ; deleted text end new text begin . new text end

new text begin (c) Persons receiving grants under this section shall have the following responsibilities: new text end

new text begin (1) spend the grant money in a manner consistent with their individualized service plan with the local agency; new text end

new text begin (2) notify the local agency of any necessary changes in the grant expenditures; new text end

new text begin (3) arrange and pay for supports; and new text end

new text begin (4) inform the local agency of areas where they have experienced difficulty securing or maintaining supports. new text end

new text begin (d) The county shall report client outcomes, services, and costs under this paragraph in a manner prescribed by the commissioner. new text end

deleted text begin (4) deleted text end new text begin Subd. 5i. new text end [IMMUNITY.] The state of Minnesota, county, lead agency under contract, or tribal government under contract to administer the alternative care program shall not be liable for damages, injuries, or liabilities sustained through the purchase of direct supports or goods by the person, the person's family, or the authorized representative with funds received through the cash payments under this section. Liabilities include, but are not limited to, workers' compensation, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA) deleted text begin ; deleted text end new text begin . new text end

deleted text begin (5) persons receiving grants under this section shall have the following responsibilities: deleted text end

deleted text begin (i) spend the grant money in a manner consistent with their individualized service plan with the local agency; deleted text end

deleted text begin (ii) notify the local agency of any necessary changes in the grant expenditures; deleted text end

deleted text begin (iii) arrange and pay for supports; and deleted text end

deleted text begin (iv) inform the local agency of areas where they have experienced difficulty securing or maintaining supports; and deleted text end

deleted text begin (6) the county shall report client outcomes, services, and costs under this paragraph in a manner prescribed by the commissioner. deleted text end

Sec. 6.

Minnesota Statutes 2002, section 256B.0913, subdivision 6, is amended to read:

Subd. 6.

Alternative care program administration.

new text begin (a) new text end The alternative care program is administered by the county agency. This agency is the lead agency responsible for the local administration of the alternative care program as described in this section. However, it may contract with the public health nursing service to be the lead agency. The commissioner may contract with federally recognized Indian tribes with a reservation in Minnesota to serve as the lead agency responsible for the local administration of the alternative care program as described in the contract.

new text begin (b) Alternative care pilot projects operate according to this section and the provisions of Laws 1993, First Special Session chapter 1, article 5, section 133, under agreement with the commissioner. Each pilot project agreement period shall begin no later than the first payment cycle of the state fiscal year and continue through the last payment cycle of the state fiscal year. new text end

Sec. 7.

Minnesota Statutes 2002, section 256B.0913, subdivision 7, is amended to read:

Subd. 7.

Case management.

deleted text begin Providers of case management services for persons receiving services funded by the alternative care program must meet the qualification requirements and standards specified in section 256B.0915, subdivision 1b. deleted text end The case manager must not approve alternative care funding for a client in any setting in which the case manager cannot reasonably ensure the client's health and safety. The case manager is responsible for the cost-effectiveness of the alternative care individual care plan and must not approve any care plan in which the cost of services funded by alternative care and client contributions exceeds the limit specified in section 256B.0915, subdivision 3, paragraph (b). deleted text begin The county may allow a case manager employed by the county to delegate certain aspects of the case management activity to another individual employed by the county provided there is oversight of the individual by the case manager. The case manager may not delegate those aspects which require professional judgment including assessments, reassessments, and care plan development. deleted text end

Sec. 8.

Minnesota Statutes 2002, section 256B.0913, subdivision 8, is amended to read:

Subd. 8.

Requirements for individual care plan.

(a) The case manager shall implement the plan of care for each alternative care client and ensure that a client's service needs and eligibility are reassessed at least every 12 months. The plan shall include any services prescribed by the individual's attending physician as necessary to allow the individual to remain in a community setting. In developing the individual's care plan, the case manager should include the use of volunteers from families and neighbors, religious organizations, social clubs, and civic and service organizations to support the formal home care services. The county shall be held harmless for damages or injuries sustained through the use of volunteers under this subdivision including workers' compensation liability. The lead agency shall provide documentation in each individual's plan of care and, if requested, to the commissioner that the most cost-effective alternatives available have been offered to the individual and that the individual was free to choose among available qualified providers, both public and private new text begin , including qualified case management or service coordination providers other than those employed by the lead agency when the lead agency maintains responsibility for prior authorizing services in accordance with statutory and administrative requirements new text end . The case manager must give the individual a ten-day written notice of any denial, termination, or reduction of alternative care services.

(b) If the county administering alternative care services is different than the county of financial responsibility, the care plan may be implemented without the approval of the county of financial responsibility.

Sec. 9.

Minnesota Statutes 2002, section 256B.0913, subdivision 10, is amended to read:

Subd. 10.

Allocation formula.

(a) The alternative care appropriation for fiscal years 1992 and beyond shall cover only alternative care eligible clients. By July 1 of each year, the commissioner shall allocate to county agencies the state funds available for alternative care for persons eligible under subdivision 2.

(b) The adjusted base for each county is the county's current fiscal year base allocation plus any targeted funds approved during the current fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each county, the determination of alternative care program expenditures shall be based on payments for services rendered from April 1 through March 31 in the base year, to the extent that claims have been submitted and paid by June 1 of that year.

(c) If the alternative care program expenditures as defined in paragraph (b) are 95 percent or more of the county's adjusted base allocation, the allocation for the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that inflation is included in the state budget.

(d) If the alternative care program expenditures as defined in paragraph (b) are less than 95 percent of the county's adjusted base allocation, the allocation for the next fiscal year is the adjusted base allocation less the amount of unspent funds below the 95 percent level.

(e) If the annual legislative appropriation for the alternative care program is inadequate to fund the combined county allocations for a biennium, the commissioner shall distribute to each county the entire annual appropriation as that county's percentage of the computed base as calculated in paragraphs (c) and (d).

new text begin (f) On agreement between the commissioner and the lead agency, the commissioner may have discretion to reallocate alternative care base allocations distributed to lead agencies in which the base amount exceeds program expenditures. new text end

Sec. 10.

Minnesota Statutes 2002, section 256B.0913, subdivision 12, is amended to read:

Subd. 12.

Client premiums.

(a) A premium is required for all alternative care eligible clients to help pay for the cost of participating in the program. The amount of the premium for the alternative care client shall be determined as follows:

(1) when the alternative care client's income less recurring and predictable medical expenses is deleted text begin greater than the recipient's maintenance needs allowance as defined in section 256B.0915, subdivision 1d, paragraph (a), but deleted text end less than 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the premium is being computed, and total assets are less than $10,000, the fee is zero;

(2) when the alternative care client's income less recurring and predictable medical expenses is greater than 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the premium is being computed, and total assets are less than $10,000, the fee is 25 percent of the cost of alternative care services or the difference between 150 percent of the federal poverty guideline effective on July 1 of the state fiscal year in which the premium is being computed and the client's income less recurring and predictable medical expenses, whichever is less; and

(3) when the alternative care client's total assets are greater than $10,000, the fee is 25 percent of the cost of alternative care services.

For married persons, total assets are defined as the total marital assets less the estimated community spouse asset allowance, under section 256B.059, if applicable. For married persons, total income is defined as the client's income less the monthly spousal allotment, under section 256B.058.

All alternative care services except case management shall be included in the estimated costs for the purpose of determining deleted text begin 25 percent of deleted text end the deleted text begin costs deleted text end new text begin premium amount new text end .

Premiums are due and payable each month alternative care services are received unless the actual cost of the services is less than the premium new text begin , in which case the fee is the lesser amount new text end .

(b) The fee shall be waived by the commissioner when:

(1) a person who is residing in a nursing facility is receiving case management only;

(2) a person is applying for medical assistance;

(3) a married couple is requesting an asset assessment under the spousal impoverishment provisions;

(4) a person is found eligible for alternative care, but is not yet receiving alternative care services; deleted text begin or deleted text end

(5) a person's fee under paragraph (a) is less than $25 new text begin ; or new text end

new text begin (6) a person has chosen to participate in a consumer-directed service plan for which the cost is no greater than the total cost of the person's alternative care service plan less the monthly premium amount that would otherwise be assessed new text end .

(c) The county agency must record in the state's receivable system the client's assessed premium amount or the reason the premium has been waived. The commissioner will bill and collect the premium from the client. Money collected must be deposited in the general fund and is appropriated to the commissioner for the alternative care program. The client must supply the county with the client's social security number at the time of application. The county shall supply the commissioner with the client's social security number and other information the commissioner requires to collect the premium from the client. The commissioner shall collect unpaid premiums using the Revenue Recapture Act in chapter 270A and other methods available to the commissioner. The commissioner may require counties to inform clients of the collection procedures that may be used by the state if a premium is not paid. This paragraph does not apply to alternative care pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133, if a county operating under the pilot project reports the following dollar amounts to the commissioner quarterly:

(1) total premiums billed to clients;

(2) total collections of premiums billed; and

(3) balance of premiums owed by clients.

If a county does not adhere to these reporting requirements, the commissioner may terminate the billing, collecting, and remitting portions of the pilot project and require the county involved to operate under the procedures set forth in this paragraph.

Sec. 11.

Minnesota Statutes 2002, section 256B.0915, subdivision 3, is amended to read:

Subd. 3.

Limits of cases deleted text begin , rates, payments, and forecasting deleted text end .

deleted text begin (a) deleted text end The number of medical assistance waiver recipients that a county may serve must be allocated according to the number of medical assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be served with the approval of the commissioner.

deleted text begin (b) deleted text end new text begin Subd. 3a. new text end [ELDERLY WAIVER COST LIMITS.] new text begin (a) new text end The monthly limit for the cost of waivered services to an individual elderly waiver client shall be the weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first day of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented. Effective on the first day of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented and the first day of each subsequent state fiscal year, the monthly limit for the cost of waivered services to an individual elderly waiver client shall be the rate of the case mix resident class to which the waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect on the last day of the previous state fiscal year, adjusted by the greater of any legislatively adopted home and community-based services cost-of-living percentage increase or any legislatively adopted statewide percent rate increase for nursing facilities.

deleted text begin (c) deleted text end new text begin (b) new text end If extended medical supplies and equipment or environmental modifications are or will be purchased for an elderly waiver client, the costs may be prorated for up to 12 consecutive months beginning with the month of purchase. If the monthly cost of a recipient's waivered services exceeds the monthly limit established in paragraph deleted text begin (b) deleted text end new text begin (a) new text end , the annual cost of all waivered services shall be determined. In this event, the annual cost of all waivered services shall not exceed 12 times the monthly limit of waivered services as described in paragraph deleted text begin (b) deleted text end new text begin (a) new text end .

deleted text begin (d) deleted text end new text begin Subd. 3b. new text end [COST LIMITS FOR ELDERLY WAIVER APPLICANTS WHO RESIDE IN A NURSING FACILITY.] new text begin (a) new text end For a person who is a nursing facility resident at the time of requesting a determination of eligibility for elderly waivered services, a monthly conversion limit for the cost of elderly waivered services may be requested. The monthly conversion limit for the cost of elderly waiver services shall be the resident class assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where the resident currently resides until July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented. Effective on July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented, the monthly conversion limit for the cost of elderly waiver services shall be the per diem nursing facility rate as determined by the resident assessment system as described in section 256B.437 for that resident in the nursing facility where the resident currently resides multiplied by 365 and divided by 12, less the recipient's maintenance needs allowance as described in subdivision 1d. The initially approved conversion rate may be adjusted by the greater of any subsequent legislatively adopted home and community-based services cost-of-living percentage increase or any subsequent legislatively adopted statewide percentage rate increase for nursing facilities. The limit under this deleted text begin clause deleted text end new text begin subdivision new text end only applies to persons discharged from a nursing facility after a minimum 30-day stay and found eligible for waivered services on or after July 1, 1997.

new text begin (b) new text end The following costs must be included in determining the total monthly costs for the waiver client:

(1) cost of all waivered services, including extended medical supplies and equipment and environmental modifications; and

(2) cost of skilled nursing, home health aide, and personal care services reimbursable by medical assistance.

deleted text begin (e) deleted text end new text begin Subd. 3c. new text end [SERVICE APPROVAL AND CONTRACTING PROVISIONS.] new text begin (a) new text end Medical assistance funding for skilled nursing services, private duty nursing, home health aide, and personal care services for waiver recipients must be approved by the case manager and included in the individual care plan.

deleted text begin (f) deleted text end new text begin (b) new text end A county is not required to contract with a provider of supplies and equipment if the monthly cost of the supplies and equipment is less than $250.

deleted text begin (g) deleted text end new text begin Subd. 3d. new text end [ADULT FOSTER CARE RATE.] The adult foster care rate shall be considered a difficulty of care payment and shall not include room and board. The adult foster care service rate shall be negotiated between the county agency and the foster care provider. The elderly waiver payment for the foster care service in combination with the payment for all other elderly waiver services, including case management, must not exceed the limit specified in new text begin subdivision 3a, new text end paragraph deleted text begin (b) deleted text end new text begin (a) new text end .

deleted text begin (h) deleted text end new text begin Subd. 3e. new text end [ASSISTED LIVING SERVICE RATE.] new text begin (a) new text end Payment for assisted living service shall be a monthly rate negotiated and authorized by the county agency based on an individualized service plan for each resident and may not cover direct rent or food costs.

deleted text begin (1) deleted text end new text begin (b) new text end The individualized monthly negotiated payment for assisted living services as described in section 256B.0913, deleted text begin subdivision 5, paragraph (g) or (h) deleted text end new text begin subdivisions 5d to 5f new text end , and residential care services as described in section 256B.0913, subdivision deleted text begin 5, paragraph (f) deleted text end new text begin 5c new text end , shall not exceed the nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit is being calculated, of the greater of either the statewide or any of the geographic groups' weighted average monthly nursing facility rate of the case mix resident class to which the elderly waiver eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented. Effective on July 1 of the state fiscal year in which the resident assessment system as described in section 256B.437 for nursing home rate determination is implemented and July 1 of each subsequent state fiscal year, the individualized monthly negotiated payment for the services described in this clause shall not exceed the limit described in this clause which was in effect on June 30 of the previous state fiscal year and which has been adjusted by the greater of any legislatively adopted home and community-based services cost-of-living percentage increase or any legislatively adopted statewide percent rate increase for nursing facilities.

deleted text begin (2) deleted text end new text begin (c) new text end The individualized monthly negotiated payment for assisted living services described in section 144A.4605 and delivered by a provider licensed by the department of health as a class A home care provider or an assisted living home care provider and provided in a building that is registered as a housing with services establishment under chapter 144D and that provides 24-hour supervision in combination with the payment for other elderly waiver services, including case management, must not exceed the limit specified in deleted text begin paragraph (b) deleted text end new text begin subdivision 3a new text end .

deleted text begin (i) deleted text end new text begin Subd. 3f. new text end [INDIVIDUAL SERVICE RATES; EXPENDITURE FORECASTS.] new text begin (a) new text end The county shall negotiate individual service rates with vendors and may authorize payment for actual costs up to the county's current approved rate. Persons or agencies must be employed by or under a contract with the county agency or the public health nursing agency of the local board of health in order to receive funding under the elderly waiver program, except as a provider of supplies and equipment when the monthly cost of the supplies and equipment is less than $250.

deleted text begin (j) deleted text end new text begin (b) new text end Reimbursement for the medical assistance recipients under the approved waiver shall be made from the medical assistance account through the invoice processing procedures of the department's Medicaid Management Information System (MMIS), only with the approval of the client's case manager. The budget for the state share of the Medicaid expenditures shall be forecasted with the medical assistance budget, and shall be consistent with the approved waiver.

deleted text begin (k) deleted text end new text begin Subd. 3g. new text end [SERVICE RATE LIMITS; STATE ASSUMPTION OF COSTS.] new text begin (a) new text end To improve access to community services and eliminate payment disparities between the alternative care program and the elderly waiver, the commissioner shall establish statewide maximum service rate limits and eliminate county-specific service rate limits.

deleted text begin (1) deleted text end new text begin (b) new text end Effective July 1, 2001, for service rate limits, except those described or defined in deleted text begin paragraphs (g) and (h) deleted text end new text begin subdivisions 3d and 3e new text end , the rate limit for each service shall be the greater of the alternative care statewide maximum rate or the elderly waiver statewide maximum rate.

deleted text begin (2) deleted text end new text begin (c) new text end Counties may negotiate individual service rates with vendors for actual costs up to the statewide maximum service rate limit.

Sec. 12.

Minnesota Statutes 2002, section 256B.431, subdivision 2r, is amended to read:

Subd. 2r.

Payment restrictions on leave days.

Effective July 1, 1993, the commissioner shall limit payment for leave days in a nursing facility to 79 percent of that nursing facility's total payment rate for the involved resident. new text begin For services rendered on or after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the commissioner shall limit payment for leave days in a nursing facility to 60 percent of that nursing facility's total payment rate for the involved resident. new text end

Sec. 13.

Minnesota Statutes 2002, section 256B.431, is amended by adding a subdivision to read:

new text begin Subd. 2t. new text end

new text begin Payment limitation. new text end

new text begin For services rendered on or after July 1, 2003, for facilities reimbursed under this section or section 256B.434, the Medicaid program shall only pay a co-payment during a Medicare-covered skilled nursing facility stay if the Medicare rate less the resident's co-payment responsibility is less than the Medicaid RUG-III case-mix payment rate. The amount that shall be paid by the Medicaid program is equal to the amount by which the Medicaid RUG-III case-mix payment rate exceeds the Medicare rate less the co-payment responsibility. Health plans paying for nursing home services under section 256B.69, subdivision 6a, may limit payments as allowed under this subdivision. new text end

Sec. 14.

Minnesota Statutes 2002, section 256B.431, subdivision 32, is amended to read:

Subd. 32.

Payment during first 90 days.

(a) For rate years beginning on or after July 1, 2001, the total payment rate for a facility reimbursed under this section, section 256B.434, or any other section for the first 90 paid days after admission shall be:

(1) for the first 30 paid days, the rate shall be 120 percent of the facility's medical assistance rate for each case mix class; deleted text begin and deleted text end

(2) for the next 60 paid days after the first 30 paid days, the rate shall be 110 percent of the facility's medical assistance rate for each case mix class deleted text begin . deleted text end new text begin ; new text end

deleted text begin (b) deleted text end new text begin (3) new text end beginning with the 91st paid day after admission, the payment rate shall be the rate otherwise determined under this section, section 256B.434, or any other section deleted text begin . deleted text end new text begin ; and new text end

deleted text begin (c) deleted text end new text begin (4) payments under new text end this deleted text begin subdivision applies deleted text end new text begin paragraph apply new text end to admissions occurring on or after July 1, 2001 new text begin , and before July 1, 2003, and to resident days occurring before July 30, 2003 new text end .

new text begin (b) For rate years beginning on or after July 1, 2003, the total payment rate for a facility reimbursed under this section, section 256B.434, or any other section shall be: new text end

new text begin (1) for the first 30 calendar days after admission, the rate shall be 120 percent of the facility's medical assistance rate for each RUG class; new text end

new text begin (2) beginning with the 31st calendar day after admission, the payment rate shall be the rate otherwise determined under this section, section 256B.434, or any other section; and new text end

new text begin (3) payments under this paragraph apply to admissions occurring on or after July 1, 2003. new text end

new text begin (c) Effective January 1, 2004, the enhanced rates under this subdivision shall not be allowed if a resident has resided in any nursing facility during the previous 30 calendar days. new text end

Sec. 15.

Minnesota Statutes 2002, section 256B.431, is amended by adding a subdivision to read:

new text begin Subd. 38. new text end

new text begin Nursing home rate increases effective in fiscal year 2004. new text end

new text begin Effective June 1, 2003, the commissioner shall provide to each nursing home reimbursed under this section or section 256B.434, an increase in each case mix payment rate equal to the increase in the per-bed surcharge paid under section 256.9657, subdivision 1, paragraph (d), divided by 365 and further divided by .90. The increase shall not be subject to any annual percentage increase. The 30-day advance notice requirement in section 256B.47, subdivision 2, shall not apply to rate increases resulting from this section. The commissioner shall not adjust the rate increase under this subdivision unless an adjustment under section 256.9657, subdivision 1, paragraph (e), is greater than 1.5 percent of the surcharge amount. new text end

[EFFECTIVE DATE.] new text begin This section is effective May 31, 2003. new text end

Sec. 16.

Minnesota Statutes 2002, section 256B.434, subdivision 4, is amended to read:

Subd. 4.

Alternate rates for nursing facilities.

(a) For nursing facilities which have their payment rates determined under this section rather than section 256B.431, the commissioner shall establish a rate under this subdivision. The nursing facility must enter into a written contract with the commissioner.

(b) A nursing facility's case mix payment rate for the first rate year of a facility's contract under this section is the payment rate the facility would have received under section 256B.431.

(c) A nursing facility's case mix payment rates for the second and subsequent years of a facility's contract under this section are the previous rate year's contract payment rates plus an inflation adjustment and, for facilities reimbursed under this section or section 256B.431, an adjustment to include the cost of any increase in health department licensing fees for the facility taking effect on or after July 1, 2001. The index for the inflation adjustment must be based on the change in the Consumer Price Index-All Items (United States City average) (CPI-U) forecasted by deleted text begin Data Resources, Inc. deleted text end new text begin the commissioner of finance's national economic consultant new text end , as forecasted in the fourth quarter of the calendar year preceding the rate year. The inflation adjustment must be based on the 12-month period from the midpoint of the previous rate year to the midpoint of the rate year for which the rate is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July 1, 2001, deleted text begin and deleted text end July 1, 2002, new text begin July 1, 2003, and July 1, 2004, new text end this paragraph shall apply only to the property-related payment rate, except that adjustments to include the cost of any increase in health department licensing fees taking effect on or after July 1, 2001, shall be provided. In determining the amount of the property-related payment rate adjustment under this paragraph, the commissioner shall determine the proportion of the facility's rates that are property-related based on the facility's most recent cost report.

(d) The commissioner shall develop additional incentive-based payments of up to five percent above the standard contract rate for achieving outcomes specified in each contract. The specified facility-specific outcomes must be measurable and approved by the commissioner. The commissioner may establish, for each contract, various levels of achievement within an outcome. After the outcomes have been specified the commissioner shall assign various levels of payment associated with achieving the outcome. Any incentive-based payment cancels if there is a termination of the contract. In establishing the specified outcomes and related criteria the commissioner shall consider the following state policy objectives:

(1) improved cost effectiveness and quality of life as measured by improved clinical outcomes;

(2) successful diversion or discharge to community alternatives;

(3) decreased acute care costs;

(4) improved consumer satisfaction;

(5) the achievement of quality; or

(6) any additional outcomes proposed by a nursing facility that the commissioner finds desirable.

Sec. 17.

Minnesota Statutes 2002, section 256B.437, subdivision 6, is amended to read:

Subd. 6.

Planned closure rate adjustment.

(a) The commissioner of human services shall calculate the amount of the planned closure rate adjustment available under subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under clause (2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided by capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day of the month following completion of closure of the facility designated for closure in the application and becomes part of the nursing facility's total operating payment rate.

(c) Applicants may use the planned closure rate adjustment to allow for a property payment for a new nursing facility or an addition to an existing nursing facility or as an operating payment rate adjustment. Applications approved under this subdivision are exempt from other requirements for moratorium exceptions under section 144A.073, subdivisions 2 and 3.

(d) Upon the request of a closing facility, the commissioner must allow the facility a closure rate adjustment as provided under section 144A.161, subdivision 10.

(e) A facility that has received a planned closure rate adjustment may reassign it to another facility that is under the same ownership at any time within three years of its effective date. The amount of the adjustment shall be computed according to paragraph (a).

(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased, the commissioner shall recalculate planned closure rate adjustments for facilities that delicense beds under this section on or after July 1, 2001, to reflect the increase in the per bed dollar amount. The recalculated planned closure rate adjustment shall be effective from the date the per bed dollar amount is increased.

new text begin (g) A 26-bed facility that voluntarily delicensed its beds in June 2002 for which no closure plan was submitted shall be permitted to assign a planned closure rate adjustment, effective 30 days after final enactment and then delayed in accordance with section 144A.161, subdivision 10, to a 22-bed facility under common ownership. The commissioner shall not rescind the planned closure rate adjustments that were assigned to the five nursing facilities with the lowest rates in the development region. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 18.

Minnesota Statutes 2002, section 256I.02, is amended to read:

256I.02 PURPOSE.

The Group Residential Housing Act establishes a comprehensive system of rates and payments for persons who reside in deleted text begin a group residence deleted text end new text begin the community new text end and who meet the eligibility criteria under section 256I.04, subdivision 1.

Sec. 19.

Minnesota Statutes 2002, section 256I.04, subdivision 3, is amended to read:

Subd. 3.

Moratorium on the development of group residential housing beds.

(a) County agencies shall not enter into agreements for new group residential housing beds with total rates in excess of the MSA equivalent rate except: (1) deleted text begin for group residential housing establishments meeting the requirements of subdivision 2a, clause (2) with department approval; (2) deleted text end for group residential housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, provided the facility is needed to meet the census reduction targets for persons with mental retardation or related conditions at regional treatment centers; deleted text begin (3) deleted text end new text begin (2) new text end to ensure compliance with the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements for inappropriately placed persons with mental retardation or related conditions or mental illness; deleted text begin (4) deleted text end new text begin (3) new text end up to 80 beds in a single, specialized facility located in Hennepin county that will provide housing for chronic inebriates who are repetitive users of detoxification centers and are refused placement in emergency shelters because of their state of intoxication, and planning for the specialized facility must have been initiated before July 1, 1991, in anticipation of receiving a grant from the housing finance agency under section 462A.05, subdivision 20a, paragraph (b); deleted text begin (5) deleted text end new text begin (4) new text end notwithstanding the provisions of subdivision 2a, for up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey county for homeless adults with a mental illness, a history of substance abuse, or human immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this section, "homeless adult" means a person who is living on the street or in a shelter or discharged from a regional treatment center, community hospital, or residential treatment program and has no appropriate housing available and lacks the resources and support necessary to access appropriate housing. At least 70 percent of the supportive housing units must serve homeless adults with mental illness, substance abuse problems, or human immunodeficiency virus or acquired immunodeficiency syndrome who are about to be or, within the previous six months, has been discharged from a regional treatment center, or a state-contracted psychiatric bed in a community hospital, or a residential mental health or chemical dependency treatment program. If a person meets the requirements of subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group residential housing rate for that person is limited to the supplementary rate under section 256I.05, subdivision 1a, and is determined by subtracting the amount of the person's countable income that exceeds the MSA equivalent rate from the group residential housing supplementary rate. A resident in a demonstration project site who no longer participates in the demonstration program shall retain eligibility for a group residential housing payment in an amount determined under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are available and the services can be provided through a managed care entity. If federal matching funds are not available, then service funding will continue under section 256I.05, subdivision 1a; or (6) for group residential housing beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which are used exclusively for recipients receiving home and community-based waiver services under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who resided in a nursing facility for the six months immediately prior to the month of entry into the group residential housing setting. The group residential housing rate for these beds must be set so that the monthly group residential housing payment for an individual occupying the bed when combined with the nonfederal share of services delivered under the waiver for that person does not exceed the nonfederal share of the monthly medical assistance payment made for the person to the nursing facility in which the person resided prior to entry into the group residential housing establishment. The rate may not exceed the MSA equivalent rate plus $426.37 for any case.

(b) A county agency may enter into a group residential housing agreement for beds with rates in excess of the MSA equivalent rate in addition to those currently covered under a group residential housing agreement if the additional beds are only a replacement of beds with rates in excess of the MSA equivalent rate which have been made available due to closure of a setting, a change of licensure or certification which removes the beds from group residential housing payment, or as a result of the downsizing of a group residential housing setting. The transfer of available beds from one county to another can only occur by the agreement of both counties.

Sec. 20.

Minnesota Statutes 2002, section 256I.05, subdivision 1, is amended to read:

Subdivision 1.

Maximum rates.

deleted text begin (a) deleted text end Monthly room and board rates negotiated by a county agency for a recipient living in group residential housing must not exceed the MSA equivalent rate specified under section 256I.03, subdivision 5 deleted text begin , deleted text end new text begin . new text end deleted text begin with the exception that a county agency may negotiate a supplementary room and board rate that exceeds the MSA equivalent rate for recipients of waiver services under title XIX of the Social Security Act. This exception is subject to the following conditions: deleted text end

deleted text begin (1) the setting is licensed by the commissioner of human services under Minnesota Rules, parts 9555.5050 to 9555.6265; deleted text end

deleted text begin (2) the setting is not the primary residence of the license holder and in which the license holder is not the primary caregiver; and deleted text end

deleted text begin (3) the average supplementary room and board rate in a county for a calendar year may not exceed the average supplementary room and board rate for that county in effect on January 1, 2000. For calendar years beginning on or after January 1, 2002, within the limits of appropriations specifically for this purpose, the commissioner shall increase each county's supplemental room and board rate average on an annual basis by a factor consisting of the percentage change in the Consumer Price Index-All items, United States city average (CPI-U) for that calendar year compared to the preceding calendar year as forecasted by Data Resources, Inc., in the third quarter of the preceding calendar year. If a county has not negotiated supplementary room and board rates for any facilities located in the county as of January 1, 2000, or has an average supplemental room and board rate under $100 per person as of January 1, 2000, it may submit a supplementary room and board rate request with budget information for a facility to the commissioner for approval. deleted text end

deleted text begin The county agency may at any time negotiate a higher or lower room and board rate than the average supplementary room and board rate. deleted text end

deleted text begin (b) Notwithstanding paragraph (a), clause (3), county agencies may negotiate a supplementary room and board rate that exceeds the MSA equivalent rate by up to $426.37 for up to five facilities, serving not more than 20 individuals in total, that were established to replace an intermediate care facility for persons with mental retardation and related conditions located in the city of Roseau that became uninhabitable due to flood damage in June 2002. deleted text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004, or upon receipt of federal approval of waiver amendment, whichever is later. new text end

Sec. 21.

Minnesota Statutes 2002, section 256I.05, subdivision 1a, is amended to read:

Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section 256I.04, subdivision 3, deleted text begin in addition to the room and board rate specified in subdivision 1, deleted text end the county agency may negotiate a payment not to exceed $426.37 for other services necessary to provide room and board provided by the group residence if the residence is licensed by or registered by the department of health, or licensed by the department of human services to provide services in addition to room and board, and if the provider of services is not also concurrently receiving funding for services for a recipient under a home and community-based waiver under title XIX of the Social Security Act; or funding from the medical assistance program under section 256B.0627, subdivision 4, for personal care services for residents in the setting; or residing in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000. If funding is available for other necessary services through a home and community-based waiver, or personal care services under section 256B.0627, subdivision 4, then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided in law, in no case may the supplementary service rate deleted text begin plus the supplementary room and board rate deleted text end exceed $426.37. The registration and licensure requirement does not apply to establishments which are exempt from state licensure because they are located on Indian reservations and for which the tribe has prescribed health and safety requirements. Service payments under this section may be prohibited under rules to prevent the supplanting of federal funds with state funds. The commissioner shall pursue the feasibility of obtaining the approval of the Secretary of Health and Human Services to provide home and community-based waiver services under title XIX of the Social Security Act for residents who are not eligible for an existing home and community-based waiver due to a primary diagnosis of mental illness or chemical dependency and shall apply for a waiver if it is determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the GRH fund for beds under this section to other funding programs administered by the department after consultation with the county or counties in which the affected beds are located. The commissioner may also make cost-neutral transfers from the GRH fund to county human service agencies for beds permanently removed from the GRH census under a plan submitted by the county agency and approved by the commissioner. The commissioner shall report the amount of any transfers under this provision annually to the legislature.

(c) The provisions of paragraph (b) do not apply to a facility that has its reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

Sec. 22.

Minnesota Statutes 2002, section 256I.05, subdivision 7c, is amended to read:

Subd. 7c.

Demonstration project.

The commissioner is authorized to pursue a demonstration project under federal food stamp regulation for the purpose of gaining federal reimbursement of food and nutritional costs currently paid by the state group residential housing program. new text begin The commissioner shall seek approval no later than January 1, 2004. Any reimbursement received is nondedicated revenue to the general fund. new text end

Sec. 23. new text begin REVISOR'S INSTRUCTION. new text end

new text begin For sections in Minnesota Statutes and Minnesota Rules affected by the repealed sections in this article, the revisor shall delete internal cross-references where appropriate and make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning. new text end

Sec. 24. new text begin REPEALER. new text end

new text begin Minnesota Statutes 2002, sections 256B.0917; and 256B.437, subdivision 2, are repealed effective July 1, 2003. new text end

ARTICLE 5

CONTINUING CARE FOR PERSONS WITH DISABILITIES

Section 1.

Minnesota Statutes 2002, section 252.32, subdivision 1, is amended to read:

Subdivision 1.

Program established.

In accordance with state policy established in section 256F.01 that all children are entitled to live in families that offer safe, nurturing, permanent relationships, and that public services be directed toward preventing the unnecessary separation of children from their families, and because many families who have children with deleted text begin mental retardation or related conditions deleted text end new text begin disabilities new text end have special needs and expenses that other families do not have, the commissioner of human services shall establish a program to assist families who have deleted text begin dependents deleted text end new text begin dependent children new text end with deleted text begin mental retardation or related conditions deleted text end new text begin disabilities new text end living in their home. The program shall make support grants available to the families.

Sec. 2.

Minnesota Statutes 2002, section 252.32, subdivision 1a, is amended to read:

Subd. 1a.

Support grants.

(a) Provision of support grants must be limited to families who require support and whose dependents are under the age of deleted text begin 22 and who have mental retardation or who have a related condition deleted text end new text begin 21 new text end and who have been deleted text begin determined by a screening team established deleted text end new text begin certified disabled new text end under section deleted text begin 256B.092 to be at risk of institutionalization deleted text end new text begin 256B.055, subdivision 12, paragraphs (a), (b), (c), (d), and (e) new text end . Families who are receiving home and community-based waivered services for persons with mental retardation or related conditions are not eligible for support grants.

deleted text begin Families receiving grants who will be receiving home and community-based waiver services for persons with mental retardation or a related condition for their family member within the grant year, and who have ongoing payments for environmental or vehicle modifications which have been approved by the county as a grant expense and would have qualified for payment under this waiver may receive a onetime grant payment from the commissioner to reduce or eliminate the principal of the remaining debt for the modifications, not to exceed the maximum amount allowable for the remaining years of eligibility for a family support grant. The commissioner is authorized to use up to $20,000 annually from the grant appropriation for this purpose. Any amount unexpended at the end of the grant year shall be allocated by the commissioner in accordance with subdivision 3a, paragraph (b), clause (2). deleted text end Families whose annual adjusted gross income is $60,000 or more are not eligible for support grants except in cases where extreme hardship is demonstrated. Beginning in state fiscal year 1994, the commissioner shall adjust the income ceiling annually to reflect the projected change in the average value in the United States Department of Labor Bureau of Labor Statistics consumer price index (all urban) for that year.

(b) Support grants may be made available as monthly subsidy grants and lump sum grants.

(c) Support grants may be issued in the form of cash, voucher, and direct county payment to a vendor.

(d) Applications for the support grant shall be made by the legal guardian to the county social service agency. The application shall specify the needs of the families, the form of the grant requested by the families, and deleted text begin that deleted text end the deleted text begin families have agreed to use the support grant for deleted text end items and services deleted text begin within the designated reimbursable expense categories and recommendations of the county deleted text end new text begin to be reimbursed new text end .

deleted text begin (e) Families who were receiving subsidies on the date of implementation of the $60,000 income limit in paragraph (a) continue to be eligible for a family support grant until December 31, 1991, if all other eligibility criteria are met. After December 31, 1991, these families are eligible for a grant in the amount of one-half the grant they would otherwise receive, for as long as they remain eligible under other eligibility criteria. deleted text end

Sec. 3.

Minnesota Statutes 2002, section 252.32, subdivision 3, is amended to read:

Subd. 3.

Amount of support grant; use.

Support grant amounts shall be determined by the county social service agency. deleted text begin Each service deleted text end new text begin Services new text end and deleted text begin item deleted text end new text begin items new text end purchased with a support grant must:

(1) be over and above the normal costs of caring for the dependent if the dependent did not have a disability;

(2) be directly attributable to the dependent's disabling condition; and

(3) enable the family to delay or prevent the out-of-home placement of the dependent.

The design and delivery of services and items purchased under this section must suit the dependent's chronological age and be provided in the least restrictive environment possible, consistent with the needs identified in the individual service plan.

Items and services purchased with support grants must be those for which there are no other public or private funds available to the family. Fees assessed to parents for health or human services that are funded by federal, state, or county dollars are not reimbursable through this program.

new text begin In approving or denying applications, the county shall consider the following factors: new text end

new text begin (1) the extent and areas of the functional limitations of the disabled child; new text end

new text begin (2) the degree of need in the home environment for additional support; and new text end

new text begin (3) the potential effectiveness of the grant to maintain and support the person in the family environment. new text end

The maximum monthly grant amount shall be $250 per eligible dependent, or $3,000 per eligible dependent per state fiscal year, within the limits of available funds. The county social service agency may consider the dependent's supplemental security income in determining the amount of the support grant. deleted text begin The county social service agency may exceed $3,000 per state fiscal year per eligible dependent for emergency circumstances in cases where exceptional resources of the family are required to meet the health, welfare-safety needs of the child. deleted text end

deleted text begin County social service agencies shall continue to provide funds to families receiving state grants on June 30, 1997, if eligibility criteria continue to be met. deleted text end Any adjustments to their monthly grant amount must be based on the needs of the family and funding availability.

Sec. 4.

Minnesota Statutes 2002, section 252.32, subdivision 3c, is amended to read:

Subd. 3c.

County board responsibilities.

County boards receiving funds under this section shall:

(1) deleted text begin determine the needs of families for services in accordance with section 256B.092 or 256E.08 and any rules adopted under those sections deleted text end new text begin submit a plan to the department for the management of the family support grant program. The plan must include the projected number of families the county will serve and policies and procedures for: new text end

new text begin (i) identifying potential families for the program; new text end

new text begin (ii) grant distribution; new text end

new text begin (iii) waiting list procedures; and new text end

new text begin (iv) prioritization of families to receive grants new text end ;

(2) determine the eligibility of all persons proposed for program participation;

(3) approve a plan for items and services to be reimbursed and inform families of the county's approval decision;

(4) issue support grants directly to, or on behalf of, eligible families;

(5) inform recipients of their right to appeal under subdivision 3e;

(6) submit quarterly financial reports under subdivision 3b and indicate deleted text begin on the screening documents deleted text end the annual grant level for each family, the families denied grants, and the families eligible but waiting for funding; and

(7) coordinate services with other programs offered by the county.

Sec. 5.

Minnesota Statutes 2002, section 256.476, subdivision 1, is amended to read:

Subdivision 1.

Purpose and goals.

The commissioner of human services shall establish a consumer support grant program for individuals with functional limitations and their families who wish to purchase and secure their own supports. The commissioner and local agencies shall jointly develop an implementation plan which must include a way to resolve the issues related to county liability. The program shall:

(1) make support grants deleted text begin or exception grants described in subdivision 11 deleted text end available to individuals or families as an effective alternative to deleted text begin existing programs and services, such as deleted text end the developmental disability family support program, personal care attendant services, home health aide services, and private duty nursing services;

(2) provide consumers more control, flexibility, and responsibility over their services and supports;

(3) promote local program management and decision making; and

(4) encourage the use of informal and typical community supports.

Sec. 6.

Minnesota Statutes 2002, section 256.476, subdivision 3, is amended to read:

Subd. 3.

Eligibility to apply for grants.

(a) A person is eligible to apply for a consumer support grant if the person meets all of the following criteria:

(1) the person is eligible for and has been approved to receive services under medical assistance as determined under sections 256B.055 and 256B.056 or the person has been approved to receive a grant under the developmental disability family support program under section 252.32;

(2) the person is able to direct and purchase the person's own care and supports, or the person has a family member, legal representative, or other authorized representative who can purchase and arrange supports on the person's behalf;

(3) the person has functional limitations, requires ongoing supports to live in the community, and is at risk of or would continue institutionalization without such supports; and

(4) the person will live in a home. For the purpose of this section, "home" means the person's own home or home of a person's family member. These homes are natural home settings and are not licensed by the department of health or human services.

(b) Persons may not concurrently receive a consumer support grant if they are:

(1) receiving deleted text begin home and community-based services under United States Code, title 42, section 1396h(c); deleted text end personal care attendant and home health aide services new text begin , or private duty nursing new text end under section 256B.0625; a developmental disability family support grant; or alternative care services under section 256B.0913; or

(2) residing in an institutional or congregate care setting.

(c) A person or person's family receiving a consumer support grant shall not be charged a fee or premium by a local agency for participating in the program.

(d) deleted text begin The commissioner may limit the participation of recipients of services from federal waiver programs in the consumer support grant program if the participation of these individuals will result in an increase in the cost to the state. deleted text end new text begin Individuals receiving home and community-based waivers under United States Code, title 42, section 1396h(c), are not eligible for the consumer support grant. new text end

(e) The commissioner shall establish a budgeted appropriation each fiscal year for the consumer support grant program. The number of individuals participating in the program will be adjusted so the total amount allocated to counties does not exceed the amount of the budgeted appropriation. The budgeted appropriation will be adjusted annually to accommodate changes in demand for the consumer support grants.

Sec. 7.

Minnesota Statutes 2002, section 256.476, subdivision 4, is amended to read:

Subd. 4.

Support grants; criteria and limitations.

(a) A county board may choose to participate in the consumer support grant program. If a county has not chosen to participate by July 1, 2002, the commissioner shall contract with another county or other entity to provide access to residents of the nonparticipating county who choose the consumer support grant option. The commissioner shall notify the county board in a county that has declined to participate of the commissioner's intent to enter into a contract with another county or other entity at least 30 days in advance of entering into the contract. The local agency shall establish written procedures and criteria to determine the amount and use of support grants. These procedures must include, at least, the availability of respite care, assistance with daily living, and adaptive aids. The local agency may establish monthly or annual maximum amounts for grants and procedures where exceptional resources may be required to meet the health and safety needs of the person on a time-limited basis, however, the total amount awarded to each individual may not exceed the limits established in subdivision 11.

(b) Support grants to a person or a person's family will be provided through a monthly subsidy payment and be in the form of cash, voucher, or direct county payment to vendor. Support grant amounts must be determined by the local agency. Each service and item purchased with a support grant must meet all of the following criteria:

(1) it must be over and above the normal cost of caring for the person if the person did not have functional limitations;

(2) it must be directly attributable to the person's functional limitations;

(3) it must enable the person or the person's family to delay or prevent out-of-home placement of the person; and

(4) it must be consistent with the needs identified in the service deleted text begin plan deleted text end new text begin agreement new text end , when applicable.

(c) Items and services purchased with support grants must be those for which there are no other public or private funds available to the person or the person's family. Fees assessed to the person or the person's family for health and human services are not reimbursable through the grant.

(d) In approving or denying applications, the local agency shall consider the following factors:

(1) the extent and areas of the person's functional limitations;

(2) the degree of need in the home environment for additional support; and

(3) the potential effectiveness of the grant to maintain and support the person in the family environment or the person's own home.

(e) At the time of application to the program or screening for other services, the person or the person's family shall be provided sufficient information to ensure an informed choice of alternatives by the person, the person's legal representative, if any, or the person's family. The application shall be made to the local agency and shall specify the needs of the person and family, the form and amount of grant requested, the items and services to be reimbursed, and evidence of eligibility for medical assistance.

(f) Upon approval of an application by the local agency and agreement on a support plan for the person or person's family, the local agency shall make grants to the person or the person's family. The grant shall be in an amount for the direct costs of the services or supports outlined in the service agreement.

(g) Reimbursable costs shall not include costs for resources already available, such as special education classes, day training and habilitation, case management, other services to which the person is entitled, medical costs covered by insurance or other health programs, or other resources usually available at no cost to the person or the person's family.

(h) The state of Minnesota, the county boards participating in the consumer support grant program, or the agencies acting on behalf of the county boards in the implementation and administration of the consumer support grant program shall not be liable for damages, injuries, or liabilities sustained through the purchase of support by the individual, the individual's family, or the authorized representative under this section with funds received through the consumer support grant program. Liabilities include but are not limited to: workers' compensation liability, the Federal Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section, participating county boards and agencies acting on behalf of county boards are exempt from the provisions of section 268.04.

Sec. 8.

Minnesota Statutes 2002, section 256.476, subdivision 5, is amended to read:

Subd. 5.

Reimbursement, allocations, and reporting.

(a) For the purpose of transferring persons to the consumer support grant program from deleted text begin specific programs or services, such as deleted text end the developmental disability family support program and personal care assistant services, home health aide services, or private duty nursing services, the amount of funds transferred by the commissioner between the developmental disability family support program account, the medical assistance account, or the consumer support grant account shall be based on each county's participation in transferring persons to the consumer support grant program from those programs and services.

(b) At the beginning of each fiscal year, county allocations for consumer support grants shall be based on:

(1) the number of persons to whom the county board expects to provide consumer supports grants;

(2) their eligibility for current program and services;

(3) the amount of nonfederal dollars allowed under subdivision 11; and

(4) projected dates when persons will start receiving grants. County allocations shall be adjusted periodically by the commissioner based on the actual transfer of persons or service openings, and the nonfederal dollars associated with those persons or service openings, to the consumer support grant program.

(c) The amount of funds transferred by the commissioner from the medical assistance account for an individual may be changed if it is determined by the county or its agent that the individual's need for support has changed.

(d) The authority to utilize funds transferred to the consumer support grant account for the purposes of implementing and administering the consumer support grant program will not be limited or constrained by the spending authority provided to the program of origination.

(e) The commissioner may use up to five percent of each county's allocation, as adjusted, for payments for administrative expenses, to be paid as a proportionate addition to reported direct service expenditures.

(f) The county allocation for each individual or individual's family cannot exceed the amount allowed under subdivision 11.

(g) The commissioner may recover, suspend, or withhold payments if the county board, local agency, or grantee does not comply with the requirements of this section.

(h) Grant funds unexpended by consumers shall return to the state once a year. The annual return of unexpended grant funds shall occur in the quarter following the end of the state fiscal year.

Sec. 9.

Minnesota Statutes 2002, section 256.476, subdivision 11, is amended to read:

Subd. 11.

Consumer support grant program after july 1, 2001.

(a) Effective July 1, 2001, the commissioner shall allocate consumer support grant resources to serve additional individuals based on a review of Medicaid authorization and payment information of persons eligible for a consumer support grant from the most recent fiscal year. The commissioner shall use the following methodology to calculate maximum allowable monthly consumer support grant levels:

(1) For individuals whose program of origination is medical assistance home care under section 256B.0627, the maximum allowable monthly grant levels are calculated by:

(i) determining the nonfederal share of the average service authorization for each home care rating;

(ii) calculating the overall ratio of actual payments to service authorizations by program;

(iii) applying the overall ratio to the average service authorization level of each home care rating;

(iv) adjusting the result for any authorized rate increases provided by the legislature; and

(v) adjusting the result for the average monthly utilization per recipient deleted text begin ; and deleted text end new text begin . new text end

(2) deleted text begin for persons with programs of origination other than the program described in clause (1), the maximum grant level for an individual shall not exceed the total of the nonfederal dollars expended on the individual by the program of origination deleted text end new text begin The commissioner may review and evaluate the methodology to reflect changes in the home care programs overall ratio of actual payments to service authorizations new text end .

(b) new text begin Effective July 1, 2003, new text end persons new text begin previously new text end receiving deleted text begin consumer support deleted text end new text begin exception new text end grants deleted text begin prior to July 1, 2001, may continue to receive the grant amount established prior to July 1, 2001 deleted text end new text begin will have their grants calculated using the methodology in paragraph (a), clause (1). If a person currently receiving an exception grant wishes to have their home care rating reevaluated, they may request an assessment as defined in section 256B.0627, subdivision 1, paragraph (b) new text end .

deleted text begin (c) The commissioner may provide up to 200 exception grants, including grants in use under paragraph (b). Eligible persons shall be provided an exception grant in priority order based upon the date of the commissioner's receipt of the county request. The maximum allowable grant level for an exception grant shall be based upon the nonfederal share of the average service authorization from the most recent fiscal year for each home care rating category. The amount of each exception grant shall be based upon the commissioner's determination of the nonfederal dollars that would have been expended if services had been available for an individual who is unable to obtain the support needed from the program of origination due to the unavailability of qualified service providers at the time or the location where the supports are needed. deleted text end

Sec. 10.

Minnesota Statutes 2002, section 256.9657, is amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin Icf/mr license surcharge. new text end

new text begin Effective July 1, 2003, each nonstate-operated facility as defined under section 256B.501, subdivision 1, shall pay to the commissioner an annual surcharge according to the schedule in subdivision 4, paragraph (d). The annual surcharge shall be $1,040 per licensed bed. If the number of licensed beds is reduced, the surcharge shall be based on the number of remaining licensed beds the second month following the receipt of timely notice by the commissioner of human services that beds have been delicensed. The facility must notify the commissioner of health in writing when beds are delicensed. The commissioner of health must notify the commissioner of human services within ten working days after receiving written notification. If the notification is received by the commissioner of human services by the 15th of the month, the invoice for the second following month must be reduced to recognize the delicensing of beds. The commissioner may reduce, and may subsequently restore, the surcharge under this subdivision based on the commissioner's determination of a permissible surcharge. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 11.

Minnesota Statutes 2002, section 256.9657, subdivision 4, is amended to read:

Subd. 4.

Payments into the account.

(a) Payments to the commissioner under subdivisions 1 to 3 must be paid in monthly installments due on the 15th of the month beginning October 15, 1992. The monthly payment must be equal to the annual surcharge divided by 12. Payments to the commissioner under subdivisions 2 and 3 for fiscal year 1993 must be based on calendar year 1990 revenues. Effective July 1 of each year, beginning in 1993, payments under subdivisions 2 and 3 must be based on revenues earned in the second previous calendar year.

(b) Effective October 1, 1995, and each October 1 thereafter, the payments in subdivisions 2 and 3 must be based on revenues earned in the previous calendar year.

(c) If the commissioner of health does not provide by August 15 of any year data needed to update the base year for the hospital and health maintenance organization surcharges, the commissioner of human services may estimate base year revenue and use that estimate for the purposes of this section until actual data is provided by the commissioner of health.

new text begin (d) Payments to the commissioner under subdivision 3b must be paid in monthly installments due on the 15th of the month beginning July 15, 2003. The monthly payment must be equal to the annual surcharge divided by 12. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 12.

Minnesota Statutes 2002, section 256B.0621, subdivision 4, is amended to read:

Subd. 4.

Relocation targeted case management provider qualifications.

deleted text begin The following qualifications and certification standards must be met by providers of relocation targeted case management: deleted text end

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

deleted text begin (b) deleted text end new text begin (a) new text end A relocation targeted 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.

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

new text begin (c) A relocation targeted 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. Contracted providers must provide information on all conflicts of interest and obtain the recipient's informed consent or provide the recipient with alternatives. new text end

Sec. 13.

Minnesota Statutes 2002, section 256B.0625, subdivision 19c, is amended to read:

Subd. 19c.

Personal care.

Medical assistance covers personal care assistant services provided by an individual who is qualified to provide the services according to subdivision 19a and section 256B.0627, where the services are prescribed by a physician in accordance with a plan of treatment and are supervised by the recipient or a qualified professional. "Qualified professional" means a mental health professional as defined in section 245.462, subdivision 18, or 245.4871, subdivision 27; or a registered nurse as defined in sections 148.171 to 148.285 new text begin , or a licensed social worker as defined in section 148B.21 new text end . As part of the assessment, the county public health nurse will assist the recipient or responsible party to identify the most appropriate person to provide supervision of the personal care assistant. The qualified professional shall perform the duties described in Minnesota Rules, part 9505.0335, subpart 4.

Sec. 14.

Minnesota Statutes 2002, section 256B.0627, subdivision 1, is amended to read:

Subdivision 1.

Definition.

(a) "Activities of daily living" includes eating, toileting, grooming, dressing, bathing, transferring, mobility, and positioning.

(b) "Assessment" means a review and evaluation of a recipient's need for home care services conducted in person. Assessments for private duty nursing shall be conducted by a registered private duty nurse. Assessments for home health agency services shall be conducted by a home health agency nurse. Assessments for personal care assistant services shall be conducted by the county public health nurse or a certified public health nurse under contract with the county. A face-to-face assessment must include: documentation of health status, determination of need, evaluation of service effectiveness, identification of appropriate services, service plan development or modification, coordination of services, referrals and follow-up to appropriate payers and community resources, completion of required reports, recommendation of service authorization, and consumer education. Once the need for personal care assistant services is determined under this section, the county public health nurse or certified public health nurse under contract with the county is responsible for communicating this recommendation to the commissioner and the recipient. A face-to-face assessment for personal care assistant services is conducted on those recipients who have never had a county public health nurse assessment. A face-to-face assessment must occur at least annually or when there is a significant change in the recipient's condition or when there is a change in the need for personal care assistant services. A service update may substitute for the annual face-to-face assessment when there is not a significant change in recipient condition or a change in the need for personal care assistant service. A service update or review for temporary increase includes a review of initial baseline data, evaluation of service effectiveness, redetermination of service need, modification of service plan and appropriate referrals, update of initial forms, obtaining service authorization, and on going consumer education. Assessments for medical assistance home care services for mental retardation or related conditions and alternative care services for developmentally disabled home and community-based waivered recipients may be conducted by the county public health nurse to ensure coordination and avoid duplication. Assessments must be completed on forms provided by the commissioner within 30 days of a request for home care services by a recipient or responsible party.

(c) "Care plan" means a written description of personal care assistant services developed by the qualified professional or the recipient's physician with the recipient or responsible party to be used by the personal care assistant with a copy provided to the recipient or responsible party.

(d) "Complex and regular private duty nursing care" means:

(1) complex care is private duty nursing provided to recipients who are ventilator dependent or for whom a physician has certified that were it not for private duty nursing the recipient would meet the criteria for inpatient hospital intensive care unit (ICU) level of care; and

(2) regular care is private duty nursing provided to all other recipients.

(e) "Health-related functions" means functions that can be delegated or assigned by a licensed health care professional under state law to be performed by a personal care attendant.

(f) "Home care services" means a health service, determined by the commissioner as medically necessary, that is ordered by a physician and documented in a service plan that is reviewed by the physician at least once every 60 days for the provision of home health services, or private duty nursing, or at least once every 365 days for personal care. Home care services are provided to the recipient at the recipient's residence that is a place other than a hospital or long-term care facility or as specified in section 256B.0625.

(g) "Instrumental activities of daily living" includes meal planning and preparation, managing finances, shopping for food, clothing, and other essential items, performing essential household chores, communication by telephone and other media, and getting around and participating in the community.

(h) "Medically necessary" has the meaning given in Minnesota Rules, parts 9505.0170 to 9505.0475.

(i) "Personal care assistant" means a person who:

(1) is at least 18 years old, except for persons 16 to 18 years of age who participated in a related school-based job training program or have completed a certified home health aide competency evaluation;

(2) is able to effectively communicate with the recipient and personal care provider organization;

(3) effective July 1, 1996, has completed one of the training requirements as specified in Minnesota Rules, part 9505.0335, subpart 3, items A to D;

(4) has the ability to, and provides covered personal care assistant services according to the recipient's care plan, responds appropriately to recipient needs, and reports changes in the recipient's condition to the supervising qualified professional or physician;

(5) is not a consumer of personal care assistant services; and

(6) is subject to criminal background checks and procedures specified in section 245A.04.

(j) "Personal care provider organization" means an organization enrolled to provide personal care assistant services under the medical assistance program that complies with the following: (1) owners who have a five percent interest or more, and managerial officials are subject to a background study as provided in section 245A.04. This applies to currently enrolled personal care provider organizations and those agencies seeking enrollment as a personal care provider organization. An organization will be barred from enrollment if an owner or managerial official of the organization has been convicted of a crime specified in section 245A.04, or a comparable crime in another jurisdiction, unless the owner or managerial official meets the reconsideration criteria specified in section 245A.04; (2) the organization must maintain a surety bond and liability insurance throughout the duration of enrollment and provides proof thereof. The insurer must notify the department of human services of the cancellation or lapse of policy; and (3) the organization must maintain documentation of services as specified in Minnesota Rules, part 9505.2175, subpart 7, as well as evidence of compliance with personal care assistant training requirements.

(k) "Responsible party" means an individual deleted text begin residing with a recipient of personal care assistant services deleted text end who is capable of providing the deleted text begin supportive care deleted text end new text begin support new text end necessary to assist the recipient to live in the community, is at least 18 years old, new text begin actively participates in planning and directing of personal care assistant services, new text end and is not deleted text begin a deleted text end new text begin the new text end personal care assistant. new text begin The responsible party must be accessible to the recipient and the personal care assistant when personal care services are being provided and monitor the services at least weekly according to the plan of care. The responsible party must be identified at the time of assessment and listed on the recipient's service agreement and care plan. new text end Responsible parties deleted text begin who are parents of minors or guardians of minors or incapacitated persons deleted text end may delegate the responsibility to another adult deleted text begin during a temporary absence of at least 24 hours but not more than six months. The person delegated as a responsible party must be able to meet the definition of responsible party, except that the delegated responsible party is required to reside with the recipient only while serving as the responsible party deleted text end new text begin who is not the personal care assistant. The responsible party must assure that the delegate performs the functions of the responsible party, is identified at the time of the assessment, and is listed on the service agreement and the care plan new text end . Foster care license holders may be designated the responsible party for residents of the foster care home if case management is provided as required in section 256B.0625, subdivision 19a. For persons who, as of April 1, 1992, are sharing personal care assistant services in order to obtain the availability of 24-hour coverage, an employee of the personal care provider organization may be designated as the responsible party if case management is provided as required in section 256B.0625, subdivision 19a.

(l) "Service plan" means a written description of the services needed based on the assessment developed by the nurse who conducts the assessment together with the recipient or responsible party. The service plan shall include a description of the covered home care services, frequency and duration of services, and expected outcomes and goals. The recipient and the provider chosen by the recipient or responsible party must be given a copy of the completed service plan within 30 calendar days of the request for home care services by the recipient or responsible party.

(m) "Skilled nurse visits" are provided in a recipient's residence under a plan of care or service plan that specifies a level of care which the nurse is qualified to provide. These services are:

(1) nursing services according to the written plan of care or service plan and accepted standards of medical and nursing practice in accordance with chapter 148;

(2) services which due to the recipient's medical condition may only be safely and effectively provided by a registered nurse or a licensed practical nurse;

(3) assessments performed only by a registered nurse; and

(4) teaching and training the recipient, the recipient's family, or other caregivers requiring the skills of a registered nurse or licensed practical nurse.

(n) "Telehomecare" means the use of telecommunications technology by a home health care professional to deliver home health care services, within the professional's scope of practice, to a patient located at a site other than the site where the practitioner is located.

Sec. 15.

Minnesota Statutes 2002, section 256B.0627, subdivision 4, is amended to read:

Subd. 4.

Personal care assistant services.

(a) The personal care assistant services that are eligible for payment are services and supports furnished to an individual, as needed, to assist in accomplishing activities of daily living; instrumental activities of daily living; health-related functions through hands-on assistance, supervision, and cuing; and redirection and intervention for behavior including observation and monitoring.

(b) Payment for services will be made within the limits approved using the prior authorized process established in subdivision 5.

(c) The amount and type of services authorized shall be based on an assessment of the recipient's needs in these areas:

(1) bowel and bladder care;

(2) skin care to maintain the health of the skin;

(3) repetitive maintenance range of motion, muscle strengthening exercises, and other tasks specific to maintaining a recipient's optimal level of function;

(4) respiratory assistance;

(5) transfers and ambulation;

(6) bathing, grooming, and hairwashing necessary for personal hygiene;

(7) turning and positioning;

(8) assistance with furnishing medication that is self-administered;

(9) application and maintenance of prosthetics and orthotics;

(10) cleaning medical equipment;

(11) dressing or undressing;

(12) assistance with eating and meal preparation and necessary grocery shopping;

(13) accompanying a recipient to obtain medical diagnosis or treatment;

(14) assisting, monitoring, or prompting the recipient to complete the services in clauses (1) to (13);

(15) redirection, monitoring, and observation that are medically necessary and an integral part of completing the personal care assistant services described in clauses (1) to (14);

(16) redirection and intervention for behavior, including observation and monitoring;

(17) interventions for seizure disorders, including monitoring and observation if the recipient has had a seizure that requires intervention within the past three months;

(18) tracheostomy suctioning using a clean procedure if the procedure is properly delegated by a registered nurse. Before this procedure can be delegated to a personal care assistant, a registered nurse must determine that the tracheostomy suctioning can be accomplished utilizing a clean rather than a sterile procedure and must ensure that the personal care assistant has been taught the proper procedure; and

(19) incidental household services that are an integral part of a personal care service described in clauses (1) to (18).

For purposes of this subdivision, monitoring and observation means watching for outward visible signs that are likely to occur and for which there is a covered personal care service or an appropriate personal care intervention. For purposes of this subdivision, a clean procedure refers to a procedure that reduces the numbers of microorganisms or prevents or reduces the transmission of microorganisms from one person or place to another. A clean procedure may be used beginning 14 days after insertion.

(d) The personal care assistant services that are not eligible for payment are the following:

(1) services not ordered by the physician;

(2) assessments by personal care assistant provider organizations or by independently enrolled registered nurses;

(3) services that are not in the service plan;

(4) services provided by the recipient's spouse, legal guardian for an adult or child recipient, or parent of a recipient under age 18;

(5) services provided by a foster care provider of a recipient who cannot direct the recipient's own care, unless monitored by a county or state case manager under section 256B.0625, subdivision 19a;

(6) services provided by the residential or program license holder in a residence for more than four persons;

(7) services that are the responsibility of a residential or program license holder under the terms of a service agreement and administrative rules;

(8) sterile procedures;

(9) injections of fluids into veins, muscles, or skin;

(10) deleted text begin services provided by parents of adult recipients, adult children, or siblings of the recipient, unless these relatives meet one of the following hardship criteria and the commissioner waives this requirement: deleted text end

deleted text begin (i) the relative resigns from a part-time or full-time job to provide personal care for the recipient; deleted text end

deleted text begin (ii) the relative goes from a full-time to a part-time job with less compensation to provide personal care for the recipient; deleted text end

deleted text begin (iii) the relative takes a leave of absence without pay to provide personal care for the recipient; deleted text end

deleted text begin (iv) the relative incurs substantial expenses by providing personal care for the recipient; or deleted text end

deleted text begin (v) because of labor conditions, special language needs, or intermittent hours of care needed, the relative is needed in order to provide an adequate number of qualified personal care assistants to meet the medical needs of the recipient; deleted text end

deleted text begin (11) deleted text end homemaker services that are not an integral part of a personal care assistant services;

deleted text begin (12) deleted text end new text begin (11) new text end home maintenance, or chore services;

deleted text begin (13) deleted text end new text begin (12) new text end services not specified under paragraph (a); and

deleted text begin (14) deleted text end new text begin (13) new text end services not authorized by the commissioner or the commissioner's designee.

(e) The recipient or responsible party may choose to supervise the personal care assistant or to have a qualified professional, as defined in section 256B.0625, subdivision 19c, provide the supervision. As required under section 256B.0625, subdivision 19c, the county public health nurse, as a part of the assessment, will assist the recipient or responsible party to identify the most appropriate person to provide supervision of the personal care assistant. Health-related delegated tasks performed by the personal care assistant will be under the supervision of a qualified professional or the direction of the recipient's physician. If the recipient has a qualified professional, Minnesota Rules, part 9505.0335, subpart 4, applies.

Sec. 16.

Minnesota Statutes 2002, section 256B.0627, subdivision 9, is amended to read:

Subd. 9.

Flexible use of personal care assistant hours.

(a) deleted text begin The commissioner may allow for the flexible use of personal care assistant hours. deleted text end "Flexible use" means the scheduled use of authorized hours of personal care assistant services, which vary within the length of the service authorization in order to more effectively meet the needs and schedule of the recipient. Recipients may use their approved hours flexibly within the service authorization period for medically necessary covered services specified in the assessment required in subdivision 1. The flexible use of authorized hours does not increase the total amount of authorized hours available to a recipient as determined under subdivision 5. The commissioner shall not authorize additional personal care assistant services to supplement a service authorization that is exhausted before the end date under a flexible service use plan, unless the county public health nurse determines a change in condition and a need for increased services is established.

(b) deleted text begin The recipient or responsible party, together with the county public health nurse, shall determine whether flexible use is an appropriate option based on the needs and preferences of the recipient or responsible party, and, if appropriate, must ensure that the allocation of hours covers the ongoing needs of the recipient over the entire service authorization period. As part of the assessment and service planning process, the recipient or responsible party must work with the county public health nurse to develop a written month-to-month plan of the projected use of personal care assistant services that is part of the service plan and ensures that the: deleted text end

deleted text begin (1) health and safety needs of the recipient will be met; deleted text end

deleted text begin (2) total annual authorization will not exceed before the end date; and deleted text end

deleted text begin (3) how actual use of hours will be monitored. deleted text end

deleted text begin (c) If the actual use of personal care assistant service varies significantly from the use projected in the plan, the written plan must be promptly updated by the recipient or responsible party and the county public health nurse. deleted text end

deleted text begin (d) deleted text end The recipient or responsible party, together with the provider, must work to monitor and document the use of authorized hours and ensure that a recipient is able to manage services effectively throughout the authorized period. deleted text begin The provider must ensure that the month-to-month plan is incorporated into the care plan. deleted text end Upon request of the recipient or responsible party, the provider must furnish regular updates to the recipient or responsible party on the amount of personal care assistant services used.

deleted text begin (e) The recipient or responsible party may revoke the authorization for flexible use of hours by notifying the provider and county public health nurse in writing. deleted text end

deleted text begin (f) If the requirements in paragraphs (a) to (e) have not substantially been met, the commissioner shall deny, revoke, or suspend the authorization to use authorized hours flexibly. The recipient or responsible party may appeal the commissioner's action according to section 256.045. The denial, revocation, or suspension to use the flexible hours option shall not affect the recipient's authorized level of personal care assistant services as determined under subdivision 5. deleted text end

Sec. 17.

Minnesota Statutes 2002, section 256B.0911, subdivision 4d, is amended to read:

Subd. 4d.

Preadmission screening of individuals under 65 years of age.

(a) It is the policy of the state of Minnesota to ensure that individuals with disabilities or chronic illness are served in the most integrated setting appropriate to their needs and have the necessary information to make informed choices about home and community-based service options.

(b) Individuals under 65 years of age who are admitted to a nursing facility from a hospital must be screened prior to admission as outlined in subdivisions 4a through 4c.

(c) Individuals under 65 years of age who are admitted to nursing facilities with only a telephone screening must receive a face-to-face assessment from the long-term care consultation team member of the county in which the facility is located or from the recipient's county case manager within deleted text begin 20 working deleted text end new text begin 40 calendar new text end days of admission.

(d) Individuals under 65 years of age who are admitted to a nursing facility without preadmission screening according to the exemption described in subdivision 4b, paragraph (a), clause (3), and who remain in the facility longer than 30 days must receive a face-to-face assessment within 40 days of admission.

(e) At the face-to-face assessment, the long-term care consultation team member or county case manager must perform the activities required under subdivision 3b.

(f) For individuals under 21 years of age, a screening interview which recommends nursing facility admission must be face-to-face and approved by the commissioner before the individual is admitted to the nursing facility.

(g) In the event that an individual under 65 years of age is admitted to a nursing facility on an emergency basis, the county must be notified of the admission on the next working day, and a face-to-face assessment as described in paragraph (c) must be conducted within deleted text begin 20 working days deleted text end new text begin 40 calendar days new text end of admission.

(h) At the face-to-face assessment, the long-term care consultation team member or the case manager must present information about home and community-based options so the individual can make informed choices. If the individual chooses home and community-based services, the long-term care consultation team member or case manager must complete a written relocation plan within 20 working days of the visit. The plan shall describe the services needed to move out of the facility and a time line for the move which is designed to ensure a smooth transition to the individual's home and community.

(i) An individual under 65 years of age residing in a nursing facility shall receive a face-to-face assessment at least every 12 months to review the person's service choices and available alternatives unless the individual indicates, in writing, that annual visits are not desired. In this case, the individual must receive a face-to-face assessment at least once every 36 months for the same purposes.

(j) Notwithstanding the provisions of subdivision 6, the commissioner may pay county agencies directly for face-to-face assessments for individuals under 65 years of age who are being considered for placement or residing in a nursing facility.

Sec. 18.

Minnesota Statutes 2002, section 256B.0915, is amended by adding a subdivision to read:

new text begin Subd. 9. new text end

new text begin Tribal management of elderly waiver. new text end

new text begin Notwithstanding contrary provisions of this section, or those in other state laws or rules, the commissioner and White Earth Reservation may develop a model for tribal management of the elderly waiver program and implement this model through a contract between the state and White Earth Reservation. The model shall include the provision of tribal waiver case management, assessment for personal care assistance, and administrative requirements otherwise carried out by counties but shall not include tribal financial eligibility determination for medical assistance. new text end

Sec. 19.

Minnesota Statutes 2002, section 256B.47, subdivision 2, is amended to read:

Subd. 2.

Notice to residents.

new text begin (a) new text end No increase in nursing facility rates for private paying residents shall be effective unless the nursing facility notifies the resident or person responsible for payment of the increase in writing 30 days before the increase takes effect.

A nursing facility may adjust its rates without giving the notice required by this subdivision when the purpose of the rate adjustment is to reflect a deleted text begin necessary deleted text end change in the deleted text begin level of care provided to a deleted text end new text begin case-mix classification of the new text end resident. If the state fails to set rates as required by section 256B.431, new text begin subdivision 1, new text end the time required for giving notice is decreased by the number of days by which the state was late in setting the rates.

new text begin (b) If the state does not set rates by the date required in section 256B.431, subdivision 1, nursing facilities shall meet the requirement for advance notice by informing the resident or person responsible for payments, on or before the effective date of the increase, that a rate increase will be effective on that date. If the exact amount has not yet been determined, the nursing facility may raise the rates by the amount anticipated to be allowed. Any amounts collected from private pay residents in excess of the allowable rate must be repaid to private pay residents with interest at the rate used by the commissioner of revenue for the late payment of taxes and in effect on the date the rate increase is effective. new text end

Sec. 20.

Minnesota Statutes 2002, section 256B.5012, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Rate increase effective june 1, 2003. new text end

new text begin For rate periods beginning on or after June 1, 2003, the commissioner shall increase the total operating payment rate for each facility reimbursed under this section by $3 per day. The increase shall not be subject to any annual percentage increase. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 21.

Minnesota Statutes 2002, section 256B.5013, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Rate adjustments for short-term admissions for crisis or specialized medical care. new text end

new text begin Beginning July 1, 2003, the commissioner may designate up to 25 beds in ICF/MR facilities statewide to provide crisis respite or specialized respite care for medically fragile individuals. The commissioner shall adjust the monthly facility rate to provide payment for vacancies in designated respite beds by an amount equal to the rate for each recipient residing in a respite bed for up to 15 days per bed per month. The commissioner may designate respite beds in other facilities based on the respite care needs of a region or county as provided in section 252.28. Nothing in this section shall be construed as limiting payments for short-term admissions of eligible recipients to an ICF/MR that is not designated for respite care under this subdivision and does not receive a temporary rate adjustment. new text end

Sec. 22. new text begin LICENSING CHANGE. new text end

new text begin Notwithstanding Minnesota Statutes, section 252.291, the commissioner of human services shall allow an existing intermediate care facility for persons with mental retardation or related conditions located in Goodhue county serving 39 children to be converted to four separately licensed or certified cottages serving up to six children each. new text end

Sec. 23. new text begin REVISOR'S INSTRUCTION. new text end

new text begin For sections in Minnesota Statutes and Minnesota Rules affected by the repealed sections in this article, the revisor shall delete internal cross-references where appropriate and make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning. new text end

Sec. 24. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 252.32, subdivision 2; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 256B.0955; and 256B.5013, subdivision 4, are repealed July 1, 2003. new text end

new text begin (b) Laws 2001, First Special Session chapter 9, article 13, section 24, is repealed July 1, 2003. new text end

ARTICLE 6

OCCUPATIONAL LICENSES

Section 1.

Minnesota Statutes 2002, section 116J.70, subdivision 2a, is amended to read:

Subd. 2a.

License; exceptions.

"Business license" or "license" does not include the following:

(1) any occupational license or registration issued by a licensing board listed in section 214.01 or any occupational registration issued by the commissioner of health pursuant to section 214.13;

(2) any license issued by a county, home rule charter city, statutory city, township, or other political subdivision;

(3) any license required to practice the following occupation regulated by the following sections:

(i) abstracters regulated pursuant to chapter 386;

(ii) accountants regulated pursuant to chapter 326A;

(iii) adjusters regulated pursuant to chapter 72B;

(iv) architects regulated pursuant to chapter 326;

(v) assessors regulated pursuant to chapter 270;

(vi) athletic trainers regulated pursuant to chapter 148;

(vii) attorneys regulated pursuant to chapter 481;

(viii) auctioneers regulated pursuant to chapter 330;

(ix) barbers regulated pursuant to chapter 154;

(x) beauticians regulated pursuant to chapter 155A;

(xi) boiler operators regulated pursuant to chapter 183;

(xii) chiropractors regulated pursuant to chapter 148;

(xiii) collection agencies regulated pursuant to chapter 332;

(xiv) cosmetologists regulated pursuant to chapter 155A;

(xv) dentists, registered dental assistants, and dental hygienists regulated pursuant to chapter 150A;

(xvi) new text begin denturists regulated pursuant to chapter 150B; new text end

new text begin (xvii) new text end detectives regulated pursuant to chapter 326;

deleted text begin (xvii) deleted text end new text begin (xviii) new text end electricians regulated pursuant to chapter 326;

deleted text begin (xviii) deleted text end new text begin (xix) new text end mortuary science practitioners regulated pursuant to chapter 149A;

deleted text begin (xix) deleted text end new text begin (xx) new text end engineers regulated pursuant to chapter 326;

deleted text begin (xx) deleted text end new text begin (xxi) new text end insurance brokers and salespersons regulated pursuant to chapter 60A;

deleted text begin (xxi) deleted text end new text begin (xxii) new text end certified interior designers regulated pursuant to chapter 326;

deleted text begin (xxii) deleted text end new text begin (xxiii) new text end midwives regulated pursuant to chapter 147D;

deleted text begin (xxiii) deleted text end new text begin (xxiv) new text end nursing home administrators regulated pursuant to chapter 144A;

deleted text begin (xxiv) deleted text end new text begin (xxv) new text end optometrists regulated pursuant to chapter 148;

deleted text begin (xxv) deleted text end new text begin (xxvi) new text end osteopathic physicians regulated pursuant to chapter 147;

deleted text begin (xxvi) deleted text end new text begin (xxvii) new text end pharmacists regulated pursuant to chapter 151;

deleted text begin (xxvii) deleted text end new text begin (xxviii) new text end physical therapists regulated pursuant to chapter 148;

deleted text begin (xxviii) deleted text end new text begin (xxix) new text end physician assistants regulated pursuant to chapter 147A;

deleted text begin (xxix) deleted text end new text begin (xxx) new text end physicians and surgeons regulated pursuant to chapter 147;

deleted text begin (xxx) deleted text end new text begin (xxxi) new text end plumbers regulated pursuant to chapter 326;

deleted text begin (xxxi) deleted text end new text begin (xxxii) new text end podiatrists regulated pursuant to chapter 153;

deleted text begin (xxxii) deleted text end new text begin (xxxiii) new text end practical nurses regulated pursuant to chapter 148;

deleted text begin (xxxiii) deleted text end new text begin (xxxiv) new text end professional fund raisers regulated pursuant to chapter 309;

deleted text begin (xxxiv) deleted text end new text begin (xxxv) new text end psychologists regulated pursuant to chapter 148;

deleted text begin (xxxv) deleted text end new text begin (xxxvi) new text end real estate brokers, salespersons, and others regulated pursuant to chapters 82 and 83;

deleted text begin (xxxvi) deleted text end new text begin (xxxvii) new text end registered nurses regulated pursuant to chapter 148;

deleted text begin (xxxvii) deleted text end new text begin (xxxviii) new text end securities brokers, dealers, agents, and investment advisers regulated pursuant to chapter 80A;

deleted text begin (xxxviii) deleted text end new text begin (xxxix) new text end steamfitters regulated pursuant to chapter 326;

deleted text begin (xxxix) deleted text end new text begin (xl) new text end teachers and supervisory and support personnel regulated pursuant to chapter 125;

deleted text begin (xl) deleted text end new text begin (xli) new text end veterinarians regulated pursuant to chapter 156;

deleted text begin (xli) deleted text end new text begin (xlii) new text end water conditioning contractors and installers regulated pursuant to chapter 326;

deleted text begin (xlii) deleted text end new text begin (xliii) new text end water well contractors regulated pursuant to chapter 103I;

deleted text begin (xliii) deleted text end new text begin (xliv) new text end water and waste treatment operators regulated pursuant to chapter 115;

deleted text begin (xliv) deleted text end new text begin (xlv) new text end motor carriers regulated pursuant to chapter 221;

deleted text begin (xlv) deleted text end new text begin (xlvi) new text end professional firms regulated under chapter 319B;

deleted text begin (xlvi) deleted text end new text begin (xlvii) new text end real estate appraisers regulated pursuant to chapter 82B; new text begin or new text end

deleted text begin (xlvii) deleted text end new text begin (xlviii) new text end residential building contractors, residential remodelers, residential roofers, manufactured home installers, and specialty contractors regulated pursuant to chapter 326;

(4) any driver's license required pursuant to chapter 171;

(5) any aircraft license required pursuant to chapter 360;

(6) any watercraft license required pursuant to chapter 86B;

(7) any license, permit, registration, certification, or other approval pertaining to a regulatory or management program related to the protection, conservation, or use of or interference with the resources of land, air, or water, which is required to be obtained from a state agency or instrumentality; and

(8) any pollution control rule or standard established by the pollution control agency or any health rule or standard established by the commissioner of health or any licensing rule or standard established by the commissioner of human services.

Sec. 2.

Minnesota Statutes 2002, section 144.335, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

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

(a) "Patient" means a natural person who has received health care services from a provider for treatment or examination of a medical, psychiatric, or mental condition, the surviving spouse and parents of a deceased patient, or a person the patient appoints in writing as a representative, including a health care agent acting pursuant to chapter 145C, unless the authority of the agent has been limited by the principal in the principal's health care directive. Except for minors who have received health care services pursuant to sections 144.341 to 144.347, in the case of a minor, patient includes a parent or guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.

(b) "Provider" means (1) any person who furnishes health care services and is regulated to furnish the services pursuant to chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 150A, new text begin 150B, new text end 151, 153, or 153A, or Minnesota Rules, chapter 4666; (2) a home care provider licensed under section 144A.46; (3) a health care facility licensed pursuant to this chapter or chapter 144A; (4) a physician assistant registered under chapter 147A; and (5) an unlicensed mental health practitioner regulated pursuant to sections 148B.60 to 148B.71.

(c) "Individually identifiable form" means a form in which the patient is or can be identified as the subject of the health records.

Sec. 3.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Accrediting association. new text end

new text begin "Accrediting association" means an organization recognized by the commissioner that evaluates schools and education programs of alcohol and drug counseling or is listed in Nationally Recognized Accrediting Agencies and Associations, Criteria and Procedures for Listing by the U.S. Secretary of Education and Current List (1996), which is incorporated by reference. new text end

Sec. 4.

Minnesota Statutes 2002, section 148C.01, subdivision 2, is amended to read:

Subd. 2.

Alcohol and drug counselor.

"Alcohol and drug counselor" or "counselor" means a person who:

(1) uses, as a representation to the public, any title, initials, or description of services incorporating the words "alcohol and drug counselor";

(2) offers to render professional alcohol and drug counseling services relative to the abuse of or the dependency on alcohol or other drugs to the general public or groups, organizations, corporations, institutions, or government agencies for compensation, implying that the person is licensed and trained, experienced or expert in alcohol and drug counseling;

(3) holds a valid license issued under deleted text begin sections 148C.01 to 148C.11 deleted text end new text begin this chapter new text end to engage in the practice of alcohol and drug counseling; or

(4) is an applicant for an alcohol and drug counseling license.

Sec. 5.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2a. new text end

new text begin Alcohol and drug counselor academic course work. new text end

new text begin "Alcohol and drug counselor academic course work" means classroom education, which is directly related to alcohol and drug counseling and meets the requirements of section 148C.04, subdivision 5a, and is taken through an accredited school or educational program. new text end

Sec. 6.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2b. new text end

new text begin Alcohol and drug counselor continuing education activity. new text end

new text begin "Alcohol and drug counselor continuing education activity" means clock hours that meet the requirements of section 148C.075 and Minnesota Rules, part 4747.1100, and are obtained by a licensee at educational programs of annual conferences, lectures, panel discussions, workshops, seminars, symposiums, employer-sponsored inservices, or courses taken through accredited schools or education programs, including home study courses. A home study course need not be provided by an accredited school or education program to meet continuing education requirements. new text end

Sec. 7.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2c. new text end

new text begin Alcohol and drug counselor technician. new text end

new text begin "Alcohol and drug counselor technician" means a person not licensed as an alcohol and drug counselor who is performing acts authorized under section 148C.045. new text end

Sec. 8.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2d. new text end

new text begin Alcohol and drug counselor training. new text end

new text begin "Alcohol and drug counselor training" means clock hours obtained by an applicant at educational programs of annual conferences, lectures, panel discussions, workshops, seminars, symposiums, employer-sponsored inservices, or courses taken through accredited schools or education programs, including home study courses. Clock hours obtained from accredited schools or education programs must be measured under Minnesota Rules, part 4747.1100, subpart 5. new text end

Sec. 9.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2f. new text end

new text begin Clock hour. new text end

new text begin "Clock hour" means an instructional session of 50 consecutive minutes, excluding coffee breaks, registration, meals without a speaker, and social activities. new text end

Sec. 10.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 2g. new text end

new text begin Credential. new text end

new text begin "Credential" means a license, permit, certification, registration, or other evidence of qualification or authorization to engage in the practice of an occupation. new text end

Sec. 11.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 4a. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a person who holds a valid license under this chapter. new text end

Sec. 12.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 11a. new text end

new text begin Student. new text end

new text begin "Student" means a person enrolled in an alcohol and drug counselor education program at an accredited school or educational program and earning a minimum of nine semester credits per calendar year towards completion of an associate's, bachelor's, master's, or doctorate degree requirements that include an additional 18 semester credits or 270 clock hours of alcohol and drug counseling specific course work and 440 clock hours of practicum. new text end

Sec. 13.

Minnesota Statutes 2002, section 148C.01, subdivision 12, is amended to read:

Subd. 12.

Supervised alcohol and drug deleted text begin counseling experience deleted text end new text begin counselor new text end .

deleted text begin Except during the transition period, deleted text end "Supervised alcohol and drug deleted text begin counseling experience deleted text end new text begin counselor new text end " means deleted text begin practical experience gained by deleted text end a student, deleted text begin volunteer, or deleted text end new text begin either before, during, or after the student completes a program from an accredited school or educational program of alcohol and drug counseling, an new text end intern, deleted text begin and deleted text end new text begin or a person issued a temporary permit under section 148C.04, subdivision 4, and who is new text end supervised by a person either licensed under this chapter or exempt under its provisions deleted text begin ; either before, during, or after the student completes a program from an accredited school or educational program of alcohol and drug counseling deleted text end .

Sec. 14.

Minnesota Statutes 2002, section 148C.01, is amended by adding a subdivision to read:

new text begin Subd. 12a. new text end

new text begin Supervisor. new text end

new text begin "Supervisor" means a licensed alcohol and drug counselor licensed under this chapter or other licensed professional practicing alcohol and drug counseling under section 148C.11 who monitors activities of and accepts legal liability for the person practicing under supervision. A supervisor shall supervise no more than three trainees practicing under section 148C.04, subdivision 6. new text end

Sec. 15.

Minnesota Statutes 2002, section 148C.03, subdivision 1, is amended to read:

Subdivision 1.

General.

The commissioner shall, after consultation with the advisory council or a committee established by rule:

(a) adopt and enforce rules for licensure of alcohol and drug counselors, including establishing standards and methods of determining whether applicants and licensees are qualified under section 148C.04. The rules must provide for examinations and establish standards for the regulation of professional conduct. The rules must be designed to protect the public;

(b) develop and, at least twice a year, administer an examination to assess applicants' knowledge and skills. The commissioner may contract for the administration of an examination with an entity designated by the commissioner. The examinations must be psychometrically valid and reliable; must be written and oral, with the oral examination based on a written case presentation; must minimize cultural bias; and must be balanced in various theories relative to the practice of alcohol and drug counseling;

(c) issue licenses to individuals qualified under sections 148C.01 to 148C.11;

(d) issue copies of the rules for licensure to all applicants;

(e) adopt rules to establish and implement procedures, including a standard disciplinary process and rules of professional conduct;

(f) carry out disciplinary actions against licensees;

(g) establish, with the advice and recommendations of the advisory council, written internal operating procedures for receiving and investigating complaints and for taking disciplinary actions as appropriate;

(h) educate the public about the existence and content of the rules for alcohol and drug counselor licensing to enable consumers to file complaints against licensees who may have violated the rules;

(i) evaluate the rules in order to refine and improve the methods used to enforce the commissioner's standards; and

(j) deleted text begin set, deleted text end collect deleted text begin , and adjust deleted text end license fees for alcohol and drug counselors deleted text begin so that the total fees collected will as closely as possible equal anticipated expenditures during the biennium, as provided in section 16A.1285; fees for initial and renewal application and examinations; late fees for counselors who submit license renewal applications after the renewal deadline; and a surcharge fee. The surcharge fee must include an amount necessary to recover, over a five-year period, the commissioner's direct expenditures for the adoption of the rules providing for the licensure of alcohol and drug counselors. All fees received shall be deposited in the state treasury and credited to the special revenue fund deleted text end .

Sec. 16.

Minnesota Statutes 2002, section 148C.0351, subdivision 1, is amended to read:

Subdivision 1.

Application forms.

Unless exempted under section 148C.11, a person who practices alcohol and drug counseling in Minnesota must:

(1) apply to the commissioner for a license to practice alcohol and drug counseling on forms provided by the commissioner;

(2) include with the application a statement that the statements in the application are true and correct to the best of the applicant's knowledge and belief;

(3) include with the application a nonrefundable application fee specified deleted text begin by the commissioner deleted text end new text begin in section 148C.12 new text end ;

(4) include with the application information describing the applicant's experience, including the number of years and months the applicant has practiced alcohol and drug counseling as defined in section 148C.01;

(5) include with the application the applicant's business address and telephone number, or home address and telephone number if the applicant conducts business out of the home, and if applicable, the name of the applicant's supervisor, manager, and employer;

(6) include with the application a written and signed authorization for the commissioner to make inquiries to appropriate state regulatory agencies and private credentialing organizations in this or any other state where the applicant has practiced alcohol and drug counseling; and

(7) complete the application in sufficient detail for the commissioner to determine whether the applicant meets the requirements for filing. The commissioner may ask the applicant to provide additional information necessary to clarify incomplete or ambiguous information submitted in the application.

Sec. 17.

Minnesota Statutes 2002, section 148C.0351, is amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Initial license; term. new text end

new text begin (a) An initial license is effective on the date the commissioner indicates on the license certificate, with the license number, sent to the applicant upon approval of the application. new text end

new text begin (b) An initial license is valid for a period beginning with the effective date in paragraph (a) and ending on the date specified by the commissioner on the license certificate placing the applicant in an existing two-year renewal cycle, as established under section 148C.05, subdivision 1. new text end

Sec. 18.

new text begin [148C.0355] COMMISSIONER ACTION ON APPLICATIONS FOR LICENSURE. new text end

new text begin The commissioner shall act on each application for licensure within 90 days from the date the completed application and all required information is received by the commissioner. The commissioner shall determine if the applicant meets the requirements for licensure and whether there are grounds for denial of licensure under this chapter. If the commissioner denies an application on grounds other than the applicant's failure of an examination, the commissioner shall: new text end

new text begin (1) notify the applicant, in writing, of the denial and the reason for the denial and provide the applicant 30 days from the date of the letter informing the applicant of the denial in which the applicant may provide additional information to address the reasons for the denial. If the applicant does not respond in writing to the commissioner within the 30-day period, the denial is final. If the commissioner receives additional information, the commissioner shall review it and make a final determination thereafter; new text end

new text begin (2) notify the applicant that an application submitted following denial is a new application and must be accompanied by the appropriate fee as specified in section 148C.12; and new text end

new text begin (3) notify the applicant of the right to request a hearing under chapter 14. new text end

Sec. 19.

Minnesota Statutes 2002, section 148C.04, is amended to read:

148C.04 REQUIREMENTS FOR LICENSURE.

Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner shall issue licenses to the individuals qualified under deleted text begin sections 148C.01 to 148C.11 deleted text end new text begin this chapter new text end to practice alcohol and drug counseling.

Subd. 2. [FEE.] Each applicant shall pay a nonrefundable fee deleted text begin set by the commissioner pursuant to section 148C.03 deleted text end new text begin as specified in section 148C.12 new text end . Fees paid to the commissioner shall be deposited in the special revenue fund.

Subd. 3. [ deleted text begin LICENSING deleted text end REQUIREMENTS FOR deleted text begin THE FIRST FIVE YEARS deleted text end new text begin LICENSURE BEFORE JULY 1, 2008 new text end .] deleted text begin For five years after the effective date of the rules authorized in section 148C.03, the deleted text end new text begin An new text end applicant deleted text begin , unless qualified under section 148C.06 during the 25-month period authorized therein, under section 148C.07, or under subdivision 4, deleted text end new text begin for a license new text end must furnish evidence satisfactory to the commissioner that the applicant has met all the requirements in clauses (1) to (3). The applicant must have:

(1) received an associate degree, or an equivalent number of credit hours, and a certificate in alcohol and drug counseling new text begin , new text end including new text begin 18 semester credits or new text end 270 clock hours of deleted text begin alcohol and drug counseling classroom education deleted text end new text begin academic course work in accordance with subdivision 5a, paragraph (a), new text end from an accredited school or educational program and 880 clock hours of supervised alcohol and drug counseling practicum;

(2) completed a written case presentation and satisfactorily passed an oral examination new text begin established by the commissioner new text end that demonstrates competence in the core functions; and

(3) satisfactorily passed a written examination as established by the commissioner.

Subd. 4. [ deleted text begin LICENSING deleted text end REQUIREMENTS deleted text begin AFTER FIVE YEARS deleted text end new text begin FOR LICENSURE AFTER JULY 1, 2008 new text end .] deleted text begin Beginning five years after the effective date of the rules authorized in section 148C.03, subdivision 1 , deleted text end An applicant for deleted text begin licensure deleted text end new text begin a license new text end must submit evidence to the commissioner that the applicant has met one of the following requirements:

(1) the applicant must have:

(i) received a bachelor's degree from an accredited school or educational program, including deleted text begin 480 deleted text end new text begin 18 semester credits or 270 new text end clock hours of deleted text begin alcohol and drug counseling education deleted text end new text begin academic course work in accordance with subdivision 5a, paragraph (a), new text end from an accredited school or educational program and 880 clock hours of supervised alcohol and drug counseling practicum;

(ii) completed a written case presentation and satisfactorily passed an oral examination new text begin established by the commissioner new text end that demonstrates competence in the core functions; and

(iii) satisfactorily passed a written examination as established by the commissioner; or

(2) the applicant must meet the requirements of section 148C.07.

new text begin Subd. 5a. new text end [ACADEMIC COURSE WORK.] new text begin (a) Minimum academic course work requirements for licensure as referred to under subdivision 3, clause (1), and subdivision 4, clause (1), item (i), must be in the following areas: new text end

new text begin (1) overview of alcohol and drug counseling focusing on the transdisciplinary foundations of alcohol and drug counseling and providing an understanding of theories of chemical dependency, the continuum of care, and the process of change; new text end

new text begin (2) pharmacology of substance abuse disorders and the dynamics of addiction; new text end

new text begin (3) screening, intake, assessment, and treatment planning; new text end

new text begin (4) counseling theory and practice, crisis intervention, orientation, and client education; new text end

new text begin (5) case management, consultation, referral, treatment planning, reporting, recordkeeping, and professional and ethical responsibilities; and new text end

new text begin (6) multicultural aspects of chemical dependency to include awareness of learning outcomes described in Minnesota Rules, part 4747.1100, subpart 2, and the ability to know when consultation is needed. new text end

new text begin (b) Advanced academic course work includes, at a minimum, the course work required in paragraph (a) and additional course work in the following areas: new text end

new text begin (1) advanced study in the areas listed in paragraph (a); new text end

new text begin (2) chemical dependency and the family; new text end

new text begin (3) treating substance abuse disorders in culturally diverse and identified populations; new text end

new text begin (4) dual diagnoses/co-occurring disorders with substance abuse disorders; and new text end

new text begin (5) ethics and chemical dependency. new text end

Subd. 6. [TEMPORARY deleted text begin PRACTICE deleted text end new text begin PERMIT new text end REQUIREMENTS.] (a) deleted text begin A person may temporarily deleted text end new text begin The commissioner shall issue a temporary permit to new text end practice alcohol and drug counseling prior to being licensed under this chapter if the person:

(1) either:

(i) deleted text begin meets the associate degree education and practicum requirements of subdivision 3, clause (1); deleted text end

deleted text begin (ii) meets the bachelor's degree education and practicum requirements of subdivision 4, clause (1), item (i); or deleted text end

deleted text begin (iii) deleted text end submits verification of a current and unrestricted credential for the practice of alcohol and drug counseling from a national certification body or a certification or licensing body from another state, United States territory, or federally recognized tribal authority;

new text begin (ii) submits verification of the completion of at least 64 semester credits, including 270 clock hours or 18 semester credits of formal classroom education in alcohol and drug counseling and at least 440 clock hours of alcohol and drug counseling practicum from an accredited school or educational program; or new text end

new text begin (iii) meets the requirements of section 148C.11, subdivision 6, clauses (1), (2), and (5); new text end

(2) deleted text begin requests deleted text end new text begin applies new text end , in writing, deleted text begin temporary practice status with the commissioner deleted text end on an application form deleted text begin according to section 148C.0351 deleted text end new text begin provided by the commissioner new text end , which includes the nonrefundable deleted text begin license deleted text end new text begin temporary permit new text end fee new text begin as specified in section 148C.12 new text end and an affirmation by the person's supervisor, as defined in paragraph deleted text begin (b) deleted text end new text begin (c) new text end , clause (1), deleted text begin and deleted text end which is signed and dated by the person and the person's supervisor; new text begin and new text end

(3) has not been disqualified to practice temporarily on the basis of a background investigation under section 148C.09, subdivision 1a deleted text begin ; and deleted text end new text begin . new text end

deleted text begin (4) has been notified deleted text end new text begin (b) The commissioner must notify the person new text end in writing new text begin within 90 days from the date the completed application and all required information is received new text end by the commissioner deleted text begin that deleted text end new text begin whether new text end the person is qualified to practice under this subdivision.

deleted text begin (b) deleted text end new text begin (c) new text end A person practicing under this subdivision:

(1) may practice deleted text begin only in a program licensed by the department of human services and deleted text end new text begin under tribal jurisdiction or new text end under the direct deleted text begin , on-site deleted text end supervision of a person who is licensed under this chapter deleted text begin and employed in that licensed program deleted text end ;

(2) is subject to the rules of professional conduct set by rule; and

(3) is not subject to the continuing education requirements of section deleted text begin 148C.05 deleted text end new text begin 148C.075 new text end .

(c) A person practicing under this subdivision deleted text begin may not deleted text end new text begin must new text end use deleted text begin with the public any deleted text end new text begin the new text end title or description stating or implying that the person is deleted text begin licensed to engage deleted text end new text begin a trainee engaged new text end in the practice of alcohol and drug counseling.

(d) deleted text begin The temporary status of deleted text end A person deleted text begin applying for temporary practice deleted text end new text begin practicing new text end under this subdivision deleted text begin expires on the date the commissioner grants or denies licensing deleted text end new text begin must annually submit a renewal application on forms provided by the commissioner with the renewal fee required in section 148C.12, subdivision 3, and the commissioner may renew the temporary permit if the trainee meets the requirements of this subdivision. A trainee may renew a practice permit no more than five times new text end .

new text begin (e) A temporary permit expires if not renewed, upon a change of employment of the trainee or upon a change in supervision, or upon the granting or denial by the commissioner of a license. new text end

Subd. 7. [EFFECT AND SUSPENSION OF TEMPORARY PRACTICE.] Approval of a person's application for temporary practice creates no rights to or expectation of approval from the commissioner for licensure as an alcohol and drug counselor. The commissioner may suspend or restrict a person's temporary practice status according to section 148C.09.

[EFFECTIVE DATE.] new text begin Subdivisions 1, 2, 3, 4, and 5 are effective January 28, 2003. Subdivision 6 is effective July 1, 2003. new text end

Sec. 20.

new text begin [148C.045] ALCOHOL AND DRUG COUNSELOR TECHNICIAN. new text end

new text begin An alcohol and drug counselor technician may perform the services described in section 148C.01, subdivision 9, paragraphs (1), (2), and (3), while under the direct supervision of a licensed alcohol and drug counselor. new text end

Sec. 21.

Minnesota Statutes 2002, section 148C.05, subdivision 1, is amended to read:

Subdivision 1.

new text begin biennial new text end renewal deleted text begin requirements deleted text end .

deleted text begin To renew a license, an applicant must: deleted text end

deleted text begin (1) complete a renewal application every two years on a form provided by the commissioner and submit the biennial renewal fee by the deadline; and deleted text end

deleted text begin (2) submit additional information if requested by the commissioner to clarify information presented in the renewal application. This information must be submitted within 30 days of the commissioner's request. deleted text end new text begin A license must be renewed every two years. new text end

Sec. 22.

Minnesota Statutes 2002, section 148C.05, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Renewal requirements. new text end

new text begin To renew a license, an applicant must submit to the commissioner: new text end

new text begin (1) a completed and signed application for license renewal, including a signed consent authorizing the commissioner to obtain information about the applicant from third parties, including, but not limited to, employers, former employers, and law enforcement agencies; new text end

new text begin (2) the renewal fee required under section 148C.12; and new text end

new text begin (3) additional information as requested by the commissioner to clarify information presented in the renewal application. The licensee must submit information within 30 days of the date of the commissioner's request. new text end

Sec. 23.

Minnesota Statutes 2002, section 148C.05, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin License renewal notice. new text end

new text begin At least 60 calendar days before the renewal deadline date in subdivision 6, the commissioner shall mail a renewal notice to the licensee's last known address on file with the commissioner. The notice must include an application for license renewal, the renewal deadline, and notice of fees required for renewal. The licensee's failure to receive notice does not relieve the licensee of the obligation to meet the renewal deadline and other requirements for license renewal. new text end

Sec. 24.

Minnesota Statutes 2002, section 148C.05, is amended by adding a subdivision to read:

new text begin Subd. 6. new text end

new text begin Renewal deadline and lapse of licensure. new text end

new text begin (a) Licensees must comply with paragraphs (b) to (d). new text end

new text begin (b) Each license certificate must state an expiration date. An application for license renewal must be received by the commissioner or postmarked at least 30 calendar days before the expiration date. If the postmark is illegible, the application must be considered timely if received at least 21 calendar days before the expiration date. new text end

new text begin (c) An application for license renewal not received within the time required under paragraph (b) must be accompanied by a late fee in addition to the renewal fee required in section 148C.12. new text end

new text begin (d) A licensee's license lapses if the licensee fails to submit to the commissioner a license renewal application by the licensure expiration date. A licensee shall not engage in the practice of alcohol and drug counseling while the license is lapsed. A licensee whose license has lapsed may renew the license by complying with section 148C.06. new text end

Sec. 25.

new text begin [148C.055] INACTIVE OR LAPSED LICENSE. new text end

new text begin Subdivision 1. new text end [INACTIVE LICENSE STATUS.] new text begin Unless a complaint is pending against the licensee, a licensee whose license is in good standing may request, in writing, that the license be placed on the inactive list. If a complaint is pending against a licensee, a license may not be placed on the inactive list until action relating to the complaint is concluded. The commissioner must receive the request for inactive status before expiration of the license. A request for inactive status received after the license expiration date must be denied. A licensee may renew a license that is inactive under this subdivision by meeting the renewal requirements of section 148C.06, subdivision 2, except that payment of a late renewal fee is not required. A licensee must not practice alcohol and drug counseling while the license is inactive. new text end

new text begin Subd. 2. new text end [RENEWAL OF INACTIVE LICENSE.] new text begin A licensee whose license is inactive shall renew the inactive status by the inactive status expiration date determined by the commissioner or the license will lapse. An application for renewal of inactive status must include evidence satisfactory to the commissioner that the licensee has completed 40 clock hours of continuing professional education required in section 148C.075, and be received by the commissioner at least 30 calendar days before the expiration date. If the postmark is illegible, the application must be considered timely if received at least 21 calendar days before the expiration date. Late renewal of inactive status must be accompanied by a late fee as required in section 148C.12. new text end

new text begin Subd. 3. new text end [RENEWAL OF LAPSED LICENSE.] new text begin An individual whose license has lapsed for less than two years may renew the license by submitting: new text end

new text begin (1) a completed and signed license renewal application; new text end

new text begin (2) the inactive license renewal fee or the renewal fee and the late fee as required under section 148C.12; and new text end

new text begin (3) proof of having met the continuing education requirements in section 148C.075 since the individual's initial licensure or last license renewal. The license issued is then effective for the remainder of the next two-year license cycle. new text end

new text begin Subd. 4. new text end [LICENSE RENEWAL FOR TWO YEARS OR MORE AFTER LICENSE EXPIRATION DATE.] new text begin An individual who submitted a license renewal two years or more after the license expiration date must submit the following: new text end

new text begin (1) a completed and signed application for licensure, as required by section 148C.0351; new text end

new text begin (2) the initial license fee as required in section 148C.12; and new text end

new text begin (3) verified documentation of having achieved a passing score within the past year on an examination required by the commissioner. new text end

Sec. 26.

Minnesota Statutes 2002, section 148C.07, is amended to read:

148C.07 RECIPROCITY.

deleted text begin The commissioner shall issue an appropriate license to deleted text end new text begin (a) new text end An individual who holds a current license or deleted text begin other credential to engage in alcohol and drug counseling deleted text end new text begin national certification as an alcohol and drug counselor new text end from another jurisdiction deleted text begin if the commissioner finds that the requirements for that credential are substantially similar to the requirements in sections 148C.01 to 148C.11 deleted text end new text begin must file with the commissioner a completed application for licensure by reciprocity containing the information required under this section new text end .

new text begin (b) The applicant must request the credentialing authority of the jurisdiction in which the credential is held to send directly to the commissioner a statement that the credential is current and in good standing, the applicant's qualifications that entitled the applicant to the credential, and a copy of the jurisdiction's credentialing laws and rules that were in effect at the time the applicant obtained the credential. new text end

new text begin (c) The commissioner shall issue a license if the commissioner finds that the requirements, which the applicant had to meet to obtain the credential from the other jurisdiction were substantially similar to the current requirements for licensure in this chapter, and the applicant is not otherwise disqualified under section 148C.09. new text end

Sec. 27.

new text begin [148C.075] CONTINUING EDUCATION REQUIREMENTS. new text end

new text begin Subdivision 1. new text end [GENERAL REQUIREMENTS.] new text begin The commissioner shall establish a two-year continuing education reporting schedule requiring licensees to report completion of the requirements of this section. Licensees must document completion of a minimum of 40 clock hours of continuing education activities each reporting period. A licensee may be given credit only for activities that directly relate to the practice of alcohol and drug counseling, the core functions, or the rules of professional conduct in Minnesota Rules, part 4747.1400. The continuing education reporting form must require reporting of the following information: new text end

new text begin (1) the continuing education activity title; new text end

new text begin (2) a brief description of the continuing education activity; new text end

new text begin (3) the sponsor, presenter, or author; new text end

new text begin (4) the location and attendance dates; new text end

new text begin (5) the number of clock hours; and new text end

new text begin (6) a statement that the information is true and correct to the best knowledge of the licensee. new text end

new text begin Only continuing education obtained during the previous two-year reporting period may be considered at the time of reporting. Clock hours must be earned and reported in increments of one-half clock hour with a minimum of one clock hour for each continuing education activity. new text end

new text begin Subd. 2. new text end [CONTINUING EDUCATION REQUIREMENTS FOR LICENSEE'S FIRST FOUR YEARS.] new text begin A licensee must, as part of meeting the clock hour requirement of this section, obtain and document 18 hours of cultural diversity training within the first four years after the licensee's initial license effective date according to the commissioner's reporting schedule. new text end

new text begin Subd. 3. new text end [CONTINUING EDUCATION REQUIREMENTS AFTER LICENSEE'S INITIAL FOUR YEARS.] new text begin Beginning four years following a licensee's initial license effective date and according to the board's reporting schedule, a licensee must document completion of a minimum of six clock hours each reporting period of cultural diversity training. Licensees must also document completion of six clock hours in courses directly related to the rules of professional conduct in Minnesota Rules, part 4747.1400. new text end

new text begin Subd. 4. new text end [STANDARDS FOR APPROVAL.] new text begin In order to obtain clock hour credit for a continuing education activity, the activity must: new text end

new text begin (1) constitute an organized program of learning; new text end

new text begin (2) reasonably be expected to advance the knowledge and skills of the alcohol and drug counselor; new text end

new text begin (3) pertain to subjects that directly relate to the practice of alcohol and drug counseling and the core functions of an alcohol and drug counselor, or the rules of professional conduct in Minnesota Rules, part 4747.1400; new text end

new text begin (4) be conducted by individuals who have education, training, and experience and are knowledgeable about the subject matter; and new text end

new text begin (5) be presented by a sponsor who has a system to verify participation and maintains attendance records for three years, unless the sponsor provides dated evidence to each participant with the number of clock hours awarded. new text end

Sec. 28.

Minnesota Statutes 2002, section 148C.10, subdivision 1, is amended to read:

Subdivision 1.

Practice.

deleted text begin After the commissioner adopts rules, deleted text end No deleted text begin individual deleted text end new text begin person, other than those individuals exempted under section 148C.11, or 148C.045, new text end shall engage in alcohol and drug counseling deleted text begin practice unless that individual holds a valid license deleted text end new text begin without first being licensed under this chapter new text end as an alcohol and drug counselor. new text begin For purposes of this chapter, an individual engages in the practice of alcohol and drug counseling if the individual performs or offers to perform alcohol and drug counseling services as defined in section 148C.01, subdivision 10, or if the individual is held out as able to perform those services. new text end

Sec. 29.

Minnesota Statutes 2002, section 148C.10, subdivision 2, is amended to read:

Subd. 2.

Use of titles.

deleted text begin After the commissioner adopts rules, deleted text end No deleted text begin individual deleted text end new text begin person new text end shall present themselves or any other individual to the public by any title incorporating the words "licensed alcohol and drug counselor" or otherwise hold themselves out to the public by any title or description stating or implying that they are licensed or otherwise qualified to practice alcohol and drug counseling unless that individual holds a valid license. deleted text begin City, county, and state agency alcohol and drug counselors who are not licensed under sections 148C.01 to 148C.11 may use the title "city agency alcohol and drug counselor," "county agency alcohol and drug counselor," or "state agency alcohol and drug counselor." Hospital alcohol and drug counselors who are not licensed under sections 148C.01 to 148C.11 may use the title "hospital alcohol and drug counselor" while acting within the scope of their employment deleted text end new text begin Persons issued a temporary permit must use titles consistent with section 148C.04, subdivision 6, paragraph (c) new text end .

Sec. 30.

Minnesota Statutes 2002, section 148C.11, is amended to read:

148C.11 EXCEPTIONS TO LICENSE REQUIREMENT.

Subdivision 1. [OTHER PROFESSIONALS.] new text begin (a) new text end Nothing in deleted text begin sections 148C.01 to 148C.10 shall prevent deleted text end new text begin this chapter prevents new text end members of other professions or occupations from performing functions for which they are qualified or licensed. This exception includes, but is not limited to, licensed physicians, registered nurses, licensed practical nurses, licensed psychological practitioners, members of the clergy, American Indian medicine men and women, licensed attorneys, probation officers, licensed marriage and family therapists, licensed social workers, licensed professional counselors, licensed school counselors, and registered occupational therapists or occupational therapy assistants.

new text begin (b) Nothing in this chapter prohibits technicians and resident managers in programs licensed by the department of human services from discharging their duties as provided in Minnesota Rules, chapter 9530. new text end

new text begin (c) Any person who is exempt under this section but who elects to obtain a license under this chapter is subject to this chapter to the same extent as other licensees. new text end

new text begin (d) new text end These persons must not, however, use a title incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug counselor" or otherwise hold themselves out to the public by any title or description stating or implying that they are engaged in the practice of alcohol and drug counseling, or that they are licensed to engage in the practice of alcohol and drug counseling. Persons engaged in the practice of alcohol and drug counseling are not exempt from the commissioner's jurisdiction solely by the use of one of the above titles.

Subd. 2. [STUDENTS.] Nothing in sections 148C.01 to 148C.10 shall prevent students enrolled in an accredited school of alcohol and drug counseling from engaging in the practice of alcohol and drug counseling new text begin while new text end under qualified supervision in an accredited school of alcohol and drug counseling.

Subd. 3. [FEDERALLY RECOGNIZED TRIBES; ETHNIC MINORITIES.] (a) Alcohol and drug counselors deleted text begin licensed to practice deleted text end new text begin practicing new text end alcohol and drug counseling according to standards established by federally recognized tribes, while practicing under tribal jurisdiction, are exempt from the requirements of this chapter. In practicing alcohol and drug counseling under tribal jurisdiction, individuals deleted text begin licensed deleted text end new text begin practicing new text end under that authority shall be afforded the same rights, responsibilities, and recognition as persons licensed pursuant to this chapter.

(b) The commissioner shall develop special licensing criteria for issuance of a license to alcohol and drug counselors who: (1) practice alcohol and drug counseling with a member of an ethnic minority population or with a person with a disability as defined by rule; or (2) are employed by agencies whose primary agency service focus addresses ethnic minority populations or persons with a disability as defined by rule. These licensing criteria may differ from the licensing deleted text begin criteria deleted text end new text begin requirements new text end specified in section 148C.04. To develop, implement, and evaluate the effect of these criteria, the commissioner shall establish a committee comprised of, but not limited to, representatives from the Minnesota commission serving deaf and hard-of-hearing people, the council on affairs of Chicano/Latino people, the council on Asian-Pacific Minnesotans, the council on Black Minnesotans, the council on disability, and the Indian affairs council. The committee does not expire.

(c) The commissioner shall issue a license to an applicant who (1) is an alcohol and drug counselor who is exempt under paragraph (a) from the requirements of this chapter; (2) has at least 2,000 hours of alcohol and drug counselor experience as defined by the core functions; and (3) meets the licensing requirements that are in effect on the date of application under section 148C.04, subdivision 3 or 4, except the written case presentation and oral examination component under section 148C.04, subdivision 3, clause (2), or 4, clause (1), item (ii). When applying for a license under this paragraph, an applicant must follow the procedures for admission to licensure specified under section 148C.0351. A person who receives a license under this paragraph must complete the written case presentation and satisfactorily pass the oral examination component under section 148C.04, subdivision 3, clause (2), or 4, clause (1), item (ii), at the earliest available opportunity after the commissioner begins administering oral examinations. The commissioner may suspend or restrict a person's license according to section 148C.09 if the person fails to complete the written case presentation and satisfactorily pass the oral examination. This paragraph expires July 1, 2004.

Subd. 4. [HOSPITAL ALCOHOL AND DRUG COUNSELORS.] deleted text begin The licensing of hospital alcohol and drug counselors shall be voluntary, while the counselor is employed by the hospital. deleted text end new text begin Effective January 1, 2006, new text end hospitals employing alcohol and drug counselors shall deleted text begin not deleted text end be required to employ licensed alcohol and drug counselors deleted text begin , nor shall they require their alcohol and drug counselors to be licensed, however, nothing in this chapter will prohibit hospitals from requiring their counselors to be eligible for licensure deleted text end . new text begin An alcohol or drug counselor employed by a hospital must be licensed as an alcohol and drug counselor in accordance with this chapter. new text end

Subd. 5. [CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] deleted text begin The licensing of city, county, and state agency alcohol and drug counselors shall be voluntary, while the counselor is employed by the city, county, or state agency. deleted text end new text begin Effective January 1, 2006, new text end city, county, and state agencies employing alcohol and drug counselors shall deleted text begin not deleted text end be required to employ licensed alcohol and drug counselors deleted text begin , nor shall they require their drug and alcohol counselors to be licensed deleted text end . new text begin An alcohol and drug counselor employed by a city, county, or state agency must be licensed as an alcohol and drug counselor in accordance with this chapter. new text end

new text begin Subd. 6. new text end [TRANSITION PERIOD FOR HOSPITAL AND CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] new text begin For the period between July 1, 2003, and January 1, 2006, the commissioner shall grant a license to an individual who is employed as an alcohol and drug counselor at a Minnesota hospital or a city, county, or state agency in Minnesota if the individual: new text end

new text begin (1) was employed as an alcohol and drug counselor at a hospital or a city, county, or state agency before August 1, 2002; new text end

new text begin (2) has 8,000 hours of alcohol and drug counselor work experience; new text end

new text begin (3) has completed a written case presentation and satisfactorily passed an oral examination established by the commissioner; new text end

new text begin (4) has satisfactorily passed a written examination as established by the commissioner; and new text end

new text begin (5) meets the requirements in section 148C.0351. new text end

Sec. 31.

new text begin [148C.12] FEES. new text end

new text begin Subdivision 1. new text end [APPLICATION FEE.] new text begin The application fee is $295. new text end

new text begin Subd. 2. new text end [BIENNIAL RENEWAL FEE.] new text begin The license renewal fee is $295. If the commissioner changes the renewal schedule and the expiration date is less than two years, the fee must be prorated. new text end

new text begin Subd. 3. new text end [TEMPORARY PERMIT FEE.] new text begin The initial fee for applicants under section 148C.04, subdivision 6, paragraph (a), is $100. The fee for annual renewal of a temporary permit is $100. new text end

new text begin Subd. 4. new text end [EXAMINATION FEE.] new text begin The examination fee for the written examination is $95 and for the oral examination is $200. new text end

new text begin Subd. 5. new text end [INACTIVE RENEWAL FEE.] new text begin The inactive renewal fee is $150. new text end

new text begin Subd. 6. new text end [LATE FEE.] new text begin The late fee is 25 percent of the biennial renewal fee, the inactive renewal fee, or the annual fee for renewal of temporary practice status. new text end

new text begin Subd. 7. new text end [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] new text begin The fee for renewal of a license that has expired for less than two years is the total of the biennial renewal fee, the late fee, and a fee of $100 for review and approval of the continuing education report. new text end

new text begin Subd. 8. new text end [FEE FOR LICENSE VERIFICATIONS.] new text begin The fee for license verification to institutions and other jurisdictions is $25. new text end

new text begin Subd. 9. new text end [SURCHARGE FEE.] new text begin Notwithstanding section 16A.1285, subdivision 2, a surcharge of $99 shall be paid at the time of initial application for or renewal of an alcohol and drug counselor license until June 30, 2013. new text end

new text begin Subd. 10. new text end [NONREFUNDABLE FEES.] new text begin All fees are nonrefundable. new text end

Sec. 32.

Minnesota Statutes 2002, section 150A.05, subdivision 2, is amended to read:

Subd. 2.

Exemptions and exceptions of certain practices and operations.

Sections 150A.01 to 150A.12 do not apply to:

(1) the practice of dentistry or dental hygiene in any branch of the armed services of the United States, the United States Public Health Service, or the United States Veterans Administration;

(2) the practice of dentistry, dental hygiene, or dental assisting by undergraduate dental students, dental hygiene students, and dental assisting students of the University of Minnesota, schools of dental hygiene, or schools of dental assisting approved by the board, when acting under the direction and supervision of a licensed dentist or a licensed dental hygienist acting as an instructor;

(3) the practice of dentistry by licensed dentists of other states or countries while appearing as clinicians under the auspices of a duly approved dental school or college, or a reputable dental society, or a reputable dental study club composed of dentists;

(4) the actions of persons while they are taking examinations for licensure or registration administered or approved by the board pursuant to sections 150A.03, subdivision 1, and 150A.06, subdivisions 1, 2, and 2a;

(5) the practice of dentistry by dentists and dental hygienists licensed by other states during their functioning as examiners responsible for conducting licensure or registration examinations administered by regional and national testing agencies with whom the board is authorized to affiliate and participate under section 150A.03, subdivision 1, and the practice of dentistry by the regional and national testing agencies during their administering examinations pursuant to section 150A.03, subdivision 1;

(6) the use of X-rays or other diagnostic imaging modalities for making radiographs or other similar records in a hospital under the supervision of a physician or dentist or by a person who is credentialed to use diagnostic imaging modalities or X-ray machines for dental treatment, roentgenograms, or dental diagnostic purposes by a credentialing agency other than the board of dentistry; deleted text begin or deleted text end

(7) the service, other than service performed directly upon the person of a patient, of constructing, altering, repairing, or duplicating any denture, partial denture, crown, bridge, splint, orthodontic, prosthetic, or other dental appliance, when performed according to a written work order from a licensed dentist in accordance with section 150A.10, subdivision 3 new text begin ; or new text end

new text begin (8) services that are included within the practice of denturism, as defined in section 150B.01, and that are provided by denturists licensed under chapter 150B new text end .

Sec. 33.

new text begin [150B.01] DEFINITIONS. new text end

new text begin Subdivision 1. new text end [APPLICATION.] new text begin The definitions in this section apply to this chapter. new text end

new text begin Subd. 2. new text end [ADVISORY COUNCIL.] new text begin "Advisory council" means the denture technology advisory council. new text end

new text begin Subd. 3. new text end [BOARD.] new text begin "Board" means the board of dentistry. new text end

new text begin Subd. 4. new text end [DENTURE.] new text begin "Denture" means a removable full or partial upper or lower dental appliance to be worn in the mouth to replace missing natural teeth. new text end

new text begin Subd. 5. new text end [DENTURIST.] new text begin "Denturist" means a person who engages in the practice of denturism and is licensed under this chapter. new text end

new text begin Subd. 6. new text end [PRACTICE OF DENTURISM.] new text begin "Practice of denturism" means: new text end

new text begin (1) making, placing, constructing, altering, reproducing, or repairing a denture; and new text end

new text begin (2) taking impressions and furnishing or supplying a denture directly to a person, or advising the use of the denture, and maintaining a facility for these purposes. new text end

Sec. 34.

new text begin [150B.02] PRACTICE OF DENTURISM PERMITTED. new text end

new text begin A licensed denturist may engage in the practice of denturism only on patients at facilities that serve individuals who are uninsured or who are Minnesota health care public program recipients, including a hospital; nursing home; home health agency; housing with services; group home serving the elderly or disabled; state-operated facility licensed by the commissioner of human services or the commissioner of corrections; federal, state, or local public health facility; or nonprofit organization. new text end

Sec. 35.

new text begin [150B.03] LICENSURE; PROTECTED TITLES AND RESTRICTIONS ON USE. new text end

new text begin Subdivision 1. new text end [LICENSURE REQUIRED.] new text begin No person may engage in the practice of denturism unless the person is licensed as a denturist under this chapter. new text end

new text begin Subd. 2. new text end [PROTECTED TITLES.] new text begin No person may hold himself or herself out to the public as a denturist, use the title "licensed denturist" or "denturist," or use any other titles, words, letters, abbreviations, or insignia indicating or implying that the person is licensed under this chapter or eligible for licensure under this chapter, unless the person has been licensed as a denturist under this chapter. new text end

new text begin Subd. 3. new text end [PENALTY.] new text begin A person who violates any provision of this section is guilty of a misdemeanor. new text end

Sec. 36.

new text begin [150B.04] EXCLUSIONS FROM CHAPTER. new text end

new text begin Nothing in this chapter prohibits or restricts: new text end

new text begin (1) the practice of a health-related occupation by a person who is licensed, registered, or certified in Minnesota and who is practicing within the scope of practice of that occupation; new text end

new text begin (2) the practice of denturism by a person employed in the service of the federal government while performing duties incident to that employment; new text end

new text begin (3) the practice of denturism by a student enrolled in a school approved by the board, if the denturism services provided by a student are provided according to a course of instruction or an assignment from an instructor, and under the supervision of an instructor; or new text end

new text begin (4) work performed by dental laboratories and dental technicians under the written prescription of a dentist. new text end

Sec. 37.

new text begin [150B.05] EXAMINATION AND REFERRAL REQUIREMENTS. new text end

new text begin Before making and fitting a denture, a denturist must receive from the patient a certificate of oral health from a licensed dentist or physician certifying that a denture will pose no threat to the patient's health. The certificate must be dated within 60 days from the date the services are performed by the denturist. Nothing in this section shall be construed to require a certificate of oral health before a denturist can perform services to alter or repair a denture or advise on the use of a denture. new text end

Sec. 38.

new text begin [150B.06] DUTIES OF BOARD. new text end

new text begin To regulate denturists, the board shall exercise the following powers and duties: new text end

new text begin (1) establish qualifications for persons applying for licensure; new text end

new text begin (2) prescribe, administer, and determine the requirements for examinations and establish what constitutes a passing grade for licensure; new text end

new text begin (3) adopt rules necessary to implement this chapter; new text end

new text begin (4) evaluate schools, and designate those schools from which graduation will be accepted as proof of an applicant's completion of the course work requirements for licensure; new text end

new text begin (5) discipline applicants and persons licensed under this chapter who violate a ground for disciplinary action; new text end

new text begin (6) issue licenses for the practice of denturism; new text end

new text begin (7) administer oaths and subpoena witnesses to carry out the activities authorized under this chapter; new text end

new text begin (8) establish forms and procedures necessary to implement this chapter; and new text end

new text begin (9) hire staff as needed to implement this chapter and act on behalf of the board and the advisory council. new text end

Sec. 39.

new text begin [150B.07] DENTURE TECHNOLOGY ADVISORY COUNCIL. new text end

new text begin Subdivision 1. new text end [ESTABLISHMENT; MEMBERSHIP.] new text begin (a) The board shall appoint seven persons to a denture technology advisory council. The advisory council shall consist of: new text end

new text begin (1) four persons who are licensed denturists under this chapter. The initial appointees need not be licensed denturists but must have at least five years of experience in the practice of denturism or in a related field; new text end

new text begin (2) two persons who are public members, as defined in section 214.02, and who are not affiliated with any health care occupation or facility. At least one of the public members must be over 65 years of age and must represent senior citizens; and new text end

new text begin (3) one person who is a dentist serving on the board of dentistry. new text end

new text begin (b) No person may serve more than two consecutive terms on the advisory council. new text end

new text begin Subd. 2. new text end [ORGANIZATION.] new text begin The advisory council shall be organized and administered under section 15.059. new text end

new text begin Subd. 3. new text end [DUTIES.] new text begin At the board's request, the advisory council shall: new text end

new text begin (1) advise the board regarding licensure qualifications for denturists; new text end

new text begin (2) advise the board regarding requirements for examinations, what constitutes a passing grade on an examination, and prescribing and administering examinations; new text end

new text begin (3) advise the board regarding rules that are necessary to implement this chapter; new text end

new text begin (4) review reports of investigations related to individuals and make recommendations to the board as to whether licensure should be denied or disciplinary action should be taken; and new text end

new text begin (5) perform other duties for advisory councils authorized by chapter 214, as directed by the board. new text end

Sec. 40.

new text begin [150B.08] LICENSURE FEES. new text end

new text begin Subdivision 1. new text end [FEES.] new text begin The following denturist license fees shall be paid to the board: new text end

new text begin (1) licensure fee, $905; new text end

new text begin (2) license renewal fee, $905; new text end

new text begin (3) inactive license fee, $905; and new text end

new text begin (4) inactive license renewal fee, $905. new text end

new text begin Subd. 2. new text end [SURCHARGE FEE.] new text begin Notwithstanding section 16A.1285, subdivision 2, a surcharge of $1,644 shall be paid at the time of initial application for or renewal of a denturist license until June 30, 2008. new text end

new text begin Subd. 3. new text end [NONREFUNDABLE; WHERE DEPOSITED.] new text begin All fees collected are nonrefundable and must be deposited in the state government special revenue fund. new text end

Sec. 41.

new text begin [150B.09] REQUIREMENTS FOR LICENSURE. new text end

new text begin Subdivision 1. new text end [GENERAL REQUIREMENTS FOR LICENSURE.] new text begin The board shall issue a license to practice denturism to an applicant who: new text end

new text begin (1) submits a completed application to the board on a form provided by the board; new text end

new text begin (2) submits the fees required under section 150B.08; new text end

new text begin (3) documents successful completion of formal training lasting at least two years with a major course of study in the practice of denturism, at a school approved by the board. The formal training must include special training in oral pathology, infection control, medical emergencies, and clinical experience specified by the board; and new text end

new text begin (4) passes a written examination and practical examination approved by the board. new text end

new text begin Subd. 2. new text end [LICENSURE BY RECIPROCITY.] new text begin The board shall issue a license by reciprocity to practice denturism to an applicant who is currently licensed or registered to practice denturism in another state that the board determines has substantially equivalent licensure or registration standards to those in this state, and who: new text end

new text begin (1) submits a completed application to the board on a form provided by the board; new text end

new text begin (2) submits the fees required under section 150B.08; new text end

new text begin (3) provides proof of having successfully passed a written examination and practical examination for denturism in the state where the applicant is licensed or registered, if the board determines that the examinations are substantially equivalent to those in this state; and new text end

new text begin (4) submits an affidavit from the agency that licenses or registers denturists in the state where the applicant is licensed or registered, attesting to the fact that the applicant is currently licensed or registered in that state. new text end

new text begin Subd. 3. new text end [LICENSURE BY EQUIVALENCY DURING TRANSITION PERIOD.] new text begin Between July 1, 2003, and June 30, 2005, the board shall issue a license by equivalency to an applicant who: new text end

new text begin (1) submits a completed application to the board on a form provided by the board; new text end

new text begin (2) submits the fees required under section 150B.08; new text end

new text begin (3) submits either: new text end

new text begin (i) three affidavits from persons other than family members attesting that the applicant has been employed in the practice of denturism for at least five years, or submits documentation of at least 4,000 hours of practical experience in the practice of denturism; or new text end

new text begin (ii) documentation of successful completion of a training course approved by the board, or successful completion of an equivalent course approved by the board; and new text end

new text begin (4) passes a written examination and practical examination approved by the board. new text end

new text begin Subd. 4. new text end [CONTENT OF LICENSE.] new text begin A license must list all addresses where the licensed denturist will engage in the practice of denturism. new text end

new text begin Subd. 5. new text end [LICENSE RENEWAL.] new text begin The board shall establish by rule the requirements for license renewal. The requirements for license renewal shall not be more stringent than the requirements for licensure established in this chapter. new text end

Sec. 42.

new text begin [150B.10] LICENSURE EXAMINATION. new text end

new text begin Subdivision 1. new text end [EXAMINATION ADMINISTRATION.] new text begin The board shall prescribe and administer the written and practical examinations for licensure under this chapter. The board may hire denturists licensed under this chapter to prepare, administer, and grade the examinations, or may contract with regional examiners to prepare, administer, and grade the examinations. new text end

new text begin Subd. 2. new text end [REQUIREMENTS FOR EXAMINATIONS.] new text begin The examinations must determine the qualifications, fitness, and ability of the applicant to practice denturism. The examinations must include a written examination and a practical examination involving a demonstration of skills. The written examination must cover the following subjects: head and oral anatomy and physiology, oral pathology, partial denture construction and design, microbiology, clinical dental technology, dental laboratory technology, clinical jurisprudence, asepsis, medical emergencies, and cardiopulmonary resuscitation. Examinations must be held at least annually. The first examination must be administered no later than December 31, 2003. new text end

new text begin Subd. 3. new text end [FAILURE OF WRITTEN OR PRACTICAL EXAMINATION.] new text begin Upon payment of an appropriate fee, an applicant who fails either the written or practical examination may take again the portion of the examination that the applicant failed. new text end

Sec. 43.

new text begin [150B.11] INACTIVE LICENSE. new text end

new text begin Subdivision 1. new text end [GENERAL.] new text begin Licensed denturists may place their license on inactive status. A person whose license is on inactive status shall not engage in the practice of denturism in this state without first reactivating the license. An inactive license must be renewed according to a schedule established by the board. Failure to renew an inactive license shall result in cancellation of the inactive license. new text end

new text begin Subd. 2. new text end [CHANGE TO ACTIVE STATUS.] new text begin The board shall by rule establish requirements under which a person whose license is on inactive status may change the license to active status. new text end

new text begin Subd. 3. new text end [DISCIPLINARY ACTION.] new text begin If a disciplinary proceeding has been initiated to suspend or revoke a person's inactive license, the license shall remain inactive until the proceedings are completed. new text end

Sec. 44.

new text begin [150B.12] GROUNDS FOR DISCIPLINARY ACTION; DISCIPLINARY ACTIONS; SUSPENSION. new text end

new text begin Subdivision 1. new text end [GROUNDS FOR DENIAL OF LICENSURE OR DISCIPLINE.] new text begin The board may refuse to grant a license, may approve licensure with conditions, or may discipline a denturist licensed under this chapter using any disciplinary actions listed in subdivision 2 on proof that the individual has: new text end

new text begin (1) intentionally submitted false or misleading information to the board or the advisory council; new text end

new text begin (2) failed, within 30 days, to provide information in response to a written request by the board or advisory council; new text end

new text begin (3) engaged in the practice of denturism in an incompetent manner or in a manner that falls below the community standard of care; new text end

new text begin (4) violated any provision of this chapter; new text end

new text begin (5) failed to perform the practice of denturism with reasonable judgment, skill, or safety due to the use of alcohol or drugs, or due to other physical or mental impairment; new text end

new text begin (6) been convicted of violating any state or federal law, rule, or regulation which directly relates to the practice of denturism; new text end

new text begin (7) aided or abetted another person in violating any provision of this chapter; new text end

new text begin (8) been disciplined for conduct in the practice of an occupation by the state of Minnesota, another jurisdiction, or a national professional association, if any of the grounds for discipline are the same or substantially equivalent to those in this chapter; new text end

new text begin (9) not cooperated with the board or advisory council in an investigation of allegations of a ground for disciplinary action; new text end

new text begin (10) advertised in a manner that is false or misleading; new text end

new text begin (11) engaged in dishonest, unethical, or unprofessional conduct in connection with the practice of denturism that is likely to deceive, defraud, or harm the public; new text end

new text begin (12) demonstrated a willful or careless disregard for the health, welfare, or safety of a patient; new text end

new text begin (13) performed medical diagnosis, practiced dentistry, or provided treatment, other than the practice of denturism, without being licensed to do so under the laws of this state; new text end

new text begin (14) paid or promised to pay a commission or part of a fee to any person who contacts the denturist for consultation or sends patients to the denturist for treatment; new text end

new text begin (15) engaged in an incentive payment arrangement, other than that prohibited by clause (14), that promotes overutilization of the practice of denturism, whereby the referring person or person who controls the availability of denturist services to a patient profits unreasonably as a result of patient treatment; new text end

new text begin (16) engaged in abusive or fraudulent billing practices, including violations of federal Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical assistance laws; new text end

new text begin (17) obtained money, property, or services from a patient through the use of undue influence, high-pressure sales tactics, harassment, duress, deception, or fraud; new text end

new text begin (18) performed services for a patient who had no possibility of benefiting from the services; new text end

new text begin (19) failed to refer a patient to a dentist or physician for examination or services as required under section 150B.05, or otherwise violated section 150B.05; new text end

new text begin (20) engaged in conduct with a patient that is sexual or may reasonably be interpreted by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient; new text end

new text begin (21) violated a federal or state court order, including a conciliation court judgment, or a disciplinary order issued by the board, related to the person's practice of denturism; or new text end

new text begin (22) any other just cause related to the practice of denturism. new text end

new text begin Subd. 2. new text end [FORMS OF DISCIPLINARY ACTION.] new text begin When the board finds that an applicant or a licensed denturist has engaged in a ground for disciplinary action under this chapter, the board may take one or more of the following actions: new text end

new text begin (1) refuse to grant a license; new text end

new text begin (2) revoke the license; new text end

new text begin (3) suspend the license; new text end

new text begin (4) impose limitations or conditions on the license; new text end

new text begin (5) impose a civil penalty not exceeding $10,000 for each separate violation, the amount of the civil penalty to be fixed so as to deprive the denturist of any economic advantage gained by the violation charged or to reimburse the board for all costs of the investigation and proceeding; including, but not limited to, the amount paid by the board for services from the office of administrative hearings, attorney fees, court reports, witnesses, reproduction of records, advisory council members' per diem compensation, staff time, and expense incurred by advisory council members and department staff; new text end

new text begin (6) order the denturist to provide uncompensated professional service under supervision at a designated clinic or other health care institution; new text end

new text begin (7) censure or reprimand the denturist; or new text end

new text begin (8) any other action justified by the case. new text end

new text begin Subd. 3. new text end [DISCOVERY; SUBPOENAS.] new text begin In all matters relating to the board's investigation and enforcement activities related to denturists, the board may issue subpoenas and compel the attendance of witnesses and the production of all necessary papers, books, records, documents, and other evidentiary materials. Any person failing or refusing to appear or testify regarding any matter about which the person may be lawfully questioned or failing to produce any papers, books, records, documents, or other evidentiary materials in the matter to be heard, after having been required by order of the board or by a subpoena of the board to do so may, upon application by the board to the district court in any district, be ordered to comply with the order or subpoena. The board may administer oaths to witnesses or take their affirmation. Depositions may be taken within or outside the state in the manner provided by law for the taking of depositions in civil actions. A subpoena or other process or paper may be served upon a person it names anywhere within the state by any officer authorized to serve subpoenas or other process in civil actions in the same manner as prescribed by law for service of process issued out of the district court of this state. new text end

new text begin Subd. 4. new text end [TEMPORARY SUSPENSION.] new text begin In addition to any other remedy provided by law, the board may, without a hearing, temporarily suspend the right of a denturist to practice if the board finds that the denturist has violated a statute or rule that the board has authority to enforce and that continued practice by the denturist would create a serious risk of harm to others. The suspension takes effect upon service of a written order on the denturist specifying the statute or rule violated. The order remains in effect until the board issues a final order in the matter after a hearing or upon agreement between the board and the denturist. Service of the order is effective if the order is served on the denturist or the denturist's attorney either personally or by first class mail. Within ten days of service of the order, the board shall hold a hearing on the sole issue of whether there is a reasonable basis to continue, modify, or lift the suspension. Evidence presented by the board or denturist must be by affidavit only. The denturist or the denturist's attorney of record may appear for oral argument. Within five working days after the hearing, the board shall issue an order and, if the suspension is continued, schedule a contested case hearing within 45 days after issuance of the order. The administrative law judge shall issue a report within 30 days after closing of the contested case hearing record. The board shall issue a final order within 30 days after receipt of that report, the hearing record, and any exceptions to the report filed by the parties. new text end

new text begin Subd. 5. new text end [AUTOMATIC SUSPENSION.] new text begin A denturist's right to practice is automatically suspended if (1) a guardian is appointed for a denturist, by order of a district court under sections 525.54 to 525.61, or (2) the denturist is committed by order of a district court under chapter 253B. The right to practice remains suspended until the denturist is restored to capacity by a court and, upon petition by the denturist, the suspension is terminated by the board after a hearing or upon agreement between the board and the denturist. new text end

Sec. 45.

new text begin [150B.13] ADDITIONAL REMEDIES. new text end

new text begin Subdivision 1. new text end [CEASE AND DESIST.] new text begin (a) The board may issue a cease and desist order to stop a person from violating or threatening to violate a statute, rule, or order which the board has issued or has authority to enforce. The cease and desist order must state the reason for its issuance and give notice of the person's right to request a hearing under sections 14.57 to 14.62. If, within 15 days of service of the order, the subject of the order fails to request a hearing in writing, the order is the final order of the board and is not reviewable by a court or agency. new text end

new text begin (b) A hearing must be initiated by the board not later than 30 days from the date of the board's receipt of a written hearing request. Within 30 days of receipt of the administrative law judge's report, and any written agreement or exceptions filed by the parties, the board shall issue a final order modifying, vacating, or making permanent the cease and desist order as the facts require. The final order remains in effect until modified or vacated by the board. new text end

new text begin (c) When a request for a stay of a cease and desist order accompanies a timely hearing request, the board may, in the board's discretion, grant the stay. If the board does not grant a requested stay, the board shall refer the request to the office of administrative hearings within three working days of receipt of the request. Within ten days after receiving the request from the board, an administrative law judge shall issue a recommendation to grant or deny the stay. The board shall grant or deny the stay within five working days of receiving the administrative law judge's recommendation. new text end

new text begin (d) In the event of noncompliance with a cease and desist order, the board may institute a proceeding in district court to obtain injunctive relief or other appropriate relief, including a civil penalty payable to the board not exceeding $10,000 for each separate violation. new text end

new text begin Subd. 2. new text end [INJUNCTIVE RELIEF.] new text begin In addition to any other remedy provided by law, including the issuance of a cease and desist order under subdivision 1, the board may in the board's own name bring an action in district court for injunctive relief to restrain a denturist from a violation or threatened violation of any statute, rule, or order which the board has authority to administer, enforce, or issue. new text end

new text begin Subd. 3. new text end [ADDITIONAL POWERS.] new text begin The issuance of a cease and desist order or injunctive relief granted under this section does not relieve a denturist from criminal prosecution by a competent authority or from disciplinary action by the board. new text end

Sec. 46.

new text begin [150B.14] REPORTING OBLIGATIONS. new text end

new text begin Subdivision 1. new text end [PERMISSION TO REPORT.] new text begin A person who has knowledge of any conduct constituting grounds for disciplinary action relating to the practice of denturism under this chapter may report the violation to the board. new text end

new text begin Subd. 2. new text end [INSTITUTIONS.] new text begin A state agency, political subdivision, agency of a local unit of government, private agency, hospital, clinic, prepaid medical plan, or other health care institution or organization located in this state shall report to the board any action taken by the agency, institution, or organization or any of its administrators or medical or other committees to revoke, suspend, restrict, or condition a denturist's privilege to practice or treat patients or clients in the institution, or as part of the organization, any denial of privileges, or any other disciplinary action for conduct that might constitute grounds for disciplinary action by the board under this chapter. The institution, organization, or governmental entity shall also report the resignation of any denturists before the conclusion of any disciplinary action proceeding for conduct that might constitute grounds for disciplinary action under this chapter, or before the commencement of formal charges but after the denturist had knowledge that formal charges were contemplated or were being prepared. new text end

new text begin Subd. 3. new text end [PROFESSIONAL SOCIETIES.] new text begin A state or local professional society for denturists shall report to the board any termination, revocation, or suspension of membership or any other disciplinary action taken against a denturist. If the society has received a complaint that might be grounds for discipline under this chapter against a member on which it has not taken any disciplinary action, the society shall report the complaint and the reason why it has not taken action on it or shall direct the complainant to the board. new text end

new text begin Subd. 4. new text end [LICENSED PROFESSIONALS.] new text begin A licensed health professional shall report to the board personal knowledge of any conduct that the licensed health professional reasonably believes constitutes grounds for disciplinary action under this chapter by a denturist, including conduct indicating that the denturist may be medically incompetent, or may be medically or physically unable to engage safely in the provision of services. If the information was obtained in the course of a client relationship, the client is a denturist, and the treating individual successfully counsels the denturist to limit or withdraw from practice to the extent required by the impairment, the board may deem this limitation of or withdrawal from practice to be sufficient disciplinary action. new text end

new text begin Subd. 5. new text end [INSURERS.] new text begin (a) Each insurer authorized to sell insurance described in section 60A.06, subdivision 1, clause (13), and providing professional liability insurance to denturists or the medical joint underwriting association under chapter 62F, shall submit to the board quarterly reports concerning the denturists against whom malpractice settlements and awards have been made. The report must contain at least the following information: new text end

new text begin (1) the total number of malpractice settlements or awards made; new text end

new text begin (2) the date the malpractice settlements or awards were made; new text end

new text begin (3) the allegations contained in the claim or complaint leading to the settlements or awards made; new text end

new text begin (4) the dollar amount of each settlement or award; new text end

new text begin (5) the address of the practice of the denturist against whom an award was made or with whom a settlement was made; and new text end

new text begin (6) the name of the denturist against whom an award was made or with whom a settlement was made. new text end

new text begin (b) The insurance company shall, in addition to the above information, submit to the board any information, records, and files, including clients' charts and records, it possesses that tend to substantiate a charge that a denturist may have engaged in conduct violating this chapter. new text end

new text begin Subd. 6. new text end [SELF REPORTING.] new text begin A denturist shall report to the board any personal action that would require that a report be filed with the board by any person, health care facility, business, or organization under subdivisions 2 to 5. The denturist shall also report the revocation, suspension, restriction, limitation, or other disciplinary action in this state and report the filing of charges regarding the denturist's license or right of practice in another state or jurisdiction. new text end

new text begin Subd. 7. new text end [DEADLINES; FORMS.] new text begin Reports required by subdivisions 2 to 6 must be submitted no later than 30 days after the reporter learns of the occurrence of the reportable event or transaction. The board may provide forms for the submission of the reports required by this section, may require that reports be submitted on the forms provided, and may adopt rules necessary to assure prompt and accurate reporting. new text end

Sec. 47.

new text begin [150B.15] INVESTIGATIONS; PROFESSIONAL COOPERATION; EXCHANGING INFORMATION. new text end

new text begin Subdivision 1. new text end [COOPERATION.] new text begin A denturist who is the subject of an investigation, or who is questioned in connection with an investigation, by or on behalf of the board, shall cooperate fully with the investigation. Cooperation includes responding fully to any question raised by or on behalf of the board relating to the subject of the investigation whether tape recorded or not. Challenges to requests of the board may be brought before the appropriate agency or court. new text end

new text begin Subd. 2. new text end [EXCHANGING INFORMATION.] new text begin (a) The board shall establish internal operating procedures for: new text end

new text begin (1) exchanging information with state boards; agencies, including the office of ombudsman for mental health and mental retardation; health-related and law enforcement facilities; departments responsible for licensing health-related occupations, facilities, and programs; and law enforcement personnel in this and other states; and new text end

new text begin (2) coordinating investigations involving matters within the jurisdiction of more than one regulatory agency. new text end

new text begin (b) The procedures for exchanging information must provide for forwarding to an entity described in paragraph (a), clause (1), any information or evidence, including the results of investigations, that is relevant to matters within the regulatory jurisdiction of that entity. The data have the same classification in the possession of the agency receiving the data as they have in the possession of the agency providing the data. new text end

new text begin (c) The board shall establish procedures for exchanging information with other states regarding disciplinary action against denturists. new text end

new text begin (d) The board shall forward to another governmental agency any complaints received by the board that do not relate to the board's jurisdiction but that relate to matters within the jurisdiction of the other governmental agency. The agency to which a complaint is forwarded shall advise the board of the disposition of the complaint. A complaint or other information received by another governmental agency relating to a statute or rule that the board is empowered to enforce must be forwarded to the board to be processed according to this section. new text end

new text begin (e) The board shall furnish to a person who made a complaint regarding a denturist a description of the actions of the board relating to the complaint. new text end

Sec. 48.

Minnesota Statutes 2002, section 319B.40, is amended to read:

319B.40 PROFESSIONAL HEALTH SERVICES.

(a) Individuals who furnish professional services pursuant to a license, registration, or certificate issued by the state of Minnesota to practice medicine pursuant to sections 147.01 to 147.22, as a physician assistant pursuant to sections 147A.01 to 147A.27, chiropractic pursuant to sections 148.01 to 148.106, registered nursing pursuant to sections 148.171 to 148.285, optometry pursuant to sections 148.52 to 148.62, psychology pursuant to sections 148.88 to 148.98, social work pursuant to sections 148B.18 to 148B.289, dentistry pursuant to sections 150A.01 to 150A.12, pharmacy pursuant to sections 151.01 to 151.40, or podiatric medicine pursuant to sections 153.01 to 153.26 are specifically authorized to practice any of these categories of services in combination if the individuals are organized under this chapter.

(b) new text begin Denturists licensed pursuant to chapter 150B are authorized to provide professional services in combination with dentists licensed pursuant to sections 150A.01 to 150A.12 if the individuals providing the services are organized under this chapter and if the combination does not impede the independent professional judgment of either party. new text end

new text begin (c) new text end This authorization does not authorize an individual to practice any profession, or furnish a professional service, for which the individual is not licensed, registered, or certified, but otherwise applies regardless of any contrary provision of a licensing statute or rules adopted pursuant to that statute, related to practicing and organizing in combination with other health services professionals.

Sec. 49. new text begin EVALUATION OF LICENSED DENTURISTS. new text end

new text begin The dental access advisory committee established under Minnesota Statutes, section 256B.55, shall evaluate the use of denturists in the public assistance health care programs. The evaluation shall include the quality of services provided by licensed denturists, the cost effectiveness of using licensed denturists, and the overall effect on dental access. Based on the evaluation, the advisory committee shall include in the report required to be submitted to the legislature on February 1, 2006, recommendations on repealing Minnesota Statutes, section 150B.02, and on the requirement specified in Minnesota Statutes, section 150B.05, that a patient present a denturist with a certificate of oral health from a licensed dentist or physician before receiving certain services from the denturist. new text end

Sec. 50. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 148C.0351, subdivision 2; 148C.05, subdivisions 2, 3, and 4; 148C.06; and 148C.10, subdivision 1a, are repealed. new text end

new text begin (b) Minnesota Rules, parts 4747.0030, subparts 25, 28, and 30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A, B, and D; 4747.0070, subparts 4 and 5; 4747.0080; 4747.0090; 4747.0100; 4747.0300; 4747.0400, subparts 2 and 3; 4747.0500; 4747.0600; 4747.1000; 4747.1100, subpart 3; and 4747.1600, are repealed. new text end

ARTICLE 7

CHILDREN'S SERVICES

Section 1.

Minnesota Statutes 2002, section 124D.23, subdivision 1, is amended to read:

Subdivision 1.

Establishment.

(a) In order to qualify as a family services collaborative, a minimum of one school district, one county, one public health entity, one community action agency as defined in section 119A.375, and one Head Start grantee if the community action agency is not the designated federal grantee for the Head Start program must agree in writing to provide coordinated family services and commit resources to an integrated fund. Collaboratives are expected to have broad community representation, which may include other local providers, including additional school districts, counties, and public health entities, other municipalities, public libraries, existing culturally specific community organizations, tribal entities, local health organizations, private and nonprofit service providers, child care providers, local foundations, community-based service groups, businesses, local transit authorities or other transportation providers, community action agencies under section 119A.375, senior citizen volunteer organizations, parent organizations, parents, and sectarian organizations that provide nonsectarian services.

(b) Members of the governing bodies of political subdivisions involved in the establishment of a family services collaborative shall select representatives of the nongovernmental entities listed in paragraph (a) to serve on the governing board of a collaborative. The governing body members of the political subdivisions shall select one or more representatives of the nongovernmental entities within the family service collaborative.

new text begin (c) Two or more family services collaboratives or children's mental health collaboratives may consolidate decision-making, pool resources, and collectively act on behalf of the individual collaboratives, based on a written agreement among the participating collaboratives. new text end

Sec. 2.

Minnesota Statutes 2002, section 144.551, subdivision 1, is amended to read:

Subdivision 1.

Restricted construction or modification.

(a) The following construction or modification may not be commenced:

(1) any erection, building, alteration, reconstruction, modernization, improvement, extension, lease, or other acquisition by or on behalf of a hospital that increases the bed capacity of a hospital, relocates hospital beds from one physical facility, complex, or site to another, or otherwise results in an increase or redistribution of hospital beds within the state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a hospital, clinic, or other health care facility that is a national referral center engaged in substantial programs of patient care, medical research, and medical education meeting state and national needs that receives more than 40 percent of its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a health care facility held an approved certificate of need on May 1, 1984, regardless of the date of expiration of the certificate;

(3) a project for which a certificate of need was denied before July 1, 1990, if a timely appeal results in an order reversing the denial;

(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200, section 2;

(5) a project involving consolidation of pediatric specialty hospital services within the Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number of pediatric specialty hospital beds among the hospitals being consolidated;

(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to an existing licensed hospital that will allow for the reconstruction of a new philanthropic, pediatric-orthopedic hospital on an existing site and that will not result in a net increase in the number of hospital beds. Upon completion of the reconstruction, the licenses of both hospitals must be reinstated at the capacity that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds within a hospital building or identifiable complex of buildings provided the relocation or redistribution does not result in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from one physical site or complex to another; or (iii) redistribution of hospital beds within the state or a region of the state;

(8) relocation or redistribution of hospital beds within a hospital corporate system that involves the transfer of beds from a closed facility site or complex to an existing site or complex provided that: (i) no more than 50 percent of the capacity of the closed facility is transferred; (ii) the capacity of the site or complex to which the beds are transferred does not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal health systems agency boundary in place on July 1, 1983; and (iv) the relocation or redistribution does not involve the construction of a new hospital building;

(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice county that primarily serves adolescents and that receives more than 70 percent of its patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a combined licensed capacity of 130 beds or less if: (i) the new hospital site is located within five miles of the current site; and (ii) the total licensed capacity of the replacement hospital, either at the time of construction of the initial building or as the result of future expansion, will not exceed 70 licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an existing state facility operated by the commissioner of human services to a new or existing facility, building, or complex operated by the commissioner of human services; from one regional treatment center site to another; or from one building or site to a new or existing building or site on the same campus;

(12) the construction or relocation of hospital beds operated by a hospital having a statutory obligation to provide hospital and medical services for the indigent that does not result in a net increase in the number of hospital beds;

(13) a construction project involving the addition of up to 31 new beds in an existing nonfederal hospital in Beltrami county; deleted text begin or deleted text end

(14) a construction project involving the addition of up to eight new beds in an existing nonfederal hospital in Otter Tail county with 100 licensed acute care beds new text begin ; or new text end

new text begin (15) a project for the construction or relocation of up to 20 hospital beds for the operation of up to two psychiatric facilities or units for children provided that the operation of the facilities or units have received the approval of the commissioner of human services new text end .

Sec. 3.

Minnesota Statutes 2002, section 245.4874, is amended to read:

245.4874 DUTIES OF COUNTY BOARD.

The county board in each county shall use its share of mental health and Community Social Services Act funds allocated by the commissioner according to a biennial children's mental health component of the community social services plan required under section 245.4888, and approved by the commissioner. The county board must:

(1) develop a system of affordable and locally available children's mental health services according to sections 245.487 to 245.4888;

(2) establish a mechanism providing for interagency coordination as specified in section 245.4875, subdivision 6;

(3) develop a biennial children's mental health component of the community social services plan required under section 256E.09 which considers the assessment of unmet needs in the county as reported by the local children's mental health advisory council under section 245.4875, subdivision 5, paragraph (b), clause (3). The county shall provide, upon request of the local children's mental health advisory council, readily available data to assist in the determination of unmet needs;

(4) assure that parents and providers in the county receive information about how to gain access to services provided according to sections 245.487 to 245.4888;

(5) coordinate the delivery of children's mental health services with services provided by social services, education, corrections, health, and vocational agencies to improve the availability of mental health services to children and the cost-effectiveness of their delivery;

(6) assure that mental health services delivered according to sections 245.487 to 245.4888 are delivered expeditiously and are appropriate to the child's diagnostic assessment and individual treatment plan;

(7) provide the community with information about predictors and symptoms of emotional disturbances and how to access children's mental health services according to sections 245.4877 and 245.4878;

(8) provide for case management services to each child with severe emotional disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, and 5;

(9) provide for screening of each child under section 245.4885 upon admission to a residential treatment facility, acute care hospital inpatient treatment, or informal admission to a regional treatment center;

(10) prudently administer grants and purchase-of-service contracts that the county board determines are necessary to fulfill its responsibilities under sections 245.487 to 245.4888;

(11) assure that mental health professionals, mental health practitioners, and case managers employed by or under contract to the county to provide mental health services are qualified under section 245.4871;

(12) assure that children's mental health services are coordinated with adult mental health services specified in sections 245.461 to 245.486 so that a continuum of mental health services is available to serve persons with mental illness, regardless of the person's age; deleted text begin and deleted text end

(13) assure that culturally informed mental health consultants are used as necessary to assist the county board in assessing and providing appropriate treatment for children of cultural or racial minority heritage new text begin ; and new text end

new text begin (14) arrange for or provide a children's mental health screening to a child receiving child protective services or a child in out-of-home placement, a child for whom parental rights have been terminated, a child alleged or found to be delinquent, and a child found to have committed a juvenile petty offense for the third or subsequent time, unless a screening has been performed within the previous 180 days, or the child is currently under the care of a mental health professional. The screening shall be conducted with a screening instrument approved by the commissioner of human services and shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer or local social services agency staff person who is trained in the use of the screening instrument. If the screen indicates a need for assessment, the child's family, or if the family lacks mental health insurance, the local social services agency, in consultation with the child's family, shall have conducted a diagnostic assessment, including a functional assessment, as defined in section 245.4871 new text end .

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 4.

Minnesota Statutes 2002, section 245.493, subdivision 1a, is amended to read:

Subd. 1a.

Duties of certain coordinating bodies.

new text begin (a) new text end By mutual agreement of the collaborative and a coordinating body listed in this subdivision, a children's mental health collaborative or a collaborative established by the merger of a children's mental health collaborative and a family services collaborative under section 124D.23, may assume the duties of a community transition interagency committee established under section 125A.22; an interagency early intervention committee established under section 125A.30; a local advisory council established under section 245.4875, subdivision 5; or a local coordinating council established under section 245.4875, subdivision 6.

new text begin (b) Two or more family services collaboratives or children's mental health collaboratives may consolidate decision-making, pool resources, and collectively act on behalf of the individual collaboratives, based on a written agreement among the participating collaboratives. new text end

Sec. 5.

Minnesota Statutes 2002, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 35a. new text end

new text begin Children's mental health crisis response services. new text end

new text begin Medical assistance covers children's mental health crisis response services according to section 256B.0944. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 6.

Minnesota Statutes 2002, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 35b. new text end

new text begin Children's therapeutic services and supports. new text end

new text begin Medical assistance covers children's therapeutic services and supports according to section 256B.0943. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 7.

Minnesota Statutes 2002, section 256B.0625, is amended by adding a subdivision to read:

new text begin Subd. 45. new text end

new text begin Subacute psychiatric care for persons under 21 years of age. new text end

new text begin Medical assistance covers subacute psychiatric care for person under 21 years of age when: new text end

new text begin (1) the services meet the requirements of Code of Federal Regulations, title 42, section 440.160; new text end

new text begin (2) the facility is accredited as a psychiatric treatment facility by the joint commission on accreditation of healthcare organizations, the commission on accreditation of rehabilitation facilities, or the council on accreditation; and new text end

new text begin (3) the facility is licensed by the commissioner of health under section 144.50. new text end

Sec. 8.

new text begin [256B.0943] CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS. new text end

new text begin Subdivision 1. new text end [DEFINITIONS.] new text begin For purposes of this section, the following terms have the meanings given them. new text end

new text begin (a) "Children's therapeutic services and supports" means the flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. The services are time-limited interventions that are delivered using various treatment modalities and combinations of services designed to reach treatment outcomes identified in the individual treatment plan. new text end

new text begin (b) "Clinical supervision" means the overall responsibility of the mental health professional for the control and direction of individualized treatment planning, service delivery, and treatment review for each client. A mental health professional who is an enrolled Minnesota health care program provider accepts full professional responsibility for a supervisee's actions and decisions, instructs the supervisee in the supervisee's work, and oversees or directs the supervisee's work. new text end

new text begin (c) "County board" means the county board of commissioners or board established under sections 402.01 to 402.10 or 471.59. new text end

new text begin (d) "Crisis assistance" has the meaning given in section 245.4871, subdivision 9a. new text end

new text begin (e) "Culturally competent provider" means a provider who understands and can utilize to a client's benefit the client's culture when providing services to the client. A provider may be culturally competent because the provider is of the same cultural or ethnic group as the client or the provider has developed the knowledge and skills through training and experience to provide services to culturally diverse clients. new text end

new text begin (f) "Day treatment program" for children means a site-based structured program consisting of group psychotherapy for more than three individuals and other intensive therapeutic services provided by a multidisciplinary team, under the clinical supervision of a mental health professional. new text end

new text begin (g) "Diagnostic assessment" has the meaning given in section 245.4871, subdivision 11. new text end

new text begin (h) "Direct service time" means the time that a mental health professional, mental health practitioner, or mental health behavioral aide spends face-to-face with a client and the client's family. Direct service time includes time in which the provider obtains a client's history or provides service components of children's therapeutic services and supports. Direct service time does not include time doing work before and after providing direct services, including scheduling, maintaining clinical records, consulting with others about the client's mental health status, preparing reports, receiving clinical supervision directly related to the client's psychotherapy session, and revising the client's individual treatment plan. new text end

new text begin (i) "Direction of mental health behavioral aide" means the activities of a mental health professional or mental health practitioner in guiding the mental health behavioral aide in providing services to a client. The direction of a mental health behavioral aide must be based on the client's individualized treatment plan and meet the requirements in subdivision 6, paragraph (b), clause (5). new text end

new text begin (j) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15. For persons at least age 18 but under age 21, mental illness has the meaning given in section 245.462, subdivision 20, paragraph (a). new text end

new text begin (k) "Individual behavioral plan" means a plan of intervention, treatment, and services for a child written by a mental health professional or mental health practitioner, under the clinical supervision of a mental health professional, to guide the work of the mental health behavioral aide. new text end

new text begin (l) "Individual treatment plan" has the meaning given in section 245.4871, subdivision 21. new text end

new text begin (m) "Mental health professional" means an individual as defined in section 245.4871, subdivision 27, clauses (1) to (5), or tribal vendor as defined in section 256B.02, subdivision 7, paragraph (b). new text end

new text begin (n) "Preschool program" means a day program licensed under Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a children's therapeutic services and supports provider to provide a structured treatment program to a child who is at least 33 months old but who has not yet attended the first day of kindergarten. new text end

new text begin (o) "Skills training" means individual, family, or group training designed to improve the basic functioning of the child with emotional disturbance and the child's family in the activities of daily living and community living, and to improve the social functioning of the child and the child's family in areas important to the child's maintaining or reestablishing residency in the community. Individual, family, and group skills training must: new text end

new text begin (1) consist of activities designed to promote skill development of the child and the child's family in the use of age-appropriate daily living skills, interpersonal and family relationships, and leisure and recreational services; new text end

new text begin (2) consist of activities that will assist the family's understanding of normal child development and to use parenting skills that will help the child with emotional disturbance achieve the goals outlined in the child's individual treatment plan; and new text end

new text begin (3) promote family preservation and unification, promote the family's integration with the community, and reduce the use of unnecessary out-of-home placement or institutionalization of children with emotional disturbance. new text end

new text begin Subd. 2. new text end [COVERED SERVICE COMPONENTS OF CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] new text begin (a) Subject to federal approval, medical assistance covers medically necessary children's therapeutic services and supports as defined in this section that an eligible provider entity under subdivisions 4 and 5 provides to a client eligible under subdivision 3. new text end

new text begin (b) The service components of children's therapeutic services and supports are: new text end

new text begin (1) individual, family, and group psychotherapy; new text end

new text begin (2) individual, family, or group skills training provide by a mental health professional or mental health practitioner; new text end

new text begin (3) crisis assistance; new text end

new text begin (4) mental health behavioral aide services; and new text end

new text begin (5) direction of a mental health behavioral aide. new text end

new text begin (c) Service components may be combined to constitute therapeutic programs, including day treatment programs and preschool programs. Although day treatment and preschool programs have specific client and provider eligibility requirements, medical assistance only pays for the service components listed in paragraph (b). new text end

new text begin Subd. 3. new text end [DETERMINATION OF CLIENT ELIGIBILITY.] new text begin A client's eligibility to receive children's therapeutic services and supports under this section shall be determined based on a diagnostic assessment by a mental health professional that is performed within 180 days of the initial start of service. The diagnostic assessment must: new text end

new text begin (1) include current diagnoses on all five axes of the client's current mental health status; new text end

new text begin (2) determine whether a child under age 18 has a diagnosis of emotional disturbance or, if the person is between the ages of 18 and 21, whether the person has a mental illness; new text end

new text begin (3) document children's therapeutic services and supports as medically necessary to address an identified disability, functional impairment, and the individual client's needs and goals; new text end

new text begin (4) be used in the development of the individualized treatment plan; and new text end

new text begin (5) be completed annually until age 18. For individuals between age 18 and 21, unless a client's mental health condition has changed markedly since the client's most recent diagnostic assessment, annual updating is necessary. For the purpose of this section, "updating" means a written summary, including current diagnoses on all five axes, by a mental health professional of the client's current mental health status and service needs. new text end

new text begin Subd. 4. new text end [PROVIDER ENTITY CERTIFICATION.] new text begin (a) Effective July 1, 2003, the commissioner shall establish an initial provider entity application and certification process and recertification process to determine whether a provider entity has an administrative and clinical infrastructure that meets the requirements in subdivisions 5 and 6. The commissioner shall recertify a provider entity at least every three years. The commissioner shall establish a process for decertification of a provider entity that no longer meets the requirements in this section. The county, tribe, and the commissioner shall be mutually responsible and accountable for the county's, tribe's, and state's part of the certification, recertification, and decertification processes. new text end

new text begin (b) For purposes of this section, a provider entity must be: new text end

new text begin (1) an Indian health services facility or a facility owned and operated by a tribe or tribal organization operating as a 638 facility under Public Law 93-368 certified by the state; new text end

new text begin (2) a county-operated entity certified by the state; or new text end

new text begin (3) a noncounty entity recommended for certification by the provider's host county and certified by the state. new text end

new text begin Subd. 5. new text end [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE REQUIREMENTS.] new text begin (a) To be an eligible provider entity under this section, a provider entity must have an administrative infrastructure that establishes authority and accountability for decision making and oversight of functions, including finance, personnel, system management, clinical practice, and performance measurement. The provider must have written policies and procedures that it reviews and updates every three years and distributes to staff initially and upon each subsequent update. new text end

new text begin (b) The administrative infrastructure written policies and procedures must include: new text end

new text begin (1) personnel procedures, including a process for: (i) recruiting, hiring, training, and retention of culturally and linguistically competent providers; (ii) conducting a criminal background check on all direct service providers and volunteers; (iii) investigating, reporting, and acting on violations of ethical conduct standards; (iv) investigating, reporting, and acting on violations of data privacy policies that are compliant with federal and state laws; (v) utilizing volunteers, including screening applicants, training and supervising volunteers, and providing liability coverage for volunteers; and (vi) documenting that a mental health professional, mental health practitioner, or mental health behavioral aide meets the applicable provider qualification criteria, training criteria under subdivision 8, and clinical supervision or direction of a mental health behavioral aide requirements under subdivision 6; new text end

new text begin (2) fiscal procedures, including internal fiscal control practices and a process for collecting revenue that is compliant with federal and state laws; new text end

new text begin (3) if a client is receiving services from a case manager or other provider entity, a service coordination process that ensures services are provided in the most appropriate manner to achieve maximum benefit to the client. The provider entity must ensure coordination and nonduplication of services consistent with county board coordination procedures established under section 245.4881, subdivision 5; new text end

new text begin (4) a performance measurement system, including monitoring to determine cultural appropriateness of services identified in the individual treatment plan, as determined by the client's culture, beliefs, values, and language, and family-driven services; and new text end

new text begin (5) a process to establish and maintain individual client records. The client's records must include: (i) the client's personal information; (ii) forms applicable to data privacy; (iii) the client's diagnostic assessment, updates, tests, individual treatment plan, and individual behavior plan, if necessary; (iv) documentation of service delivery as specified under subdivision 6; (v) telephone contacts; (vi) discharge plan; and (vii) if applicable, insurance information. new text end

new text begin Subd. 6. new text end [PROVIDER ENTITY CLINICAL INFRASTRUCTURE REQUIREMENTS.] new text begin (a) To be an eligible provider entity under this section, a provider entity must have a clinical infrastructure that utilizes diagnostic assessment, an individualized treatment plan, service delivery, and individual treatment plan review that are culturally competent, child-centered, and family-driven to achieve maximum benefit for the client. The provider entity must review and update the clinical policies and procedures every three years and must distribute the policies and procedures to staff initially and upon each subsequent update. new text end

new text begin (b) The clinical infrastructure written policies and procedures must include policies and procedures for: new text end

new text begin (1) providing or obtaining a client's diagnostic assessment that identifies acute and chronic clinical disorders, co-occurring medical conditions, sources of psychological and environmental problems, and a functional assessment. The functional assessment must clearly summarize the client's individual strengths and needs; new text end

new text begin (2) developing an individual treatment plan that is: (i) based on the information in the client's diagnostic assessment; (ii) developed no later than the end of the first psychotherapy session after the completion of the client's diagnostic assessment by the mental health professional who provides the client's psychotherapy; (iii) developed through a child-centered, family-driven planning process that identifies service needs and individualized, planned, and culturally appropriate interventions that contain specific treatment goals and objectives for the client and the client's family or foster family; (iv) reviewed at least once every 90 days and revised, if necessary; and (v) signed by the client or, if appropriate, by the client's parent or other person authorized by statute to consent to mental health services for the client; new text end

new text begin (3) developing an individual behavior plan that documents services to be provided by the mental health behavioral aide. The individual behavior plan must include: (i) detailed instructions on the service to be provided; (ii) time allocated to each service; (iii) methods of documenting the child's behavior; (iv) methods of monitoring the child's progress in reaching objectives; and (v) goals to increase or decrease targeted behavior as identified in the individual treatment plan; new text end

new text begin (4) clinical supervision of the mental health practitioner and mental health behavioral aide. A mental health professional must document the clinical supervision the professional provides by cosigning individual treatment plans and making entries in the client's record on supervisory activities. Clinical supervision does not include the authority to make or terminate court-ordered placements of the child. A clinical supervisor must be available for urgent consultation as required by the individual client's needs or the situation. Clinical supervision may occur individually or in a small group to discuss treatment and review progress toward goals. The focus of clinical supervision must be the client's treatment needs and progress and the mental health practitioner's or behavioral aide's ability to provide services; new text end

new text begin (5) providing direction to a mental health behavioral aide. For entities that employ mental health behavioral aides, the clinical supervisor must be employed by the provider entity to ensure necessary and appropriate oversight for the client's treatment and continuity of care. The mental health professional or mental health practitioner giving direction must begin with the goals on the individualized treatment plan, and instruct the mental health behavioral aide on how to construct therapeutic activities and interventions that will lead to goal attainment. The professional or practitioner giving direction must also instruct the mental health behavioral aide about the client's diagnosis, functional status, and other characteristics that are likely to affect service delivery. Direction must also include determining that the mental health behavioral aide has the skills to interact with the client and the client's family in ways that convey personal and cultural respect and that the aide actively solicits information relevant to treatment from the family. The aide must be able to clearly explain the activities the aide is doing with the client and the activities' relationship to treatment goals. Direction is more didactic than is supervision and requires the professional or practitioner providing it to continuously evaluate the mental health behavioral aide's ability to carry out the activities of the individualized treatment plan and the individualized behavior plan. When providing direction, the professional or practitioner must: (i) review progress notes prepared by the mental health behavioral aide for accuracy and consistency with diagnostic assessment, treatment plan, and behavior goals and the professional or practitioner must approve and sign the progress notes; (ii) identify changes in treatment strategies, revise the individual behavior plan, and communicate treatment instructions and methodologies as appropriate to ensure that treatment is implemented correctly; (iii) demonstrate family-friendly behaviors that support healthy collaboration among the child, the child's family, and providers as treatment is planned and implemented; (iv) ensure that the mental health behavioral aide is able to effectively communicate with the child, the child's family, and the provider; and (v) record the results of any evaluation and corrective actions taken to modify the work of the mental health behavioral aide; new text end

new text begin (6) providing service delivery that implements the individual treatment plan and meets the requirements under subdivision 9; and new text end

new text begin (7) individual treatment plan review. The review must determine the extent to which the services have met the goals and objectives in the previous treatment plan. The review must assess the client's progress and ensure that services and treatment goals continue to be necessary and appropriate to the client and the client's family or foster family. Revision of the individual treatment plan does not require a new diagnostic assessment unless the client's mental health status has changed markedly. The updated treatment plan must be signed by the client, if appropriate, and by the client's parent or other person authorized by statute to give consent to the mental health services for the child. new text end

new text begin Subd. 7. new text end [QUALIFICATIONS OF INDIVIDUAL AND TEAM PROVIDERS.] new text begin (a) An individual or team provider working within the scope of the provider's practice or qualifications may provide service components of children's therapeutic services and supports that are identified as medically necessary in a client's individual treatment plan. new text end

new text begin (b) An individual provider and multidisciplinary team include: new text end

new text begin (1) a mental health professional as defined in subdivision 1, paragraph (m); new text end

new text begin (2) a mental health practitioner as defined in section 245.4871, subdivision 26. The mental health practitioner must work under the clinical supervision of a mental health professional; new text end

new text begin (3) a mental health behavioral aide working under the direction of a mental health professional to implement the rehabilitative mental health services identified in the client's individual treatment plan. A level I mental health behavioral aide must: (i) be at least 18 years old; (ii) have a high school diploma or general equivalency diploma (GED) or two years of experience as a primary caregiver to a child with severe emotional disturbance within the previous ten years; and (iii) meet preservices and continuing education requirements under subdivision 8. A level II mental health behavioral aide must: (i) be at least 18 years old; (ii) have an associate or bachelor's degree or 4,000 hours of experience in delivering clinical services in the treatment of mental illness concerning children or adolescents; and (iii) meet preservice and continuing education requirements in subdivision 8; new text end

new text begin (4) a preschool program multidisciplinary team that includes at least one mental health professional and one or more of the following individuals under the clinical supervision of a mental health professional: (i) a mental health practitioner; or (ii) a program person, including a teacher, assistant teacher, or aide, who meets the qualifications and training standards of a level I mental health behavioral aide; or new text end

new text begin (5) a day treatment multidisciplinary team that includes at least one mental health professional and one mental health practitioner. new text end

new text begin Subd. 8. new text end [REQUIRED PRESERVICE AND CONTINUING EDUCATION.] new text begin (a) A provider entity shall establish a plan to provide preservice and continuing education for staff. The plan must clearly describe the type of training necessary to maintain current skills and obtain new skills, and that relates to the provider entity's goals and objectives for services offered. new text end

new text begin (b) A provider that employs a mental health behavioral aide under this section must require the mental health behavioral aide to complete 30 hours of preservice training. The preservice training must include topics specified in Minnesota Rules, part 9535.4068, subparts 1 and 2, and parent team training. The preservice training must include 15 hours of in-person training of a mental health behavioral aide in mental health services delivery and eight hours of parent team training. Components of parent team training include: new text end

new text begin (1) partnering with parents; new text end

new text begin (2) fundamentals of family support; new text end

new text begin (3) fundamentals of policy and decision making; new text end

new text begin (4) defining equal partnership; new text end

new text begin (5) complexities of the parent and service provider partnership in multiple service delivery systems due to system strengths and weaknesses; new text end

new text begin (6) sibling impacts; new text end

new text begin (7) support networks; and new text end

new text begin (8) community resources. new text end

new text begin (c) A provider entity that employs a mental health practitioner and a mental health behavioral aide to provide children's therapeutic services and supports under this section must require the mental health practitioner and mental health behavioral aide to complete 20 hours of continuing education every two calendar years. The continuing education must be related to serving the needs of a child with emotional disturbance in the child's home environment and the child's family. The topics covered in orientation and training must conform to Minnesota Rules, part 9535.4068. new text end

new text begin (d) The provider entity must document the mental health practitioner's or mental health behavioral aide's annual completion of the required continuing education. The documentation must include the date, subject, and number of hours of the continuing education, and attendance records, as verified by the staff member's signature, job title, and the instructor's name. The provider entity must keep documentation for each employee, including records of attendance at professional workshops and conferences, at a central location and in the employee's personnel file. new text end

new text begin Subd. 9. new text end [SERVICE DELIVERY CRITERIA.] new text begin (a) In delivering services under this section, a certified provider entity must ensure that: new text end

new text begin (1) each individual provider's caseload size permits the provider to deliver services to both clients with severe, complex needs and clients with less intensive needs. The provider's caseload size should reasonably enable the provider to play an active role in service planning, monitoring, and delivering services to meet the client's and client's family's needs, as specified in each client's individual treatment plan; new text end

new text begin (2) site-based programs, including day treatment and preschool programs, provide staffing and facilities to ensure the client's health, safety, and protection of rights, and that the programs are able to implement each client's individual treatment plan; new text end

new text begin (3) a day treatment program is provided to a group of clients by a multidisciplinary staff under the clinical supervision of a mental health professional. The day treatment program must be provided in and by: (i) an outpatient hospital accredited by the joint commission on accreditation of health organizations and licensed under sections 144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii) an entity that is under contract with the county board to operate a program that meets the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must stabilize the client's mental health status while developing and improving the client's independent living and socialization skills. The goal of the day treatment program must be to reduce or relieve the effects of mental illness and provide training to enable the client to live in the community. The program must be available at least one day a week for a minimum three-hour time block. The three-hour time block must include at least one hour, but no more than two hours, of individual or group psychotherapy. The remainder of the three-hour time block may include recreation therapy, socialization therapy, or independent living skills therapy, but only if the therapies are included in the client's individual treatment plan. Day treatment programs are not part of inpatient or residential treatment services; and new text end

new text begin (4) a preschool program is a structured treatment program offered to a child who is at least 33 months old, but who has not yet reached the first day of kindergarten, by a preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts 9503.0005 to 9503.0175. The program must be available at least one day a week for a minimum two-hour time block. The structured treatment program may include individual or group psychotherapy and recreation therapy, socialization therapy, or independent living skills therapy, if included in the client's individual treatment plan. new text end

new text begin (b) A provider entity must delivery the service components of children's therapeutic services and supports in compliance with the following requirements: new text end

new text begin (1) individual, family, and group psychotherapy must be delivered as specified in Minnesota Rules, parts 9505.0523; new text end

new text begin (2) individual, family, or group skills training must be provided by a mental health professional or a mental health practitioner who has a consulting relationship with a mental health professional who accepts full professional responsibility for the training; new text end

new text begin (3) crisis assistance must be an intense, time-limited, and designed to resolve or stabilize crisis through arrangements for direct intervention and support services to the child and the child's family. Crisis assistance must utilize resources designed to address abrupt or substantial changes in the functioning of the child or the child's family as evidenced by a sudden change in behavior with negative consequences for well being, a loss of usual coping mechanisms, or the presentation of danger to self or others; new text end

new text begin (4) medically necessary services that are provided by a mental health behavioral aide must be designed to improve the functioning of the child and support the family in activities of daily and community living. A mental health behavioral aide must document the delivery of services in written progress notes. The mental health behavioral aide must implement goals in the treatment plan for the child's emotional disturbance that allow the child to acquire developmentally and therapeutically appropriate daily living skills, social skills, and leisure and recreational skills through targeted activities. These activities may include: new text end

new text begin (i) assisting a child as needed with skills development in dressing, eating, and toileting; new text end

new text begin (ii) assisting, monitoring, and guiding the child to complete tasks, including facilitating the child's participation in medical appointments; new text end

new text begin (iii) observing the child and intervening to redirect the child's inappropriate behavior; new text end

new text begin (iv) assisting the child in using age-appropriate self-management skills as related to the child's emotional disorder or mental illness, including problem solving, decision making, communication, conflict resolution, anger management, social skills, and recreational skills; new text end

new text begin (v) implementing deescalation techniques as recommended by the mental health professional; new text end

new text begin (vi) implementing any other mental health service that the mental health professional has approved as being within the scope of the behavioral aide's duties; or new text end

new text begin (vii) assisting the parents to develop and use parenting skills that help the child achieve the goals outlined in the child's individual treatment plan or individual behavioral plan. Parenting skills must be directed exclusively to the child's treatment; and new text end

new text begin (5) direction of a mental health behavioral aide must include the following: new text end

new text begin (i) a total of one hour of on-site observation by a mental health professional during the first 12 hours of service provided to a child; new text end

new text begin (ii) ongoing on-site observation by a mental health professional or mental health practitioner for at least a total of one hour during every 40 hours of service provided to a child; and new text end

new text begin (iii) immediate accessibility of the mental health professional or mental health practitioner to the mental health behavioral aide during service provision. new text end

new text begin Subd. 10. new text end [SERVICE AUTHORIZATION.] new text begin The commissioner shall publish in the State Register a list of health services that require prior authorization, as well as the criteria and standards used to select health services on the list. The list and the criteria and standards used to formulate the list are not subject to the requirements of sections 14.001 to 14.69. The commissioner's decision on whether prior authorization is required for a health service is not subject to administrative appeal. new text end

new text begin Subd. 11. new text end [DOCUMENTATION AND BILLING.] new text begin (a) A provider entity must document the services it provides under this section. The provider entity must ensure that the entity's documentation standards meet the requirements of federal and state laws. Services billed under this section that are not documented according to this subdivision shall be subject to monetary recovery by the commissioner. new text end

new text begin (b) An individual mental health provider must promptly document the following in a client's record after providing services to the client: new text end

new text begin (1) each occurrence of the client's mental health service, including the date, type, length, and scope of the service; new text end

new text begin (2) the name of the person who gave the service; new text end

new text begin (3) contact made with other persons interested in the client, including representatives of the courts, corrections systems, or schools. The provider must document the name and date of each contact; new text end

new text begin (4) any contact made with the client's other mental health providers, case manager, family members, primary caregiver, legal representative, or the reason the provider did not contact the client's family members, primary caregiver, or legal representative, if applicable; and new text end

new text begin (5) required clinical supervision, as appropriate. new text end

new text begin Subd. 12. new text end [EXCLUDED SERVICES.] new text begin The following services are not eligible for medical assistance payment as children's therapeutic services and supports: new text end

new text begin (1) service components of children's therapeutic services and supports simultaneously provided by more than one provider entity unless prior authorization is obtained; new text end

new text begin (2) children's therapeutic services and supports provided in violation of medical assistance policy in Minnesota Rules, part 9505.0220; new text end

new text begin (3) mental health behavioral aide services provided by a personal care assistant who is not qualified as a mental health behavioral aide and employed by a certified children's therapeutic services and supports provider entity; new text end

new text begin (4) services that are the responsibility of a residential or program license holder, including foster care providers under the terms of a service agreement or administrative rules governing licensure; new text end

new text begin (5) up to 15 hours of children's therapeutic services and supports provided within a six-month period to a child with severe emotional disturbance who is residing in a hospital, a group home as defined in Minnesota Rules, part 9560.0520, subpart 4, a residential treatment facility licensed under Minnesota Rules, parts 9545.0900 to 9545.1090, a regional treatment center, or other institutional group setting or who is participating in a program of partial hospitalization are eligible for medical assistance payment if part of the discharge plan; and new text end

new text begin (6) adjunctive activities that may be offered by a provider entity but are not otherwise covered by medical assistance, including: new text end

new text begin (i) a service that is primarily recreation oriented or that is provided in a setting that is not medically supervised. This includes sports activities, exercise groups, activities such as craft hours, leisure time, social hours, meal or snack time, trips to community activities, and tours; new text end

new text begin (ii) a social or educational service that does not have or cannot reasonably be expected to have a therapeutic outcome related to the client's emotional disturbance; new text end

new text begin (iii) consultation with other providers or service agency staff about the care or progress of a client; new text end

new text begin (iv) prevention or education programs provided to the community; and new text end

new text begin (v) treatment for clients with primary diagnoses of alcohol or other drug abuse. new text end

[EFFECTIVE DATE.] new text begin Unless otherwise specified, this section is effective July 1, 2004. new text end

Sec. 9.

new text begin [256B.0944] COVERED SERVICES; CHILDREN'S MENTAL HEALTH CRISIS RESPONSE SERVICES. new text end

new text begin Subdivision 1. new text end [DEFINITIONS.] new text begin For purposes of this section, the following terms have the meanings given them. new text end

new text begin (a) "Mental health crisis" means a child's behavioral, emotional, or psychiatric situation that, but for the provision of crisis response services to the child, would likely result in significantly reduced levels of functioning in primary activities of daily living, an emergency situation, or the child's placement in a more restrictive setting, including, but not limited to, inpatient hospitalization. new text end

new text begin (b) "Mental health emergency" means a child's behavioral, emotional, or psychiatric situation that causes an immediate need for mental health services and is consistent with section 62Q.55. A physician, mental health professional, or crisis mental health practitioner determines a mental health crisis or emergency for medical assistance reimbursement with input from the client and the client's family, if possible. new text end

new text begin (c) "Mental health crisis assessment" means an immediate face-to-face assessment by a physician, mental health professional, or mental health practitioner under the clinical supervision of a mental health professional, following a screening that suggests the child may be experiencing a mental health crisis or mental health emergency situation. new text end

new text begin (d) "Mental health mobile crisis intervention services" means face-to-face, short-term intensive mental health services initiated during a mental health crisis or mental health emergency. Mental health mobile crisis services must help the recipient cope with immediate stressors, identify and utilize available resources and strengths, and begin to return to the recipient's baseline level of functioning. Mental health mobile services must be provided on-site by a mobile crisis intervention team outside of an emergency room, urgent care, or an inpatient hospital setting. new text end

new text begin (e) "Mental health crisis stabilization services" means individualized mental health services provided to a recipient following crisis intervention services that are designed to restore the recipient to the recipient's prior functional level. The individual treatment plan recommending mental health crisis stabilization must be completed by the intervention team or by staff after an inpatient or urgent care visit. Mental health crisis stabilization services may be provided in the recipient's home, the home of a family member or friend of the recipient, another community setting, or a short-term supervised, licensed residential program if the service is not included in the facility's cost pool or per diem. Mental health crisis stabilization is not reimbursable when provided as part of a partial hospitalization or day treatment program. new text end

new text begin Subd. 2. new text end [MEDICAL ASSISTANCE COVERAGE.] new text begin Medical assistance covers medically necessary children's mental health crisis response services, subject to federal approval, if provided to an eligible recipient under subdivision 3, by a qualified provider entity under subdivision 4 or a qualified individual provider working within the provider's scope of practice, and identified in the recipient's individual crisis treatment plan under subdivision 8. new text end

new text begin Subd. 3. new text end [ELIGIBILITY.] new text begin An eligible recipient is an individual who: new text end

new text begin (1) is eligible for medical assistance; new text end

new text begin (2) is under age 18 or between the ages of 18 and 21; new text end

new text begin (3) is screened as possibly experiencing a mental health crisis or mental health emergency where a mental health crisis assessment is needed; new text end

new text begin (4) is assessed as experiencing a mental health crisis or mental health emergency, and mental health mobile crisis intervention or mental health crisis stabilization services are determined to be medically necessary; and new text end

new text begin (5) meets the criteria for emotional disturbance or mental illness. new text end

new text begin Subd. 4. new text end [PROVIDER ENTITY STANDARDS.] new text begin (a) A crisis intervention and crisis stabilization provider entity must meet the administrative and clinical standards specified in section 256B.0943, subdivisions 5 and 6, meet the standards listed in paragraph (b), and be: new text end

new text begin (1) an Indian health service facility or facility owned and operated by a tribe or a tribal organization operating under Public Law 93-638 as a 638 facility; new text end

new text begin (2) a county board-operated entity; or new text end

new text begin (3) a provider entity that is under contract with the county board in the county where the potential crisis or emergency is occurring. new text end

new text begin (b) The children's mental health crisis response services provider entity must: new text end

new text begin (1) ensure that mental health crisis assessment and mobile crisis intervention services are available 24 hours a day, seven days a week; new text end

new text begin (2) directly provide the services or, if services are subcontracted, the provider entity must maintain clinical responsibility for services and billing; new text end

new text begin (3) ensure that crisis intervention services are provided in a manner consistent with sections 245.487 to 245.4888; and new text end

new text begin (4) develop and maintain written policies and procedures regarding service provision that include safety of staff and recipients in high-risk situations. new text end

new text begin Subd. 5. new text end [MOBILE CRISIS INTERVENTION STAFF QUALIFICATIONS.] new text begin (a) To provide children's mental health mobile crisis intervention services, a mobile crisis intervention team must include: new text end

new text begin (1) at least two mental health professionals as defined in section 256B.0943, subdivision 1, paragraph (m); or new text end

new text begin (2) a combination of at least one mental health professional and one mental health practitioner as defined in section 245.4871, subdivision 26, with the required mental health crisis training and under the clinical supervision of a mental health professional on the team. new text end

new text begin (b) The team must have at least two people with at least one member providing on-site crisis intervention services when needed. Team members must be experienced in mental health assessment, crisis intervention techniques, and clinical decision making under emergency conditions and have knowledge of local services and resources. The team must recommend and coordinate the team's services with appropriate local resources, including as the county social services agency, mental health service providers, and local law enforcement, if necessary. new text end

new text begin Subd. 6. new text end [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE INTERVENTION TREATMENT PLANNING.] new text begin (a) Before initiating mobile crisis intervention services, a screening of the potential crisis situation must be conducted. The screening may use the resources of crisis assistance and emergency services as defined in sections 245.4871, subdivision 14, and 245.4879, subdivisions 1 and 2. The screening must gather information, determine whether a crisis situation exists, identify the parties involved, and determine an appropriate response. new text end

new text begin (b) If a crisis exists, a crisis assessment must be completed. A crisis assessment must evaluate any immediate needs for which emergency services are needed and, as time permits, the recipient's current life situation, sources of stress, mental health problems and symptoms, strengths, cultural considerations, support network, vulnerabilities, and current functioning. new text end

new text begin (c) If the crisis assessment determines mobile crisis intervention services are needed, the intervention services must be provided promptly. As the opportunity presents itself during the intervention, at least two members of the mobile crisis intervention team must confer directly or by telephone about the assessment, treatment plan, and actions taken and needed. At least one of the team members must be on site providing crisis intervention services. If providing on-site crisis intervention services, a mental health practitioner must seek clinical supervision as required under subdivision 9. new text end

new text begin (d) The mobile crisis intervention team must develop an initial, brief crisis treatment plan as soon as appropriate but no later than 24 hours after the initial face-to-face intervention. The plan must address the needs and problems noted in the crisis assessment and include measurable short-term goals, cultural considerations, and frequency and type of services to be provided to achieve the goals and reduce or eliminate the crisis. The crisis treatment plan must be updated as needed to reflect current goals and services. The team must involve the client and the client's family in developing and implementing the plan. new text end

new text begin (e) The team must document in progress notes which short-term goals have been met and when no further crisis intervention services are required. new text end

new text begin (f) If the client's crisis is stabilized, but the client needs a referral for mental health crisis stabilization services or to other services, the team must provide a referral to these services. If the recipient has a case manager, planning for other services must be coordinated with the case manager. new text end

new text begin Subd. 7. new text end [CRISIS STABILIZATION SERVICES.] new text begin (a) Crisis stabilization services must be provided by a mental health professional or a mental health practitioner who works under the clinical supervision of a mental health professional and for a crisis stabilization services provider entity, and must meet the following standards: new text end

new text begin (1) a crisis stabilization treatment plan must be developed which meets the criteria in subdivision 8; new text end

new text begin (2) services must be delivered according to the treatment plan and include face-to-face contact with the recipient by qualified staff for further assessment, help with referrals, updating the crisis stabilization treatment plan, supportive counseling, skills training, and collaboration with other service providers in the community; and new text end

new text begin (3) mental health practitioners must have completed at least 30 hours of training in crisis intervention and stabilization during the past two years. new text end

new text begin Subd. 8. new text end [TREATMENT PLAN.] new text begin (a)The individual crisis stabilization treatment plan must include, at a minimum: new text end

new text begin (1) a list of problems identified in the assessment; new text end

new text begin (2) a list of the recipient's strengths and resources; new text end

new text begin (3) concrete, measurable short-term goals and tasks to be achieved, including time frames for achievement of the goals; new text end

new text begin (4) specific objectives directed toward the achievement of each goal; new text end

new text begin (5) documentation of the participants involved in the service planning; new text end

new text begin (6) planned frequency and type of services initiated; new text end

new text begin (7) a crisis response action plan if a crisis should occur; and new text end

new text begin (8) clear progress notes on the outcome of goals. new text end

new text begin (b) The client, if clinically appropriate, must be a participant in the development of the crisis stabilization treatment plan. The client or the client's legal guardian must sign the service plan or documentation must be provided why this was not possible. A copy of the plan must be given to the client and the client's legal guardian. The plan should include services arranged, including specific providers where applicable. new text end

new text begin (c) A treatment plan must be developed by a mental health professional or mental health practitioner under the clinical supervision of a mental health professional. A written plan must be completed within 24 hours of beginning services with the client. new text end

new text begin Subd. 9. new text end [SUPERVISION.] new text begin (a) A mental health practitioner may provide crisis assessment and mobile crisis intervention services if the following clinical supervision requirements are met: new text end

new text begin (1) the mental health provider entity must accept full responsibility for the services provided; new text end

new text begin (2) the mental health professional of the provider entity, who is an employee or under contract with the provider entity, must be immediately available by telephone or in person for clinical supervision; new text end

new text begin (3) the mental health professional is consulted, in person or by telephone, during the first three hours when a mental health practitioner provides on-site service; and new text end

new text begin (4) the mental health professional must review and approve the tentative crisis assessment and crisis treatment plan, document the consultation, and sign the crisis assessment and treatment plan within the next business day. new text end

new text begin (b) If the mobile crisis intervention services continue into a second calendar day, a mental health professional must contact the client face-to-face on the second day to provide services and update the crisis treatment plan. The on-site observation must be documented in the client's record and signed by the mental health professional. new text end

new text begin Subd. 10. new text end [CLIENT RECORD.] new text begin The provider must maintain a file for each client that complies with the requirements under section 256B.0943, subdivision 11, and contains the following information: new text end

new text begin (1) individual crisis treatment plans signed by the recipient, mental health professional, and mental health practitioner who developed the crisis treatment plan, or if the recipient refused to sign the plan, the date and reason stated by the recipient for not signing the plan; new text end

new text begin (2) signed release of information forms; new text end

new text begin (3) recipient health information and current medications; new text end

new text begin (4) emergency contacts for the recipient; new text end

new text begin (5) case records that document the date of service, place of service delivery, signature of the person providing the service, and the nature, extent, and units of service. Direct or telephone contact with the recipient's family or others should be documented; new text end

new text begin (6) required clinical supervision by mental health professionals; new text end

new text begin (7) summary of the recipient's case reviews by staff; and new text end

new text begin (8) any written information by the recipient that the recipient wants in the file. new text end

new text begin Subd. 11. new text end [EXCLUDED SERVICES.] new text begin The following services are excluded from reimbursement under this section: new text end

new text begin (1) room and board services; new text end

new text begin (2) services delivered to a recipient while admitted to an inpatient hospital; new text end

new text begin (3) transportation services under children's mental health crisis response service; new text end

new text begin (4) services provided and billed by a provider who is not enrolled under medical assistance to provide children's mental health crisis response services; new text end

new text begin (5) crisis response services provided by a residential treatment center to clients in their facility; new text end

new text begin (6) services performed by volunteers; new text end

new text begin (7) direct billing of time spent "on call" when not delivering services to a recipient; new text end

new text begin (8) provider service time included in case management reimbursement; new text end

new text begin (9) outreach services to potential recipients; and new text end

new text begin (10) a mental health service that is not medically necessary. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 10.

Minnesota Statutes 2002, section 256B.0945, subdivision 2, is amended to read:

Subd. 2.

Covered services.

All services must be included in a child's individualized treatment or multiagency plan of care as defined in chapter 245.

deleted text begin (a) For facilities that are institutions for mental diseases according to statute and regulation or are not institutions for mental diseases but are approved by the commissioner to provide services under this paragraph, medical assistance covers the full contract rate, including room and board if the services meet the requirements of Code of Federal Regulations, title 42, section 440.160. deleted text end

deleted text begin (b) deleted text end For facilities that are not institutions for mental diseases according to federal statute and regulation deleted text begin and are not providing services under paragraph (a) deleted text end , medical assistance covers mental health related services that are required to be provided by a residential facility under section 245.4882 and administrative rules promulgated thereunder, except for room and board.

Sec. 11.

Minnesota Statutes 2002, section 256B.0945, subdivision 4, is amended to read:

Subd. 4.

Payment rates.

(a) Notwithstanding sections 256B.19 and 256B.041, payments to counties for residential services provided by a residential facility shall only be made of federal earnings for services provided under this section, and the nonfederal share of costs for services provided under this section shall be paid by the county from sources other than federal funds or funds used to match other federal funds. deleted text begin Payment to counties for services provided according to subdivision 2, paragraph (a), shall be the federal share of the contract rate. deleted text end Payment to counties for services provided according to deleted text begin subdivision 2, paragraph (b), deleted text end new text begin this section new text end shall be a proportion of the per day contract rate that relates to rehabilitative mental health services and shall not include payment for costs or services that are billed to the IV-E program as room and board.

(b) The commissioner shall set aside a portion not to exceed five percent of the federal funds earned under this section to cover the state costs of administering this section. Any unexpended funds from the set-aside shall be distributed to the counties in proportion to their earnings under this section.

Sec. 12.

Minnesota Statutes 2002, section 259.67, subdivision 4, is amended to read:

Subd. 4.

Eligibility conditions.

(a) The placing agency shall use the AFDC requirements as specified in federal law as of July 16, 1996, when determining the child's eligibility for adoption assistance under title IV-E of the Social Security Act. If the child does not qualify, the placing agency shall certify a child as eligible for state funded adoption assistance only if the following criteria are met:

(1) Due to the child's characteristics or circumstances it would be difficult to provide the child an adoptive home without adoption assistance.

(2)(i) A placement agency has made reasonable efforts to place the child for adoption without adoption assistance, but has been unsuccessful; or

(ii) the child's licensed foster parents desire to adopt the child and it is determined by the placing agency that the adoption is in the best interest of the child.

(3) The child has been a ward of the commissioner deleted text begin or deleted text end new text begin , new text end a Minnesota-licensed child-placing agency new text begin , or a tribal social service agency of Minnesota recognized by the Secretary of the Interior new text end .

(b) For purposes of this subdivision, the characteristics or circumstances that may be considered in determining whether a child is a child with special needs under United States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of paragraph (a), clause (1), are the following:

(1) The child is a member of a sibling group to be placed as one unit in which at least one sibling is older than 15 months of age or is described in clause (2) or (3).

(2) The child has documented physical, mental, emotional, or behavioral disabilities.

(3) The child has a high risk of developing physical, mental, emotional, or behavioral disabilities.

new text begin (4) The child is adopted according to tribal law without a termination of parental rights or relinquishment, provided that the tribe has documented the valid reason why the child cannot or should not be returned to the home of the child's parent. new text end

(c) When a child's eligibility for adoption assistance is based upon the high risk of developing physical, mental, emotional, or behavioral disabilities, payments shall not be made under the adoption assistance agreement unless and until the potential disability manifests itself as documented by an appropriate health care professional.

Sec. 13.

Minnesota Statutes 2002, section 260B.157, subdivision 1, is amended to read:

Subdivision 1.

Investigation.

Upon request of the court the local social services agency or probation officer shall investigate the personal and family history and environment of any minor coming within the jurisdiction of the court under section 260B.101 and shall report its findings to the court. The court may order any minor coming within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or psychologist appointed by the court.

The court shall have a chemical use assessment conducted when a child is (1) found to be delinquent for violating a provision of chapter 152, or for committing a felony-level violation of a provision of chapter 609 if the probation officer determines that alcohol or drug use was a contributing factor in the commission of the offense, or (2) alleged to be delinquent for violating a provision of chapter 152, if the child is being held in custody under a detention order. The assessor's qualifications and the assessment criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under chapter 254B are to be used to pay for the recommended treatment, the assessment and placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.

new text begin The court shall have a children's mental health screening conducted when a child is alleged to be delinquent or is found to be delinquent. The screening shall be conducted with a screening instrument approved by the commissioner of human services and shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is trained in the use of the screening instrument. If the screening indicates a need for assessment, the local social services agency, in consultation with the child's family, shall have a diagnostic assessment conducted, including a functional assessment, as defined in section 245.4871. new text end

With the consent of the commissioner of corrections and agreement of the county to pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction in an institution maintained by the commissioner for the detention, diagnosis, custody and treatment of persons adjudicated to be delinquent, in order that the condition of the minor be given due consideration in the disposition of the case. Any funds received under the provisions of this subdivision shall not cancel until the end of the fiscal year immediately following the fiscal year in which the funds were received. The funds are available for use by the commissioner of corrections during that period and are hereby appropriated annually to the commissioner of corrections as reimbursement of the costs of providing these services to the juvenile courts.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 14.

Minnesota Statutes 2002, section 260B.176, subdivision 2, is amended to read:

Subd. 2.

Reasons for detention.

(a) If the child is not released as provided in subdivision 1, the person taking the child into custody shall notify the court as soon as possible of the detention of the child and the reasons for detention.

(b) No child may be detained in a juvenile secure detention facility or shelter care facility longer than 36 hours, excluding Saturdays, Sundays, and holidays, after being taken into custody for a delinquent act as defined in section 260B.007, subdivision 6, unless a petition has been filed and the judge or referee determines pursuant to section 260B.178 that the child shall remain in detention.

(c) No child may be detained in an adult jail or municipal lockup longer than 24 hours, excluding Saturdays, Sundays, and holidays, or longer than six hours in an adult jail or municipal lockup in a standard metropolitan statistical area, after being taken into custody for a delinquent act as defined in section 260B.007, subdivision 6, unless:

(1) a petition has been filed under section 260B.141; and

(2) a judge or referee has determined under section 260B.178 that the child shall remain in detention.

After August 1, 1991, no child described in this paragraph may be detained in an adult jail or municipal lockup longer than 24 hours, excluding Saturdays, Sundays, and holidays, or longer than six hours in an adult jail or municipal lockup in a standard metropolitan statistical area, unless the requirements of this paragraph have been met and, in addition, a motion to refer the child for adult prosecution has been made under section 260B.125. Notwithstanding this paragraph, continued detention of a child in an adult detention facility outside of a standard metropolitan statistical area county is permissible if:

(i) the facility in which the child is detained is located where conditions of distance to be traveled or other ground transportation do not allow for court appearances within 24 hours. A delay not to exceed 48 hours may be made under this clause; or

(ii) the facility is located where conditions of safety exist. Time for an appearance may be delayed until 24 hours after the time that conditions allow for reasonably safe travel. "Conditions of safety" include adverse life-threatening weather conditions that do not allow for reasonably safe travel.

The continued detention of a child under clause (i) or (ii) must be reported to the commissioner of corrections.

(d) If a child described in paragraph (c) is to be detained in a jail beyond 24 hours, excluding Saturdays, Sundays, and holidays, the judge or referee, in accordance with rules and procedures established by the commissioner of corrections, shall notify the commissioner of the place of the detention and the reasons therefor. The commissioner shall thereupon assist the court in the relocation of the child in an appropriate juvenile secure detention facility or approved jail within the county or elsewhere in the state, or in determining suitable alternatives. The commissioner shall direct that a child detained in a jail be detained after eight days from and including the date of the original detention order in an approved juvenile secure detention facility with the approval of the administrative authority of the facility. If the court refers the matter to the prosecuting authority pursuant to section 260B.125, notice to the commissioner shall not be required.

new text begin (e) When a child is detained for an alleged delinquent act in a state licensed juvenile facility or program, or when a child is detained in an adult jail or municipal lockup as provided in paragraph (c), the supervisor of the facility shall, if the child's parent or legal guardian consents, have a children's mental health screening conducted with a screening instrument approved by the commissioner of human services, unless a screening has been performed within the previous 180 days or the child is currently under the care of a mental health professional. The screening shall be conducted by a mental health practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is trained in the use of the screening instrument. The screening shall be conducted after the initial detention hearing has been held and the court has ordered the child continued in detention. The results of the screening may only be presented to the court at the dispositional phase of the court proceedings on the matter unless the parent or legal guardian consents to presentation at a different time. If the screening indicates a need for assessment, the local social services agency or probation officer, with the approval of the child's parent or legal guardian, shall have a diagnostic assessment conducted, including a functional assessment, as defined in section 245.4871. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 15.

Minnesota Statutes 2002, section 260B.178, subdivision 1, is amended to read:

Subdivision 1.

Hearing and release requirements.

(a) The court shall hold a detention hearing:

(1) within 36 hours of the time the child was taken into custody, excluding Saturdays, Sundays, and holidays, if the child is being held at a juvenile secure detention facility or shelter care facility; or

(2) within 24 hours of the time the child was taken into custody, excluding Saturdays, Sundays, and holidays, if the child is being held at an adult jail or municipal lockup.

(b) Unless there is reason to believe that the child would endanger self or others, not return for a court hearing, run away from the child's parent, guardian, or custodian or otherwise not remain in the care or control of the person to whose lawful custody the child is released, or that the child's health or welfare would be immediately endangered, the child shall be released to the custody of a parent, guardian, custodian, or other suitable person, subject to reasonable conditions of release including, but not limited to, a requirement that the child undergo a chemical use assessment as provided in section 260B.157, subdivision 1 new text begin , and a children's mental health screening as provided in section 260B.176, subdivision 2, paragraph (e) new text end . In determining whether the child's health or welfare would be immediately endangered, the court shall consider whether the child would reside with a perpetrator of domestic child abuse.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 16.

Minnesota Statutes 2002, section 260B.193, subdivision 2, is amended to read:

Subd. 2.

Consideration of reports.

Before making a disposition in a case, or appointing a guardian for a child, the court may consider any report or recommendation made by the local social services agency, probation officer, licensed child-placing agency, foster parent, guardian ad litem, tribal representative, or other authorized advocate for the child or child's family, a school district concerning the effect on student transportation of placing a child in a school district in which the child is not a resident, or any other information deemed material by the court. new text begin In addition, the court may consider the results of the children's mental health screening provided in section 260B.157, subdivision 1. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 17.

Minnesota Statutes 2002, section 260B.235, subdivision 6, is amended to read:

Subd. 6.

Alternative disposition.

In addition to dispositional alternatives authorized by subdivision deleted text begin 3 deleted text end new text begin 4 new text end , in the case of a third or subsequent finding by the court pursuant to an admission in court or after trial that a child has committed a juvenile alcohol or controlled substance offense, the juvenile court shall order a chemical dependency evaluation of the child and if warranted by the evaluation, the court may order participation by the child in an inpatient or outpatient chemical dependency treatment program, or any other treatment deemed appropriate by the court. new text begin In the case of a third or subsequent finding that a child has committed any juvenile petty offense, the court shall order a children's mental health screening be conducted as provided in section 260B.157, subdivision 1, and if indicated by the screening, to undergo a diagnostic assessment, including a functional assessment, as defined in section 245.4871. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2004. new text end

Sec. 18. new text begin MEDICAL ASSISTANCE FOR MENTAL HEALTH SERVICES PROVIDED IN OUT-OF-HOME PLACEMENT SETTINGS. new text end

new text begin The commissioner of human services shall develop a plan in conjunction with the commissioner of corrections and representatives from counties, provider groups, and other stakeholders, to secure medical assistance funding for mental health-related services provided in out-of-home placement settings, including treatment foster care, group homes, and residential programs licensed under Minnesota Statutes, chapters 241 and 245A. The plan must include proposed legislation, fiscal implications, and other pertinent information. new text end

new text begin Treatment foster care services must be provided by a child placing agency licensed under Minnesota Rules, parts 9543.0010 to 9543.0150 or 9545.0755 to 9545.0845. new text end

new text begin The commissioner shall report to the legislature by January 15, 2004. new text end

Sec. 19. new text begin TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS. new text end

new text begin Beginning July 1, 2003, the commissioner shall use the provider certification process under Minnesota Statutes, section 256B.0943, instead of the provider certification process required in Minnesota Rules, parts 9505.0324; 9505.0326; and 9505.0327. new text end

Sec. 20. new text begin REVISOR'S INSTRUCTION. new text end

new text begin For sections in Minnesota Statutes and Minnesota Rules affected by the repealed sections in this article, the revisor shall delete internal cross-references where appropriate and make changes necessary to correct the punctuation, grammar, or structure of the remaining text and preserve its meaning. new text end

Sec. 21. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 256B.0945, subdivision 10, is repealed. new text end

new text begin (b) Minnesota Statutes 2002, section 256B.0625, subdivisions 35 and 36, are repealed effective July 1, 2004. new text end

new text begin (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 9505.0327, are repealed effective July 1, 2004. new text end

ARTICLE 8

PROHIBITED TRANSFERS; LIENS; ESTATE CLAIMS

Section 1.

Minnesota Statutes 2002, section 256B.0595, subdivision 1, is amended to read:

Subdivision 1.

Prohibited transfers.

(a) For transfers of assets made on or before August 10, 1993, if a person or the person's spouse has given away, sold, or disposed of, for less than fair market value, any asset or interest therein, except assets other than the homestead that are excluded under the supplemental security program, within 30 months before or any time after the date of institutionalization if the person has been determined eligible for medical assistance, or within 30 months before or any time after the date of the first approved application for medical assistance if the person has not yet been determined eligible for medical assistance, the person is ineligible for long-term care services for the period of time determined under subdivision 2.

(b) Effective for transfers made after August 10, 1993, a person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or person's spouse, may not give away, sell, or dispose of, for less than fair market value, any asset or interest therein, except assets other than the homestead that are excluded under the supplemental security income program, for the purpose of establishing or maintaining medical assistance eligibility. new text begin This applies to all transfers, including those made by a community spouse after the month in which the institutionalized spouse is determined eligible for medical assistance. new text end For purposes of determining eligibility for long-term care services, any transfer of such assets within 36 months before or any time after an institutionalized person applies for medical assistance, or 36 months before or any time after a medical assistance recipient becomes institutionalized, for less than fair market value may be considered. Any such transfer is presumed to have been made for the purpose of establishing or maintaining medical assistance eligibility and the person is ineligible for long-term care services for the period of time determined under subdivision 2, unless the person furnishes convincing evidence to establish that the transaction was exclusively for another purpose, or unless the transfer is permitted under subdivision 3 or 4. Notwithstanding the provisions of this paragraph, in the case of payments from a trust or portions of a trust that are considered transfers of assets under federal law, any transfers made within 60 months before or any time after an institutionalized person applies for medical assistance and within 60 months before or any time after a medical assistance recipient becomes institutionalized, may be considered.

(c) This section applies to transfers, for less than fair market value, of income or assets, including assets that are considered income in the month received, such as inheritances, court settlements, and retroactive benefit payments or income to which the person or the person's spouse is entitled but does not receive due to action by the person, the person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse.

(d) This section applies to payments for care or personal services provided by a relative, unless the compensation was stipulated in a notarized, written agreement which was in existence when the service was performed, the care or services directly benefited the person, and the payments made represented reasonable compensation for the care or services provided. A notarized written agreement is not required if payment for the services was made within 60 days after the service was provided.

(e) This section applies to the portion of any asset or interest that a person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse, transfers to any annuity that exceeds the value of the benefit likely to be returned to the person or spouse while alive, based on estimated life expectancy using the life expectancy tables employed by the supplemental security income program to determine the value of an agreement for services for life. The commissioner may adopt rules reducing life expectancies based on the need for long-term care. This section applies to an annuity described in this paragraph purchased on or after March 1, 2002, that:

(1) is not purchased from an insurance company or financial institution that is subject to licensing or regulation by the Minnesota department of commerce or a similar regulatory agency of another state;

(2) does not pay out principal and interest in equal monthly installments; or

(3) does not begin payment at the earliest possible date after annuitization.

(f) For purposes of this section, long-term care services include services in a nursing facility, services that are eligible for payment according to section 256B.0625, subdivision 2, because they are provided in a swing bed, intermediate care facility for persons with mental retardation, and home and community-based services provided pursuant to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient in a nursing facility or in a swing bed, or intermediate care facility for persons with mental retardation or who is receiving home and community-based services under sections 256B.0915, 256B.092, and 256B.49.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 2.

Minnesota Statutes 2002, section 256B.0595, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Prohibited transfers. new text end

new text begin (a) Notwithstanding any contrary provisions of this section, this subdivision applies to transfers involving recipients of medical assistance that are made on or after July 1, 2003, and to all transfers involving persons who apply for medical assistance on or after July 1, 2003, if the transfer occurred within 72 months before the person applies for medical assistance, except that this subdivision does not apply to transfers made prior to July 1, 2003. A person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse, may not give away, sell, dispose of, or reduce ownership or control of any income, asset, or interest therein for less than fair market value for the purpose of establishing or maintaining medical assistance eligibility. This applies to all transfers, including those made by a community spouse after the month in which the institutionalized spouse is determined eligible for medical assistance. For purposes of determining eligibility for medical assistance services, any transfer of such income or assets for less than fair market value within 72 months before or any time after a person applies for medical assistance may be considered. Any such transfer is presumed to have been made for the purpose of establishing or maintaining medical assistance eligibility, and the person is ineligible for medical assistance services for the period of time determined under subdivision 2b, unless the person furnishes convincing evidence to establish that the transaction was exclusively for another purpose or unless the transfer is permitted under subdivision 3b or 4b. new text end

new text begin (b) This section applies to transfers to trusts. The commissioner shall determine valid trust purposes under this section. Assets placed into a trust that is not for a valid purpose shall always be considered available for the purposes of medical assistance eligibility, regardless of when the trust is established. new text end

new text begin (c) This section applies to transfers of income or assets for less than fair market value, including assets that are considered income in the month received, such as inheritances, court settlements, and retroactive benefit payments or income to which the person or the person's spouse is entitled but does not receive due to action by the person, the person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse. new text end

new text begin (d) This section applies to payments for care or personal services provided by a relative, unless the compensation was stipulated in a notarized written agreement that was in existence when the service was performed, the care or services directly benefited the person, and the payments made represented reasonable compensation for the care or services provided. A notarized written agreement is not required if payment for the services was made within 60 days after the service was provided. new text end

new text begin (e) This section applies to the portion of any income, asset, or interest therein that a person, a person's spouse, or any person, court, or administrative body with legal authority to act in place of, on behalf of, at the direction of, or upon the request of the person or the person's spouse, transfers to any annuity that exceeds the value of the benefit likely to be returned to the person or the person's spouse while alive, based on estimated life expectancy, using the life expectancy tables employed by the supplemental security income program, or based on a shorter life expectancy if the annuitant had a medical condition that would shorten his or her life expectancy and that was diagnosed before funds were placed into the annuity. The agency may request and receive a physician's statement to determine if the annuitant had a diagnosed medical condition that would shorten his or her life expectancy. If so, the agency shall determine the expected value of the benefits based upon the physician's statement instead of using a life expectancy table. This section applies to an annuity described in this paragraph purchased on or after March 1, 2002, that: new text end

new text begin (1) is not purchased from an insurance company or financial institution that is subject to licensing or regulation by the Minnesota department of commerce or a similar regulatory agency of another state; new text end

new text begin (2) does not pay out principal and interest in equal monthly installments; or new text end

new text begin (3) does not begin payment at the earliest possible date after annuitization. new text end

new text begin (f) Transfers under this section shall affect determinations of eligibility for all medical assistance services or long-term care services, whichever receives federal approval. new text end

[EFFECTIVE DATE.] new text begin (a) This section is effective July 1, 2003, to the extent permitted by federal law. If any provision of this section is prohibited by federal law, the provision shall become effective when federal law is changed to permit its application or a waiver is received. The commissioner of human services shall notify the revisor of statutes when federal law is enacted or a waiver or other federal approval is received and publish a notice in the State Register. The commissioner must include the notice in the first State Register published after the effective date of the federal changes. new text end

new text begin (b) If, by July 1, 2003, any provision of this section is not effective because of prohibitions in federal law, the commissioner of human services shall apply to the federal government by August 1, 2003, for a waiver of those prohibitions or other federal authority, and that provision shall become effective upon receipt of a federal waiver or other federal approval, notification to the revisor of statutes, and publication of a notice in the State Register to that effect. In applying for federal approval to extend the lookback period, the commissioner shall seek the longest lookback period the federal government will approve, not to exceed 72 months. new text end

Sec. 3.

Minnesota Statutes 2002, section 256B.0595, subdivision 2, is amended to read:

Subd. 2.

Period of ineligibility.

(a) For any uncompensated transfer occurring on or before August 10, 1993, the number of months of ineligibility for long-term care services shall be the lesser of 30 months, or the uncompensated transfer amount divided by the average medical assistance rate for nursing facility services in the state in effect on the date of application. The amount used to calculate the average medical assistance payment rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with the month in which the assets were transferred. If the transfer was not reported to the local agency at the time of application, and the applicant received long-term care services during what would have been the period of ineligibility if the transfer had been reported, a cause of action exists against the transferee for the cost of long-term care services provided during the period of ineligibility, or for the uncompensated amount of the transfer, whichever is less. The action may be brought by the state or the local agency responsible for providing medical assistance under chapter 256G. The uncompensated transfer amount is the fair market value of the asset at the time it was given away, sold, or disposed of, less the amount of compensation received.

(b) For uncompensated transfers made after August 10, 1993, the number of months of ineligibility for long-term care services shall be the total uncompensated value of the resources transferred divided by the average medical assistance rate for nursing facility services in the state in effect on the date of application. The amount used to calculate the average medical assistance payment rate shall be adjusted each July 1 to reflect payment rates for the previous calendar year. The period of ineligibility begins with new text begin the first day of new text end the month new text begin after the month new text end in which the assets were transferred except that if one or more uncompensated transfers are made during a period of ineligibility, the total assets transferred during the ineligibility period shall be combined and a penalty period calculated to begin deleted text begin in deleted text end new text begin on the first day of new text end the month new text begin after the month in which new text end the first uncompensated transfer was made. If the transfer was not reported to the local agency deleted text begin at the time of application deleted text end , and the applicant received medical assistance services during what would have been the period of ineligibility if the transfer had been reported, a cause of action exists against the transferee for the cost of medical assistance services provided during the period of ineligibility, or for the uncompensated amount of the transfer, whichever is less. The action may be brought by the state or the local agency responsible for providing medical assistance under chapter 256G. The uncompensated transfer amount is the fair market value of the asset at the time it was given away, sold, or disposed of, less the amount of compensation received. Effective for transfers made on or after March 1, 1996, involving persons who apply for medical assistance on or after April 13, 1996, no cause of action exists for a transfer unless:

(1) the transferee knew or should have known that the transfer was being made by a person who was a resident of a long-term care facility or was receiving that level of care in the community at the time of the transfer;

(2) the transferee knew or should have known that the transfer was being made to assist the person to qualify for or retain medical assistance eligibility; or

(3) the transferee actively solicited the transfer with intent to assist the person to qualify for or retain eligibility for medical assistance.

(c) If a calculation of a penalty period results in a partial month, payments for long-term care services shall be reduced in an amount equal to the fraction, except that in calculating the value of uncompensated transfers, if the total value of all uncompensated transfers made in a month not included in an existing penalty period does not exceed $200, then such transfers shall be disregarded for each month prior to the month of application for or during receipt of medical assistance.

[EFFECTIVE DATE.] new text begin Paragraph (b) of this section is effective July 1, 2003. new text end

Sec. 4.

Minnesota Statutes 2002, section 256B.0595, is amended by adding a subdivision to read:

new text begin Subd. 2b. new text end

new text begin Period of ineligibility. new text end

new text begin (a) Notwithstanding any contrary provisions of this section, this subdivision applies to transfers, including transfers to trusts, involving recipients of medical assistance that are made on or after July 1, 2003, and to all transfers involving persons who apply for medical assistance on or after July 1, 2003, regardless of when the transfer occurred, except that this subdivision does not apply to transfers made prior to July 1, 2003. For any uncompensated transfer occurring within 72 months prior to the date of application, at any time after application, or while eligible, the number of months of cumulative ineligibility for medical assistance services shall be the total uncompensated value of the assets and income transferred divided by the statewide average per-person nursing facility payment made by the state in effect at the time a penalty for a transfer is determined. The amount used to calculate the average per-person nursing facility payment shall be adjusted each July 1 to reflect average payments for the previous calendar year. For applicants, the period of ineligibility begins with the month in which the person applied for medical assistance and satisfied all other requirements for eligibility, or the first month the local agency becomes aware of the transfer and can give proper notice, if later. For recipients, the period of ineligibility begins in the first month after the month the agency becomes aware of the transfer and can give proper notice, except that penalty periods for transfers made during a period of ineligibility as determined under this section shall begin in the month following the existing period of ineligibility. If the transfer was not reported to the local agency, and the applicant received medical assistance services during what would have been the period of ineligibility if the transfer had been reported, a cause of action exists against the transferee for the cost of medical assistance services provided during the period of ineligibility or for the uncompensated amount of the transfer that was not recovered from the transferor through the implementation of a penalty period under this subdivision, whichever is less. Recovery shall include the costs incurred due to the action. The action may be brought by the state or the local agency responsible for providing medical assistance under chapter 256B. The total uncompensated value is the fair market value of the income or asset at the time it was given away, sold, or disposed of, less the amount of compensation received. No cause of action exists for a transfer unless: new text end

new text begin (1) the transferee knew or should have known that the transfer was being made by a person who was a resident of a long-term care facility or was receiving that level of care in the community at the time of the transfer; new text end

new text begin (2) the transferee knew or should have known that the transfer was being made to assist the person to qualify for or retain medical assistance eligibility; or new text end

new text begin (3) the transferee actively solicited the transfer with intent to assist the person to qualify for or retain eligibility for medical assistance. new text end

new text begin (b) If a calculation of a penalty period results in a partial month, payments for medical assistance services shall be reduced in an amount equal to the fraction, except that in calculating the value of uncompensated transfers, if the total value of all uncompensated transfers made in a month not included in an existing penalty period does not exceed $200, then such transfers shall be disregarded for each month prior to the month of application for or during receipt of medical assistance. new text end

new text begin (c) Ineligibility under this section shall apply to medical assistance services or long-term care services, whichever receives federal approval. new text end

[EFFECTIVE DATE.] new text begin (a) This section is effective July 1, 2003, to the extent permitted by federal law. If any provision of this section is prohibited by federal law, the provision shall become effective when federal law is changed to permit its application or a waiver is received. The commissioner of human services shall notify the revisor of statutes when federal law is enacted or a waiver or other federal approval is received and publish a notice in the State Register. The commissioner must include the notice in the first State Register published after the effective date of the federal changes. new text end

new text begin (b) If, by July 1, 2003, any provision of this section is not effective because of prohibitions in federal law, the commissioner of human services shall apply to the federal government by August 1, 2003, for a waiver of those prohibitions or other federal authority, and that provision shall become effective upon receipt of a federal waiver or other federal approval, notification to the revisor of statutes, and publication of a notice in the State Register to that effect. In applying for federal approval to extend the lookback period, the commissioner shall seek the longest lookback period the federal government will approve, not to exceed 72 months. new text end

Sec. 5.

Minnesota Statutes 2002, section 256B.0595, is amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin Homestead exception to transfer prohibition. new text end

new text begin (a) This subdivision applies to transfers involving recipients of medical assistance that are made on or after July 1, 2003, and to all transfers involving persons who apply for medical assistance on or after July 1, 2003, regardless of when the transfer occurred, except that this subdivision does not apply to transfers made prior to July 1, 2003. A person is not ineligible for medical assistance services due to a transfer of assets for less than fair market value as described in subdivision 1b, if the asset transferred was a homestead, and: new text end

new text begin (1) a satisfactory showing is made that the individual intended to dispose of the homestead at fair market value or for other valuable consideration; or new text end

new text begin (2) the local agency grants a waiver of a penalty resulting from a transfer for less than fair market value because denial of eligibility would cause undue hardship for the individual and there exists an imminent threat to the individual's health and well-being. Whenever an applicant or recipient is denied eligibility because of a transfer for less than fair market value, the local agency shall notify the applicant or recipient that the applicant or recipient may request a waiver of the penalty if the denial of eligibility will cause undue hardship. In evaluating a waiver, the local agency shall take into account whether the individual was the victim of financial exploitation, whether the individual has made reasonable efforts to recover the transferred property or resource, and other factors relevant to a determination of hardship. If the local agency does not approve a hardship waiver, the local agency shall issue a written notice to the individual stating the reasons for the denial and the process for appealing the local agency's decision. new text end

new text begin (b) When a waiver is granted under paragraph (a), clause (2), a cause of action exists against the person to whom the homestead was transferred for that portion of medical assistance services granted within 72 months of the date the transferor applied for medical assistance and satisfied all other requirements for eligibility or the amount of the uncompensated transfer, whichever is less, together with the costs incurred due to the action. The action shall be brought by the state unless the state delegates this responsibility to the local agency responsible for providing medical assistance under chapter 256B. new text end

[EFFECTIVE DATE.] new text begin (a) This section is effective July 1, 2003, to the extent permitted by federal law. If any provision of this section is prohibited by federal law, the provision shall become effective when federal law is changed to permit its application or a waiver is received. The commissioner of human services shall notify the revisor of statutes when federal law is enacted or a waiver or other federal approval is received and publish a notice in the State Register. The commissioner must include the notice in the first State Register published after the effective date of the federal changes. new text end

new text begin (b) If, by July 1, 2003, any provision of this section is not effective because of prohibitions in federal law, the commissioner of human services shall apply to the federal government by August 1, 2003, for a waiver of those prohibitions or other federal authority, and that provision shall become effective upon receipt of a federal waiver or other federal approval, notification to the revisor of statutes, and publication of a notice in the State Register to that effect. In applying for federal approval to extend the lookback period, the commissioner shall seek the longest lookback period the federal government will approve, not to exceed 72 months. new text end

Sec. 6.

Minnesota Statutes 2002, section 256B.0595, is amended by adding a subdivision to read:

new text begin Subd. 4b. new text end

new text begin Other exceptions to transfer prohibition. new text end

new text begin This subdivision applies to transfers involving recipients of medical assistance that are made on or after July 1, 2003, and to all transfers involving persons who apply for medical assistance on or after July 1, 2003, regardless of when the transfer occurred, except that this subdivision does not apply to transfers made prior to July 1, 2003. A person or a person's spouse who made a transfer prohibited by subdivision 1b is not ineligible for medical assistance services if one of the following conditions applies: new text end

new text begin (1) the assets or income were transferred to the individual's spouse or to another for the sole benefit of the spouse, except that after eligibility is established and the assets have been divided between the spouses as part of the asset allowance under section 256B.059, no further transfers between spouses may be made; new text end

new text begin (2) the institutionalized spouse, prior to being institutionalized, transferred assets or income to a spouse, provided that the spouse to whom the assets or income were transferred does not then transfer those assets or income to another person for less than fair market value. At the time when one spouse is institutionalized, assets must be allocated between the spouses as provided under section 256B.059; new text end

new text begin (3) the assets or income were transferred to a trust for the sole benefit of the individual's child who is blind or permanently and totally disabled as determined in the supplemental security income program and the trust reverts to the state upon the disabled child's death to the extent the medical assistance has paid for services for the grantor or beneficiary of the trust. This clause applies to a trust established after the commissioner publishes a notice in the State Register that the commissioner has been authorized to implement this clause due to a change in federal law or the approval of a federal waiver; new text end

new text begin (4) a satisfactory showing is made that the individual intended to dispose of the assets or income either at fair market value or for other valuable consideration; or new text end

new text begin (5) the local agency determines that denial of eligibility for medical assistance services would cause undue hardship and grants a waiver of a penalty resulting from a transfer for less than fair market value because there exists an imminent threat to the individual's health and well-being. Whenever an applicant or recipient is denied eligibility because of a transfer for less than fair market value, the local agency shall notify the applicant or recipient that the applicant or recipient may request a waiver of the penalty if the denial of eligibility will cause undue hardship. In evaluating a waiver, the local agency shall take into account whether the individual was the victim of financial exploitation, whether the individual has made reasonable efforts to recover the transferred property or resource, and other factors relevant to a determination of hardship. If the local agency does not approve a hardship waiver, the local agency shall issue a written notice to the individual stating the reasons for the denial and the process for appealing the local agency's decision. When a waiver is granted, a cause of action exists against the person to whom the assets were transferred for that portion of medical assistance services granted within 72 months of the date the transferor applied for medical assistance and satisfied all other requirements for eligibility, or the amount of the uncompensated transfer, whichever is less, together with the costs incurred due to the action. The action shall be brought by the state unless the state delegates this responsibility to the local agency responsible for providing medical assistance under this chapter. new text end

[EFFECTIVE DATE.] new text begin (a) This section is effective July 1, 2003, to the extent permitted by federal law. If any provision of this section is prohibited by federal law, the provision shall become effective when federal law is changed to permit its application or a waiver is received. The commissioner of human services shall notify the revisor of statutes when federal law is enacted or a waiver or other federal approval is received and publish a notice in the State Register. The commissioner must include the notice in the first State Register published after the effective date of the federal changes. new text end

new text begin (b) If, by July 1, 2003, any provision of this section is not effective because of prohibitions in federal law, the commissioner of human services shall apply to the federal government by August 1, 2003, for a waiver of those prohibitions or other federal authority, and that provision shall become effective upon receipt of a federal waiver or other federal approval, notification to the revisor of statutes, and publication of a notice in the State Register to that effect. In applying for federal approval to extend the lookback period, the commissioner shall seek the longest lookback period the federal government will approve, not to exceed 72 months. new text end

Sec. 7.

Minnesota Statutes 2002, section 256B.15, subdivision 1, is amended to read:

Subdivision 1.

new text begin policy, applicability, purpose, and construction; new text end definition.

new text begin (a) It is the policy of this state that individuals or couples, either or both of whom participate in the medical assistance program, use their own assets to pay their share of the total cost of their care during or after their enrollment in the program according to applicable federal law and the laws of this state. The following provisions apply: new text end

new text begin (1) subdivisions 1c to 1k shall not apply to claims arising under this section which are presented under section 525.313; new text end

new text begin (2) the provisions of subdivisions 1c to 1k expanding the interests included in an estate for purposes of recovery under this section give effect to the provisions of United States Code, title 42, section 1396p, governing recoveries, but do not give rise to any express or implied liens in favor of any other parties not named in these provisions; new text end

new text begin (3) the continuation of a recipient's life estate or joint tenancy interest in real property after the recipient's death for the purpose of recovering medical assistance under this section modifies common law principles holding that these interests terminate on the death of the holder; new text end

new text begin (4) all laws, rules, and regulations governing or involved with a recovery of medical assistance shall be liberally construed to accomplish their intended purposes; and new text end

new text begin (5) a deceased recipient's life estate and joint tenancy interests continued under this section shall be owned by the remaindermen or surviving joint tenants as their interests may appear on the date of the recipient's death. They shall not be merged into the remainder interest or the interests of the surviving joint tenants by reason of ownership. They shall be subject to the provisions of this section. Any conveyance, transfer, sale, assignment, or encumbrance by a remainderman, a surviving joint tenant, or their heirs, successors, and assigns shall be deemed to include all of their interest in the deceased recipient's life estate or joint tenancy interest continued under this section. new text end

new text begin (b) new text end For purposes of this section, "medical assistance" includes the medical assistance program under this chapter deleted text begin and deleted text end new text begin , new text end the general assistance medical care program under chapter 256D, deleted text begin but does not include deleted text end new text begin and new text end the alternative care program for nonmedical assistance recipients under section 256B.0913 deleted text begin , subdivision 4 deleted text end .

[EFFECTIVE DATE.] new text begin Paragraph (a) of this section is effective August 1, 2003, and applies to estates of decedents who die on or after that date. The amendments to paragraph (b) are effective July 1, 2003, and apply to estates of decedents who die on or after that date. new text end

Sec. 8.

Minnesota Statutes 2002, section 256B.15, subdivision 1a, is amended to read:

Subd. 1a.

Estates subject to claims.

If a person receives any medical assistance hereunder, on the person's death, if single, or on the death of the survivor of a married couple, either or both of whom received medical assistance, new text begin or as otherwise provided for in this section, new text end the total amount paid for medical assistance rendered for the person and spouse shall be filed as a claim against the estate of the person or the estate of the surviving spouse in the court having jurisdiction to probate the estate or to issue a decree of descent according to sections 525.31 to 525.313.

A claim shall be filed if medical assistance was rendered for either or both persons under one of the following circumstances:

(a) the person was over 55 years of age, and received services under this chapter deleted text begin , excluding alternative care deleted text end ;

(b) the person resided in a medical institution for six months or longer, received services under this chapter deleted text begin excluding alternative care deleted text end , and, at the time of institutionalization or application for medical assistance, whichever is later, the person could not have reasonably been expected to be discharged and returned home, as certified in writing by the person's treating physician. For purposes of this section only, a "medical institution" means a skilled nursing facility, intermediate care facility, intermediate care facility for persons with mental retardation, nursing facility, or inpatient hospital; or

(c) the person received general assistance medical care services under chapter 256D.

The claim shall be considered an expense of the last illness of the decedent for the purpose of section 524.3-805. Any statute of limitations that purports to limit any county agency or the state agency, or both, to recover for medical assistance granted hereunder shall not apply to any claim made hereunder for reimbursement for any medical assistance granted hereunder. Notice of the claim shall be given to all heirs and devisees of the decedent whose identity can be ascertained with reasonable diligence. The notice must include procedures and instructions for making an application for a hardship waiver under subdivision 5; time frames for submitting an application and determination; and information regarding appeal rights and procedures. Counties are entitled to one-half of the nonfederal share of medical assistance collections from estates that are directly attributable to county effort. new text begin Counties are entitled to ten percent of the collections for alternative care directly attributable to county effort. new text end

[EFFECTIVE DATE.] new text begin The amendments in this section relating to the alternative care program are effective July 1, 2003, and apply to the estates of decedents who die on or after that date. The remaining amendments in this section are effective August 1, 2003, and apply to the estates of decedents who die on and after that date. new text end

Sec. 9.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1c. new text end

new text begin Notice of potential claim. new text end

new text begin (a) A state agency with a claim or potential claim under this section may file a notice of potential claim under this subdivision anytime before or within one year after a medical assistance recipient dies. The claimant shall be the state agency. A notice filed prior to the recipient's death shall not take effect and shall not be effective as notice until the recipient dies. A notice filed after a recipient dies shall be effective from the time of filing. new text end

new text begin (b) The notice of claim shall be filed or recorded in the real estate records in the office of the county recorder or registrar of titles for each county in which any part of the property is located. The recorder shall accept the notice for recording or filing. The registrar of titles shall accept the notice for filing if the recipient has a recorded interest in the property. The registrar of titles shall not carry forward to a new certificate of title any notice filed more than one year from the date of the recipient's death. new text end

new text begin (c) The notice must be dated, state the name of the claimant, the medical assistance recipient's name and social security number if filed before their death and their date of death if filed after they die, the name and date of death of any predeceased spouse of the medical assistance recipient for whom a claim may exist, a statement that the claimant may have a claim arising under this section, generally identify the recipient's interest in the property, contain a legal description for the property and whether it is abstract or registered property, a statement of when the notice becomes effective and the effect of the notice, be signed by an authorized representative of the state agency, and may include such other contents as the state agency may deem appropriate. new text end

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 10.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1d. new text end

new text begin Effect of notice. new text end

new text begin From the time it takes effect, the notice shall be notice to remaindermen, joint tenants, or to anyone else owning or acquiring an interest in or encumbrance against the property described in the notice that the medical assistance recipient's life estate, joint tenancy, or other interests in the real estate described in the notice: new text end

new text begin (1) shall, in the case of life estate and joint tenancy interests, continue to exist for purposes of this section, and be subject to liens and claims as provided in this section; new text end

new text begin (2) shall be subject to a lien in favor of the claimant effective upon the death of the recipient and dealt with as provided in this section; new text end

new text begin (3) may be included in the recipient's estate, as defined in this section; and new text end

new text begin (4) may be subject to administration and all other provisions of chapter 524 and may be sold, assigned, transferred, or encumbered free and clear of their interest or encumbrance to satisfy claims under this section. new text end

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 11.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1e. new text end

new text begin Full or partial release of notice. new text end

new text begin (a) The claimant may fully or partially release the notice and the lien arising out of the notice of record in the real estate records where the notice is filed or recorded at any time. The claimant may give a full or partial release to extinguish any life estates or joint tenancy interests which are or may be continued under this section or whose existence or nonexistence may create a cloud on the title to real property at any time whether or not a notice has been filed. The recorder or registrar of titles shall accept the release for recording or filing. If the release is a partial release, it must include a legal description of the property being released. new text end

new text begin (b) At any time, the claimant may, at the claimant's discretion, wholly or partially release, subordinate, modify, or amend the recorded notice and the lien arising out of the notice. new text end

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 12.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1f. new text end

new text begin Agency lien. new text end

new text begin (a) The notice shall constitute a lien in favor of the department of human services against the recipient's interests in the real estate it describes for a period of 20 years from the date of filing or the date of the recipient's death, whichever is later. Notwithstanding any law or rule to the contrary, a recipient's life estate and joint tenancy interests shall not end upon the recipient's death but shall continue according to subdivisions 1h, 1i, and 1j. The amount of the lien shall be equal to the total amount of the claims that could be presented in the recipient's estate under this section. new text end

new text begin (b) If no estate has been opened for the deceased recipient, any holder of an interest in the property may apply to the lienholder for a statement of the amount of the lien or for a full or partial release of the lien. The application shall include the applicant's name, current mailing address, current home and work telephone numbers, and a description of their interest in the property, a legal description of the recipient's interest in the property, and the deceased recipient's name, date of birth, and social security number. The lienholder shall send the applicant by certified mail, return receipt requested, a written statement showing the amount of the lien, whether the lienholder is willing to release the lien and under what conditions, and inform them of the right to a hearing under section 256.045. The lienholder shall have the discretion to compromise and settle the lien upon any terms and conditions the lienholder deems appropriate. new text end

new text begin (c) Any holder of an interest in property subject to the lien has a right to request a hearing under section 256.045 to determine the validity, extent, or amount of the lien. The request must be in writing, and must include the names, current addresses, and home and business telephone numbers for all other parties holding an interest in the property. A request for a hearing by any holder of an interest in the property shall be deemed to be a request for a hearing by all parties owning interests in the property. Notice of the hearing shall be given to the lienholder, the party filing the appeal, and all of the other holders of interests in the property at the addresses listed in the appeal by certified mail, return receipt requested, or by ordinary mail. Any owner of an interest in the property to whom notice of the hearing is mailed shall be deemed to have waived any and all claims or defenses in respect to the lien unless they appear and assert any claims or defenses at the hearing. new text end

new text begin (d) If the claim the lien secures could be filed under subdivision 1h, the lienholder may collect, compromise, settle, or release the lien upon any terms and conditions it deems appropriate. If the claim the lien secures could be filed under subdivision 1i or 1j, the lien may be adjusted or enforced to the same extent had it been filed under subdivisions 1i and 1j, and the provisions of subdivisions 1i, clause (f), and lj, clause (d), shall apply to voluntary payment, settlement, or satisfaction of the lien. new text end

new text begin (e) If no probate proceedings have been commenced for the recipient as of the date the lienholder executes a release of the lien on a recipient's life estate or joint tenancy interest, created for purposes of this section, the release shall terminate the life estate or joint tenancy interest created under this section as of the date it is recorded or filed to the extent of the release. If the claimant executes a release for purposes of extinguishing a life estate or a joint tenancy interest created under this section to remove a cloud on title to real property, the release shall have the effect of extinguishing any life estate or joint tenancy interests in the property it describes which may have been continued by reason of this section retroactive to the date of death of the deceased life tenant or joint tenant except as provided for in section 514.981, subdivision 6. new text end

new text begin (f) If the deceased recipient's estate is probated, a claim shall be filed under this section. The amount of the lien shall be limited to the amount of the claim as finally allowed. If the claim the lien secures is filed under subdivision 1h, the lien may be released in full after any allowance of the claim becomes final or according to any agreement to settle and satisfy the claim. The release shall release the lien but shall not extinguish or terminate the interest being released. If the claim the lien secures is filed under subdivision 1i or 1j, the lien shall be released after the lien under subdivision 1i or 1j is filed or recorded, or settled according to any agreement to settle and satisfy the claim. The release shall not extinguish or terminate the interest being released. If the claim is finally disallowed in full, the claimant shall release the claimant's lien at the claimant's expense. new text end

[EFFECTIVE DATE.] new text begin This section takes effect on August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 13.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1g. new text end

new text begin Estate property. new text end

new text begin Notwithstanding any law or rule to the contrary, if a claim is presented under this section, interests or the proceeds of interests in real property a decedent owned as a life tenant or a joint tenant with a right of survivorship shall be part of the decedent's estate, subject to administration, and shall be dealt with as provided in this section. new text end

[EFFECTIVE DATE.] new text begin This section takes effect on August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 14.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1h. new text end

new text begin Estates of specific persons receiving medical assistance. new text end

new text begin (a) For purposes of this section, paragraphs (b) to (k) apply if a person received medical assistance for which a claim may be filed under this section and died single, or the surviving spouse of the couple and was not survived by any of the persons described in subdivisions 3 and 4. new text end

new text begin (b) For purposes of this section, the person's estate consists of: (1) their probate estate; (2) all of the person's interests or proceeds of those interests in real property the person owned as a life tenant or as a joint tenant with a right of survivorship at the time of the person's death; (3) all of the person's interests or proceeds of those interests in securities the person owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time of the person's death, to the extent they become part of the probate estate under section 524.6-307; and (4) all of the person's interests in joint accounts, multiple party accounts, and pay on death accounts, or the proceeds of those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent they become part of the probate estate under section 524.6-207. Notwithstanding any law or rule to the contrary, a state or county agency with a claim under this section shall be a creditor under section 524.6-307. new text end

new text begin (c) Notwithstanding any law or rule to the contrary, the person's life estate or joint tenancy interest in real property not subject to a medical assistance lien under sections 514.980 to 514.985 on the date of the person's death shall not end upon the person's death and shall continue as provided in this subdivision. The life estate in the person's estate shall be that portion of the interest in the real property subject to the life estate that is equal to the life estate percentage factor for the life estate as listed in the Life Estate Mortality Table of the health care program's manual for a person who was the age of the medical assistance recipient on the date of the person's death. The joint tenancy interest in real property in the estate shall be equal to the fractional interest the person would have owned in the jointly held interest in the property had they and the other owners held title to the property as tenants in common on the date the person died. new text end

new text begin (d) The court upon its own motion, or upon motion by the personal representative or any interested party, may enter an order directing the remaindermen or surviving joint tenants and their spouses, if any, to sign all documents, take all actions, and otherwise fully cooperate with the personal representative and the court to liquidate the decedent's life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of those interests to the personal representative and provide for any legal and equitable sanctions as the court deems appropriate to enforce and carry out the order, including an award of reasonable attorney fees. new text end

new text begin (e) The personal representative may make, execute, and deliver any conveyances or other documents necessary to convey the decedent's life estate or joint tenancy interest in the estate that are necessary to liquidate and reduce to cash the decedent's interest or for any other purposes. new text end

new text begin (f) Subject to administration, all costs, including reasonable attorney fees, directly and immediately related to liquidating the decedent's life estate or joint tenancy interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation allocable to the decedent's interest and the net proceeds shall be turned over to the personal representative and applied to payment of the claim presented under this section. new text end

new text begin (g) The personal representative shall bring a motion in the district court in which the estate is being probated to compel the remaindermen or surviving joint tenants to account for and deliver to the personal representative all or any part of the proceeds of any sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the decedent's life estate or joint tenancy interest in the decedent's estate, and do everything necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of the sale or other disposition over to the personal representative. The court may grant any legal or equitable relief including, but not limited to, ordering a partition of real estate under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy interest available to the estate for payment of a claim under this section. new text end

new text begin (h) Subject to administration, the personal representative shall use all of the cash or proceeds of interests to pay an allowable claim under this section. The remaindermen or surviving joint tenants and their spouses, if any, may enter into a written agreement with the personal representative or the claimant to settle and satisfy obligations imposed at any time before or after a claim is filed. new text end

new text begin (i) The personal representative may provide any or all of the other owners, remaindermen, or surviving joint tenants with an affidavit terminating the decedent's estate's interest in real property the decedent owned as a life tenant or as a joint tenant with others, if the personal representative determines that neither the decedent nor any of the decedent's predeceased spouses received any medical assistance for which a claim could be filed under this section, or if the personal representative has filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as presented, or if there is a written agreement under paragraph (h), or if the claim, as allowed, has been paid in full or to the full extent of the assets the estate has available to pay it. The affidavit may be recorded in the office of the county recorder or filed in the office of the registrar of titles for the county in which the real property is located. Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a joint tenant with others. The affidavit shall: (1) be signed by the personal representative; (2) identify the decedent and the interest being terminated; (3) give recording information sufficient to identify the instrument that created the interest in real property being terminated; (4) legally describe the affected real property; (5) state that the personal representative has determined that neither the decedent nor any of the decedent's predeceased spouses received any medical assistance for which a claim could be filed under this section; (6) state that the decedent's estate has other assets sufficient to pay the claim, as presented, or that there is a written agreement between the personal representative and the claimant and the other owners or remaindermen or other joint tenants to satisfy the obligations imposed under this subdivision; and (7) state that the affidavit is being given to terminate the estate's interest under this subdivision, and any other contents as may be appropriate. new text end

new text begin The recorder or registrar of titles shall accept the affidavit for recording or filing. The affidavit shall be effective as provided in this section and shall constitute notice even if it does not include recording information sufficient to identify the instrument creating the interest it terminates. The affidavit shall be conclusive evidence of the stated facts. new text end

new text begin (j) The holder of a lien arising under subdivision 1c shall release the lien at the holder's expense against an interest terminated under paragraph (h) to the extent of the termination. new text end

new text begin (k) If a lien arising under subdivision 1c is not released under paragraph (j), prior to closing the estate, the personal representative shall deed the interest subject to the lien to the remaindermen or surviving joint tenants as their interests may appear. Upon recording or filing, the deed shall work a merger of the recipient's life estate or joint tenancy interest, subject to the lien, into the remainder interest or interest the decedent and others owned jointly. The lien shall attach to and run with the property to the extent of the decedent's interest at the time of the decedent's death. new text end

[EFFECTIVE DATE.] new text begin This section takes effect on August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 15.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1i. new text end

new text begin Estates of persons receiving medical assistance and survived by others. new text end

new text begin (a) For purposes of this subdivision, the person's estate consists of the person's probate estate and all of the person's interests in real property the person owned as a life tenant or a joint tenant at the time of the person's death. new text end

new text begin (b) Notwithstanding any law or rule to the contrary, this subdivision applies if a person received medical assistance for which a claim could be filed under this section but for the fact the person was survived by a spouse or by a person listed in subdivision 3, or if subdivision 4 applies to a claim arising under this section. new text end

new text begin (c) The person's life estate or joint tenancy interests in real property not subject to a medical assistance lien under sections 514.980 to 514.985 on the date of the person's death shall not end upon death and shall continue as provided in this subdivision. The life estate in the estate shall be the portion of the interest in the property subject to the life estate that is equal to the life estate percentage factor for the life estate as listed in the Life Estate Mortality Table of the health care program's manual for a person who was the age of the medical assistance recipient on the date of the person's death. The joint tenancy interest in the estate shall be equal to the fractional interest the medical assistance recipient would have owned in the jointly held interest in the property had they and the other owners held title to the property as tenants in common on the date the medical assistance recipient died. new text end

new text begin (d) The county agency shall file a claim in the estate under this section on behalf of the claimant who shall be the commissioner of human services, notwithstanding that the decedent is survived by a spouse or a person listed in subdivision 3. The claim, as allowed, shall not be paid by the estate and shall be disposed of as provided in this paragraph. The personal representative or the court shall make, execute, and deliver a lien in favor of the claimant on the decedent's interest in real property in the estate in the amount of the allowed claim on forms provided by the commissioner to the county agency filing the lien. The lien shall bear interest as provided under section 524.3-806, shall attach to the property it describes upon filing or recording, and shall remain a lien on the real property it describes for a period of 20 years from the date it is filed or recorded. The lien shall be a disposition of the claim sufficient to permit the estate to close. new text end

new text begin (e) The state or county agency shall file or record the lien in the office of the county recorder or registrar of titles for each county in which any of the real property is located. The recorder or registrar of titles shall accept the lien for filing or recording. All recording or filing fees shall be paid by the department of human services. The recorder or registrar of titles shall mail the recorded lien to the department of human services. The lien need not be attested, certified, or acknowledged as a condition of recording or filing. Upon recording or filing of a lien against a life estate or a joint tenancy interest, the interest subject to the lien shall merge into the remainder interest or the interest the recipient and others owned jointly. The lien shall attach to and run with the property to the extent of the decedent's interest in the property at the time of the decedent's death as determined under this section. new text end

new text begin (f) The department shall make no adjustment or recovery under the lien until after the decedent's spouse, if any, has died, and only at a time when the decedent has no surviving child described in subdivision 3. The estate, any owner of an interest in the property which is or may be subject to the lien, or any other interested party, may voluntarily pay off, settle, or otherwise satisfy the claim secured or to be secured by the lien at any time before or after the lien is filed or recorded. Such payoffs, settlements, and satisfactions shall be deemed to be voluntary repayments of past medical assistance payments for the benefit of the deceased recipient, and neither the process of settling the claim, the payment of the claim, or the acceptance of a payment shall constitute an adjustment or recovery that is prohibited under this subdivision. new text end

new text begin (g) The lien under this subdivision may be enforced or foreclosed in the manner provided by law for the enforcement of judgment liens against real estate or by a foreclosure by action under chapter 581. When the lien is paid, satisfied, or otherwise discharged, the state or county agency shall prepare and file a release of lien at its own expense. No action to foreclose the lien shall be commenced unless the lienholder has first given 30 days' prior written notice to pay the lien to the owners and parties in possession of the property subject to the lien. The notice shall: (1) include the name, address, and telephone number of the lienholder; (2) describe the lien; (3) give the amount of the lien; (4) inform the owner or party in possession that payment of the lien in full must be made to the lienholder within 30 days after service of the notice or the lienholder may begin proceedings to foreclose the lien; and (5) be served by personal service, certified mail, return receipt requested, ordinary first class mail, or by publishing it once in a newspaper of general circulation in the county in which any part of the property is located. Service of the notice shall be complete upon mailing or publication. new text end

[EFFECTIVE DATE.] new text begin This section takes effect August 1, 2003, and applies to estates of decedents who die on and after that date. new text end

Sec. 16.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1j. new text end

new text begin Claims in estates of decedents survived by other survivors. new text end

new text begin For purposes of this subdivision, the provisions in subdivision 1i, paragraphs (a) to (c) apply. new text end

new text begin (a) If payment of a claim filed under this section is limited as provided in subdivision 4, and if the estate does not have other assets sufficient to pay the claim in full, as allowed, the personal representative or the court shall make, execute, and deliver a lien on the property in the estate that is exempt from the claim under subdivision 4 in favor of the commissioner of human services on forms provided by the commissioner to the county agency filing the claim. If the estate pays a claim filed under this section in full from other assets of the estate, no lien shall be filed against the property described in subdivision 4. new text end

new text begin (b) The lien shall be in an amount equal to the unpaid balance of the allowed claim under this section remaining after the estate has applied all other available assets of the estate to pay the claim. The property exempt under subdivision 4 shall not be sold, assigned, transferred, conveyed, encumbered, or distributed until after the personal representative has determined the estate has other assets sufficient to pay the allowed claim in full, or until after the lien has been filed or recorded. The lien shall bear interest as provided under section 524.3-806, shall attach to the property it describes upon filing or recording, and shall remain a lien on the real property it describes for a period of 20 years from the date it is filed or recorded. The lien shall be a disposition of the claim sufficient to permit the estate to close. new text end

new text begin (c) The state or county agency shall file or record the lien in the office of the county recorder or registrar of titles in each county in which any of the real property is located. The department shall pay the filing fees. The lien need not be attested, certified, or acknowledged as a condition of recording or filing. The recorder or registrar of titles shall accept the lien for filing or recording. new text end

new text begin (d) The commissioner shall make no adjustment or recovery under the lien until none of the persons listed in subdivision 4 are residing on the property or until the property is sold or transferred. The estate or any owner of an interest in the property that is or may be subject to the lien, or any other interested party, may voluntarily pay off, settle, or otherwise satisfy the claim secured or to be secured by the lien at any time before or after the lien is filed or recorded. The payoffs, settlements, and satisfactions shall be deemed to be voluntary repayments of past medical assistance payments for the benefit of the deceased recipient and neither the process of settling the claim, the payment of the claim, or acceptance of a payment shall constitute an adjustment or recovery that is prohibited under this subdivision. new text end

new text begin (e) A lien under this subdivision may be enforced or foreclosed in the manner provided for by law for the enforcement of judgment liens against real estate or by a foreclosure by action under chapter 581. When the lien has been paid, satisfied, or otherwise discharged, the claimant shall prepare and file a release of lien at the claimant's expense. No action to foreclose the lien shall be commenced unless the lienholder has first given 30 days prior written notice to pay the lien to the record owners of the property and the parties in possession of the property subject to the lien. The notice shall: (1) include the name, address, and telephone number of the lienholder; (2) describe the lien; (3) give the amount of the lien; (4) inform the owner or party in possession that payment of the lien in full must be made to the lienholder within 30 days after service of the notice or the lienholder may begin proceedings to foreclose the lien; and (5) be served by personal service, certified mail, return receipt requested, ordinary first class mail, or by publishing it once in a newspaper of general circulation in the county in which any part of the property is located. Service shall be complete upon mailing or publication. new text end

new text begin (f) Upon filing or recording of a lien against a life estate or joint tenancy interest under this subdivision, the interest subject to the lien shall merge into the remainder interest or the interest the decedent and others owned jointly, effective on the date of recording and filing. The lien shall attach to and run with the property to the extent of the decedent's interest in the property at the time of the decedent's death as determined under this section. new text end

new text begin (g)(1) An affidavit may be provided by a personal representative stating the personal representative has determined in good faith that a decedent survived by a spouse or a person listed in subdivision 3, or by a person listed in subdivision 4, or the decedent's predeceased spouse did not receive any medical assistance giving rise to a claim under this section, or that the real property described in subdivision 4 is not needed to pay in full a claim arising under this section. new text end

new text begin (2) The affidavit shall: (i) describe the property and the interest being extinguished; (ii) name the decedent and give the date of death; (iii) state the facts listed in clause (1); (iv) state that the affidavit is being filed to terminate the life estate or joint tenancy interest created under this subdivision; (v) be signed by the personal representative; and (vi) contain any other information that the affiant deems appropriate. new text end

new text begin (3) Except as provided in section 514.981, subdivision 6, when the affidavit is filed or recorded, the life estate or joint tenancy interest in real property that the affidavit describes shall be terminated effective as of the date of filing or recording. The termination shall be final and may not be set aside for any reason. new text end

[EFFECTIVE DATE.] new text begin This section takes effect on August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 17.

Minnesota Statutes 2002, section 256B.15, is amended by adding a subdivision to read:

new text begin Subd. 1k. new text end

new text begin Filing. new text end

new text begin Any notice, lien, release, or other document filed under subdivisions 1c to 1l, and any lien, release of lien, or other documents relating to a lien filed under subdivisions 1h, 1i, and 1j must be filed or recorded in the office of the county recorder or registrar of titles, as appropriate, in the county where the affected real property is located. Notwithstanding section 386.77, the state or county agency shall pay any applicable filing fee. An attestation, certification, or acknowledgment is not required as a condition of filing. If the property described in the filing is registered property, the registrar of titles shall record the filing on the certificate of title for each parcel of property described in the filing. If the property described in the filing is abstract property, the recorder shall file and index the property in the county's grantor-grantee indexes and any tract indexes the county maintains for each parcel of property described in the filing. The recorder or registrar of titles shall return the filed document to the party filing it at no cost. If the party making the filing provides a duplicate copy of the filing, the recorder or registrar of titles shall show the recording or filing data on the copy and return it to the party at no extra cost. new text end

[EFFECTIVE DATE.] new text begin This section takes effect on August 1, 2003, and applies to the estates of decedents who die on or after that date. new text end

Sec. 18.

Minnesota Statutes 2002, section 256B.15, subdivision 2, is amended to read:

Subd. 2.

Limitations on claims.

The claim shall include only the total amount of medical assistance rendered after age 55 or during a period of institutionalization described in subdivision 1a, clause (b), and the total amount of general assistance medical care rendered, and shall not include interest. Claims that have been allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A claim against the estate of a surviving spouse who did not receive medical assistance, for medical assistance rendered for the predeceased spouse, is limited to the value of the assets of the estate that were marital property or jointly owned property at any time during the marriage. new text begin Claims for alternative care shall be net of all premiums paid under section 256B.0913, subdivision 12, on or after July 1, 2003, and shall be limited to services provided on or after July 1, 2003. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for decedents dying on or after that date. new text end

Sec. 19.

Minnesota Statutes 2002, section 256B.15, subdivision 3, is amended to read:

Subd. 3.

new text begin surviving spouse, new text end minor, blind, or disabled children.

If a decedent deleted text begin who deleted text end new text begin is survived by a spouse, or new text end was single deleted text begin , deleted text end or deleted text begin who was deleted text end the surviving spouse of a married couple deleted text begin , deleted text end new text begin and new text end is survived by a child who is under age 21 or blind or permanently and totally disabled according to the supplemental security income program criteria, deleted text begin no deleted text end new text begin a new text end claim shall be filed against the estate new text begin according to this section new text end .

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to decedents who die on or after that date. new text end

Sec. 20.

Minnesota Statutes 2002, section 256B.15, subdivision 4, is amended to read:

Subd. 4.

Other survivors.

If the decedent who was single or the surviving spouse of a married couple is survived by one of the following persons, a claim exists against the estate in an amount not to exceed the value of the nonhomestead property included in the estate new text begin and the personal representative shall make, execute, and deliver to the county agency a lien against the homestead property in the estate for any unpaid balance of the claim to the claimant as provided under this section new text end :

(a) a sibling who resided in the decedent medical assistance recipient's home at least one year before the decedent's institutionalization and continuously since the date of institutionalization; or

(b) a son or daughter or a grandchild who resided in the decedent medical assistance recipient's home for at least two years immediately before the parent's or grandparent's institutionalization and continuously since the date of institutionalization, and who establishes by a preponderance of the evidence having provided care to the parent or grandparent who received medical assistance, that the care was provided before institutionalization, and that the care permitted the parent or grandparent to reside at home rather than in an institution.

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to decedents who die on or after that date. new text end

Sec. 21.

Minnesota Statutes 2002, section 514.981, subdivision 6, is amended to read:

Subd. 6.

Time limits; claim limits new text begin ; liens on life estates and joint tenancies new text end .

(a) A medical assistance lien is a lien on the real property it describes for a period of ten years from the date it attaches according to section 514.981, subdivision 2, paragraph (a), except as otherwise provided for in sections 514.980 to 514.985. The agency may renew a medical assistance lien for an additional ten years from the date it would otherwise expire by recording or filing a certificate of renewal before the lien expires. The certificate shall be recorded or filed in the office of the county recorder or registrar of titles for the county in which the lien is recorded or filed. The certificate must refer to the recording or filing data for the medical assistance lien it renews. The certificate need not be attested, certified, or acknowledged as a condition for recording or filing. The registrar of titles or the recorder shall file, record, index, and return the certificate of renewal in the same manner as provided for medical assistance liens in section 514.982, subdivision 2.

(b) A medical assistance lien is not enforceable against the real property of an estate to the extent there is a determination by a court of competent jurisdiction, or by an officer of the court designated for that purpose, that there are insufficient assets in the estate to satisfy the agency's medical assistance lien in whole or in part because of the homestead exemption under section 256B.15, subdivision 4, the rights of the surviving spouse or minor children under section 524.2-403, paragraphs (a) and (b), or claims with a priority under section 524.3-805, paragraph (a), clauses (1) to (4). For purposes of this section, the rights of the decedent's adult children to exempt property under section 524.2-403, paragraph (b), shall not be considered costs of administration under section 524.3-805, paragraph (a), clause (1).

new text begin (c) Notwithstanding any law or rule to the contrary, the provisions in clauses (1) to (7) apply if a life estate subject to a medical assistance lien ends according to its terms, or if a medical assistance recipient who owns a life estate or any interest in real property as a joint tenant that is subject to a medical assistance lien dies. new text end

new text begin (1) The medical assistance recipient's life estate or joint tenancy interest in the real property shall not end upon the recipient's death but shall merge into the remainder interest or other interest in real property the medical assistance recipient owned in joint tenancy with others. The medical assistance lien shall attach to and run with the remainder or other interest in the real property to the extent of the medical assistance recipient's interest in the property at the time of the recipient's death as determined under this section. new text end

new text begin (2) If the medical assistance recipient's interest was a life estate in real property, the lien shall be a lien against the portion of the remainder equal to the percentage factor for the life estate of a person the medical assistance recipient's age on the date the life estate ended according to its terms or the date of the medical assistance recipient's death as listed in the Life Estate Mortality Table in the health care program's manual. new text end

new text begin (3) If the medical assistance recipient owned the interest in real property in joint tenancy with others, the lien shall be a lien against the portion of that interest equal to the fractional interest the medical assistance recipient would have owned in the jointly owned interest had the medical assistance recipient and the other owners held title to that interest as tenants in common on the date the medical assistance recipient died. new text end

new text begin (4) The medical assistance lien shall remain a lien against the remainder or other jointly owned interest for the length of time and be renewable as provided in paragraph (a). new text end

new text begin (5) Subdivision 5, paragraphs (a), clause (4), (b), clauses (1) and (2); and subdivision 6, paragraph (b), do not apply to medical assistance liens which attach to interests in real property as provided under this subdivision. new text end

new text begin (6) The continuation of a medical assistance recipient's life estate or joint tenancy interest in real property after the medical assistance recipient's death for the purpose of recovering medical assistance provided for in sections 514.980 to 514.985 modifies common law principles holding that these interests terminate on the death of the holder. new text end

new text begin (7) Notwithstanding any law or rule to the contrary, no release, satisfaction, discharge, or affidavit under section 256B.15 shall extinguish or terminate the life estate or joint tenancy interest of a medical assistance recipient subject to a lien under sections 514.980 to 514.985 on the date the recipient dies. new text end

[EFFECTIVE DATE.] new text begin This section is effective August 1, 2003, and applies to all medical assistance liens recorded or filed on or after that date. new text end

Sec. 22.

new text begin [514.991] ALTERNATIVE CARE LIENS; DEFINITIONS. new text end

new text begin Subdivision 1. new text end [APPLICABILITY.] new text begin The definitions in this section apply to sections 514.991 to 514.995. new text end

new text begin Subd. 2. new text end [ALTERNATIVE CARE AGENCY, AGENCY, OR DEPARTMENT.] new text begin "Alternative care agency," "agency," or "department" means the department of human services when it pays for or provides alternative care benefits for a nonmedical assistance recipient directly or through a county social services agency under chapter 256B according to section 256B.0913. new text end

new text begin Subd. 3. new text end [ALTERNATIVE CARE BENEFIT OR BENEFITS.] new text begin "Alternative care benefit" or "benefits" means a benefit provided to a nonmedical assistance recipient under chapter 256B according to section 256B.0913. new text end

new text begin Subd. 4. new text end [ALTERNATIVE CARE RECIPIENT OR RECIPIENT.] new text begin "Alternative care recipient" or "recipient" means a person who receives alternative care grant benefits. new text end

new text begin Subd. 5. new text end [ALTERNATIVE CARE LIEN OR LIEN.] new text begin "Alternative care lien" or "lien" means a lien filed under sections 514.992 to 514.995. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for services for persons first enrolling in the alternative care program on or after that date and on the first day of the first eligibility renewal period for persons enrolled in the alternative care program prior to July 1, 2003. new text end

Sec. 23.

new text begin [514.992] ALTERNATIVE CARE LIEN. new text end

new text begin Subdivision 1. new text end [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] new text begin (a) Subject to sections 514.991 to 514.995, payments made by an alternative care agency to provide benefits to a recipient or to the recipient's spouse who owns property in this state constitute a lien in favor of the agency on all real property the recipient owns at and after the time the benefits are first paid. new text end

new text begin (b) The amount of the lien is limited to benefits paid for services provided to recipients over 55 years of age and provided on and after July 1, 2003. new text end

new text begin Subd. 2. new text end [ATTACHMENT.] new text begin (a) A lien attaches to and becomes enforceable against specific real property as of the date when all of the following conditions are met: new text end

new text begin (1) the agency has paid benefits for a recipient; new text end

new text begin (2) the recipient has been given notice and an opportunity for a hearing under paragraph (b); new text end

new text begin (3) the lien has been filed as provided for in section 514.993 or memorialized on the certificate of title for the property it describes; and new text end

new text begin (4) all restrictions against enforcement have ceased to apply. new text end

new text begin (b) An agency may not file a lien until it has sent the recipient, their authorized representative, or their legal representative written notice of its lien rights by certified mail, return receipt requested, or registered mail and there has been an opportunity for a hearing under section 256.045. No person other than the recipient shall have a right to a hearing under section 256.045 prior to the time the lien is filed. The hearing shall be limited to whether the agency has met all of the prerequisites for filing the lien and whether any of the exceptions in this section apply. new text end

new text begin (c) An agency may not file a lien against the recipient's homestead when any of the following exceptions apply: new text end

new text begin (1) while the recipient's spouse is also physically present and lawfully and continuously residing in the homestead; new text end

new text begin (2) a child of the recipient who is under age 21 or who is blind or totally and permanently disabled according to supplemental security income criteria is also physically present on the property and lawfully and continuously residing on the property from and after the date the recipient first receives benefits; new text end

new text begin (3) a child of the recipient who has also lawfully and continuously resided on the property for a period beginning at least two years before the first day of the month in which the recipient began receiving alternative care, and who provided uncompensated care to the recipient which enabled the recipient to live without alternative care services for the two-year period; new text end

new text begin (4) a sibling of the recipient who has an ownership interest in the property of record in the office of the county recorder or registrar of titles for the county in which the real property is located and who has also continuously occupied the homestead for a period of at least one year immediately prior to the first day of the first month in which the recipient received benefits and continuously since that date. new text end

new text begin (d) A lien only applies to the real property it describes. new text end

new text begin Subd. 3. new text end [CONTINUATION OF LIEN.] new text begin A lien remains effective from the time it is filed until it is paid, satisfied, discharged, or becomes unenforceable under sections 514.991 to 514.995. new text end

new text begin Subd. 4. new text end [PRIORITY OF LIEN.] new text begin (a) A lien which attaches to the real property it describes is subject to the rights of anyone else whose interest in the real property is perfected of record before the lien has been recorded or filed under section 514.993, including: new text end

new text begin (1) an owner, other than the recipient or the recipient's spouse; new text end

new text begin (2) a good faith purchaser for value without notice of the lien; new text end

new text begin (3) a holder of a mortgage or security interest; or new text end

new text begin (4) a judgment lien creditor whose judgment lien has attached to the recipient's interest in the real property. new text end

new text begin (b) The rights of the other person have the same protections against an alternative care lien as are afforded against a judgment lien that arises out of an unsecured obligation and arises as of the time of the filing of an alternative care grant lien under section 514.993. The lien shall be inferior to a lien for property taxes and special assessments and shall be superior to all other matters first appearing of record after the time and date the lien is filed or recorded. new text end

new text begin Subd. 5. new text end [SETTLEMENT, SUBORDINATION, AND RELEASE.] new text begin (a) An agency may, with absolute discretion, settle or subordinate the lien to any other lien or encumbrance of record upon the terms and conditions it deems appropriate. new text end

new text begin (b) The agency filing the lien shall release and discharge the lien: new text end

new text begin (1) if it has been paid, discharged, or satisfied; new text end

new text begin (2) if it has received reimbursement for the amounts secured by the lien, has entered into a binding and legally enforceable agreement under which it is reimbursed for the amount of the lien, or receives other collateral sufficient to secure payment of the lien; new text end

new text begin (3) against some, but not all, of the property it describes upon the terms, conditions, and circumstances the agency deems appropriate; new text end

new text begin (4) to the extent it cannot be lawfully enforced against the property it describes because of an error, omission, or other material defect in the legal description contained in the lien or a necessary prerequisite to enforcement of the lien; and new text end

new text begin (5) if, in its discretion, it determines the filing or enforcement of the lien is contrary to the public interest. new text end

new text begin (c) The agency executing the lien shall execute and file the release as provided for in section 514.993, subdivision 2. new text end

new text begin Subd. 6. new text end [LENGTH OF LIEN.] new text begin (a) A lien shall be a lien on the real property it describes for a period of ten years from the date it attaches according to subdivision 2, paragraph (a), except as otherwise provided for in sections 514.992 to 514.995. The agency filing the lien may renew the lien for one additional ten-year period from the date it would otherwise expire by recording or filing a certificate of renewal before the lien expires. The certificate of renewal shall be recorded or filed in the office of the county recorder or registrar of titles for the county in which the lien is recorded or filed. The certificate must refer to the recording or filing data for the lien it renews. The certificate need not be attested, certified, or acknowledged as a condition for recording or filing. The recorder or registrar of titles shall record, file, index, and return the certificate of renewal in the same manner provided for liens in section 514.993, subdivision 2. new text end

new text begin (b) An alternative care lien is not enforceable against the real property of an estate to the extent there is a determination by a court of competent jurisdiction, or by an officer of the court designated for that purpose, that there are insufficient assets in the estate to satisfy the lien in whole or in part because of the homestead exemption under section 256B.15, subdivision 4, the rights of a surviving spouse or a minor child under section 524.2-403, paragraphs (a) and (b), or claims with a priority under section 524.3-805, paragraph (a), clauses (1) to (4). For purposes of this section, the rights of the decedent's adult children to exempt property under section 524.2-403, paragraph (b), shall not be considered costs of administration under section 524.3-805, paragraph (a), clause (1). new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for services for persons first enrolling in the alternative care program on or after that date and on the first day of the first eligibility renewal period for persons enrolled in the alternative care program prior to July 1, 2003. new text end

Sec. 24.

new text begin [514.993] LIEN; CONTENTS AND FILING. new text end

new text begin Subdivision 1. new text end [CONTENTS.] new text begin A lien shall be dated and must contain: new text end

new text begin (1) the recipient's full name, last known address, and social security number; new text end

new text begin (2) a statement that benefits have been paid to or for the recipient's benefit; new text end

new text begin (3) a statement that all of the recipient's interests in the real property described in the lien may be subject to or affected by the agency's right to reimbursement for benefits; new text end

new text begin (4) a legal description of the real property subject to the lien and whether it is registered or abstract property; and new text end

new text begin (5) such other contents, if any, as the agency deems appropriate. new text end

new text begin Subd. 2. new text end [FILING.] new text begin Any lien, release, or other document required or permitted to be filed under sections 514.991 to 514.995 must be recorded or filed in the office of the county recorder or registrar of titles, as appropriate, in the county where the real property is located. Notwithstanding section 386.77, the agency shall pay the applicable filing fee for any documents filed under sections 514.991 to 514.995. An attestation, certification, or acknowledgment is not required as a condition of filing. If the property described in the lien is registered property, the registrar of titles shall record it on the certificate of title for each parcel of property described in the lien. If the property described in the lien is abstract property, the recorder shall file the lien in the county's grantor-grantee indexes and any tract indexes the county maintains for each parcel of property described in the lien. The recorder or registrar shall return the recorded or filed lien to the agency at no cost. If the agency provides a duplicate copy of the lien, the recorder or registrar of titles shall show the recording or filing data on the copy and return it to the agency at no cost. The agency is responsible for filing any lien, release, or other documents under sections 514.991 to 514.995. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for services for persons first enrolling in the alternative care program on or after that date and on the first day of the first eligibility renewal period for persons enrolled in the alternative care program prior to July 1, 2003. new text end

Sec. 25.

new text begin [514.994] ENFORCEMENT; OTHER REMEDIES. new text end

new text begin Subdivision 1. new text end [FORECLOSURE OR ENFORCEMENT OF LIEN.] new text begin The agency may enforce or foreclose a lien filed under sections 514.991 to 514.995 in the manner provided for by law for enforcement of judgment liens against real estate or by a foreclosure by action under chapter 581. The lien shall remain enforceable as provided for in sections 514.991 to 514.995 notwithstanding any laws limiting the enforceability of judgments. new text end

new text begin Subd. 2. new text end [HOMESTEAD EXEMPTION.] new text begin The lien may not be enforced against the homestead property of the recipient or the spouse while they physically occupy it as their lawful residence. new text end

new text begin Subd. 3. new text end [AGENCY CLAIM OR REMEDY.] new text begin Sections 514.992 to 514.995 do not limit the agency's right to file a claim against the recipient's estate or the estate of the recipient's spouse, do not limit any other claims for reimbursement the agency may have, and do not limit the availability of any other remedy to the agency. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for services for persons first enrolling in the alternative care program on or after that date and on the first day of the first eligibility renewal period for persons enrolled in the alternative care program prior to July 1, 2003. new text end

Sec. 26.

new text begin [514.995] AMOUNTS RECEIVED TO SATISFY LIEN. new text end

new text begin Amounts the agency receives to satisfy the lien must be deposited in the state treasury and credited to the fund from which the benefits were paid. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for services for persons first enrolling in the alternative care program on or after that date and on the first day of the first eligibility renewal period for persons enrolled in the alternative care program prior to July 1, 2003. new text end

Sec. 27.

Minnesota Statutes 2002, section 524.3-805, is amended to read:

524.3-805 CLASSIFICATION OF CLAIMS.

(a) If the applicable assets of the estate are insufficient to pay all claims in full, the personal representative shall make payment in the following order:

(1) costs and expenses of administration;

(2) reasonable funeral expenses;

(3) debts and taxes with preference under federal law;

(4) reasonable and necessary medical, hospital, or nursing home expenses of the last illness of the decedent, including compensation of persons attending the decedent new text begin , a claim filed under section 256B.15 for recovery of expenditures for alternative care for nonmedical assistance recipients under section 256B.0913, new text end and including a claim filed pursuant to section 256B.15;

(5) reasonable and necessary medical, hospital, and nursing home expenses for the care of the decedent during the year immediately preceding death;

(6) debts with preference under other laws of this state, and state taxes;

(7) all other claims.

(b) No preference shall be given in the payment of any claim over any other claim of the same class, and a claim due and payable shall not be entitled to a preference over claims not due, except that if claims for expenses of the last illness involve only claims filed under section new text begin 256B.15 for recovery of expenditures for alternative care for nonmedical assistance recipients under section 256B.0913, section new text end 246.53 for costs of state hospital care and claims filed under section 256B.15, new text begin claims filed to recover expenditures for alternative care for nonmedical assistance recipients under section 256B.0913 shall have preference over claims filed under both section 246.53 and other claims filed under section 256B.15, and new text end claims filed under section 246.53 have preference over claims filed under section 256B.15 new text begin for recovery of amounts other than those for expenditures for alternative care for nonmedical assistance recipients under section 256B.0913 new text end .

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003, for decedents dying on or after that date. new text end

ARTICLE 9

ADULT MENTAL HEALTH AND ALTERNATIVE PROGRAMS FOR OFFENDERS WITH MENTAL ILLNESS

Section 1.

new text begin [256B.0596] MENTAL HEALTH CASE MANAGEMENT. new text end

new text begin Counties shall contract with eligible providers willing to provide mental health case management services under section 256B.0625, subdivision 20. In order to be eligible, in addition to general provider requirements under this chapter, the provider must: new text end

new text begin (1) be willing to provide the mental health case management services; and new text end

new text begin (2) have a minimum of at least one contact with the client per week. new text end

Sec. 2.

new text begin [256B.0622] INTENSIVE REHABILITATIVE MENTAL HEALTH SERVICES. new text end

new text begin Subdivision 1. new text end [SCOPE.] new text begin Subject to federal approval, medical assistance covers medically necessary, intensive nonresidential and residential rehabilitative mental health services as defined in subdivision 2, for recipients as defined in subdivision 3, when the services are provided by an entity meeting the standards in this section. new text end

new text begin Subd. 2. new text end [DEFINITIONS.] new text begin For purposes of this section, the following terms have the meanings given them. new text end

new text begin (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, fair weather lodge, and other evidence-based practices, and directed to recipients with a serious mental illness who require intensive services. new text end

new text begin (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 evidence-based practices. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin (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. new text end

new text begin Subd. 3. new text end [ELIGIBILITY.] new text begin An eligible recipient is an individual who: new text end

new text begin (1) is age 18 or older; new text end

new text begin (2) is eligible for medical assistance; new text end

new text begin (3) is diagnosed with a mental illness; new text end

new text begin (4) because of a mental illness, has substantial disability and functional impairment in three or more of the areas listed in section 245.462, subdivision 11a, so that self-sufficiency is markedly reduced; new text end

new text begin (5) has one or more of the following: a history of two or more inpatient hospitalizations in the past year, significant independent living instability, homelessness, or very frequent use of mental health and related services yielding poor outcomes; and new text end

new text begin (6) in the written opinion of a licensed mental health professional, has the need for mental health services that cannot be met with other available community-based services, or is likely to experience a mental health crisis or require a more restrictive setting if intensive rehabilitative mental health services are not provided. new text end

new text begin Subd. 4. new text end [PROVIDER CERTIFICATION AND CONTRACT REQUIREMENTS.] new text begin (a) The intensive nonresidential rehabilitative mental health services provider must: new text end

new text begin (1) have a contract with the host county to provide intensive adult rehabilitative mental health services; and new text end

new text begin (2) be certified by the commissioner as being in compliance with this section and section 256B.0623. new text end

new text begin (b) The intensive residential rehabilitative mental health services provider must: new text end

new text begin (1) be licensed under Minnesota Rules, parts 9520.0500 to 9520.0670; new text end

new text begin (2) not exceed 16 beds per site; new text end

new text begin (3) comply with the additional standards in this section; and new text end

new text begin (4) have a contract with the host county to provide these services. new text end

new text begin (c) The commissioner shall develop procedures for counties and providers to submit contracts and other documentation as needed to allow the commissioner to determine whether the standards in this section are met. new text end

new text begin Subd. 5. new text end [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND RESIDENTIAL PROVIDERS.] new text begin (a) Services must be provided by qualified staff as defined in section 256B.0623, subdivision 5, who are trained and supervised according to section 256B.0623, subdivision 6, except that mental health rehabilitation workers acting as overnight staff are not required to comply with section 256B.0623, subdivision 5, clause (3)(iv). new text end

new text begin (b) The clinical supervisor must be an active member of the treatment team. The treatment team must meet with the clinical supervisor at least weekly to discuss recipients' progress and make rapid adjustments to meet recipients' needs. The team meeting shall include recipient-specific case reviews and general treatment discussions among team members. Recipient-specific case reviews and planning must be documented in the individual recipient's treatment record. new text end

new text begin (c) Treatment staff must have prompt access in person or by telephone to a mental health practitioner or mental health professional. The provider must have the capacity to promptly and appropriately respond to emergent needs and make any necessary staffing adjustments to assure the health and safety of recipients. new text end

new text begin (d) The initial functional assessment must be completed within ten days of intake and updated at least every three months or prior to discharge from the service, whichever comes first. new text end

new text begin (e) The initial individual treatment plan must be completed within ten days of intake and reviewed and updated at least monthly with the recipient. new text end

new text begin Subd. 6. new text end [ADDITIONAL STANDARDS APPLICABLE ONLY TO INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH SERVICES.] new text begin (a) The provider of intensive residential services must have sufficient staff to provide 24 hour per day coverage to deliver the rehabilitative services described in the treatment plan and to safely supervise and direct the activities of recipients given the recipient's level of behavioral and psychiatric stability, cultural needs, and vulnerability. The provider must have the capacity within the facility to provide integrated services for chemical dependency, illness management services, and family education when appropriate. new text end

new text begin (b) At a minimum: new text end

new text begin (1) staff must be available and provide direction and supervision whenever recipients are present in the facility; new text end

new text begin (2) staff must remain awake during all work hours; new text end

new text begin (3) there must be a staffing ratio of at least one to nine recipients for each day and evening shift. If more than nine recipients are present at the residential site, there must be a minimum of two staff during day and evening shifts, one of whom must be a mental health practitioner or mental health professional; new text end

new text begin (4) if services are provided to recipients who need the services of a medical professional, the provider shall assure that these services are provided either by the provider's own medical staff or through referral to a medical professional; and new text end

new text begin (5) the provider must employ or contract with a licensed registered nurse to ensure the effectiveness and safety of medication administration in the facility. new text end

new text begin Subd. 7. new text end [ADDITIONAL STANDARDS FOR NONRESIDENTIAL SERVICES.] new text begin The standards in this subdivision apply to intensive nonresidential rehabilitative mental health services. new text end

new text begin (1) The treatment team must use team treatment, not an individual treatment model. new text end

new text begin (2) The clinical supervisor must function as a practicing clinician at least on a part-time basis. new text end

new text begin (3) The staffing ratio must not exceed ten recipients to one full-time equivalent treatment team position. new text end

new text begin (4) Services must be available at times that meet client needs. new text end

new text begin (5) The treatment team must actively and assertively engage and reach out to the recipient's family members and significant others, after obtaining the recipient's permission. new text end

new text begin (6) The treatment team must establish ongoing communication and collaboration between the team, family, and significant others and educate the family and significant others about mental illness, symptom management, and the family's role in treatment. new text end

new text begin (7) The treatment team must provide interventions to promote positive interpersonal relationships. new text end

new text begin Subd. 8. new text end [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE REHABILITATIVE MENTAL HEALTH SERVICES.] new text begin (a) Payment for residential and nonresidential services in this section shall be based on one daily rate per provider inclusive of the following services received by an eligible recipient in a given calendar day: all rehabilitative services under this section and crisis stabilization services under section 256B.0624. new text end

new text begin (b) Except as indicated in paragraph (c), payment will not be made to more than one entity for each recipient for services provided under this section on a given day. If services under this section are provided by a team that includes staff from more than one entity, the team must determine how to distribute the payment among the members. new text end

new text begin (c) The host county shall recommend to the commissioner one rate for each entity that will bill medical assistance for services under this section and two rates for each nonresidential provider. The first nonresidential rate is for recipients who are not receiving residential services. The second nonresidential rate is for recipients who are temporarily receiving residential services and need continued contact with the nonresidential team to assure timely discharge from residential services. In developing these rates, the host county shall consider and document: new text end

new text begin (1) the cost for similar services in the local trade area; new text end

new text begin (2) actual costs incurred by entities providing the services; new text end

new text begin (3) the intensity and frequency of services to be provided to each recipient; new text end

new text begin (4) the degree to which recipients will receive services other than services under this section; new text end

new text begin (5) the costs of other services, such as case management, that will be separately reimbursed; and new text end

new text begin (6) input from the local planning process authorized by the adult mental health initiative under section 245.4661, regarding recipients' service needs. new text end

new text begin (d) The rate for intensive rehabilitative mental health services must exclude room and board, as defined in section 256I.03, subdivision 6, and services not covered under this section, such as case management, partial hospitalization, home care, and inpatient services. Physician services that are not separately billed may be included in the rate to the extent that a psychiatrist is a member of the treatment team. The county's recommendation shall specify the period for which the rate will be applicable, not to exceed two years. new text end

new text begin (e) When services under this section are provided by an assertive community team, case management functions must be an integral part of the team. The county must allocate costs which are reimbursable under this section versus costs which are reimbursable through case management or other reimbursement, so that payment is not duplicated. new text end

new text begin (f) The rate for a provider must not exceed the rate charged by that provider for the same service to other payors. new text end

new text begin (g) The commissioner shall approve or reject the county's rate recommendation, based on the commissioner's own analysis of the criteria in paragraph (c). new text end

new text begin Subd. 9. new text end [PROVIDER ENROLLMENT; RATE SETTING FOR COUNTY-OPERATED ENTITIES.] new text begin Counties that employ their own staff to provide services under this section shall apply directly to the commissioner for enrollment and rate setting. In this case, a county contract is not required and the commissioner shall perform the program review and rate setting duties which would otherwise be required of counties under this section. new text end

new text begin Subd. 10. new text end [PROVIDER ENROLLMENT; RATE SETTING FOR SPECIALIZED PROGRAM.] new text begin A provider proposing to serve a subpopulation of eligible recipients may bypass the county approval procedures in this section and receive approval for provider enrollment and rate setting directly from the commissioner under the following circumstances: new text end

new text begin (1) the provider demonstrates that the subpopulation to be served requires a specialized program which is not available from county-approved entities; and new text end

new text begin (2) the subpopulation to be served is of such a low incidence that it is not feasible to develop a program serving a single county or regional group of counties. new text end

new text begin For providers meeting the criteria in clauses (1) and (2), the commissioner shall perform the program review and rate setting duties which would otherwise be required of counties under this section. new text end

Sec. 3.

Minnesota Statutes 2002, section 256B.0623, subdivision 2, is amended to read:

Subd. 2.

Definitions.

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

(a) "Adult rehabilitative mental health services" means mental health services which are rehabilitative and enable the recipient to develop and enhance psychiatric stability, social competencies, personal and emotional adjustment, and independent living and community skills, when these abilities are impaired by the symptoms of mental illness. Adult rehabilitative mental health services are also appropriate when provided to enable a recipient to retain stability and functioning, if the recipient would be at risk of significant functional decompensation or more restrictive service settings without these services.

(1) Adult rehabilitative mental health services instruct, assist, and support the recipient in areas such as: interpersonal communication skills, community resource utilization and integration skills, crisis assistance, relapse prevention skills, health care directives, budgeting and shopping skills, healthy lifestyle skills and practices, cooking and nutrition skills, transportation skills, medication education and monitoring, mental illness symptom management skills, household management skills, employment-related skills, and transition to community living services.

(2) These services shall be provided to the recipient on a one-to-one basis in the recipient's home or another community setting or in groups.

(b) "Medication education services" means services provided individually or in groups which focus on educating the recipient about mental illness and symptoms; the role and effects of medications in treating symptoms of mental illness; and the side effects of medications. Medication education is coordinated with medication management services and does not duplicate it. Medication education services are provided by physicians, pharmacists, new text begin physician's assistants, new text end or registered nurses.

(c) "Transition to community living services" means services which maintain continuity of contact between the rehabilitation services provider and the recipient and which facilitate discharge from a hospital, residential treatment program under Minnesota Rules, chapter 9505, board and lodging facility, or nursing home. Transition to community living services are not intended to provide other areas of adult rehabilitative mental health services.

Sec. 4.

Minnesota Statutes 2002, section 256B.0623, subdivision 4, is amended to read:

Subd. 4.

Provider entity standards.

(a) The provider entity must be deleted text begin : deleted text end

deleted text begin (1) a county operated entity certified by the state; or deleted text end

deleted text begin (2) a noncounty entity certified by the entity's host county deleted text end new text begin certified by the state following the certification process and procedures developed by the commissioner new text end .

(b) The certification process is a determination as to whether the entity meets the standards in this subdivision. The certification must specify which adult rehabilitative mental health services the entity is qualified to provide.

(c) deleted text begin If an entity seeks to provide services outside its host county, it deleted text end new text begin A noncounty provider entity new text end must obtain additional certification from each county in which it will provide services. The additional certification must be based on the adequacy of the entity's knowledge of that county's local health and human service system, and the ability of the entity to coordinate its services with the other services available in that county. new text begin A county-operated entity must obtain this additional certification from any other county in which it will provide services. new text end

(d) Recertification must occur at least every deleted text begin two deleted text end new text begin three new text end years.

(e) The commissioner may intervene at any time and decertify providers with cause. The decertification is subject to appeal to the state. A county board may recommend that the state decertify a provider for cause.

(f) The adult rehabilitative mental health services provider entity must meet the following standards:

(1) have capacity to recruit, hire, manage, and train mental health professionals, mental health practitioners, and mental health rehabilitation workers;

(2) have adequate administrative ability to ensure availability of services;

(3) ensure adequate preservice and inservice new text begin and ongoing new text end training for staff;

(4) ensure that mental health professionals, mental health practitioners, and mental health rehabilitation workers are skilled in the delivery of the specific adult rehabilitative mental health services provided to the individual eligible recipient;

(5) ensure that staff is capable of implementing culturally specific services that are culturally competent and appropriate as determined by the recipient's culture, beliefs, values, and language as identified in the individual treatment plan;

(6) ensure enough flexibility in service delivery to respond to the changing and intermittent care needs of a recipient as identified by the recipient and the individual treatment plan;

(7) ensure that the mental health professional or mental health practitioner, who is under the clinical supervision of a mental health professional, involved in a recipient's services participates in the development of the individual treatment plan;

(8) assist the recipient in arranging needed crisis assessment, intervention, and stabilization services;

(9) ensure that services are coordinated with other recipient mental health services providers and the county mental health authority and the federally recognized American Indian authority and necessary others after obtaining the consent of the recipient. Services must also be coordinated with the recipient's case manager or care coordinator if the recipient is receiving case management or care coordination services;

(10) develop and maintain recipient files, individual treatment plans, and contact charting;

(11) develop and maintain staff training and personnel files;

(12) submit information as required by the state;

(13) establish and maintain a quality assurance plan to evaluate the outcome of services provided;

(14) keep all necessary records required by law;

(15) deliver services as required by section 245.461;

(16) comply with all applicable laws;

(17) be an enrolled Medicaid provider;

(18) maintain a quality assurance plan to determine specific service outcomes and the recipient's satisfaction with services; and

(19) develop and maintain written policies and procedures regarding service provision and administration of the provider entity.

deleted text begin (g) The commissioner shall develop statewide procedures for provider certification, including timelines for counties to certify qualified providers. deleted text end

Sec. 5.

Minnesota Statutes 2002, section 256B.0623, subdivision 5, is amended to read:

Subd. 5.

Qualifications of provider staff.

Adult rehabilitative mental health services must be provided by qualified individual provider staff of a certified provider entity. Individual provider staff must be qualified under one of the following criteria:

(1) a mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5) new text begin . If the recipient has a current diagnostic assessment by a licensed mental health professional as defined in section 245.462, subdivision 18, clauses (1) to (5), recommending receipt of adult mental health rehabilitative services, the definition of mental health professional for purposes of this section includes a person who is qualified under section 245.462, subdivision 18, clause (6), and who holds a current and valid national certification as a certified rehabilitation counselor or certified psychosocial rehabilitation practitioner new text end ;

(2) a mental health practitioner as defined in section 245.462, subdivision 17. The mental health practitioner must work under the clinical supervision of a mental health professional; or

(3) a mental health rehabilitation worker. A mental health rehabilitation worker means a staff person working under the direction of a mental health practitioner or mental health professional and under the clinical supervision of a mental health professional in the implementation of rehabilitative mental health services as identified in the recipient's individual treatment plan who:

(i) is at least 21 years of age;

(ii) has a high school diploma or equivalent;

(iii) has successfully completed 30 hours of training during the past two years in all of the following areas: recipient rights, recipient-centered individual treatment planning, behavioral terminology, mental illness, co-occurring mental illness and substance abuse, psychotropic medications and side effects, functional assessment, local community resources, adult vulnerability, recipient confidentiality; and

(iv) meets the qualifications in subitem (A) or (B):

(A) has an associate of arts degree in one of the behavioral sciences or human services, or is a registered nurse without a bachelor's degree, or who within the previous ten years has:

(1) three years of personal life experience with serious and persistent mental illness;

(2) three years of life experience as a primary caregiver to an adult with a serious mental illness or traumatic brain injury; or

(3) 4,000 hours of supervised paid work experience in the delivery of mental health services to adults with a serious mental illness or traumatic brain injury; or

(B)(1) is fluent in the non-English language or competent in the culture of the ethnic group to which at least deleted text begin 50 deleted text end new text begin 20 new text end percent of the mental health rehabilitation worker's clients belong;

(2) receives during the first 2,000 hours of work, monthly documented individual clinical supervision by a mental health professional;

(3) has 18 hours of documented field supervision by a mental health professional or practitioner during the first 160 hours of contact work with recipients, and at least six hours of field supervision quarterly during the following year;

(4) has review and cosignature of charting of recipient contacts during field supervision by a mental health professional or practitioner; and

(5) has 40 hours of additional continuing education on mental health topics during the first year of employment.

Sec. 6.

Minnesota Statutes 2002, section 256B.0623, subdivision 6, is amended to read:

Subd. 6.

Required training and supervision.

(a) Mental health rehabilitation workers must receive ongoing continuing education training of at least 30 hours every two years in areas of mental illness and mental health services and other areas specific to the population being served. Mental health rehabilitation workers must also be subject to the ongoing direction and clinical supervision standards in paragraphs (c) and (d).

(b) Mental health practitioners must receive ongoing continuing education training as required by their professional license; or if the practitioner is not licensed, the practitioner must receive ongoing continuing education training of at least 30 hours every two years in areas of mental illness and mental health services. Mental health practitioners must meet the ongoing clinical supervision standards in paragraph (c).

(c) new text begin Clinical supervision may be provided by a full- or part-time qualified professional employed by or under contract with the provider entity. Clinical supervision may be provided by interactive videoconferencing according to procedures developed by the commissioner. new text end A mental health professional providing clinical supervision of staff delivering adult rehabilitative mental health services must provide the following guidance:

(1) review the information in the recipient's file;

(2) review and approve initial and updates of individual treatment plans;

(3) meet with mental health rehabilitation workers and practitioners, individually or in small groups, at least monthly to discuss treatment topics of interest to the workers and practitioners;

(4) meet with mental health rehabilitation workers and practitioners, individually or in small groups, at least monthly to discuss treatment plans of recipients, and approve by signature and document in the recipient's file any resulting plan updates;

(5) meet at least deleted text begin twice a month deleted text end new text begin monthly new text end with the directing mental health practitioner, if there is one, to review needs of the adult rehabilitative mental health services program, review staff on-site observations and evaluate mental health rehabilitation workers, plan staff training, review program evaluation and development, and consult with the directing practitioner; new text begin and new text end

(6) be available for urgent consultation as the individual recipient needs or the situation necessitates deleted text begin ; and deleted text end

deleted text begin (7) provide clinical supervision by full- or part-time mental health professionals employed by or under contract with the provider entity deleted text end .

(d) An adult rehabilitative mental health services provider entity must have a treatment director who is a mental health practitioner or mental health professional. The treatment director must ensure the following:

(1) while delivering direct services to recipients, a newly hired mental health rehabilitation worker must be directly observed delivering services to recipients by deleted text begin the deleted text end new text begin a new text end mental health practitioner or mental health professional for at least six hours per 40 hours worked during the first 160 hours that the mental health rehabilitation worker works;

(2) the mental health rehabilitation worker must receive ongoing on-site direct service observation by a mental health professional or mental health practitioner for at least six hours for every six months of employment;

(3) progress notes are reviewed from on-site service observation prepared by the mental health rehabilitation worker and mental health practitioner for accuracy and consistency with actual recipient contact and the individual treatment plan and goals;

(4) immediate availability by phone or in person for consultation by a mental health professional or a mental health practitioner to the mental health rehabilitation services worker during service provision;

(5) oversee the identification of changes in individual recipient treatment strategies, revise the plan, and communicate treatment instructions and methodologies as appropriate to ensure that treatment is implemented correctly;

(6) model service practices which: respect the recipient, include the recipient in planning and implementation of the individual treatment plan, recognize the recipient's strengths, collaborate and coordinate with other involved parties and providers;

(7) ensure that mental health practitioners and mental health rehabilitation workers are able to effectively communicate with the recipients, significant others, and providers; and

(8) oversee the record of the results of on-site observation and charting evaluation and corrective actions taken to modify the work of the mental health practitioners and mental health rehabilitation workers.

(e) A mental health practitioner who is providing treatment direction for a provider entity must receive supervision at least monthly from a mental health professional to:

(1) identify and plan for general needs of the recipient population served;

(2) identify and plan to address provider entity program needs and effectiveness;

(3) identify and plan provider entity staff training and personnel needs and issues; and

(4) plan, implement, and evaluate provider entity quality improvement programs.

Sec. 7.

Minnesota Statutes 2002, section 256B.0623, subdivision 8, is amended to read:

Subd. 8.

Diagnostic assessment.

Providers of adult rehabilitative mental health services must complete a diagnostic assessment as defined in section 245.462, subdivision 9, within five days after the recipient's second visit or within 30 days after intake, whichever occurs first. In cases where a diagnostic assessment is available that reflects the recipient's current status, and has been completed within 180 days preceding admission, an update must be completed. An update shall include a written summary by a mental health professional of the recipient's current mental health status and service needs. If the recipient's mental health status has changed significantly since the adult's most recent diagnostic assessment, a new diagnostic assessment is required. new text begin For initial implementation of adult rehabilitative mental health services, until June 30, 2005, a diagnostic assessment that reflects the recipient's current status and has been completed within the past three years preceding admission is acceptable. new text end

Sec. 8.

Minnesota Statutes 2002, section 256B.82, is amended to read:

256B.82 PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE SERVICES.

Medical assistance and MinnesotaCare prepaid health plans may include coverage for adult mental health rehabilitative services under section 256B.0623 new text begin , intensive rehabilitative services under section 256B.0622, new text end and adult mental health crisis response services under section 256B.0624, beginning January 1, deleted text begin 2004 deleted text end new text begin 2005 new text end .

By January 15, deleted text begin 2003 deleted text end new text begin 2004 new text end , the commissioner shall report to the legislature how these services should be included in prepaid plans. The commissioner shall consult with mental health advocates, health plans, and counties in developing this report. The report recommendations must include a plan to ensure coordination of these services between health plans and counties, assure recipient access to essential community providers, and monitor the health plans' delivery of services through utilization review and quality standards.

Sec. 9.

new text begin [609.1055] OFFENDERS WITH SERIOUS AND PERSISTENT MENTAL ILLNESS; ALTERNATIVE PLACEMENT. new text end

new text begin When a court intends to commit an offender with a serious and persistent mental illness, as defined in section 245.462, subdivision 20, paragraph (c), to the custody of the commissioner of corrections for imprisonment at a state correctional facility, either when initially pronouncing a sentence or when revoking an offender's probation, the court, when consistent with public safety, may instead place the offender on probation or continue the offender's probation and require as a condition of the probation that the offender successfully complete an appropriate supervised alternative living program having a mental health treatment component. This section applies only to offenders who would have a remaining term of imprisonment after adjusting for credit for prior imprisonment, if any, of more than one year. new text end

Sec. 10. new text begin ALTERNATIVE LIVING PROGRAMS FOR CERTAIN OFFENDERS WITH MENTAL ILLNESS. new text end

new text begin The commissioner of corrections shall cooperate with nonprofit entities to establish supervised alternative living programs for offenders with serious and persistent mental illness, as defined in Minnesota Statutes, section 245.462, subdivision 20, paragraph (c). Each program must be structured to accommodate between eight and 13 offenders who are required to successfully complete the program as a condition of probation. Each program must provide a residential component and include mental health treatment and counseling, living and employment skills development, and supported employment. Program directors shall report program violations by participating offenders to the offender's correctional agent. new text end

new text begin By January 15, 2006, the commissioners of corrections and human services shall evaluate the alternative placements provided to offenders with mental illness under Minnesota Statutes, section 609.1055. The evaluation shall address the following issues: number of offenders who obtain and maintain employment in the community, number sentenced to prison, costs, and other issues deemed appropriate by the commissioners. The commissioners shall identify barriers to successful implementation and recommend any legislative changes needed. new text end

Sec. 11. new text begin RULE 36, MINNESOTA RULES, PARTS 9520.0500 TO 9520.0690, LICENSURE FOR ALTERNATIVE LIVING PROGRAMS FOR CERTAIN OFFENDERS WITH MENTAL ILLNESS. new text end

new text begin The commissioner of human services shall approve additional Rule 36 licenses in order to accommodate alternative living programs for certain offenders with mental illness if: new text end

new text begin (1) the provider meets applicable licensing standards; and new text end

new text begin (2) additional Rule 36 programs are necessary to meet the demand for alternative living programs for certain offenders with mental illness. new text end

Sec. 12. new text begin FINANCING FOR RULE 36 PROGRAMS FOR ALTERNATIVE LIVING PROGRAMS FOR CERTAIN OFFENDERS WITH MENTAL ILLNESS. new text end

new text begin Applicants for licensure of a Rule 36 program to provide an alternative living program for certain offenders with mental illness must be given special consideration and priority from the Minnesota housing finance agency, as allowed, in order to secure home loans for an alternative living program for certain offenders with mental illness. new text end

ARTICLE 10

DEPARTMENT OF HUMAN SERVICES MISCELLANEOUS

Section 1.

new text begin [245.945] REIMBURSEMENT TO OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION. new text end

new text begin The commissioner shall obtain federal financial participation for eligible activity by the ombudsman for mental health and mental retardation. The ombudsman shall maintain and transmit to the department of human services documentation that is necessary in order to obtain federal funds. new text end

Sec. 2.

Minnesota Statutes 2002, section 245A.10, is amended to read:

245A.10 FEES.

new text begin Subdivision 1. new text end [APPLICATION OR LICENSE FEE REQUIRED, PROGRAMS EXEMPT FROM FEE.] new text begin (a) Unless exempt under paragraph (b), new text end the commissioner shall charge a fee for evaluation of applications and inspection of programs, deleted text begin other than family day care and foster care, deleted text end which are licensed under this chapter. deleted text begin The commissioner may charge a fee for the licensing of school age child care programs, in an amount sufficient to cover the cost to the state agency of processing the license. deleted text end

new text begin (b) Notwithstanding paragraph (a), no application or license fee shall be charged by the commissioner for family child care, child foster care, adult foster care, or state-operated programs, unless the state-operated program is an intermediate care facility for persons with mental retardation or related conditions (ICF/MR). new text end

new text begin Subd. 2. new text end [APPLICATION FEE FOR INITIAL LICENSE OR CERTIFICATION.] new text begin (a) Unless exempt from paying a license fee under subdivision 2, an applicant for an initial license or certification issued by the commissioner shall submit a $500 application fee with each new application required under this subdivision. The application fee shall not be prorated, is nonrefundable, and is in lieu of the annual license or certification fee that expires on December 31. The commissioner shall not process an application until the application fee is paid. new text end

new text begin (b) Except as provided in clauses (1) to (3), an applicant shall apply for a license to provide services at a specific location. new text end

new text begin (1) For a license to provide waivered services to persons with developmental disabilities or related conditions, an applicant shall submit an application for each county in which the waivered services will be provided. new text end

new text begin (2) For a license to provide semi-independent living services to persons with developmental disabilities or related conditions, an applicant shall submit a single application to provide services statewide. new text end

new text begin (3) For a license to provide independent living assistance for youth under section 245A.22, an applicant shall submit a single application to provide services statewide. new text end

new text begin Subd. 3. new text end [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS WITH LICENSED CAPACITY.] new text begin (a) Child care centers and programs with a licensed capacity shall pay an annual nonrefundable license or certification fee based on the following schedule: new text end new text begin Licensed Capacity new text end new text begin Child Care new text end new text begin Residential Center new text end new text begin Program License Fee new text end new text begin License Fee 1 to 24 persons new text end new text begin $300 new text end new text begin $400 25 to 49 persons new text end new text begin $450 new text end new text begin $600 50 to 74 persons new text end new text begin $600 new text end new text begin $800 75 to 99 persons new text end new text begin $750 new text end new text begin $1,000 100 to 124 persons new text end new text begin $900 new text end new text begin $1,200 125 to 149 persons new text end new text begin $1,200 new text end new text begin $1,400 150 to 174 persons new text end new text begin $1,400 new text end new text begin $1,600 175 to 199 persons new text end new text begin $1,600 new text end new text begin $1,800 200 to 224 persons new text end new text begin $1,800 new text end new text begin $2,000 225 or more persons new text end new text begin $2,000 new text end new text begin $2,500 new text end

new text begin (b) A day training and habilitation program serving persons with developmental disabilities or related conditions shall be assessed a license fee based on the schedule in paragraph (a) unless the license holder serves more than 50 percent of the same persons at two or more locations in the community. When a day training and habilitation program serves more than 50 percent of the same persons in two or more locations in a community, the day training and habilitation program shall pay a license fee based on the licensed capacity of the largest facility and the other facility or facilities shall be charged a license fee based on a licensed capacity of a residential program serving one to 24 persons. new text end

new text begin Subd. 4. new text end [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS WITHOUT A LICENSED CAPACITY.] new text begin (a) Except as provided in paragraph (b), a program without a stated licensed capacity shall pay a license or certification fee of $400. new text end

new text begin (b) A mental health center or mental health clinic requesting certification for purposes of insurance and subscriber contract reimbursement under Minnesota Rules, parts 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 per year. If the mental health center or mental health clinic provides services at a primary location with satellite facilities, the satellite facilities shall be certified with the primary location without an additional charge. new text end

new text begin Subd. 5. new text end [LICENSE NOT ISSUED UNTIL LICENSE OR CERTIFICATION FEE IS PAID.] new text begin The commissioner shall not issue a license or certification until the license or certification fee is paid. The commissioner shall send a bill for the license or certification fee to the billing address identified by the license holder. If the license holder does not submit the license or certification fee payment by the due date, the commissioner shall send the license holder a past due notice. If the license holder fails to pay the license or certification fee by the due date on the past due notice, the commissioner shall send a final notice to the license holder informing the license holder that the program license will expire on December 31 unless the license fee is paid before December 31. If a license expires, the program is no longer licensed and, unless exempt from licensure under section 245A.03, subdivision 2, must not operate after the expiration date. After a license expires, if the former license holder wishes to provide licensed services, the former license holder must submit a new license application and application fee under subdivision 2. new text end

Sec. 3.

Minnesota Statutes 2002, section 245A.11, subdivision 2a, is amended to read:

Subd. 2a.

Adult foster care license capacity.

(a) An adult foster care license holder may have a maximum license capacity of five if all persons in care are age 55 or over and do not have a serious and persistent mental illness or a developmental disability.

(b) The commissioner may grant variances to paragraph (a) to allow a foster care provider with a licensed capacity of five persons to admit an individual under the age of 55 if the variance complies with section 245A.04, subdivision 9, and approval of the variance is recommended by the county in which the licensed foster care provider is located.

(c) The commissioner may grant variances to paragraph (a) to allow the use of a fifth bed for emergency crisis services for a person with serious and persistent mental illness or a developmental disability, regardless of age, if the variance complies with section 245A.04, subdivision 9, and approval of the variance is recommended by the county in which the licensed foster care provider is located.

new text begin (d) Notwithstanding paragraph (a), the commissioner may issue an adult foster care license with a capacity of five adults when the capacity is recommended by the county licensing agency of the county in which the facility is located and if the recommendation verifies that: new text end

new text begin (1) the facility meets the physical environment requirements in the adult foster care licensing rule; new text end

new text begin (2) the five-bed living arrangement is specified for each resident in the resident's: new text end

new text begin (i) individualized plan of care; new text end

new text begin (ii) individual service plan under section 256B.092, subdivision 1b, if required; or new text end

new text begin (iii) individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart 19, if required; new text end

new text begin (3) the license holder obtains written and signed informed consent from each resident or resident's legal representative documenting the resident's informed choice to living in the home and that the resident's refusal to consent would not have resulted in service termination; and new text end

new text begin (4) the facility was licensed for adult foster care before March 1, 2003. new text end

new text begin (e) The commissioner shall not issue a new adult foster care license under paragraph (d) after June 30, 2005. The commissioner shall allow a facility with an adult foster care license issued under paragraph (d) before June 30, 2005, to continue with a capacity of five or six adults if the license holder continues to comply with the requirements in paragraph (d). new text end

Sec. 4.

Minnesota Statutes 2002, section 252.27, subdivision 2a, is amended to read:

Subd. 2a.

Contribution amount.

(a) The natural or adoptive parents of a minor child, including a child determined eligible for medical assistance without consideration of parental income, must contribute monthly to the cost of services, unless the child is married or has been married, parental rights have been terminated, or the child's adoption is subsidized according to section 259.67 or through title IV-E of the Social Security Act.

(b) new text begin For households with adjusted gross income equal to or greater than 100 percent of federal poverty guidelines, new text end the parental contribution shall be deleted text begin the greater of a minimum monthly fee of $25 for households with adjusted gross income of $30,000 and over, or an amount to be deleted text end computed by applying new text begin the following schedule of rates new text end to the adjusted gross income of the natural or adoptive parents deleted text begin that exceeds 150 percent of the federal poverty guidelines for the applicable household size, the following schedule of rates deleted text end :

(1) deleted text begin on the amount of adjusted gross income over 150 percent of poverty, but not over $50,000, ten percent deleted text end new text begin if the adjusted gross income is equal to or greater than 100 percent of federal poverty guidelines and less than 175 percent of federal poverty guidelines, the parental contribution is $4 per month new text end ;

(2) deleted text begin on deleted text end new text begin if new text end the deleted text begin amount of deleted text end adjusted gross income deleted text begin over 150 percent of poverty and over $50,000 but not over $60,000, 12 percent deleted text end new text begin is equal to or greater than 175 percent of federal poverty guidelines and less than or equal to 375 percent of federal poverty guidelines, the parental contribution shall be determined using a sliding fee scale established by the commissioner of human services which begins at one percent of adjusted gross income at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted gross income for those with adjusted gross income up to 375 percent of federal poverty guidelines new text end ;

(3) deleted text begin on deleted text end new text begin if new text end the deleted text begin amount of deleted text end adjusted gross income deleted text begin over 150 deleted text end new text begin is greater than 375 new text end percent of new text begin federal new text end poverty deleted text begin , and over $60,000 but not over $75,000, 14 percent deleted text end new text begin guidelines and less than 675 percent of federal poverty guidelines, the parental contribution shall be 7.5 percent of adjusted gross income new text end ; deleted text begin and deleted text end

(4) deleted text begin on all deleted text end new text begin if the new text end adjusted gross income deleted text begin amounts over 150 deleted text end new text begin is equal to or greater than 675 new text end percent of new text begin federal new text end poverty deleted text begin , and over $75,000, 15 percent deleted text end new text begin guidelines and less than 975 percent of federal poverty guidelines, the parental contribution shall be ten percent of adjusted gross income; and new text end

new text begin (5) if the adjusted gross income is equal to or greater than 975 percent of federal poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross income new text end .

If the child lives with the parent, the deleted text begin parental contribution deleted text end new text begin annual adjusted gross income new text end is reduced by deleted text begin $200, except that the parent must pay the minimum monthly $25 fee under this paragraph deleted text end new text begin $2,400 prior to calculating the parental contribution new text end . If the child resides in an institution specified in section 256B.35, the parent is responsible for the personal needs allowance specified under that section in addition to the parental contribution determined under this section. The parental contribution is reduced by any amount required to be paid directly to the child pursuant to a court order, but only if actually paid.

(c) The household size to be used in determining the amount of contribution under paragraph (b) includes natural and adoptive parents and their dependents under age 21, including the child receiving services. Adjustments in the contribution amount due to annual changes in the federal poverty guidelines shall be implemented on the first day of July following publication of the changes.

(d) For purposes of paragraph (b), "income" means the adjusted gross income of the natural or adoptive parents determined according to the previous year's federal tax form.

(e) The contribution shall be explained in writing to the parents at the time eligibility for services is being determined. The contribution shall be made on a monthly basis effective with the first month in which the child receives services. Annually upon redetermination or at termination of eligibility, if the contribution exceeded the cost of services provided, the local agency or the state shall reimburse that excess amount to the parents, either by direct reimbursement if the parent is no longer required to pay a contribution, or by a reduction in or waiver of parental fees until the excess amount is exhausted.

(f) The monthly contribution amount must be reviewed at least every 12 months; when there is a change in household size; and when there is a loss of or gain in income from one month to another in excess of ten percent. The local agency shall mail a written notice 30 days in advance of the effective date of a change in the contribution amount. A decrease in the contribution amount is effective in the month that the parent verifies a reduction in income or change in household size.

(g) Parents of a minor child who do not live with each other shall each pay the contribution required under paragraph (a) deleted text begin , except that a deleted text end new text begin . An amount equal to the annual new text end court-ordered child support payment actually paid on behalf of the child receiving services shall be deducted from the deleted text begin contribution deleted text end new text begin adjusted gross income new text end of the parent making the payment new text begin prior to calculating the parental contribution under paragraph (b) new text end .

(h) The contribution under paragraph (b) shall be increased by an additional five percent if the local agency determines that insurance coverage is available but not obtained for the child. For purposes of this section, "available" means the insurance is a benefit of employment for a family member at an annual cost of no more than five percent of the family's annual income. For purposes of this section, "insurance" means health and accident insurance coverage, enrollment in a nonprofit health service plan, health maintenance organization, self-insured plan, or preferred provider organization.

Parents who have more than one child receiving services shall not be required to pay more than the amount for the child with the highest expenditures. There shall be no resource contribution from the parents. The parent shall not be required to pay a contribution in excess of the cost of the services provided to the child, not counting payments made to school districts for education-related services. Notice of an increase in fee payment must be given at least 30 days before the increased fee is due.

(i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if, in the 12 months prior to July 1:

(1) the parent applied for insurance for the child;

(2) the insurer denied insurance;

(3) the parents submitted a complaint or appeal, in writing to the insurer, submitted a complaint or appeal, in writing, to the commissioner of health or the commissioner of commerce, or litigated the complaint or appeal; and

(4) as a result of the dispute, the insurer reversed its decision and granted insurance.

For purposes of this section, "insurance" has the meaning given in paragraph (h).

A parent who has requested a reduction in the contribution amount under this paragraph shall submit proof in the form and manner prescribed by the commissioner or county agency, including, but not limited to, the insurer's denial of insurance, the written letter or complaint of the parents, court documents, and the written response of the insurer approving insurance. The determinations of the commissioner or county agency under this paragraph are not rules subject to chapter 14.

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 5.

Minnesota Statutes 2002, section 253B.05, is amended by adding a subdivision to read:

new text begin Subd. 5. new text end

new text begin Detoxification. new text end

new text begin If a person is intoxicated in public and held under this section for detoxification, a treatment facility may release the person without providing notice under subdivision 3, paragraph (c), as soon as the treatment facility determines the person is no longer intoxicated. Notice must be provided to the peace officer or health officer who transported the person, or the appropriate law enforcement agency, if the officer or agency requests notification. new text end

[EFFECTIVE DATE.] new text begin This section is effective the day following final enactment. new text end

Sec. 6.

Minnesota Statutes 2002, section 256.012, is amended to read:

256.012 MINNESOTA MERIT SYSTEM.

new text begin Subdivision 1. new text end [MINNESOTA MERIT SYSTEM.] The commissioner of human services shall promulgate by rule personnel standards on a merit basis in accordance with federal standards for a merit system of personnel administration for all employees of county boards engaged in the administration of community social services or income maintenance programs, all employees of human services boards that have adopted the rules of the Minnesota merit system, and all employees of local social services agencies.

Excluded from the rules are employees of institutions and hospitals under the jurisdiction of the aforementioned boards and agencies; employees of county personnel systems otherwise provided for by law that meet federal merit system requirements; duly appointed or elected members of the aforementioned boards and agencies; and the director of community social services and employees in positions that, upon the request of the appointing authority, the commissioner chooses to exempt, provided the exemption accords with the federal standards for a merit system of personnel administration.

new text begin Subd. 2. new text end [PAYMENT FOR SERVICES PROVIDED.] new text begin (a) The cost of merit system operations shall be paid by counties and other entities that utilize merit system services. Total costs shall be determined by the commissioner annually and must be set at a level that neither significantly overrecovers nor underrecovers the costs of providing the service. The costs of merit system services shall be prorated among participating counties in accordance with an agreement between the commissioner and these counties. Participating counties will be billed quarterly in advance and shall pay their share of the costs upon receipt of the billing. new text end

new text begin (b) This subdivision does not apply to counties with personnel systems otherwise provided for by law that meet federal merit system requirements. A county that applies to withdraw from the merit system must notify the commissioner of the county's intent to develop its own personnel system. This notice must be provided in writing by December 31 of the year preceding the year of final participation in the merit system. The county may withdraw once the commissioner has certified that its personnel system meets federal merit system requirements. new text end

new text begin (c) A county merit systems operations account is established in the special revenue fund. Payments received by the commissioner for merit system costs must be deposited into the merit system operations account and must be used for the purpose of providing the services and administering the merit system. new text end

new text begin (d) County payment of merit system costs is effective July 1, 2003; however, payment for the period from July 1, 2003, through December 31, 2003, shall be made no later than January 31, 2004. new text end

new text begin Subd. 3. new text end [PARTICIPATING COUNTY CONSULTATION.] new text begin The commissioner shall ensure that participating counties are consulted regularly and offered the opportunity to provide input on the management of the merit system to ensure effective use of resources and to monitor system performance. new text end

Sec. 7.

Minnesota Statutes 2002, section 256B.092, subdivision 5, is amended to read:

Subd. 5.

Federal waivers.

(a) The commissioner shall apply for any federal waivers necessary to secure, to the extent allowed by law, federal financial participation under United States Code, title 42, sections 1396 et seq., as amended, for the provision of services to persons who, in the absence of the services, would need the level of care provided in a regional treatment center or a community intermediate care facility for persons with mental retardation or related conditions. The commissioner may seek amendments to the waivers or apply for additional waivers under United States Code, title 42, sections 1396 et seq., as amended, to contain costs. The commissioner shall ensure that payment for the cost of providing home and community-based alternative services under the federal waiver plan shall not exceed the cost of intermediate care services including day training and habilitation services that would have been provided without the waivered services.

new text begin The commissioner shall seek an amendment to the 1915c home and community-based waiver to allow properly licensed adult foster care homes to provide residential services to up to five individuals with mental retardation or a related condition. If the amendment to the waiver is approved, adult foster care providers that can accommodate five individuals shall increase their capacity to five beds, provided the providers continue to meet all applicable licensing requirements. new text end

(b) The commissioner, in administering home and community-based waivers for persons with mental retardation and related conditions, shall ensure that day services for eligible persons are not provided by the person's residential service provider, unless the person or the person's legal representative is offered a choice of providers and agrees in writing to provision of day services by the residential service provider. The individual service plan for individuals who choose to have their residential service provider provide their day services must describe how health, safety, and protection needs will be met by frequent and regular contact with persons other than the residential service provider.

Sec. 8.

Minnesota Statutes 2002, section 256B.092, is amended by adding a subdivision to read:

new text begin Subd. 5a. new text end

new text begin Increasing adult foster care capacity to serve five persons. new text end

new text begin (a) When an adult foster care provider increases the capacity of an existing home licensed to serve four persons to serve a fifth person under this section, the county agency shall reduce the contracted per diem cost for room and board and the mental retardation or a related condition waiver services of the existing foster care home by an average of 14 percent for all individuals living in that home. A county agency may average the required per diem rate reductions across several adult foster care homes that expand capacity under this section, to achieve the necessary overall per diem reduction. new text end

new text begin (b) Following the contract changes in paragraph (a), the commissioner shall adjust: new text end

new text begin (1) individual county allocations for mental retardation or a related condition waivered services by the amount of savings that results from the changes made for mental retardation or a related condition waiver recipients for whom the county is financially responsible; and new text end

new text begin (2) group residential housing rate payments to the adult foster home by the amount of savings that results from the changes made. new text end

new text begin (c) Effective July 1, 2003, when a new five-person adult foster care home is licensed under this section, county agencies shall not establish group residential housing room and board rates and mental retardation or a related condition waiver service rates for the new home that exceed 86 percent of the average per diem room and board and mental retardation or a related condition waiver services costs of four-person homes serving persons with comparable needs and in the same geographic area. A county agency developing more than one new five-person adult foster care home may average the required per diem rates across the homes to achieve the necessary overall per diem reductions. new text end

new text begin (d) The commissioner shall reduce the individual county allocations for mental retardation or a related condition waivered services by the savings resulting from the per diem limits on adult foster care recipients for whom the county is financially responsible, and shall limit the group residential housing rate for a new five-person adult foster care home. new text end

Sec. 9.

Minnesota Statutes 2002, section 257.0769, is amended to read:

257.0769 FUNDING FOR THE OMBUDSPERSON PROGRAM.

new text begin Subdivision 1. new text end [APPROPRIATIONS.] (a) Money is appropriated from the special fund authorized by section 256.01, subdivision 2, clause (15), to the Indian affairs council for the purposes of sections 257.0755 to 257.0768.

(b) Money is appropriated from the special fund authorized by section 256.01, subdivision 2, clause (15), to the council on affairs of Chicano/Latino people for the purposes of sections 257.0755 to 257.0768.

(c) Money is appropriated from the special fund authorized by section 256.01, subdivision 2, clause (15), to the Council of Black Minnesotans for the purposes of sections 257.0755 to 257.0768.

(d) Money is appropriated from the special fund authorized by section 256.01, subdivision 2, clause (15), to the Council on Asian-Pacific Minnesotans for the purposes of sections 257.0755 to 257.0768.

new text begin Subd. 2. new text end [TITLE IV-E REIMBURSEMENT.] new text begin The commissioner shall obtain federal title IV-E financial participation for eligible activity by the ombudsperson for families under section 257.0755. The ombudsperson for families shall maintain and transmit to the department of human services documentation that is necessary in order to obtain federal funds. new text end

Sec. 10.

Minnesota Statutes 2002, section 259.21, subdivision 6, is amended to read:

Subd. 6.

Agency.

"Agency" means an organization or department of government designated or authorized by law to place children for adoption or any person, group of persons, organization, association or society licensed or certified by the commissioner of human services to place children for adoption new text begin , including a Minnesota federally recognized tribe new text end .

Sec. 11.

Minnesota Statutes 2002, section 259.67, subdivision 7, is amended to read:

Subd. 7.

Reimbursement of costs.

(a) Subject to rules of the commissioner, and the provisions of this subdivision a child-placing agency licensed in Minnesota or any other state, or local new text begin or tribal new text end social services agency shall receive a reimbursement from the commissioner equal to 100 percent of the reasonable and appropriate cost of providing adoption services for a child certified as eligible for adoption assistance under subdivision 4. Such assistance may include adoptive family recruitment, counseling, and special training when needed. A child-placing agency licensed in Minnesota or any other state shall receive reimbursement for adoption services it purchases for or directly provides to an eligible child. A local new text begin or tribal new text end social services agency shall receive such reimbursement only for adoption services it purchases for an eligible child.

(b) A child-placing agency licensed in Minnesota or any other state or local new text begin or tribal new text end social services agency seeking reimbursement under this subdivision shall enter into a reimbursement agreement with the commissioner before providing adoption services for which reimbursement is sought. No reimbursement under this subdivision shall be made to an agency for services provided prior to entering a reimbursement agreement. Separate reimbursement agreements shall be made for each child and separate records shall be kept on each child for whom a reimbursement agreement is made. Funds encumbered and obligated under such an agreement for the child remain available until the terms of the agreement are fulfilled or the agreement is terminated.

(c) When a local new text begin or tribal new text end social services agency uses a purchase of service agreement to provide services reimbursable under a reimbursement agreement, the commissioner may make reimbursement payments directly to the agency providing the service if direct reimbursement is specified by the purchase of service agreement, and if the request for reimbursement is submitted by the local new text begin or tribal new text end social services agency along with a verification that the service was provided.

Sec. 12.

Minnesota Statutes 2002, section 393.07, subdivision 5, is amended to read:

Subd. 5.

Compliance with federal social security act; merit system.

The commissioner of human services shall have authority to require such methods of administration as are necessary for compliance with requirements of the federal Social Security Act, as amended, and for the proper and efficient operation of all welfare programs. This authority to require methods of administration includes methods relating to the establishment and maintenance of personnel standards on a merit basis as concerns all employees of local social services agencies except those employed in an institution, sanitarium, or hospital. The commissioner of human services shall exercise no authority with respect to the selection, tenure of office, and compensation of any individual employed in accordance with such methods. The adoption of methods relating to the establishment and maintenance of personnel standards on a merit basis of all such employees of the local social services agencies and the examination thereof, and the administration thereof shall be directed and controlled exclusively by the commissioner of human services.

Notwithstanding the provisions of any other law to the contrary, every employee of every local social services agency who occupies a position which requires as prerequisite to eligibility therefor graduation from an accredited four year college or a certificate of registration as a registered nurse under section 148.231, must be employed in such position under the merit system established under authority of this subdivision. Every such employee now employed by a local social services agency and who is not under said merit system is transferred, as of January 1, 1962, to a position of comparable classification in the merit system with the same status therein as the employee had in the county of employment prior thereto and every such employee shall be subject to and have the benefit of the merit system, including seniority within the local social services agency, as though the employee had served thereunder from the date of entry into the service of the local social services agency.

deleted text begin By March 1, 1996, the commissioner of human services shall report to the chair of the senate health care and family services finance division and the chair of the house health and human services finance division on options for the delivery of merit-based employment services by entities other than the department of human services in order to reduce the administrative costs to the state while maintaining compliance with applicable federal regulations. deleted text end

Sec. 13. new text begin FEDERAL GRANTS TO MAINTAIN INDEPENDENCE AND EMPLOYMENT. new text end

new text begin (a) The commissioner of human services shall seek federal funding to participate in grant activities authorized under Public Law 106-170, the Ticket to Work and Work Incentives Improvement Act of 1999. The purpose of the federal grant funds are to establish: new text end

new text begin (1) a demonstration project to improve the availability of health care services and benefits to workers with potentially severe physical or mental impairments that are likely to lead to disability without access to Medicaid services; and new text end

new text begin (2) a comprehensive initiative to remove employment barriers that includes linkages with non-Medicaid programs, including those administered by the Social Security Administration and the Department of Labor. new text end

new text begin (b) The state's proposal for a demonstration project in paragraph (a), clause (1), shall focus on assisting workers with: new text end

new text begin (1) a serious mental illness as defined by the federal Center for Mental Health Services; new text end

new text begin (2) concurrent mental health and chemical dependency conditions; and new text end

new text begin (3) young adults up to the age of 24 who have a physical or mental impairment that is severe and will potentially lead to a determination of disability by the Social Security Administration or state medical review team. new text end

new text begin (c) The commissioner is authorized to take the actions necessary to design and implement the demonstration project in paragraph (a), clause (1), that include: new text end

new text begin (1) establishing work-related requirements for participation in the demonstration project; new text end

new text begin (2) working with stakeholders to establish methods that identify the population that will be served in the demonstration project; new text end

new text begin (3) seeking funding for activities to design, implement, and evaluate the demonstration project; new text end

new text begin (4) taking necessary administrative actions to implement the demonstration project by July 1, 2004, or within 180 days of receiving formal notice from the Centers for Medicare and Medicaid Services that a grant has been awarded; new text end

new text begin (5) establishing limits on income and resources; new text end

new text begin (6) establishing a method to coordinate health care benefits and payments with other coverage that is available to the participants; new text end

new text begin (7) establishing premiums based on guidelines that are consistent with those found in Minnesota Statutes, section 256B.057, subdivision 9, for employed persons with disabilities; new text end

new text begin (8) notifying local agencies of potentially eligible individuals in accordance with Minnesota Statutes, section 256B.19, subdivision 2c; and new text end

new text begin (9) limiting the caseload of qualifying individuals participating in the demonstration project. new text end

new text begin (d) The state's proposal for the comprehensive employment initiative in paragraph (a), clause (2), shall focus on: new text end

new text begin (1) infrastructure development that creates incentives for greater work effort and participation by people with disabilities or workers with severe physical or mental impairments; new text end

new text begin (2) consumer access to information and benefit assistance that enables the person to maximize employment and career advancement potential; new text end

new text begin (3) improved consumer access to essential assistance and support; new text end

new text begin (4) enhanced linkages between state and federal agencies to decrease the barriers to employment experienced by persons with disabilities or workers with severe physical or mental impairments; and new text end

new text begin (5) research efforts to provide useful information to guide future policy development on both the state and federal levels. new text end

new text begin (e) Funds awarded by the federal government for the purposes of this section are appropriated to the commissioner of human services. new text end

Sec. 14. new text begin REPEALER. new text end

new text begin Minnesota Statutes 2002, section 256.482, subdivision 8, is repealed. new text end

ARTICLE 11

PROGRAMS AND FUNDING TRANSFERRED FROM THE DEPARTMENT OF CHILDREN, FAMILIES AND LEARNING

Section 1.

Minnesota Statutes 2002, section 119B.011, subdivision 5, is amended to read:

Subd. 5.

Child care.

"Child care" means the care of a child by someone other than a parent deleted text begin or deleted text end new text begin , stepparent, new text end legal guardian new text begin , eligible relative caregiver, or the spouses of any of the foregoing new text end in or outside the child's own home for gain or otherwise, on a regular basis, for any part of a 24-hour day.

Sec. 2.

Minnesota Statutes 2002, section 119B.011, subdivision 6, is amended to read:

Subd. 6.

Child care fund.

"Child care fund" means a program under this chapter providing:

(1) financial assistance for child care to parents engaged in employment, job search, or education and training leading to employment deleted text begin , or an at-home infant care subsidy deleted text end ; and

(2) grants to develop, expand, and improve the access and availability of child care services statewide.

Sec. 3.

Minnesota Statutes 2002, section 119B.011, subdivision 15, is amended to read:

Subd. 15.

Income.

"Income" means earned or unearned income received by all family members, including public assistance cash benefits deleted text begin and at-home infant care subsidy payments deleted text end , unless specifically excluded and child support and maintenance distributed to the family under section 256.741, subdivision 15. The following are excluded from income: funds used to pay for health insurance premiums for family members, Supplemental Security Income, scholarships, work-study income, and grants that cover costs or reimbursement for tuition, fees, books, and educational supplies; student loans for tuition, fees, books, supplies, and living expenses; state and federal earned income tax credits; new text begin assistance specifically excluded as income by law; new text end in-kind income such as food stamps, energy assistance, foster care assistance, medical assistance, child care assistance, and housing subsidies; earned income of full-time or part-time students up to the age of 19, who have not earned a high school diploma or GED high school equivalency diploma including earnings from summer employment; grant awards under the family subsidy program; nonrecurring lump sum income only to the extent that it is earmarked and used for the purpose for which it is paid; and any income assigned to the public authority according to section 256.741.

Sec. 4.

Minnesota Statutes 2002, section 119B.011, subdivision 19, is amended to read:

Subd. 19.

Provider.

"Provider" means new text begin (1) new text end an individual or child care center or facility, either licensed or unlicensed, providing legal child care services as defined under section 245A.03 new text begin , or (2) an individual or child care center or facility holding a valid child care license issued by another state or a tribe and providing child care services in the licensing state or in the area under the licensing tribe's jurisdiction new text end . A legally unlicensed deleted text begin registered deleted text end family child care provider must be at least 18 years of age, and not a member of the MFIP assistance unit or a member of the family receiving child care assistance new text begin to be authorized new text end under this chapter.

Sec. 5.

Minnesota Statutes 2002, section 119B.011, is amended by adding a subdivision to read:

new text begin Subd. 19a. new text end

new text begin Registration. new text end

new text begin "Registration" means the process used by a county to determine whether the provider selected by a family applying for or receiving child care assistance to care for that family's children meets the requirements necessary for payment of child care assistance for care provided by that provider. new text end

Sec. 6.

Minnesota Statutes 2002, section 119B.02, subdivision 1, is amended to read:

Subdivision 1.

Child care services.

The commissioner shall develop standards for county and human services boards to provide child care services to enable eligible families to participate in employment, training, or education programs. Within the limits of available appropriations, the commissioner shall distribute money to counties to reduce the costs of child care for eligible families. The commissioner shall adopt rules to govern the program in accordance with this section. The rules must establish a sliding schedule of fees for parents receiving child care services. The rules shall provide that funds received as a lump sum payment of child support arrearages shall not be counted as income to a family in the month received but shall be prorated over the 12 months following receipt and added to the family income during those months. deleted text begin In the rules adopted under this section, county and human services boards shall be authorized to establish policies for payment of child care spaces for absent children, when the payment is required by the child's regular provider. The rules shall not set a maximum number of days for which absence payments can be made, but instead shall direct the county agency to set limits and pay for absences according to the prevailing market practice in the county. County policies for payment of absences shall be subject to the approval of the commissioner. deleted text end The commissioner shall maximize the use of federal money under title I and title IV of Public Law deleted text begin Number deleted text end 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and other programs that provide federal or state reimbursement for child care services for low-income families who are in education, training, job search, or other activities allowed under those programs. Money appropriated under this section must be coordinated with the programs that provide federal reimbursement for child care services to accomplish this purpose. Federal reimbursement obtained must be allocated to the county that spent money for child care that is federally reimbursable under programs that provide federal reimbursement for child care services. The counties shall use the federal money to expand child care services. The commissioner may adopt rules under chapter 14 to implement and coordinate federal program requirements.

Sec. 7.

new text begin [119B.025] DUTIES OF COUNTIES. new text end

new text begin Subdivision 1. new text end [FACTORS WHICH MUST BE VERIFIED.] new text begin The county shall use the universal application at the initial application or at a redetermination if a universal application has not been previously completed. When using the universal application, the county shall verify the following: new text end

new text begin (1) identity of adults; new text end

new text begin (2) presence of the minor child in the home, if questionable; new text end

new text begin (3) age; new text end

new text begin (4) immigration status, if related to eligibility; new text end

new text begin (5) social security number, if given; new text end

new text begin (6) income; new text end

new text begin (7) spousal support and child support payments made to persons outside the household; new text end

new text begin (8) residence; and new text end

new text begin (9) inconsistent information, if related to eligibility. new text end

new text begin Subd. 2. new text end [SOCIAL SECURITY NUMBERS.] new text begin The county must request social security numbers from all applicants for child care assistance under this chapter. A county may not deny child care assistance solely on the basis of failure of an applicant to report a social security number. new text end

Sec. 8.

Minnesota Statutes 2002, section 119B.03, subdivision 9, is amended to read:

Subd. 9.

Portability pool.

(a) The commissioner shall establish a pool of up to five percent of the annual appropriation for the basic sliding fee program to provide continuous child care assistance for eligible families who move between Minnesota counties. At the end of each allocation period, any unspent funds in the portability pool must be used for assistance under the basic sliding fee program. If expenditures from the portability pool exceed the amount of money available, the reallocation pool must be reduced to cover these shortages.

(b) To be eligible for portable basic sliding fee assistance, a family that has moved from a county in which it was receiving basic sliding fee assistance to a county with a waiting list for the basic sliding fee program must:

(1) meet the income and eligibility guidelines for the basic sliding fee program; and

(2) notify the new county of residence within deleted text begin 30 deleted text end new text begin 60 new text end days of moving and deleted text begin apply for basic sliding fee assistance in deleted text end new text begin submit information to new text end the new county of residence new text begin to verify eligibility for the basic sliding fee program new text end .

(c) The receiving county must:

(1) accept administrative responsibility for applicants for portable basic sliding fee assistance at the end of the two months of assistance under the Unitary Residency Act;

(2) continue basic sliding fee assistance for the lesser of six months or until the family is able to receive assistance under the county's regular basic sliding program; and

(3) notify the commissioner through the quarterly reporting process of any family that meets the criteria of the portable basic sliding fee assistance pool.

Sec. 9.

Minnesota Statutes 2002, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of section 119B.10;

(2) persons who are members of transition year families under section 119B.011, subdivision 20 new text begin , and meet the requirements of section 119B.10 new text end ;

(3) families who are participating in employment orientation or job search, or other employment or training activities that are included in an approved employability development plan under chapter 256K;

(4) MFIP families who are participating in work job search, job support, employment, or training activities as required in their job search support or employment plan, or in appeals, hearings, assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J or 256K as required in their employment plan approved according to chapter 256J or 256K; and

(6) families who are participating in programs as required in tribal contracts under section 119B.02, subdivision 2, or 256.01, subdivision 2.

Sec. 10.

Minnesota Statutes 2002, section 119B.09, subdivision 7, is amended to read:

Subd. 7.

Date of eligibility for assistance.

(a) The date of eligibility for child care assistance under this chapter is the later of the date the application was signed; the beginning date of employment, education, or training; or the date a determination has been made that the applicant is a participant in employment and training services under Minnesota Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K. deleted text begin The date of eligibility for the basic sliding fee at-home infant child care program is the later of the date the infant is born or, in a county with a basic sliding fee waiting list, the date the family applies for at-home infant child care. deleted text end

(b) deleted text begin Payment ceases for a family under the at-home infant child care program when a family has used a total of 12 months of assistance as specified under section 119B.061. deleted text end Payment of child care assistance for employed persons on MFIP is effective the date of employment or the date of MFIP eligibility, whichever is later. Payment of child care assistance for MFIP or work first participants in employment and training services is effective the date of commencement of the services or the date of MFIP or work first eligibility, whichever is later. Payment of child care assistance for transition year child care must be made retroactive to the date of eligibility for transition year child care.

Sec. 11.

Minnesota Statutes 2002, section 119B.11, subdivision 2a, is amended to read:

Subd. 2a.

Recovery of overpayments.

An amount of child care assistance paid to a recipient in excess of the payment due is recoverable by the county agency. If the family remains eligible for child care assistance, the overpayment must be recovered through recoupment as identified in Minnesota Rules, part 3400.0140, subpart 19 new text begin , except that the overpayments must be calculated and collected on a service period basis new text end . If the family no longer remains eligible for child care assistance, the county may choose to initiate efforts to recover overpayments from the family for overpayment less than $50. If the overpayment is greater than or equal to $50, the county shall seek voluntary repayment of the overpayment from the family. If the county is unable to recoup the overpayment through voluntary repayment, the county shall initiate civil court proceedings to recover the overpayment unless the county's costs to recover the overpayment will exceed the amount of the overpayment. A family with an outstanding debt under this subdivision is not eligible for child care assistance until: (1) the debt is paid in full; or (2) satisfactory arrangements are made with the county to retire the debt consistent with the requirements of this chapter and Minnesota Rules, chapter 3400, and the family is in compliance with the arrangements.

Sec. 12.

Minnesota Statutes 2002, section 119B.12, subdivision 2, is amended to read:

Subd. 2.

Parent fee.

new text begin A family must be assessed a parent fee for each service period. new text end A family's deleted text begin monthly deleted text end parent fee must be a fixed percentage of its annual gross income. Parent fees must apply to families eligible for child care assistance under sections 119B.03 and 119B.05. Income must be as defined in section 119B.011, subdivision 15. The fixed percent is based on the relationship of the family's annual gross income to 100 percent of state median income. Beginning January 1, 1998, parent fees must begin at 75 percent of the poverty level. The minimum parent fees for families between 75 percent and 100 percent of poverty level must be $5 per deleted text begin month deleted text end new text begin service period new text end . Parent fees must be established in rule and must provide for graduated movement to full payment.

Sec. 13.

new text begin [119B.125] PROVIDER REQUIREMENTS. new text end

new text begin Subdivision 1. new text end [AUTHORIZATION.] new text begin Except as provided in subdivision 3, a county must authorize the provider chosen by an applicant or a participant before the county can authorize payment for care provided by that provider. The commissioner must establish the requirements necessary for authorization of providers. new text end

new text begin Subd. 2. new text end [UNSAFE CARE.] new text begin A county may deny authorization as a child care provider to any applicant or rescind authorization of any provider when the county knows or has reason to believe that the provider is unsafe or that the circumstances of the chosen child care arrangement are unsafe. The county must include the conditions under which a provider or care arrangement will be determined to be unsafe in the county's child care fund plan under section 119B.08, subdivision 3. new text end

new text begin Subd. 3. new text end [PROVISIONAL PAYMENT.] new text begin After a county receives a completed application from a provider, the county may issue provisional authorization and payment to the provider during the time needed to determine whether to give final authorization to the provider. new text end

new text begin Subd. 4. new text end [RECORD KEEPING REQUIREMENT.] new text begin All providers must keep daily attendance records for children receiving child care assistance and must make those records available immediately to the county upon request. The daily attendance records must be retained for six years after the date of service. A county may deny authorization as a child care provider to any applicant or rescind authorization of any provider when the county knows or has reason to believe that the provider has not complied with the record keeping requirement in this subdivision. new text end

Sec. 14.

Minnesota Statutes 2002, section 119B.13, is amended by adding a subdivision to read:

new text begin Subd. 1a. new text end

new text begin Legal nonlicensed family child care provider rates. new text end

new text begin (a) Legal nonlicensed family child care providers receiving reimbursement under this chapter must be paid in hourly blocks of time for families receiving assistance. new text end

new text begin (b) The maximum rate paid to legal nonlicensed family child care providers must be 90 percent of the county maximum hourly rate for licensed family child care providers. In counties where the maximum hourly rate for licensed family child care providers is higher than the maximum weekly rate for those providers divided by 50, the maximum hourly rate that may be paid to legal nonlicensed family child care providers is the rate equal to the maximum weekly rate for licensed family child care providers divided by 50 and then multiplied by 0.90. new text end

new text begin (c) A rate which includes a provider bonus paid under subdivision 2 or a special needs rate paid under subdivision 3 may be in excess of the maximum rate allowed under this subdivision. new text end

new text begin (d) Legal nonlicensed family child care providers receiving reimbursement under this chapter may not be paid registration fees for families receiving assistance. new text end

Sec. 15.

Minnesota Statutes 2002, section 119B.13, subdivision 2, is amended to read:

Subd. 2.

Provider rate bonus for accreditation.

A family child care provider or child care center shall be paid a ten percent bonus above the maximum rate established in subdivision 1 new text begin or 1a new text end , if the provider or center holds a current early childhood development credential approved by the commissioner, up to the actual provider rate.

Sec. 16.

Minnesota Statutes 2002, section 119B.13, subdivision 6, is amended to read:

Subd. 6.

Provider payments.

new text begin (a) new text end Counties or the state shall make vendor payments to the child care provider or pay the parent directly for eligible child care expenses.

new text begin (b) new text end If payments for child care assistance are made to providers, the provider shall bill the county for services provided within ten days of the end of the deleted text begin month of deleted text end service new text begin period new text end . If bills are submitted deleted text begin in accordance with the provisions of this subdivision deleted text end new text begin within ten days of the end of the service period new text end , a county or the state shall issue payment to the provider of child care under the child care fund within 30 days of receiving deleted text begin an invoice deleted text end new text begin a bill new text end from the provider. Counties or the state may establish policies that make payments on a more frequent basis.

new text begin (c) All bills must be submitted within 60 days of the last date of service on the bill. A county may pay a bill submitted more than 60 days after the last date of service if the provider shows good cause why the bill was not submitted within 60 days. Good cause must be defined in the county's child care fund plan under section 119B.08, subdivision 3, and the definition of good cause must include county error. A county may not pay any bill submitted more than a year after the last date of service on the bill. new text end

new text begin (d) A county may stop payment issued to a provider or may refuse to pay a bill submitted by a provider if: new text end

new text begin (1) the provider admits to intentionally giving the county materially false information on the provider's billing forms; or new text end

new text begin (2) a county finds by a preponderance of the evidence that the provider intentionally gave the county materially false information on the provider's billing forms. new text end

new text begin (e) new text end A county's payment policies must be included in the county's child care plan under section 119B.08, subdivision 3. If payments are made by the state, in addition to being in compliance with this subdivision, the payments must be made in compliance with section 16A.124.

Sec. 17.

Minnesota Statutes 2002, section 119B.19, subdivision 7, is amended to read:

Subd. 7.

Child care resource and referral programs.

Within each region, a child care resource and referral program must:

(1) maintain one database of all existing child care resources and services and one database of family referrals;

(2) provide a child care referral service for families;

(3) develop resources to meet the child care service needs of families;

(4) increase the capacity to provide culturally responsive child care services;

(5) coordinate professional development opportunities for child care and school-age care providers;

(6) administer and award child care services grants;

(7) administer and provide loans for child development education and training; deleted text begin and deleted text end

(8) cooperate with the Minnesota Child Care Resource and Referral Network and its member programs to develop effective child care services and child care resources new text begin ; and new text end

new text begin (9) assist in fostering coordination, collaboration, and planning among child care programs and community programs such as school readiness, Head Start, early childhood family education, local interagency early intervention committees, early childhood screening, special education services, and other early childhood care and education services and programs that provide flexible, family-focused services to families with young children to the extent possible new text end .

Sec. 18.

Minnesota Statutes 2002, section 119B.21, subdivision 11, is amended to read:

Subd. 11.

Statewide advisory task force.

The commissioner may convene a statewide advisory task force to advise the commissioner on statewide grants or other child care issues. The following groups must be represented: family child care providers, child care center programs, school-age care providers, parents who use child care services, health services, social services, Head Start, public schools, new text begin school-based early childhood programs, special education programs, new text end employers, and other citizens with demonstrated interest in child care issues. Additional members may be appointed by the commissioner. The commissioner may compensate members for their travel, child care, and child care provider substitute expenses for attending task force meetings. The commissioner may also pay a stipend to parent representatives for participating in task force meetings.

Sec. 19.

Minnesota Statutes 2002, section 256.046, subdivision 1, is amended to read:

Subdivision 1.

Hearing authority.

A local agency must initiate an administrative fraud disqualification hearing for individuals accused of wrongfully obtaining assistance or intentional program violations, in lieu of a criminal action when it has not been pursued, in the aid to families with dependent children program formerly codified in sections 256.72 to 256.87, MFIP, child care assistance programs, general assistance, family general assistance program formerly codified in section 256D.05, subdivision 1, clause (15), Minnesota supplemental aid, medical care, or food stamp programs. The hearing is subject to the requirements of section 256.045 and the requirements in Code of Federal Regulations, title 7, section 273.16, for the food stamp program and title 45, section 235.112, as of September 30, 1995, for the cash grant new text begin , child care assistance administered under chapter 119B, new text end and medical care programs.

Sec. 20.

Minnesota Statutes 2002, section 256.0471, subdivision 1, is amended to read:

Subdivision 1.

Qualifying overpayment.

Any overpayment for assistance granted under deleted text begin section 119B.05 deleted text end new text begin chapter 119B new text end , the MFIP program formerly codified under sections 256.031 to 256.0361, and the AFDC program formerly codified under sections 256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; and the food stamp program, except agency error claims, become a judgment by operation of law 90 days after the notice of overpayment is personally served upon the recipient in a manner that is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by certified mail, return receipt requested. This judgment shall be entitled to full faith and credit in this and any other state.

Sec. 21.

Minnesota Statutes 2002, section 256.98, subdivision 8, is amended to read:

Subd. 8.

Disqualification from program.

(a) Any person found to be guilty of wrongfully obtaining assistance by a federal or state court or by an administrative hearing determination, or waiver thereof, through a disqualification consent agreement, or as part of any approved diversion plan under section 401.065, or any court-ordered stay which carries with it any probationary or other conditions, in the Minnesota family investment program, the food stamp program, the general assistance program, the group residential housing program, or the Minnesota supplemental aid program shall be disqualified from that program. In addition, any person disqualified from the Minnesota family investment program shall also be disqualified from the food stamp program. The needs of that individual shall not be taken into consideration in determining the grant level for that assistance unit:

(1) for one year after the first offense;

(2) for two years after the second offense; and

(3) permanently after the third or subsequent offense.

The period of program disqualification shall begin on the date stipulated on the advance notice of disqualification without possibility of postponement for administrative stay or administrative hearing and shall continue through completion unless and until the findings upon which the sanctions were imposed are reversed by a court of competent jurisdiction. The period for which sanctions are imposed is not subject to review. The sanctions provided under this subdivision are in addition to, and not in substitution for, any other sanctions that may be provided for by law for the offense involved. A disqualification established through hearing or waiver shall result in the disqualification period beginning immediately unless the person has become otherwise ineligible for assistance. If the person is ineligible for assistance, the disqualification period begins when the person again meets the eligibility criteria of the program from which they were disqualified and makes application for that program.

(b) A family receiving assistance through child care assistance programs under chapter 119B with a family member who is found to be guilty of wrongfully obtaining child care assistance by a federal court, state court, or an administrative hearing determination or waiver, through a disqualification consent agreement, as part of an approved diversion plan under section 401.065, or a court-ordered stay with probationary or other conditions, is disqualified from child care assistance programs. The disqualifications must be for periods of three months, six months, and two years for the first, second, and third offenses respectively. Subsequent violations must result in permanent disqualification. During the disqualification period, disqualification from any child care program must extend to all child care programs and must be immediately applied.

new text begin (c) A provider caring for children receiving assistance through child care assistance programs under chapter 119B is disqualified from receiving payment for child care services from the child care assistance program under chapter 119B when the provider is found to have wrongfully obtained child care assistance by a federal court, state court, or an administrative hearing determination or waiver under section 256.046, through a disqualification consent agreement, as part of an approved diversion plan under section 401.065, or a court-ordered stay with probationary or other conditions. The disqualification must be for a period of one year for the first offense and two years for the second offense. Any subsequent violation must result in permanent disqualification. The disqualification period must be imposed immediately after a determination is made under this paragraph. During the disqualification period, the provider is disqualified from receiving payment from any child care program under chapter 119B. new text end

Sec. 22. new text begin CHILD CARE ASSISTANCE PARENT FEE SCHEDULE. new text end

new text begin The parent fee schedule in Minnesota Rules, part 3400.0100, subpart 4, is amended as follows: new text end

new text begin (1) parent fees for families with incomes greater than 100 percent of the federal poverty guidelines but less than 35.01 percent of the state median income must equal 2.42 percent of adjusted gross income for families at 35 percent of the state median income; new text end

new text begin (2) parent fees for families with incomes equal to or greater than 35.01 percent of the state median income but less than 42.01 percent of the state median income must equal 2.97 percent of adjusted gross income for families at 42 percent of the state median income; new text end

new text begin (3) parent fees for families with incomes equal to or greater than 42.01 percent of the state median income but less than 75 percent of the state median income must begin at 4.13 percent of adjusted gross income and provide for graduated movement of fee increases using the fixed percentages of income listed in Minnesota Rules, part 3400.0100, subpart 4, increased by ten percent; and new text end

new text begin (4) parent fees for families equal to 75 percent of the state median income must equal 22 percent of gross annual income. new text end

Sec. 23. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, section 119B.061, is repealed. new text end

new text begin (b) Laws 2001, First Special Session chapter 3, article 1, section 16, is repealed. new text end

ARTICLE 12

APPROPRIATIONS

Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]

The sums shown in the columns marked "APPROPRIATIONS" are appropriated from the general fund, or any other fund named, to the agencies and for the purposes specified in the sections of this article, to be available for the fiscal years indicated for each purpose. The figures "2004" and "2005" where used in this article, mean that the appropriation or appropriations listed under them are available for the fiscal year ending June 30, 2004, or June 30, 2005, respectively. Where a dollar amount appears in parentheses, it means a reduction of an appropriation. SUMMARY BY FUND BIENNIAL 2004 2005 TOTAL General $3,922,726,000 $3,853,857,000 $7,776,583,000 State Government Special Revenue 45,274,000 44,995,000 90,269,000 Health Care Access 332,944,000 377,340,000 710,284,000 Federal TANF 267,369,000 269,318,000 536,687,000 Lottery Prize Fund 1,456,000 1,456,000 2,912,000 TOTAL $4,569,769,000 $4,546,966,000 $9,116,738,000 APPROPRIATIONS Available for the Year Ending June 30 2004 2005 Sec. 2. COMMISSIONER OF HUMAN SERVICES Subdivision 1. Total Appropriation $4,271,683,000 $4,249,074,000 Summary by Fund General 3,675,717,000 3,606,699,000 State Government Special Revenue 534,000 534,000 Health Care Access 326,607,000 371,067,000 Federal TANF 267,369,000 269,318,000 Lottery Cash Flow 1,456,000 1,456,000

[RECEIPTS FOR SYSTEMS PROJECTS.] Appropriations and federal receipts for information system projects for MAXIS, PRISM, MMIS, and SSIS must be deposited in the state system account authorized in Minnesota Statutes, section 256.014. Money appropriated for computer projects approved by the Minnesota office of technology, funded by the legislature, and approved by the commissioner of finance may be transferred from one project to another and from development to operations as the commissioner of human services considers necessary. Any unexpended balance in the appropriation for these projects does not cancel but is available for ongoing development and operations.

[GIFTS.] Notwithstanding Minnesota Statutes, chapter 7, the commissioner may accept on behalf of the state additional funding from sources other than state funds for the purpose of financing the cost of assistance program grants or nongrant administration. All additional funding is appropriated to the commissioner for use as designated by the grantor of funding.

[SYSTEMS CONTINUITY.] In the event of disruption of technical systems or computer operations, the commissioner may use available grant appropriations to ensure continuity of payments for maintaining the health, safety, and well-being of clients served by programs administered by the department of human services. Grant funds must be used in a manner consistent with the original intent of the appropriation.

[NONFEDERAL SHARE TRANSFERS.] The nonfederal share of activities for which federal administrative reimbursement is appropriated to the commissioner may be transferred to the special revenue fund.

[TANF FUNDS APPROPRIATED TO OTHER ENTITIES.] Any expenditures from the TANF block grant shall be expended in accordance with the requirements and limitations of part A of title IV of the Social Security Act, as amended, and any other applicable federal requirement or limitation. Prior to any expenditure of these funds, the commissioner shall assure that funds are expended in compliance with the requirements and limitations of federal law and that any reporting requirements of federal law are met. It shall be the responsibility of any entity to which these funds are appropriated to implement a memorandum of understanding with the commissioner that provides the necessary assurance of compliance prior to any expenditure of funds. The commissioner shall receipt TANF funds appropriated to other state agencies and coordinate all related interagency accounting transactions necessary to implement these appropriations. Unexpended TANF funds appropriated to any state, local, or nonprofit entity cancel at the end of the state fiscal year unless appropriating language permits otherwise.

[TANF FUNDS TRANSFERRED TO OTHER FEDERAL GRANTS.] The commissioner must authorize transfers from TANF to other federal block grants so that funds are available to meet the annual expenditure needs as appropriated. Transfers may be authorized prior to the expenditure year with the agreement of the receiving entity. Transferred funds must be expended in the year for which the funds were appropriated unless appropriation language permits otherwise. In accelerating transfer authorizations, the commissioner must aim to preserve the future potential transfer capacity from TANF to other block grants.

[TANF MAINTENANCE OF EFFORT.] (a) In order to meet the basic maintenance of effort (MOE) requirements of the TANF block grant specified under Code of Federal Regulations, title 45, section 263.1, the commissioner may only report nonfederal money expended for allowable activities listed in the following clauses as TANF/MOE expenditures:

(1) MFIP cash, diversionary work program, and food assistance benefits under Minnesota Statutes, chapter 256J;

(2) the child care assistance programs under Minnesota Statutes, sections 119B.03 and 119B.05, and county child care administrative costs under Minnesota Statutes, section 119B.15;

(3) state and county MFIP administrative costs under Minnesota Statutes, chapters 256J and 256K;

(4) state, county, and tribal MFIP employment services under Minnesota Statutes, chapters 256J and 256K;

(5) expenditures made on behalf of noncitizen MFIP recipients who qualify for the medical assistance without federal financial participation program under Minnesota Statutes, section 256B.06, subdivision 4, paragraphs (d), (e), and (j);

(6) the Minnesota Education Now and Babies Later (MN ENABL) program under Minnesota Statutes, section 145.9255; and

(7) expenditures for family planning activities under Minnesota Statutes, section 145.925.

(b) The commissioner shall ensure that sufficient qualified nonfederal expenditures are made each year to meet the state's TANF/MOE requirements. For the activities listed in paragraph (a), clauses (2) to (5), the commissioner may only report expenditures that are excluded from the definition of assistance under Code of Federal Regulations, title 45, section 260.31.

(c) By August 31 of each year, the commissioner shall make a preliminary calculation to determine the likelihood that the state will meet its annual federal work participation requirement under Code of Federal Regulations, title 45, sections 261.21 and 261.23, after adjustment for any caseload reduction credit under Code of Federal Regulations, title 45, section 261.41. If the commissioner determines that the state will meet its federal work participation rate for the federal fiscal year ending that September, the commissioner may reduce the expenditure under paragraph (a), clause (1), to the extent allowed under Code of Federal Regulations, title 45, section 263.1(a)(2).

(d) For fiscal years beginning with state fiscal year 2003, the commissioner shall assure that the maintenance of effort used by the commissioner of finance for the February and November forecasts required under Minnesota Statutes, section 16A.103, contains expenditures under paragraph (a), clause (1), equal to at least 25 percent of the total required under Code of Federal Regulations, title 45, section 263.1.

(e) If nonfederal expenditures for the programs and purposes listed in paragraph (a) are insufficient to meet the state's TANF/MOE requirements, the commissioner shall recommend additional allowable sources of nonfederal expenditures to the legislature, if the legislature is or will be in session to take action to specify additional sources of nonfederal expenditures for TANF/MOE before a federal penalty is imposed. The commissioner shall otherwise provide notice to the legislative commission on planning and fiscal policy under paragraph (g).

(f) If the commissioner uses authority granted under section 11, or similar authority granted by a subsequent legislature, to meet the state's TANF/MOE requirement in a reporting period, the commissioner shall inform the chairs of the appropriate legislative committees about all transfers made under that authority for this purpose.

(g) If the commissioner determines that nonfederal expenditures under paragraph (a) are insufficient to meet TANF/MOE expenditure requirements, and if the legislature is not or will not be in session to take timely action to avoid a federal penalty, the commissioner may report nonfederal expenditures from other allowable sources as TANF/MOE expenditures after the requirements of this paragraph are met. The commissioner may report nonfederal expenditures in addition to those specified under paragraph (a) as nonfederal TANF/MOE expenditures, but only ten days after the commissioner of finance has first submitted the commissioner's recommendations for additional allowable sources of nonfederal TANF/MOE expenditures to the members of the legislative commission on planning and fiscal policy for their review.

(h) The commissioner of finance shall not incorporate any changes in federal TANF expenditures or nonfederal expenditures for TANF/MOE that may result from reporting additional allowable sources of nonfederal TANF/MOE expenditures under the interim procedures in paragraph (g) into the February or November forecasts required under Minnesota Statutes, section 16A.103, unless the commissioner of finance has approved the additional sources of expenditures under paragraph (g).

(i) Minnesota Statutes, section 256.011, subdivision 3, which requires that federal grants or aids secured or obtained under that subdivision be used to reduce any direct appropriations provided by law, do not apply if the grants or aids are federal TANF funds.

(j) Notwithstanding section 14, paragraph (a), clauses (1) to (5), and paragraphs (b) to (j) expire June 30, 2007.

[TANF APPROPRIATION CANCELLATION.] Notwithstanding the provisions of Laws 2000, chapter 488, article 1, section 16, any prior appropriations of TANF funds to the department of trade and economic development or to the job skills partnership board or any transfers of TANF funds from another agency to the department of trade and economic development or to the job skills partnership board are not available until expended, and if unexpended as of June 30, 2003, these appropriations or transfers shall cancel to the TANF fund.

[CSSA TRADITIONAL APPROPRIATION.] Notwithstanding Minnesota Statutes, section 256E.06, subdivisions 1 and 2, the appropriations available under that section in fiscal years 2004 and 2005 must be distributed to each county proportionately to the aid received by the county in calendar year 2002.

[SHIFT COUNTY PAYMENT.] The commissioner shall make up to 100 percent of the calendar year 2005 payments to counties for family preservation grants, developmental disabilities semi-independent living services grants, developmental disabilities family support grants, adult mental health grants, and children's mental health grants from fiscal year 2006 appropriations. This is a onetime payment shift. Calendar year 2006 and future payments for these grants are not affected by this shift. This provision expires June 30, 2006.

[CAPITATION RATE INCREASE.] Of the health care access fund appropriations to the University of Minnesota in the higher education omnibus appropriation bill, $2,157,000 in fiscal year 2004 and $2,157,000 in fiscal year 2005 are to be used to increase the capitation payments under Minnesota Statutes, section 256B.69. Notwithstanding the provisions of section 13, this provision shall not expire. Subd. 2. Agency Management Summary by Fund General 40,473,000 26,868,000 State Government Special Revenue 415,000 415,000 Health Care Access 3,673,000 3,673,000 Federal TANF 320,000 320,000

The amounts that may be spent from the appropriation for each purpose are as follows: (a) Financial Operations Summary by Fund General 8,751,000 9,056,000 Health Care Access 828,000 828,000 Federal TANF 220,000 220,000

[SPECIAL REVENUE FUND TRANSFER.] Notwithstanding any law to the contrary, excluding accounts authorized under Minnesota Statutes, section 16A.1286, and chapter 254B, the commissioner shall transfer $1,400,000 of uncommitted special revenue fund balances to the general fund upon final enactment. The actual transfers shall be identified within the standard information provided to the chairs of the house health and human services finance committee and the senate health, human services, and corrections budget division in December 2003. (b) Legal and Regulation Operations Summary by Fund General 7,896,000 8,168,000 State Government Special Revenue 415,000 415,000 Health Care Access 244,000 244,000 Federal TANF 100,000 100,000 (c) Management Operations Summary by Fund General 16,373,000 2,076,000 Health Care Access 1,623,000 1,623,000 (d) Information Technology Operations Summary by FUnd General 7,453,000 7,568,000 Health Care Access 978,000 978,000 Subd. 3. Revenue and Pass-Through Summary by Fund Federal TANF 69,130,000 64,442,000

[REDUCTION IN TANF TRANSFER TO CHILD CARE AND DEVELOPMENT FUND.] Transfers of TANF to the child care development fund for the purposes of MFIP child care assistance shall be increased by $1,297,000 in fiscal year 2004 and $3,230,000 in fiscal year 2005. Subd. 4. Children's Services Grants Summary by Fund General 68,560,000 64,115,000 Federal TANF 640,000 640,000

[ADOPTION ASSISTANCE INCENTIVE GRANTS.] Federal funds available during fiscal year 2004 and fiscal year 2005, for adoption incentive grants are appropriated to the commissioner for these purposes.

[ADOPTION ASSISTANCE AND RELATIVE CUSTODY ASSISTANCE.] The commissioner may transfer unencumbered appropriation balances for adoption assistance and relative custody assistance between fiscal years and between programs. Subd. 5. Children's Services Management 5,221,000 5,283,000 Subd. 6. Basic Health Care Grants Summary by Fund General 1,560,443,000 1,583,192,000 Health Care Access 307,406,000 351,866,000

[UPDATING FEDERAL POVERTY GUIDELINES.] Annual updates to the federal poverty guidelines are effective each July 1, following publication by the United States Department of Health and Human Services for health care programs under Minnesota Statutes, chapters 256, 256B, 256D, and 256L.

The amounts that may be spent from this appropriation for each purpose are as follows: (a) MinnesotaCare Grants Summary by Fund Health Care Access 306,656,000 351,116,000

[MINNESOTACARE FEDERAL RECEIPTS.] Receipts received as a result of federal participation pertaining to administrative costs of the Minnesota health care reform waiver shall be deposited as nondedicated revenue in the health care access fund. Receipts received as a result of federal participation pertaining to grants shall be deposited in the federal fund and shall offset health care access funds for payments to providers.

[MINNESOTACARE FUNDING.] The commissioner may expend money appropriated from the health care access fund for MinnesotaCare in either fiscal year of the biennium. (b) MA Basic Health Care Grants - Families and Children 570,738,000 576,316,000

[SERVICES TO UNDOCUMENTED PREGNANT WOMEN.] The commissioner shall use available federal money for the State-Children's Health Insurance Program for prenatal medical assistance services provided to undocumented pregnant women beginning in fiscal year 2003. Notwithstanding section 14, this paragraph shall not expire.

[MANAGED CARE RATE INCREASE.] (a) Effective January 1, 2004, the commissioner of human services shall increase the total payments to managed care plans under Minnesota Statutes, section 256B.69, by an amount equal to the cost increases to the managed care plans from by the elimination of: (1) the exemption from the taxes imposed under Minnesota Statutes, section 297I.05, subdivision 5, for premiums paid by the state for medical assistance, general assistance medical care, and the MinnesotaCare program; and (2) the exemption of gross revenues subject to the taxes imposed under Minnesota Statutes, sections 295.50 to 295.57, for payments paid by the state for services provided under medical assistance, general assistance medical care, and the MinnesotaCare program. Any increase based on clause (2) must be reflected in provider rates paid by the managed care plan unless the managed care plan is a staff model health plan company.

(b) The commissioner of human services shall increase by two percent the fee-for-service payments under medical assistance, general assistance medical care, and the MinnesotaCare program for services subject to the hospital, surgical center, or health care provider taxes under Minnesota Statutes, sections 295.50 to 295.57, effective for services rendered on or after January 1, 2004.

(c) The commissioner of finance shall transfer from the health care access fund to the general fund the following amounts in the fiscal years indicated: 2004, $16,587,000; 2005, $46,322,000; 2006, $49,413,000; and 2007, $52,659,000.

(d) For fiscal years after 2007, the commissioner of finance shall transfer from the health care access fund to the general fund an amount equal to the revenue collected by the commissioner of revenue on the following:

(1) gross revenues received by hospitals, surgical centers, and health care providers as payments for services provided under medical assistance, general assistance medical care, and the MinnesotaCare program, including payments received directly from the state or from a prepaid plan, under Minnesota Statutes, sections 295.50 to 295.57; and

(2) premiums paid by the state under medical assistance, general assistance medical care, and the MinnesotaCare program under Minnesota Statutes, section 297I.05, subdivision 5.

The commissioner of finance shall monitor and adjust if necessary the amount transferred each fiscal year from the health care access fund to the general fund to ensure that the amount transferred equals the tax revenue collected for the items described in clauses (1) and (2) for that fiscal year.

(e) Notwithstanding section 14, these provisions shall not expire. (c) MA Basic Health Care Grants - Elderly and Disabled 684,387,000 697,778,000

[DELAY MEDICAL ASSISTANCE FEE-FOR-SERVICE - ACUTE CARE.] The following payments in fiscal year 2005 from the Medicaid Management Information System that would otherwise have been made to providers for medical assistance and general assistance medical care services shall be delayed and included in the first payment in fiscal year 2006:

(1) for hospitals, the last two payments; and

(2) for nonhospital providers, the last payment.

This payment delay shall not include payments to skilled nursing facilities, intermediate care facilities for mental retardation, prepaid health plans, home health agencies, personal care nursing providers, and providers of only waiver services. The provisions of Minnesota Statutes, section 16A.124, shall not apply to these delayed payments. Notwithstanding section 14, this provision shall not expire.

[DEAF AND HARD-OF-HEARING SERVICES.] If the service provider for mental health services to persons who are deaf or hearing impaired is not able to qualify as a medical assistance provider after making reasonable efforts, the commissioner shall transfer $227,000 in fiscal year 2005 from medical assistance to deaf and hard-of-hearing grants in order to enable the provider to continue providing services to eligible persons.

(d) General Assistance Medical Care Grants 289,788,000 291,115,000

(e) Health Care Grants - Other Assistance Summary by Fund General 4,905,000 5,278,000 Health Care Access 750,000 750,000

[GRANT FOR PHYSICIAN RESIDENT TRAINING.] Of this appropriation, $25,000 each year is to a nursing facility in the city of Waseca to continue a training program for University of Minnesota medical school physician residents.

(f) Prescription Drug Program 10,625,000 12,705,000

[PRESCRIPTION DRUG ASSISTANCE PROGRAM.] Of the appropriation for the prescription drug program under Minnesota Statutes, section 256.955, $300,000 each year is for the commissioner to establish and administer the prescription drug assistance program through the Minnesota board on aging under Minnesota Statutes, section 256.975, subdivision 9. Any federal match earned on these activities is dedicated to the prescription drug program.

[REBATE REVENUE RECAPTURE.] Any funds received by the state from a drug manufacturer due to errors in the pharmaceutical pricing used by the manufacturer in determining the prescription drug rebate are appropriated to the commissioner to augment funding of the prescription drug program established in Minnesota Statutes, section 256.955. Subd. 7. Health Care Management Summary by Fund General 24,833,000 24,376,000 Health Care Access 14,179,000 14,179,000

The amounts that may be spent from this appropriation for each purpose are as follows:

(a) Health Care Policy Administration Summary by Fund General 5,349,000 5,400,000 Health Care Access 846,000 846,000

[MINNESOTACARE OUTREACH REIMBURSEMENT.] Federal administrative reimbursement resulting from MinnesotaCare outreach is appropriated to the commissioner for this activity.

[MINNESOTA SENIOR HEALTH OPTIONS REIMBURSEMENT.] Federal administrative reimbursement resulting from the Minnesota senior health options project is appropriated to the commissioner for this activity.

[UTILIZATION REVIEW.] Federal administrative reimbursement resulting from prior authorization and inpatient admission certification by a professional review organization shall be dedicated to the commissioner for these purposes. A portion of these funds must be used for activities to decrease unnecessary pharmaceutical costs in medical assistance. (b) Health Care Options Summary by Fund General 19,484,000 18,976,000 Health Care Access 13,333,000 13,333,000

[PREPAID MEDICAL PROGRAMS.] For all counties in which the PMAP program has been operating for 12 or more months, state funding for the nonfederal share of prepaid medical assistance program administration costs for county managed care advocacy and enrollment operations is eliminated. State funding will continue for these activities for counties and tribes establishing new PMAP programs for a maximum of 16 months (four months prior to beginning PMAP enrollment and through the first 12 months of their PMAP program operation). Those counties operating PMAP programs for less than 12 months can continue to receive state funding for advocacy and enrollment activities through their first year of operation. Subd. 8. State-operated Services 195,162,000 186,775,000

[MITIGATION RELATED TO STATE-OPERATED SERVICES RESTRUCTURING.] Money appropriated to finance mitigation expenses related to restructuring state-operated services programs and administrative services may be transferred between fiscal years within the biennium.

[STATE-OPERATED SERVICES RESTRUCTURING.] For purposes of restructuring state-operated services, any state-operated services employee whose position is to be eliminated shall be afforded the options provided in applicable collective bargaining agreements. All salary and mitigation allocations from fiscal year 2004 shall be carried forward into fiscal year 2005. Provided there is no conflict with any collective bargaining agreement, any state-operated services position reduction must only be accomplished through mitigation, attrition, transfer, and other measures as provided in state or applicable collective bargaining agreements and in Minnesota Statutes, section 252.50, subdivision 11, and not through layoff.

[REPAIRS AND BETTERMENTS.] The commissioner may transfer unencumbered appropriation balances between fiscal years within the biennium for the state residential facilities repairs and betterments account and special equipment.

[NAMES REQUIRED ON MONUMENTS.] (a) Of this appropriation, $100,000 in fiscal year 2004 is to the commissioner for grants to community-based or statewide organizations for the purpose of purchasing and placing cemetery grave markers or memorial monuments that include the available names of individuals at cemeteries located at regional treatment centers operated or formerly operated by the commissioner. Individual monuments shall not be placed if the family of the deceased resident objects to the placement of the monument.

(b) To be eligible for a grant, a community-based or statewide organization must include members of local service or charitable organizations, members of the business community, persons with mental illness or developmental disabilities, and, to the extent possible, family members of deceased residents of the regional treatment center and present or former employees of the regional treatment center sites.

(c) Any unexpended portion of the appropriation shall not cancel, but shall be available in fiscal year 2005 for these purposes.

[ONETIME REDUCTION TO DEDICATED REVENUES.] (a) For fiscal year 2003 only, the commissioner shall transfer $4,700,000 of state-operated services fund balances from the accounts indicated to the general fund as follows:

(1) $3,200,000 from traumatic brain injury enterprises;

(2) $1,000,000 from lease income; and

(3) $500,000 from ICF/MR depreciation.

(b) Paragraph (a) is effective the day following final enactment. Subd. 9. Continuing Care Grants Summary by Fund General 1,581,064,000 1,533,298,000 Lottery Prize Fund 1,308,000 1,308,000

The amounts that may be spent from this appropriation for each purpose are as follows: (a) Community Social Services 55,700,000 55,700,000 (b) Aging and Adult Service Grants 13,361,000 14,129,000

[AREA AGENCY ON AGING GRANTS.] Of this appropriation, $391,000 each year is for seniors agenda for independent living grants to three nonprofit area agencies on aging to be used to match federal Older American Act grants. (c) Deaf and Hard-of-hearing Service Grants 1,725,000 1,498,000 (d) Mental Health Grants Summary by Fund General 53,909,000 35,002,000 Lottery Prize Fund 1,308,000 1,308,000

[RESTRUCTURING OF ADULT MENTAL HEALTH SERVICES.] The commissioner may make transfers that do not increase the state share of costs to effectively implement the restructuring of adult mental health services.

[MENTAL HEALTH COUNSELING FOR FARM FAMILIES.] Of the general fund appropriation, $150,000 in fiscal year 2004 is to the commissioner to be transferred to the board of trustees of the Minnesota state colleges and universities for mental health counseling support to farm families and business operators to be provided through the farm business management program at Central Lakes college and Ridgewater college. This appropriation is available until June 30, 2005. (e) Community Support Grants 11,725,000 8,794,000

[CENTERS FOR INDEPENDENT LIVING STUDY.] The commissioner of human services, in consultation with the commissioner of economic security, the centers for independent living, and consumer representatives, shall study the financing of the centers for independent living authorized under Minnesota Statutes, section 268A.11, and make recommendations on options to maximize federal financial participation. Study components shall include:

(1) the demographics of individuals served by the centers for independent living;

(2) the range of services the centers for independent living provide to these individuals;

(3) other publicly funded services received by individuals supported by the centers; and

(4) strategies for maximizing federal financial participation for eligible activities carried out by centers for independent living.

The commissioner shall report with fiscal and programmatic recommendations to the chairs of the appropriate house of representatives and senate finance and policy committees by January 15, 2004. (f) Medical Assistance Long-term Care Waivers and Home Care Grants 665,124,000 698,676,000

[REDUCE GROWTH IN MR/RC WAIVER.] The commissioner shall reduce the growth in the MR/RC waiver by not allocating the 300 additional diversion allocations that are included in the February 2003 forecast for the fiscal years that begin on July 1, 2003, and July 1, 2004.

[MANAGE THE GROWTH IN THE TBI WAIVER.] During the fiscal years beginning on July 1, 2003, and July 1, 2004, the commissioner shall allocate money for home and community-based programs covered under Minnesota Statutes, section 256B.49, to ensure a reduction in state spending that is equivalent to limiting the caseload growth of the TBI waiver to 150 in each year of the biennium. Priorities for the allocation of funds shall be for individuals anticipated to be discharged from institutional settings or who are at imminent risk of a placement in an institutional setting.

[TARGETED CASE MANAGEMENT FOR HOME CARE RECIPIENTS.] Implementation of the targeted case management benefit for home care recipients, according to Minnesota Statutes, section 256B.0621, subdivisions 2, 3, 5, 6, 7, 9, and 10, will be delayed until July 1, 2005.

[COMMON SERVICE MENU.] Implementation of the common service menu option within the home and community-based waivers, according to Minnesota Statutes, section 256B.49, subdivision 16, will be delayed until July 1, 2005. (g) Medical Assistance Long-term Care Facilities Grants 545,401,000 503,602,000

[CASH FLOW LOANS.] Of this appropriation, $2,000,000 in fiscal year 2004 is for interest-free cash flow loans to nursing facilities adversely affected by Minnesota Statutes, section 256B.431, subdivision 2t. Loans under this paragraph must be repaid upon the receipt of Medicare reimbursements for bad debt reported as a result of subdivision 2t, or by June 30, 2004, whichever occurs first. (h) Alternative Care Grants 83,270,000 77,359,000

[ALTERNATIVE CARE TRANSFER.] Any money allocated to the alternative care program that is not spent for the purposes indicated does not cancel but shall be transferred to the medical assistance account.

[ALTERNATIVE CARE APPROPRIATION.] The commissioner may expend the money appropriated for the alternative care program for that purpose in either year of the biennium.

[ALTERNATIVE CARE IMPLEMENTATION OF CHANGES TO ELIGIBILITY.] Changes to Minnesota Statutes, section 256B.0913, subdivision 4, paragraph (d), and subdivision 12, are effective July 1, 2003, for all persons found eligible for the alternative care program on or after July 1, 2003. All recipients of alternative care funding as of June 30, 2003, shall be subject to Minnesota Statutes, section 256B.0913, subdivision 4, paragraph (d), and subdivision 12, on the annual reassessment and review of their eligibility after July 1, 2003, but no later than January 1, 2004.

(i) Group Residential Housing Grants 95,096,000 81,625,000

[GROUP RESIDENTIAL HOUSING COSTS REFINANCED.] Effective July 1, 2004, the commissioner shall increase the home and community-based service rates and county allocations provided to programs established under section 1915(c) of the Social Security Act to the extent that these programs will be paying for the costs above the rate established in Minnesota Statutes, section 256I.05, subdivision 1. (j) Chemical Dependency Entitlement Grants 49,673,000 50,848,000

(k) Chemical Dependency Nonentitlement Grants 6,080,000 6,065,000 Subd. 10. Continuing Care Management Summary by Fund General 21,374,000 21,114,000 State Government Special Revenue 119,000 119,000 Lottery Prize Fund 148,000 148,000

Subd. 11. Economic Support Grants Summary by Fund General 139,832,000 122,511,000 Federal TANF 196,911,000 203,548,000

The amounts that may be spent from this appropriation for each purpose are as follows:

(a) Minnesota Family Investment Program Summary by Fund General 64,138,000 45,212,000 Federal TANF 152,428,000 159,500,000

(b) Work Grants Summary by Fund General 9,440,000 9,440,000 Federal TANF 44,223,000 43,788,000

[SUPPORTED WORK.] (a) $3,065,000 is appropriated from the TANF fund to the commissioner for the fiscal year ending July 30, 2005, for allocation to counties and tribes that submit a plan that describes the county's supported work program under Minnesota Statutes, section 256J.425, subdivision 4, paragraph (b), clause (5), and provides the number of individuals to be served in the supported work program. This appropriation shall become part of base level funding for the biennium beginning July 1, 2005.

(b) Counties and tribes that submit a supported work plan that is approved by the commissioner shall receive an allocation based on the average proportion of the MFIP case-load that has received MFIP assistance for 48 out of the last 60 months, as sampled on March 31, June 30, September 30, and December 31 of the previous calendar year, less the number of child only cases and cases where all the caregivers are age 60 or over, provided the county documents the need for supported work. Two-parent cases, with the exception of those with a caregiver age 60 or over, will be multiplied by a factor of two.

(c) Economic Support Grants - Other Assistance 4,372,000 4,700,000

[SUPPORTIVE HOUSING.] Of the general fund appropriation, $600,000 each year is to provide services to families who are participating in the supportive housing and managed care pilot project under Minnesota Statutes, section 256K.25. This appropriation shall not become part of base level funding for the biennium beginning July 1, 2005. (d) Child Support Enforcement Grants Summary by Fund General 4,139,000 4,139,000 TANF 260,000 260,000 (e) General Assistance Grants 27,095,000 26,969,000

[GENERAL ASSISTANCE STANDARD.] The commissioner shall set the monthly standard of assistance for general assistance units consisting of an adult recipient who is childless and unmarried or living apart from parents or a legal guardian at $203. The commissioner may reduce this amount according to Laws 1997, chapter 85, article 3, section 54. (f) Minnesota Supplemental Aid Grants 30,398,000 31,801,000 (g) Refugee Services Grants 250,000 250,000 Subd. 12. Economic Support Management Summary by Fund General 38,755,000 39,167,000 Health Care Access 1,349,000 1,349,000 Federal TANF 368,000 368,000

The amounts that may be spent from this appropriation for each purpose are as follows: (a) Economic Support Policy Administration Summary by Fund General 5,224,000 5,451,000 Federal TANF 368,000 368,000 (b) Economic Support Operations Summary by Fund General 33,531,000 33,716,000 Health Care Access 1,349,000 1,349,000

[ELECTRONIC BENEFIT TRANSFER TRANSACTION COSTS.] Notwithstanding the provisions of Laws 1998, chapter 407, article 6, section 116, the commissioner shall not reimburse retailers for electronic benefit transfer transaction costs.

[CHILD SUPPORT PAYMENT CENTER.] Payments to the commissioner from other governmental units, private enterprises, and individuals for services performed by the child support payment center must be deposited in the state systems account authorized under Minnesota Statutes, section 256.014. These payments are appropriated to the commissioner for the operation of the child support payment center or system, according to Minnesota Statutes, section 256.014.

[FINANCIAL INSTITUTION DATA MATCH AND PAYMENT OF FEES.] The commissioner is authorized to allocate up to $310,000 each year in fiscal year 2004 and fiscal year 2005 from the PRISM special revenue account to make payments to financial institutions in exchange for performing data matches between account information held by financial institutions and the public authority's database of child support obligors as authorized by Minnesota Statutes, section 13B.06, subdivision 7. Sec. 3. COMMISSIONER OF CHILDREN, FAMILIES, AND LEARNING

[APPROPRIATIONS.] The sums indicated in this section are appropriated from the general fund to the department of children, families, and learning for the fiscal years designated. Subdivision 1. Total Appropriation 131,093,000 131,562,000

[TRANSFER OF RESERVES.] On July 1, 2003, the commissioner of finance shall transfer $6,000,000 of the contingency reserve within the employee insurance trust fund maintained under Minnesota Statutes, section 43A.30, subdivision 6, to the general fund. Subd. 2. Child Care Programs 122,315,000 123,284,000 (a) Basic Sliding Fee Child Care 42,528,000 41,774,000 (b) MFIP Child Care 78,247,000 79,970,000 (c) Child Care Program Integrity 175,000 175,000 (d) Child Care Development 1,365,000 1,365,000 Subd. 3. Self-Sufficiency and Long-Life Learning 8,778,000 8,278,000 (a) Minnesota Economic Opportunity Grants 7,000,000 7,000,000 (b) Food Shelf Programs 1,278,000 1,278,000 (c) Family Assets for Independents 500,000 -0- Sec. 4. COMMISSIONER OF HEALTH Subdivision 1. Total Appropriation 120,499,000 119,916,000 Summary by Fund General 81,346,000 81,026,000 State Government Special Revenue 32,880,000 32,617,000 Health Care Access 6,273,000 6,273,000 Subd. 2. Health Improvement Summary by Fund General 65,788,000 65,528,000 State Government Special Revenue 1,987,000 1,987,000 Health Care Access 3,510,000 3,510,000

[TOBACCO PREVENTION ENDOWMENT FUND TRANSFERS.] (a) On July 1, 2003, the commissioner of finance shall transfer $7,400,000 from the tobacco use prevention and local public health endowment expendable trust fund to the general fund.

(b) Notwithstanding Minnesota Statutes, section 16A.62, any remaining unexpended balance in the fund after the transfer in paragraph (a) shall be transferred to the miscellaneous special revenue fund and dedicated to the commissioner of health for a youth tobacco prevention program. These funds are available until expended.

[TRANSFER OF ENDOWMENT FUNDS.] On July 1, 2003, the commissioner of finance shall transfer the tobacco use prevention and local public health endowment fund and the medical education endowment fund to the general fund.

[TOBACCO USE PREVENTION AND PUBLIC HEALTH GRANTS.] (a) Of the general fund appropriation, $7,500,000 each year is for the following purposes:

(1) $3,750,000 each year is for local tobacco prevention grants under Minnesota Statutes, section 144.396, subdivision 6; and

(2) $3,750,000 each year is for distribution under Minnesota Statutes, section 144.396, subdivision 7, for local public health promotion and protection activities.

(b) Of the amount appropriated under paragraph (a), the commissioner may retain up to $150,000 each year for administrative costs.

[FETAL ALCOHOL SPECTRUM DISORDER APPROPRIATION TRANSFER.] The general fund appropriation for fetal alcohol spectrum disorder for fiscal year 2004 and fiscal year 2005 shall be transferred to the Minnesota organization on fetal alcohol syndrome for prevention and intervention services and programs, including, but not limited to, community grants, professional education, and public awareness. The organization may retain five percent of the transferred money for administrative costs. The organization shall report to the commissioner of health annually by January 15 on the services and programs funded by the appropriation. Subd. 3. Health Quality and Access Summary by Fund General 1,017,000 1,017,000 State Government Special Revenue 8,888,000 8,888,000 Health Care Access 2,763,000 2,763,000

[STATE GOVERNMENT SPECIAL REVENUE FUND TRANSFERS.] On July 1, 2003, the commissioner of finance shall transfer $3,000,000 from the state government special revenue fund to the general fund. Subd. 4. Health Protection Summary by Fund General 9,309,000 9,309,000 State Government Special Revenue 22,005,000 21,742,000

[HIV/STI EDUCATION.] Of the general fund appropriation, $150,000 may be transferred to the commissioner of children, families and learning for regional training sites for HIV/STI education in schools established under Laws 1997, First Special Session chapter 4, article 6, section 18, and to implement Minnesota Statutes, section 121A.23, subdivision 1. Funds may support three of the existing regional sites selected in a manner to achieve geographic balance. This appropriation is available until June 30, 2005. Subd. 5. Management and Support Services 5,232,000 5,226,000 Sec. 5. VETERANS NURSING HOMES BOARD 30,030,000 30,030,000

[VETERANS HOMES SPECIAL REVENUE ACCOUNT.] The general fund appropriations made to the board may be transferred to a veterans homes special revenue account in the special revenue fund in the same manner as other receipts are deposited according to Minnesota Statutes, section 198.34, and are appropriated to the board for the operation of board facilities and programs. Sec. 6. HEALTH-RELATED BOARDS Subdivision 1. Total Appropriation 11,378,000 11,298,000 Summary by Fund General 11,314,000 11,298,000 HCAF 64,000 -0-

[STATE GOVERNMENT SPECIAL REVENUE FUND.] The appropriations in this section are from the state government special revenue fund, except where noted.

[NO SPENDING IN EXCESS OF REVENUES.] The commissioner of finance shall not permit the allotment, encumbrance, or expenditure of money appropriated in this section in excess of the anticipated biennial revenues or accumulated surplus revenues from fees collected by the boards. Neither this provision nor Minnesota Statutes, section 214.06, applies to transfers from the general contingent account.

[STATE GOVERNMENT SPECIAL REVENUE FUND TRANSFERS.] On July 1, 2003, the commissioner of finance shall transfer $7,500,000 from the state government special revenue fund to the general fund. Subd. 2. Board of Chiropractic Examiners 384,000 384,000

[CONTESTED CASE EXPENSES.] In fiscal year 2003, $70,000 in state government special revenue funds is transferred from Laws 2001, chapter 10, article 1, section 33, to the board of chiropractic examiners to pay for contested case activity. These funds are available until September 30, 2003. Subd. 3. Board of Dentistry Summary by Fund State Government Special Revenue Fund 970,000 954,000 Health Care Access Fund 64,000 -0- Subd. 4. Board of Dietetic and Nutrition Practice 101,000 101,000 Subd. 5. Board of Marriage and Family Therapy 118,000 118,000 Subd. 6. Board of Medical Practice 3,498,000 3,498,000 Subd. 7. Board of Nursing 2,405,000 2,405,000 Subd. 8. Board of Nursing Home Administrators 198,000 198,000 Subd. 9. Board of Optometry 96,000 96,000 Subd. 10. Board of Pharmacy 1,386,000 1,386,000

[ADMINISTRATIVE SERVICES UNIT.] Of this appropriation, $359,000 the first year and $359,000 the second year are for the health boards administrative services unit. The administrative services unit may receive and expend reimbursements for services performed for other agencies. Subd. 11. Board of Physical Therapy 197,000 197,000 Subd. 12. Board of Podiatry 45,000 45,000 Subd. 13. Board of Psychology 680,000 680,000 Subd. 14. Board of Social Work 1,073,000 1,073,000 Subd. 15. Board of Veterinary Medicine 163,000 163,000 Sec. 7. EMERGENCY MEDICAL SERVICES REGULATORY BOARD Subdivision 1. Total Appropriation 2,772,000 2,772,000 Summary by Fund General 2,226,000 2,226,000 State Government Special Revenue 546,000 546,000

[HEALTH PROFESSIONAL SERVICES ACTIVITY.] $546,000 each year from the state government special revenue fund is for the health professional services activity.

[ROYALTY PAYMENTS DEDICATED TO BOARD.] Royalty payments from the sale of the Internet-based ambulance reporting program are appropriated to the board and shall remain available until expended. Notwithstanding section 14, this provision shall not expire.

[EMERGENCY MEDICAL SERVICES REGIONAL GRANTS.] Of this appropriation, $402,000 each year is for the purposes of Minnesota Statutes, section 144E.50.

[AMBULANCE TRAINING GRANT CARRYFORWARD AND TRANSFER.] (a) Effective for fiscal year 2003 and succeeding fiscal years, any unspent portion of the appropriation for ambulance training grants shall not cancel but shall carry forward and be used in the following fiscal year for the purposes of Minnesota Statutes, section 144E.50. The board shall not retain any portion of the appropriation carried forward for administrative costs.

(b) Notwithstanding section 14, this provision shall not expire.

(c) This provision is effective the day following final enactment. Sec. 8. COUNCIL ON DISABILITY 607,000 607,000 Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION 1,462,000 1,462,000 Sec. 10. OMBUDSMAN FOR FAMILIES 245,000 245,000

Sec. 11. new text begin TRANSFERS. new text end

new text begin Subdivision 1. new text end [GRANTS.] new text begin The commissioner of human services, with the approval of the commissioner of finance, and after notification of the chair of the senate health, human services and corrections budget division and the chair of the house health and human services finance committee, may transfer unencumbered appropriation balances for the biennium ending June 30, 2005, within fiscal years among the MFIP, general assistance, general assistance medical care, medical assistance, Minnesota supplemental aid, and group residential housing programs, and the entitlement portion of the chemical dependency consolidated treatment fund, and between fiscal years of the biennium. new text end

new text begin Subd. 2. new text end [ADMINISTRATION.] new text begin Positions, salary money, and nonsalary administrative money may be transferred within the departments of human services and health and within the programs operated by the veterans nursing homes board as the commissioners and the board consider necessary, with the advance approval of the commissioner of finance. The commissioner or the board shall inform the chairs of the house health and human services finance committee and the senate health, human services and corrections budget division quarterly about transfers made under this provision. new text end

new text begin Subd. 3. new text end [PROHIBITED TRANSFERS.] new text begin Grant money shall not be transferred to operations within the departments of human services and health and within the programs operated by the veterans nursing homes board without the approval of the legislature. new text end

Sec. 12. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS. new text end

new text begin The commissioners of health and of human services shall not use indirect cost allocations to pay for the operational costs of any program for which they are responsible. new text end

Sec. 13. new text begin CARRYOVER LIMITATION. new text end

new text begin The appropriations in this article which are allowed to be carried forward from fiscal year 2004 to fiscal year 2005 shall not become part of the base level funding for the 2006-2007 biennial budget, unless specifically directed by the legislature. new text end

Sec. 14. new text begin SUNSET OF UNCODIFIED LANGUAGE. new text end

new text begin All uncodified language contained in this article expires on June 30, 2005, unless a different expiration date is explicit. new text end

Sec. 15. new text begin REPEALER. new text end

new text begin Laws 2002, chapter 374, article 9, section 8, is repealed effective upon final enactment. new text end

Sec. 16. new text begin EFFECTIVE DATE. new text end

new text begin The provisions in this article are effective July 1, 2003, unless a different effective date is specified. new text end

ARTICLE 13

HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS

Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]

The dollar amounts shown in the columns marked "APPROPRIATIONS" are added to or, if shown in parentheses, are subtracted from the appropriations in Laws 2001, First Special Session chapter 9, as amended by Laws 2002, chapter 220, and Laws 2002, chapter 374, and are appropriated from the general fund, or any other fund named, to the agencies and for the purposes specified in this article, to be available for the fiscal year indicated for each purpose. The figure "2003" used in this article means that the appropriation or appropriations listed under them are available for the fiscal year ending June 30, 2003. SUMMARY BY FUND 2003 General $103,756,000 Health Care Access (1,492,000) Federal TANF 20,419,000 APPROPRIATIONS Available for the Year Ending June 30, 2003 Sec. 2. COMMISSIONER OF HUMAN SERVICES Subdivision 1. Total Appropriation $128,203,000 Summary by Fund General 109,276,000 Health Care Access (1,492,000) Federal TANF 20,419,000 Subd. 2. Administrative Reimbursement/Pass-through 1,180,000 Subd. 3. Basic Health Care Grants General 59,364,000 Health Care Access (1,492,000)

The amounts that may be spent from this appropriation for each purpose are as follows:

(a) MinnesotaCare Grants Health Care Access (1,492,000)

(b) MA Basic Health Care Grants - Families and Children General 14,708,000

(c) MA Basic Health Care Grants - Elderly and Disabled General 15,137,000

(d) General Assistance Medical Care Grants General 29,519,000 Subd. 4. Continuing Care Grants General 56,615,000

The amounts that may be spent from this appropriation for each purpose are as follows:

(a) Medical Assistance Long-Term Care Waivers and Home Care Grants General 57,388,000

(b) Medical Assistance Long-Term Care Facilities Grants General 678,000

(c) Group Residential Housing Grants General (1,451,000) Subd. 5. Economic Support Grants General (6,703,000) Federal TANF 19,239,000

The amounts that may be spent from the appropriation for each purpose are as follows:

(a) Assistance to Families Grants General (9,306,000) Federal TANF 19,239,000

(b) General Assistance Grants General 3,491,000

(c) Minnesota Supplemental Aid Grants General (888,000) Sec. 3. COMMISSIONER OF HEALTH Subdivision 1. Total Appropriation (5,520,000) Summary by Fund General (5,520,000) Subd. 2. Access and Quality Improvement (5,520,000)

Sec. 4. new text begin EFFECTIVE DATE. new text end

new text begin Sections 1 to 3 are effective the day following final enactment. new text end

ARTICLE 14

DEPARTMENT OF HUMAN SERVICES HEALTH CARE POLICY AMENDMENTS

Section 1.

new text begin [144A.351] BALANCING LONG-TERM CARE: REPORT REQUIRED. new text end

new text begin The commissioners of health and human services, with the cooperation of counties and regional entities, shall prepare a report to the legislature by January 15, 2004, and biennially thereafter, regarding the status of the full range of long-term care services for the elderly in Minnesota. The report shall address: new text end

new text begin (1) demographics and need for long-term care in Minnesota; new text end

new text begin (2) summary of county and regional reports on long-term care gaps, surpluses, imbalances, and corrective action plans; new text end

new text begin (3) status of long-term care services by county and region including: new text end

new text begin (i) changes in availability of the range of long-term care services and housing options; new text end

new text begin (ii) access problems regarding long-term care; and new text end

new text begin (iii) comparative measures of long-term care availability and progress over time; and new text end

new text begin (4) recommendations regarding goals for the future of long-term care services, policy changes, and resource needs. new text end

Sec. 2.

Minnesota Statutes 2002, section 245A.035, subdivision 3, is amended to read:

Subd. 3.

Requirements for emergency license.

Before an emergency license may be issued, the following requirements must be met:

(1) the county agency must conduct an initial inspection of the premises where the foster care is to be provided to ensure the health and safety of any child placed in the home. The county agency shall conduct the inspection using a form developed by the commissioner;

(2) at the time of the inspection or placement, whichever is earlier, the relative being considered for an emergency license shall receive an application form for a child foster care license;

(3) whenever possible, prior to placing the child in the relative's home, the relative being considered for an emergency license shall provide the information required by section 245A.04, subdivision 3, paragraph deleted text begin (b) deleted text end new text begin (k) new text end ; and

(4) if the county determines, prior to the issuance of an emergency license, that anyone requiring a background study may be disqualified under section 245A.04, and the disqualification is one which the commissioner cannot set aside, an emergency license shall not be issued.

Sec. 3.

Minnesota Statutes 2002, section 245A.04, subdivision 3b, is amended to read:

Subd. 3b.

Reconsideration of disqualification.

(a) The individual who is the subject of the disqualification may request a reconsideration of the disqualification.

The individual must submit the request for reconsideration to the commissioner in writing. A request for reconsideration for an individual who has been sent a notice of disqualification under subdivision 3a, paragraph (b), clause (1) or (2), must be submitted within 30 calendar days of the disqualified individual's receipt of the notice of disqualification. Upon showing that the information in clause (1) or (2) cannot be obtained within 30 days, the disqualified individual may request additional time, not to exceed 30 days, to obtain that information. A request for reconsideration for an individual who has been sent a notice of disqualification under subdivision 3a, paragraph (b), clause (3), must be submitted within 15 calendar days of the disqualified individual's receipt of the notice of disqualification. An individual who was determined to have maltreated a child under section 626.556 or a vulnerable adult under section 626.557, and who was disqualified under this section on the basis of serious or recurring maltreatment, may request reconsideration of both the maltreatment and the disqualification determinations. The request for reconsideration of the maltreatment determination and the disqualification must be submitted within 30 calendar days of the individual's receipt of the notice of disqualification. Removal of a disqualified individual from direct contact shall be ordered if the individual does not request reconsideration within the prescribed time, and for an individual who submits a timely request for reconsideration, if the disqualification is not set aside. The individual must present information showing that:

(1) the information the commissioner relied upon in determining that the underlying conduct giving rise to the disqualification occurred, and for maltreatment, that the maltreatment was serious or recurring, is incorrect; or

(2) the subject of the study does not pose a risk of harm to any person served by the applicant, license holder, or registrant under section 144A.71, subdivision 1.

(b) The commissioner shall rescind the disqualification if the commissioner finds that the information relied on to disqualify the subject is incorrect. The commissioner may set aside the disqualification under this section if the commissioner finds that the individual does not pose a risk of harm to any person served by the applicant, license holder, or registrant under section 144A.71, subdivision 1. In determining that an individual does not pose a risk of harm, the commissioner shall consider the nature, severity, and consequences of the event or events that lead to disqualification, whether there is more than one disqualifying event, the age and vulnerability of the victim at the time of the event, the harm suffered by the victim, the similarity between the victim and persons served by the program, the time elapsed without a repeat of the same or similar event, documentation of successful completion by the individual studied of training or rehabilitation pertinent to the event, and any other information relevant to reconsideration. In reviewing a disqualification under this section, the commissioner shall give preeminent weight to the safety of each person to be served by the license holder, applicant, or registrant under section 144A.71, subdivision 1, over the interests of the license holder, applicant, or registrant under section 144A.71, subdivision 1.

(c) Unless the information the commissioner relied on in disqualifying an individual is incorrect, the commissioner may not set aside the disqualification of an individual in connection with a license to provide family day care for children, foster care for children in the provider's own home, or foster care or day care services for adults in the provider's own home if:

(1) less than ten years have passed since the discharge of the sentence imposed for the offense; and the individual has been convicted of a violation of any offense listed in sections 609.165 (felon ineligible to possess firearm), criminal vehicular homicide under 609.21 (criminal vehicular homicide and injury), 609.215 (aiding suicide or aiding attempted suicide), felony violations under 609.223 or 609.2231 (assault in the third or fourth degree), 609.713 (terroristic threats), 609.235 (use of drugs to injure or to facilitate crime), 609.24 (simple robbery), 609.255 (false imprisonment), 609.562 (arson in the second degree), 609.71 (riot), 609.498, subdivision 1 or deleted text begin 1a deleted text end new text begin 1b new text end (aggravated first degree or first degree tampering with a witness), burglary in the first or second degree under 609.582 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 609.67 (machine guns and short-barreled shotguns), 609.749, subdivision 2 (gross misdemeanor harassment; stalking), 152.021 or 152.022 (controlled substance crime in the first or second degree), 152.023, subdivision 1, clause (3) or (4), or subdivision 2, clause (4) (controlled substance crime in the third degree), 152.024, subdivision 1, clause (2), (3), or (4) (controlled substance crime in the fourth degree), 609.224, subdivision 2, paragraph (c) (fifth-degree assault by a caregiver against a vulnerable adult), 609.23 (mistreatment of persons confined), 609.231 (mistreatment of residents or patients), 609.2325 (criminal abuse of a vulnerable adult), 609.233 (criminal neglect of a vulnerable adult), 609.2335 (financial exploitation of a vulnerable adult), 609.234 (failure to report), 609.265 (abduction), 609.2664 to 609.2665 (manslaughter of an unborn child in the first or second degree), 609.267 to 609.2672 (assault of an unborn child in the first, second, or third degree), 609.268 (injury or death of an unborn child in the commission of a crime), 617.293 (disseminating or displaying harmful material to minors), a felony level conviction involving alcohol or drug use, a gross misdemeanor offense under 609.324, subdivision 1 (other prohibited acts), a gross misdemeanor offense under 609.378 (neglect or endangerment of a child), a gross misdemeanor offense under 609.377 (malicious punishment of a child), 609.72, subdivision 3 (disorderly conduct against a vulnerable adult); or an attempt or conspiracy to commit any of these offenses, as each of these offenses is defined in Minnesota Statutes; or an offense in any other state, the elements of which are substantially similar to the elements of any of the foregoing offenses;

(2) regardless of how much time has passed since the involuntary termination of parental rights under section 260C.301 or the discharge of the sentence imposed for the offense, the individual was convicted of a violation of any offense listed in sections 609.185 to 609.195 (murder in the first, second, or third degree), 609.20 (manslaughter in the first degree), 609.205 (manslaughter in the second degree), 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 (arson in the first degree), 609.749, subdivision 3, 4, or 5 (felony-level harassment; stalking), 609.228 (great bodily harm caused by distribution of drugs), 609.221 or 609.222 (assault in the first or second degree), 609.66, subdivision 1e (drive-by shooting), 609.855, subdivision 5 (shooting in or at a public transit vehicle or facility), 609.2661 to 609.2663 (murder of an unborn child in the first, second, or third degree), a felony offense under 609.377 (malicious punishment of a child), a felony offense under 609.324, subdivision 1 (other prohibited acts), a felony offense under 609.378 (neglect or endangerment of a child), 609.322 (solicitation, inducement, and promotion of prostitution), 609.342 to 609.345 (criminal sexual conduct in the first, second, third, or fourth degree), 609.352 (solicitation of children to engage in sexual conduct), 617.246 (use of minors in a sexual performance), 617.247 (possession of pictorial representations of a minor), 609.365 (incest), a felony offense under sections 609.2242 and 609.2243 (domestic assault), a felony offense of spousal abuse, a felony offense of child abuse or neglect, a felony offense of a crime against children, or an attempt or conspiracy to commit any of these offenses as defined in Minnesota Statutes, or an offense in any other state, the elements of which are substantially similar to any of the foregoing offenses;

(3) within the seven years preceding the study, the individual committed an act that constitutes maltreatment of a child under section 626.556, subdivision 10e, and that resulted in substantial bodily harm as defined in section 609.02, subdivision 7a, or substantial mental or emotional harm as supported by competent psychological or psychiatric evidence; or

(4) within the seven years preceding the study, the individual was determined under section 626.557 to be the perpetrator of a substantiated incident of maltreatment of a vulnerable adult that resulted in substantial bodily harm as defined in section 609.02, subdivision 7a, or substantial mental or emotional harm as supported by competent psychological or psychiatric evidence.

In the case of any ground for disqualification under clauses (1) to (4), if the act was committed by an individual other than the applicant, license holder, or registrant under section 144A.71, subdivision 1, residing in the applicant's or license holder's home, or the home of a registrant under section 144A.71, subdivision 1, the applicant, license holder, or registrant under section 144A.71, subdivision 1, may seek reconsideration when the individual who committed the act no longer resides in the home.

The disqualification periods provided under clauses (1), (3), and (4) are the minimum applicable disqualification periods. The commissioner may determine that an individual should continue to be disqualified from licensure or registration under section 144A.71, subdivision 1, because the license holder, applicant, or registrant under section 144A.71, subdivision 1, poses a risk of harm to a person served by that individual after the minimum disqualification period has passed.

(d) The commissioner shall respond in writing or by electronic transmission to all reconsideration requests for which the basis for the request is that the information relied upon by the commissioner to disqualify is incorrect or inaccurate within 30 working days of receipt of a request and all relevant information. If the basis for the request is that the individual does not pose a risk of harm, the commissioner shall respond to the request within 15 working days after receiving the request for reconsideration and all relevant information. If the request is based on both the correctness or accuracy of the information relied on to disqualify the individual and the risk of harm, the commissioner shall respond to the request within 45 working days after receiving the request for reconsideration and all relevant information. If the disqualification is set aside, the commissioner shall notify the applicant or license holder in writing or by electronic transmission of the decision.

(e) Except as provided in subdivision 3c, if a disqualification for which reconsideration was requested is not set aside or is not rescinded, an individual who was disqualified on the basis of a preponderance of evidence that the individual committed an act or acts that meet the definition of any of the crimes listed in subdivision 3d, paragraph (a), clauses (1) to (4); or for failure to make required reports under section 626.556, subdivision 3, or 626.557, subdivision 3, pursuant to subdivision 3d, paragraph (a), clause (4), may request a fair hearing under section 256.045. Except as provided under subdivision 3c, the fair hearing is the only administrative appeal of the final agency determination, specifically, including a challenge to the accuracy and completeness of data under section 13.04.

(f) Except as provided under subdivision 3c, if an individual was disqualified on the basis of a determination of maltreatment under section 626.556 or 626.557, which was serious or recurring, and the individual has requested reconsideration of the maltreatment determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and also requested reconsideration of the disqualification under this subdivision, reconsideration of the maltreatment determination and reconsideration of the disqualification shall be consolidated into a single reconsideration. For maltreatment and disqualification determinations made by county agencies, the consolidated reconsideration shall be conducted by the county agency. If the county agency has disqualified an individual on multiple bases, one of which is a county maltreatment determination for which the individual has a right to request reconsideration, the county shall conduct the reconsideration of all disqualifications. Except as provided under subdivision 3c, if an individual who was disqualified on the basis of serious or recurring maltreatment requests a fair hearing on the maltreatment determination under section 626.556, subdivision 10i, or 626.557, subdivision 9d, and requests a fair hearing on the disqualification, which has not been set aside or rescinded under this subdivision, the scope of the fair hearing under section 256.045 shall include the maltreatment determination and the disqualification. Except as provided under subdivision 3c, a fair hearing is the only administrative appeal of the final agency determination, specifically, including a challenge to the accuracy and completeness of data under section 13.04.

(g) In the notice from the commissioner that a disqualification has been set aside, the license holder must be informed that information about the nature of the disqualification and which factors under paragraph (b) were the bases of the decision to set aside the disqualification is available to the license holder upon request without consent of the background study subject. With the written consent of a background study subject, the commissioner may release to the license holder copies of all information related to the background study subject's disqualification and the commissioner's decision to set aside the disqualification as specified in the written consent.

Sec. 4.

Minnesota Statutes 2002, section 245A.04, subdivision 3d, is amended to read:

Subd. 3d.

Disqualification.

(a) Upon receipt of information showing, or when a background study completed under subdivision 3 shows any of the following: a conviction of one or more crimes listed in clauses (1) to (4); the individual has admitted to or a preponderance of the evidence indicates the individual has committed an act or acts that meet the definition of any of the crimes listed in clauses (1) to (4); or an investigation results in an administrative determination listed under clause (4), the individual shall be disqualified from any position allowing direct contact with persons receiving services from the license holder, entity identified in subdivision 3, paragraph (a), or registrant under section 144A.71, subdivision 1, and for individuals studied under section 245A.04, subdivision 3, paragraph (c), clauses (2), (6), and (7), the individual shall also be disqualified from access to a person receiving services from the license holder:

(1) regardless of how much time has passed since the involuntary termination of parental rights under section 260C.301 or the discharge of the sentence imposed for the offense, and unless otherwise specified, regardless of the level of the conviction, the individual was convicted of any of the following offenses: sections 609.185 (murder in the first degree); 609.19 (murder in the second degree); 609.195 (murder in the third degree); 609.2661 (murder of an unborn child in the first degree); 609.2662 (murder of an unborn child in the second degree); 609.2663 (murder of an unborn child in the third degree); 609.20 (manslaughter in the first degree); 609.205 (manslaughter in the second degree); 609.221 or 609.222 (assault in the first or second degree); 609.228 (great bodily harm caused by distribution of drugs); 609.245 (aggravated robbery); 609.25 (kidnapping); 609.561 (arson in the first degree); 609.749, subdivision 3, 4, or 5 (felony-level harassment; stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, subdivision 5 (shooting at or in a public transit vehicle or facility); 609.322 (solicitation, inducement, and promotion of prostitution); 609.342 (criminal sexual conduct in the first degree); 609.343 (criminal sexual conduct in the second degree); 609.344 (criminal sexual conduct in the third degree); 609.345 (criminal sexual conduct in the fourth degree); 609.352 (solicitation of children to engage in sexual conduct); 609.365 (incest); felony offense under 609.377 (malicious punishment of a child); a felony offense under 609.378 (neglect or endangerment of a child); a felony offense under 609.324, subdivision 1 (other prohibited acts); 617.246 (use of minors in sexual performance prohibited); 617.247 (possession of pictorial representations of minors); a felony offense under sections 609.2242 and 609.2243 (domestic assault), a felony offense of spousal abuse, a felony offense of child abuse or neglect, a felony offense of a crime against children; or attempt or conspiracy to commit any of these offenses as defined in Minnesota Statutes, or an offense in any other state or country, where the elements are substantially similar to any of the offenses listed in this clause;

(2) if less than 15 years have passed since the discharge of the sentence imposed for the offense; and the individual has received a felony conviction for a violation of any of these offenses: sections 609.21 (criminal vehicular homicide and injury); 609.165 (felon ineligible to possess firearm); 609.215 (suicide); 609.223 or 609.2231 (assault in the third or fourth degree); repeat offenses under 609.224 (assault in the fifth degree); repeat offenses under 609.3451 (criminal sexual conduct in the fifth degree); 609.498, subdivision 1 or deleted text begin 1a deleted text end new text begin 1b new text end (aggravated first degree or first degree tampering with a witness); 609.713 (terroristic threats); 609.235 (use of drugs to injure or facilitate crime); 609.24 (simple robbery); 609.255 (false imprisonment); 609.562 (arson in the second degree); 609.563 (arson in the third degree); repeat offenses under 617.23 (indecent exposure; penalties); repeat offenses under 617.241 (obscene materials and performances; distribution and exhibition prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 609.67 (machine guns and short-barreled shotguns); 609.2325 (criminal abuse of a vulnerable adult); 609.2664 (manslaughter of an unborn child in the first degree); 609.2665 (manslaughter of an unborn child in the second degree); 609.267 (assault of an unborn child in the first degree); 609.2671 (assault of an unborn child in the second degree); 609.268 (injury or death of an unborn child in the commission of a crime); 609.52 (theft); 609.2335 (financial exploitation of a vulnerable adult); 609.521 (possession of shoplifting gear); 609.582 (burglary); 609.625 (aggravated forgery); 609.63 (forgery); 609.631 (check forgery; offering a forged check); 609.635 (obtaining signature by false pretense); 609.27 (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 260C.301 (grounds for termination of parental rights); chapter 152 (drugs; controlled substance); and a felony level conviction involving alcohol or drug use. An attempt or conspiracy to commit any of these offenses, as each of these offenses is defined in Minnesota Statutes; or an offense in any other state or country, the elements of which are substantially similar to the elements of the offenses in this clause. If the individual studied is convicted of one of the felonies listed in this clause, but the sentence is a gross misdemeanor or misdemeanor disposition, the lookback period for the conviction is the period applicable to the disposition, that is the period for gross misdemeanors or misdemeanors;

(3) if less than ten years have passed since the discharge of the sentence imposed for the offense; and the individual has received a gross misdemeanor conviction for a violation of any of the following offenses: sections 609.224 (assault in the fifth degree); 609.2242 and 609.2243 (domestic assault); violation of an order for protection under 518B.01, subdivision 14; 609.3451 (criminal sexual conduct in the fifth degree); repeat offenses under 609.746 (interference with privacy); repeat offenses under 617.23 (indecent exposure); 617.241 (obscene materials and performances); 617.243 (indecent literature, distribution); 617.293 (harmful materials; dissemination and display to minors prohibited); 609.71 (riot); 609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; stalking); 609.224, subdivision 2, paragraph (c) (assault in the fifth degree by a caregiver against a vulnerable adult); 609.23 (mistreatment of persons confined); 609.231 (mistreatment of residents or patients); 609.2325 (criminal abuse of a vulnerable adult); 609.233 (criminal neglect of a vulnerable adult); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report maltreatment of a vulnerable adult); 609.72, subdivision 3 (disorderly conduct against a vulnerable adult); 609.265 (abduction); 609.378 (neglect or endangerment of a child); 609.377 (malicious punishment of a child); 609.324, subdivision 1a (other prohibited acts; minor engaged in prostitution); 609.33 (disorderly house); 609.52 (theft); 609.582 (burglary); 609.631 (check forgery; offering a forged check); 609.275 (attempt to coerce); or an attempt or conspiracy to commit any of these offenses, as each of these offenses is defined in Minnesota Statutes; or an offense in any other state or country, the elements of which are substantially similar to the elements of any of the offenses listed in this clause. If the defendant is convicted of one of the gross misdemeanors listed in this clause, but the sentence is a misdemeanor disposition, the lookback period for the conviction is the period applicable to misdemeanors; or

(4) if less than seven years have passed since the discharge of the sentence imposed for the offense; and the individual has received a misdemeanor conviction for a violation of any of the following offenses: sections 609.224 (assault in the fifth degree); 609.2242 (domestic assault); violation of an order for protection under 518B.01 (Domestic Abuse Act); violation of an order for protection under 609.3232 (protective order authorized; procedures; penalties); 609.746 (interference with privacy); 609.79 (obscene or harassing phone calls); 609.795 (letter, telegram, or package; opening; harassment); 617.23 (indecent exposure; penalties); 609.2672 (assault of an unborn child in the third degree); 617.293 (harmful materials; dissemination and display to minors prohibited); 609.66 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial exploitation of a vulnerable adult); 609.234 (failure to report maltreatment of a vulnerable adult); 609.52 (theft); 609.27 (coercion); or an attempt or conspiracy to commit any of these offenses, as each of these offenses is defined in Minnesota Statutes; or an offense in any other state or country, the elements of which are substantially similar to the elements of any of the offenses listed in this clause; a determination or disposition of failure to make required reports under section 626.556, subdivision 3, or 626.557, subdivision 3, for incidents in which: (i) the final disposition under section 626.556 or 626.557 was substantiated maltreatment, and (ii) the maltreatment was recurring or serious; or a determination or disposition of substantiated serious or recurring maltreatment of a minor under section 626.556 or of a vulnerable adult under section 626.557 for which there is a preponderance of evidence that the maltreatment occurred, and that the subject was responsible for the maltreatment.

For the purposes of this section, "serious maltreatment" means sexual abuse; maltreatment resulting in death; or maltreatment resulting in serious injury which reasonably requires the care of a physician whether or not the care of a physician was sought; or abuse resulting in serious injury. For purposes of this section, "abuse resulting in serious injury" means: bruises, bites, skin laceration or tissue damage; fractures; dislocations; evidence of internal injuries; head injuries with loss of consciousness; extensive second-degree or third-degree burns and other burns for which complications are present; extensive second-degree or third-degree frostbite, and others for which complications are present; irreversible mobility or avulsion of teeth; injuries to the eyeball; ingestion of foreign substances and objects that are harmful; near drowning; and heat exhaustion or sunstroke. For purposes of this section, "care of a physician" is treatment received or ordered by a physician, but does not include diagnostic testing, assessment, or observation. For the purposes of this section, "recurring maltreatment" means more than one incident of maltreatment for which there is a preponderance of evidence that the maltreatment occurred, and that the subject was responsible for the maltreatment. For purposes of this section, "access" means physical access to an individual receiving services or the individual's personal property without continuous, direct supervision as defined in section 245A.04, subdivision 3.

(b) Except for background studies related to child foster care, adult foster care, or family child care licensure, when the subject of a background study is regulated by a health-related licensing board as defined in chapter 214, and the regulated person has been determined to have been responsible for substantiated maltreatment under section 626.556 or 626.557, instead of the commissioner making a decision regarding disqualification, the board shall make a determination whether to impose disciplinary or corrective action under chapter 214.

(1) The commissioner shall notify the health-related licensing board:

(i) upon completion of a background study that produces a record showing that the individual was determined to have been responsible for substantiated maltreatment;

(ii) upon the commissioner's completion of an investigation that determined the individual was responsible for substantiated maltreatment; or

(iii) upon receipt from another agency of a finding of substantiated maltreatment for which the individual was responsible.

(2) The commissioner's notice shall indicate whether the individual would have been disqualified by the commissioner for the substantiated maltreatment if the individual were not regulated by the board. The commissioner shall concurrently send this notice to the individual.

(3) Notwithstanding the exclusion from this subdivision for individuals who provide child foster care, adult foster care, or family child care, when the commissioner or a local agency has reason to believe that the direct contact services provided by the individual may fall within the jurisdiction of a health-related licensing board, a referral shall be made to the board as provided in this section.

(4) If, upon review of the information provided by the commissioner, a health-related licensing board informs the commissioner that the board does not have jurisdiction to take disciplinary or corrective action, the commissioner shall make the appropriate disqualification decision regarding the individual as otherwise provided in this chapter.

(5) The commissioner has the authority to monitor the facility's compliance with any requirements that the health-related licensing board places on regulated persons practicing in a facility either during the period pending a final decision on a disciplinary or corrective action or as a result of a disciplinary or corrective action. The commissioner has the authority to order the immediate removal of a regulated person from direct contact or access when a board issues an order of temporary suspension based on a determination that the regulated person poses an immediate risk of harm to persons receiving services in a licensed facility.

(6) A facility that allows a regulated person to provide direct contact services while not complying with the requirements imposed by the health-related licensing board is subject to action by the commissioner as specified under sections 245A.06 and 245A.07.

(7) The commissioner shall notify a health-related licensing board immediately upon receipt of knowledge of noncompliance with requirements placed on a facility or upon a person regulated by the board.

Sec. 5.

Minnesota Statutes 2002, section 256B.056, subdivision 6, is amended to read:

Subd. 6.

Assignment of benefits.

To be eligible for medical assistance a person must have applied or must agree to apply all proceeds received or receivable by the person or the person's deleted text begin spouse deleted text end new text begin legal representative new text end from any third deleted text begin person deleted text end new text begin party new text end liable for the costs of medical care deleted text begin for the person, the spouse, and children deleted text end . deleted text begin The state agency shall require from any applicant or recipient of medical assistance the assignment of any rights to medical support and third party payments. deleted text end new text begin By accepting or receiving assistance, the person is deemed to have assigned the person's rights to medical support and third party payments as required by Title 19 of the Social Security Act. new text end Persons must cooperate with the state in establishing paternity and obtaining third party payments. By deleted text begin signing an application for deleted text end new text begin accepting new text end medical assistance, a person assigns to the department of human services all rights the person may have to medical support or payments for medical expenses from any other person or entity on their own or their dependent's behalf and agrees to cooperate with the state in establishing paternity and obtaining third party payments. Any rights or amounts so assigned shall be applied against the cost of medical care paid for under this chapter. Any assignment takes effect upon the determination that the applicant is eligible for medical assistance and up to three months prior to the date of application if the applicant is determined eligible for and receives medical assistance benefits. The application must contain a statement explaining this assignment. deleted text begin Any assignment shall not be effective as to benefits paid or provided under automobile accident coverage and private health care coverage prior to notification of the assignment by the person or organization providing the benefits. deleted text end new text begin For the purposes of this section, "the department of human services or the state" includes prepaid health plans under contract with the commissioner according to sections 256B.031, 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; children's mental health collaboratives under section 245.493; demonstration projects for persons with disabilities under section 256B.77; nursing facilities under the alternative payment demonstration project under section 256B.434; and the county-based purchasing entities under section 256B.692. new text end

Sec. 6.

Minnesota Statutes 2002, section 256B.057, subdivision 10, is amended to read:

Subd. 10.

Certain persons needing treatment for breast or cervical cancer.

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

(1) has been screened for breast or cervical cancer by the Minnesota breast and cervical cancer control program, and program funds have been used to pay for the person's screening;

(2) according to the person's treating health professional, needs treatment, including diagnostic services necessary to determine the extent and proper course of treatment, for breast or cervical cancer, including precancerous conditions and early stage cancer;

(3) meets the income eligibility guidelines for the Minnesota breast and cervical cancer control program;

(4) is under age 65;

(5) is not otherwise eligible for medical assistance under United States Code, title 42, section 1396(a)(10)(A)(i); and

(6) is not otherwise covered under creditable coverage, as defined under United States Code, title 42, section deleted text begin 300gg(c) deleted text end new text begin 1396a(aa) new text end .

(b) Medical assistance provided for an eligible person under this subdivision shall be limited to services provided during the period that the person receives treatment for breast or cervical cancer.

(c) A person meeting the criteria in paragraph (a) is eligible for medical assistance without meeting the eligibility criteria relating to income and assets in section 256B.056, subdivisions 1a to 5b.

Sec. 7.

Minnesota Statutes 2002, section 256B.064, subdivision 2, is amended to read:

Subd. 2.

Imposition of monetary recovery and sanctions.

(a) The commissioner shall determine any monetary amounts to be recovered and sanctions to be imposed upon a vendor of medical care under this section. Except as provided in deleted text begin paragraph deleted text end new text begin paragraphs new text end (b) new text begin and (d) new text end , neither a monetary recovery nor a sanction will be imposed by the commissioner without prior notice and an opportunity for a hearing, according to chapter 14, on the commissioner's proposed action, provided that the commissioner may suspend or reduce payment to a vendor of medical care, except a nursing home or convalescent care facility, after notice and prior to the hearing if in the commissioner's opinion that action is necessary to protect the public welfare and the interests of the program.

(b) Except for a nursing home or convalescent care facility, the commissioner may withhold or reduce payments to a vendor of medical care without providing advance notice of such withholding or reduction if either of the following occurs:

(1) the vendor is convicted of a crime involving the conduct described in subdivision 1a; or

(2) the commissioner receives reliable evidence of fraud or willful misrepresentation by the vendor.

(c) The commissioner must send notice of the withholding or reduction of payments under paragraph (b) within five days of taking such action. The notice must:

(1) state that payments are being withheld according to paragraph (b);

(2) except in the case of a conviction for conduct described in subdivision 1a, state that the withholding is for a temporary period and cite the circumstances under which withholding will be terminated;

(3) identify the types of claims to which the withholding applies; and

(4) inform the vendor of the right to submit written evidence for consideration by the commissioner.

The withholding or reduction of payments will not continue after the commissioner determines there is insufficient evidence of fraud or willful misrepresentation by the vendor, or after legal proceedings relating to the alleged fraud or willful misrepresentation are completed, unless the commissioner has sent notice of intention to impose monetary recovery or sanctions under paragraph (a).

(d) new text begin The commissioner may suspend or terminate a vendor's participation in the program without providing advance notice and an opportunity for a hearing when the suspension or termination is required because of the vendor's exclusion from participation in Medicare. Within five days of taking such action, the commissioner must send notice of the suspension or termination. The notice must: new text end

new text begin (1) state that suspension or termination is the result of the vendor's exclusion from Medicare; new text end

new text begin (2) identify the effective date of the suspension or termination; new text end

new text begin (3) inform the vendor of the need to be reinstated to Medicare before reapplying for participation in the program; and new text end

new text begin (4) inform the vendor of the right to submit written evidence for consideration by the commissioner. new text end

new text begin (e) new text end Upon receipt of a notice under paragraph (a) that a monetary recovery or sanction is to be imposed, a vendor may request a contested case, as defined in section 14.02, subdivision 3, by filing with the commissioner a written request of appeal. The appeal request must be received by the commissioner no later than 30 days after the date the notification of monetary recovery or sanction was mailed to the vendor. The appeal request must specify:

(1) each disputed item, the reason for the dispute, and an estimate of the dollar amount involved for each disputed item;

(2) the computation that the vendor believes is correct;

(3) the authority in statute or rule upon which the vendor relies for each disputed item;

(4) the name and address of the person or entity with whom contacts may be made regarding the appeal; and

(5) other information required by the commissioner.

Sec. 8.

Minnesota Statutes 2002, section 256B.437, subdivision 2, is amended to read:

Subd. 2.

Planning and development of community-based services.

(a) The commissioner of human services shall establish a process to adjust the capacity and distribution of long-term care services to equalize the supply and demand for different types of services. This process must include community planning, expansion or establishment of needed services, and analysis of voluntary nursing facility closures.

(b) The purpose of this process is to support the planning and development of community-based services. This process must support early intervention, advocacy, and consumer protection while providing resources and incentives for expanded county planning and for nursing facilities to transition to meet community needs.

(c) The process shall support and facilitate expansion of community-based services under the county-administered alternative care program under section 256B.0913 and waivers for elderly under section 256B.0915, including, but not limited to, the development of supportive services such as housing and transportation. The process shall utilize community assessments and planning developed for the community health services plan and plan update and for the community social services act plan, and other relevant information.

(d) The commissioners of health and human services, as appropriate, shall provide, by July 15, 2001, available data necessary for the county, including, but not limited to, data on nursing facility bed distribution, housing with services options, the closure of nursing facilities that occur outside of the planned closure process, and approval of planned closures in the county and contiguous counties.

(e) Each county shall submit to the commissioner of human services, by October 15, 2001, a gaps analysis that identifies local service needs, pending development of services, and any other issues that would contribute to or impede further development of community-based services. The gaps analysis must also be sent to the local area agency on aging and, if applicable, local SAIL projects, for review and comment. The review and comment must assess needs across county boundaries. The area agencies on aging and SAIL projects must provide the commissioner and the counties with their review and analyses by November 15, 2001.

(f) The addendum to the biennial plan shall be submitted biennially, beginning December 31, 2001, and every other year thereafter in accordance with the Community Social Services Act plan timeline, and shall include recommendations for development of community-based services. Area agencies on aging and SAIL projects must provide the commissioner and the counties with their review and analyses within 60 days following the Community Social Services Act plan submission date. Both planning and implementation shall be implemented within the amount of funding made available to the county board for these purposes.

(g) The plan, within the funding allocated, shall:

(1) include the gaps analysis required by paragraph (e);

(2) involve providers, consumers, cities, townships, businesses, and area agencies on aging in the planning process;

(3) address the availability of alternative care and elderly waiver services for eligible recipients;

(4) address the development of other supportive services, such as transit, housing, and workforce and economic development; and

(5) estimate the cost and timelines for development.

(h) The biennial plan addendum shall be coordinated with the county mental health plan for inclusion in the community health services plan and included as an addendum to the community social services plan.

(i) The county board having financial responsibility for persons present in another county shall cooperate with that county for planning and development of services.

(j) The county board shall cooperate in planning and development of community-based services with other counties, as necessary, and coordinate planning for long-term care services that involve more than one county, within the funding allocated for these purposes.

deleted text begin (k) The commissioners of health and human services, in cooperation with county boards, shall report biennially to the legislature, beginning February 1, 2002, regarding the development of community-based services, transition or closure of nursing facilities, and specific gaps in services in identified geographic areas that may require additional resources or flexibility, as documented by the process in this subdivision. deleted text end

Sec. 9.

Minnesota Statutes 2002, section 256B.76, is amended to read:

256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.

(a) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common procedural coding system codes titled "office and other outpatient services," "preventive medicine new and established patient," "delivery, antepartum, and postpartum care," "critical care," cesarean delivery and pharmacologic management provided to psychiatric patients, and level three codes for enhanced services for prenatal high risk, shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992. If the rate on any procedure code within these categories is different than the rate that would have been paid under the methodology in section 256B.74, subdivision 2, then the larger rate shall be paid;

(2) payments for all other services shall be paid at the lower of (i) submitted charges, or (ii) 15.4 percent above the rate in effect on June 30, 1992;

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases except that payment rates for home health agency services shall be the rates in effect on September 30, 1992;

(4) effective for services rendered on or after January 1, 2000, payment rates for physician and professional services shall be increased by three percent over the rates in effect on December 31, 1999, except for home health agency and family planning agency services; and

(5) the increases in clause (4) shall be implemented January 1, 2000, for managed care.

(b) Effective for services rendered on or after October 1, 1992, the commissioner shall make payments for dental services as follows:

(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;

(2) dental rates shall be converted from the 50th percentile of 1982 to the 50th percentile of 1989, less the percent in aggregate necessary to equal the above increases;

(3) effective for services rendered on or after January 1, 2000, payment rates for dental services shall be increased by three percent over the rates in effect on December 31, 1999;

(4) the commissioner shall award grants to community clinics or other nonprofit community organizations, political subdivisions, professional associations, or other organizations that demonstrate the ability to provide dental services effectively to public program recipients. Grants may be used to fund the costs related to coordinating access for recipients, developing and implementing patient care criteria, upgrading or establishing new facilities, acquiring furnishings or equipment, recruiting new providers, or other development costs that will improve access to dental care in a region. In awarding grants, the commissioner shall give priority to applicants that plan to serve areas of the state in which the number of dental providers is not currently sufficient to meet the needs of recipients of public programs or uninsured individuals. The commissioner shall consider the following in awarding the grants:

(i) potential to successfully increase access to an underserved population;

(ii) the ability to raise matching funds;

(iii) the long-term viability of the project to improve access beyond the period of initial funding;

(iv) the efficiency in the use of the funding; and

(v) the experience of the proposers in providing services to the target population.

The commissioner shall monitor the grants and may terminate a grant if the grantee does not increase dental access for public program recipients. The commissioner shall consider grants for the following:

(i) implementation of new programs or continued expansion of current access programs that have demonstrated success in providing dental services in underserved areas;

(ii) a pilot program for utilizing hygienists outside of a traditional dental office to provide dental hygiene services; and

(iii) a program that organizes a network of volunteer dentists, establishes a system to refer eligible individuals to volunteer dentists, and through that network provides donated dental care services to public program recipients or uninsured individuals;

(5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;

(6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000, for managed care; and

(7) effective for services provided on or after January 1, 2002, payment for diagnostic examinations and dental x-rays provided to children under age 21 shall be the lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.

(c) Effective for dental services rendered on or after January 1, 2002, the commissioner may, within the limits of available appropriation, increase reimbursements to dentists and dental clinics deemed by the commissioner to be critical access dental providers. Reimbursement to a critical access dental provider may be increased by not more than 50 percent above the reimbursement rate that would otherwise be paid to the provider. Payments to health plan companies shall be adjusted to reflect increased reimbursements to critical access dental providers as approved by the commissioner. In determining which dentists and dental clinics shall be deemed critical access dental providers, the commissioner shall review:

(1) the utilization rate in the service area in which the dentist or dental clinic operates for dental services to patients covered by medical assistance, general assistance medical care, or MinnesotaCare as their primary source of coverage;

(2) the level of services provided by the dentist or dental clinic to patients covered by medical assistance, general assistance medical care, or MinnesotaCare as their primary source of coverage; and

(3) whether the level of services provided by the dentist or dental clinic is critical to maintaining adequate levels of patient access within the service area.

In the absence of a critical access dental provider in a service area, the commissioner may designate a dentist or dental clinic as a critical access dental provider if the dentist or dental clinic is willing to provide care to patients covered by medical assistance, general assistance medical care, or MinnesotaCare at a level which significantly increases access to dental care in the service area.

(d) deleted text begin Effective July 1, 2001, the medical assistance rates for outpatient mental health services provided by an entity that operates: deleted text end

deleted text begin (1) a Medicare-certified comprehensive outpatient rehabilitation facility; and deleted text end

deleted text begin (2) a facility that was certified prior to January 1, 1993, with at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year who are medical assistance recipients, will be increased by 38 percent, when those services are provided within the comprehensive outpatient rehabilitation facility and provided to residents of nursing facilities owned by the entity. deleted text end

deleted text begin (e) deleted text end An entity that operates both a Medicare certified comprehensive outpatient rehabilitation facility and a facility which was certified prior to January 1, 1993, that is licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year are medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation services at rates that are 38 percent greater than the maximum reimbursement rate allowed under paragraph (a), clause (2), when those services are (1) provided within the comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing facilities owned by the entity.

Sec. 10.

Minnesota Statutes 2002, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

new text begin (a) new text end Effective for services rendered on or after July 1, 2001, payment for medication management provided to psychiatric patients, outpatient mental health services, day treatment services, home-based mental health services, and family community support services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of 1999 charges.

new text begin (b) Effective July 1, 2001, the medical assistance rates for outpatient mental health services provided by an entity that operates: (1) a Medicare-certified comprehensive outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993, with at least 33 percent of the clients receiving rehabilitation services in the most recent calendar year who are medical assistance recipients, will be increased by 38 percent, when those services are provided within the comprehensive outpatient rehabilitation facility and provided to residents of nursing facilities owned by the entity. new text end

Sec. 11.

Minnesota Statutes 2002, section 256D.03, subdivision 3a, is amended to read:

Subd. 3a.

Claims; assignment of benefits.

Claims must be filed pursuant to section 256D.16. General assistance medical care applicants and recipients must apply or agree to apply third party health and accident benefits to the costs of medical care. They must cooperate with the state in establishing paternity and obtaining third party payments. By deleted text begin signing an application for deleted text end new text begin accepting new text end general assistance, a person assigns to the department of human services all rights to medical support or payments for medical expenses from another person or entity on their own or their dependent's behalf and agrees to cooperate with the state in establishing paternity and obtaining third party payments. The application shall contain a statement explaining the assignment. Any rights or amounts assigned shall be applied against the cost of medical care paid for under this chapter. An assignment is effective on the date general assistance medical care eligibility takes effect. deleted text begin The assignment shall not affect benefits paid or provided under automobile accident coverage and private health care coverage until the person or organization providing the benefits has received notice of the assignment. deleted text end

Sec. 12.

Minnesota Statutes 2002, section 256L.12, subdivision 6, is amended to read:

Subd. 6.

Copayments and benefit limits.

Enrollees are responsible for all copayments in section 256L.03, subdivision deleted text begin 4 deleted text end new text begin 5 new text end , and shall pay copayments to the managed care plan or to its participating providers. The enrollee is also responsible for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit.

Sec. 13.

Minnesota Statutes 2002, section 260C.141, subdivision 2, is amended to read:

Subd. 2.

Review of foster care status.

The social services agency responsible for the placement of a child in a residential facility, as defined in section 260C.212, subdivision 1, pursuant to a voluntary release by the child's parent or parents must proceed in juvenile court to review the foster care status of the child in the manner provided in this section.

(a) Except for a child in placement due solely to the child's developmental disability or emotional disturbance, when a child continues in voluntary placement according to section 260C.212, subdivision 8, a petition shall be filed alleging the child to be in need of protection or services or seeking termination of parental rights or other permanent placement of the child away from the parent within 90 days of the date of the voluntary placement agreement. The petition shall state the reasons why the child is in placement, the progress on the out-of-home placement plan required under section 260C.212, subdivision 1, and the statutory basis for the petition under section 260C.007, subdivision 6, 260C.201, subdivision 11, or 260C.301.

(1) In the case of a petition alleging the child to be in need of protection or services filed under this paragraph, if all parties agree and the court finds it is in the best interests of the child, the court may find the petition states a prima facie case that:

(i) the child's needs are being met;

(ii) the placement of the child in foster care is in the best interests of the child;

(iii) reasonable efforts to reunify the child and the parent or guardian are being made; and

(iv) the child will be returned home in the next three months.

(2) If the court makes findings under paragraph (1), the court shall approve the voluntary arrangement and continue the matter for up to three more months to ensure the child returns to the parents' home. The responsible social services agency shall:

(i) report to the court when the child returns home and the progress made by the parent on the out-of-home placement plan required under section 260C.212, in which case the court shall dismiss jurisdiction;

(ii) report to the court that the child has not returned home, in which case the matter shall be returned to the court for further proceedings under section 260C.163; or

(iii) if any party does not agree to continue the matter under paragraph (1) and this paragraph, the matter shall proceed under section 260C.163.

(b) In the case of a child in voluntary placement due solely to the child's developmental disability or emotional disturbance according to section 260C.212, subdivision 9, the following procedures apply:

(1) [REPORT TO COURT.] (i) Unless the county attorney determines that a petition under subdivision 1 is appropriate, without filing a petition, a written report shall be forwarded to the court within 165 days of the date of the voluntary placement agreement. The written report shall contain necessary identifying information for the court to proceed, a copy of the out-of-home placement plan required under section 260C.212, subdivision 1, a written summary of the proceedings of any administrative review required under section 260C.212, subdivision 7, and any other information the responsible social services agency, parent or guardian, the child or the foster parent or other residential facility wants the court to consider.

(ii) The responsible social services agency, where appropriate, must advise the child, parent or guardian, the foster parent, or representative of the residential facility of the requirements of this section and of their right to submit information to the court. If the child, parent or guardian, foster parent, or representative of the residential facility wants to send information to the court, the responsible social services agency shall advise those persons of the reporting date and the identifying information necessary for the court administrator to accept the information and submit it to a judge with the agency's report. The responsible social services agency must also notify those persons that they have the right to be heard in person by the court and how to exercise that right. The responsible social services agency must also provide notice that an in-court hearing will not be held unless requested by a parent or guardian, foster parent, or the child.

(iii) After receiving the required report, the court has jurisdiction to make the following determinations and must do so within ten days of receiving the forwarded report: (A) whether or not the placement of the child is in the child's best interests; and (B) whether the parent and agency are appropriately planning for the child. Unless requested by a parent or guardian, foster parent, or child, no in-court hearing need be held in order for the court to make findings and issue an order under this paragraph.

(iv) If the court finds the placement is in the child's best interests and that the agency and parent are appropriately planning for the child, the court shall issue an order containing explicit, individualized findings to support its determination. The court shall send a copy of the order to the county attorney, the responsible social services agency, the parent or guardian, the child, and the foster parents. The court shall also send the parent or guardian, the child, and the foster parent notice of the required review under clause (2).

(v) If the court finds continuing the placement not to be in the child's best interests or that the agency or the parent or guardian is not appropriately planning for the child, the court shall notify the county attorney, the responsible social services agency, the parent or guardian, the foster parent, the child, and the county attorney of the court's determinations and the basis for the court's determinations.

(2) [PERMANENCY REVIEW BY PETITION.] If a child with a developmental disability or an emotional disturbance continues in out-of-home placement for 13 months from the date of a voluntary placement, a petition alleging the child to be in need of protection or services, for termination of parental rights, or for permanent placement of the child away from the parent under section 260C.201 shall be filed. The court shall conduct a permanency hearing on the petition no later than 14 months after the date of the voluntary placement. At the permanency hearing, the court shall determine the need for an order permanently placing the child away from the parent or determine whether there are compelling reasons that continued voluntary placement is in the child's best interests. A petition alleging the child to be in need of protection or services shall state the date of the voluntary placement agreement, the nature of the child's developmental disability or emotional disturbance, the plan for the ongoing care of the child, the parents' participation in the plan, new text begin the responsible social services agency's efforts to finalize a plan for the permanent placement of the child, new text end and the statutory basis for the petition.

(i) If a petition alleging the child to be in need of protection or services is filed under this paragraph, the court may find, based on the contents of the sworn petition, and the agreement of all parties, including the child, where appropriate, that there are compelling reasons that the voluntary arrangement is in the best interests of the child new text begin and that the responsible social services agency has made reasonable efforts to finalize a plan for the permanent placement of the child new text end , approve the continued voluntary placement, and continue the matter under the court's jurisdiction for the purpose of reviewing the child's placement as a continued voluntary arrangement every 12 months as long as the child continues in out-of-home placement. The matter must be returned to the court for further review every 12 months as long as the child remains in placement. The court shall give notice to the parent or guardian of the continued review requirements under this section. Nothing in this paragraph shall be construed to mean the court must order permanent placement for the child under section 260C.201, subdivision 11, as long as the court finds compelling reasons at the first review required under this section.

(ii) If a petition for termination of parental rights, for transfer of permanent legal and physical custody to a relative, for long-term foster care, or for foster care for a specified period of time is filed, the court must proceed under section 260C.201, subdivision 11.

(3) If any party, including the child, disagrees with the voluntary arrangement, the court shall proceed under section 260C.163.

Sec. 14. new text begin REPORT ON LONG-TERM CARE. new text end

new text begin The report on long-term care services required under Minnesota Statutes, section 144A.351, that is presented to the legislature by January 15, 2004, must also address strategies for increasing the purchase of long-term care insurance and the feasibility of offering government or private sector loans or lines of credit to individuals age 65 and over, for the purchase of long-term care services. new text end

Sec. 15. new text begin REPEALER. new text end

new text begin (a) Minnesota Statutes 2002, sections 62J.66; 62J.68; 144A.071, subdivision 5; and 144A.35, are repealed. new text end

new text begin (b) Laws 1998, chapter 407, article 4, section 63, is repealed. new text end

new text begin (c) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 9505.3700, are repealed effective July 1, 2003. new text end

ARTICLE 15

CHILD SUPPORT FEDERAL COMPLIANCE

Section 1.

Minnesota Statutes 2002, section 13.69, subdivision 1, is amended to read:

Subdivision 1.

Classifications.

(a) The following government data of the department of public safety are private data:

(1) medical data on driving instructors, licensed drivers, and applicants for parking certificates and special license plates issued to physically handicapped persons;

(2) other data on holders of a disability certificate under section 169.345, except that data that are not medical data may be released to law enforcement agencies;

(3) social security numbers in driver's license and motor vehicle registration records, except that social security numbers must be provided to the department of revenue for purposes of tax administration deleted text begin and deleted text end new text begin , new text end the department of labor and industry for purposes of workers' compensation administration and enforcement new text begin , and the department of natural resources for purposes of license application administration new text end ; and

(4) data on persons listed as standby or temporary custodians under section 171.07, subdivision 11, except that the data must be released to:

(i) law enforcement agencies for the purpose of verifying that an individual is a designated caregiver; or

(ii) law enforcement agencies who state that the license holder is unable to communicate at that time and that the information is necessary for notifying the designated caregiver of the need to care for a child of the license holder.

(b) The following government data of the department of public safety are confidential data: data concerning an individual's driving ability when that data is received from a member of the individual's family.

Sec. 2.

new text begin [97A.482] LICENSE APPLICATIONS; COLLECTION OF SOCIAL SECURITY NUMBERS. new text end

new text begin (a) All individual noncommercial game and fish license applications under chapters 97A, 97B, and 97C, must include the applicant's social security number. If the applicant does not have a social security number, the applicant must certify that the applicant does not have a social security number. new text end

new text begin (b) The social security numbers of individuals collected by the commissioner through game and fish license applications are private data under section 13.49, subdivision 1, and must be provided by the commissioner to the department of human services for the purpose of child support enforcement. The collection of social security numbers from game and fish license applications for the purpose of child support enforcement is required by section 466(a)(13) of the Social Security Act, United States Code, title 42, section 666(a)(13). new text end

Sec. 3.

Minnesota Statutes 2002, section 171.06, subdivision 3, is amended to read:

Subd. 3.

Contents of application; other information.

(a) An application must:

(1) state the full name, date of birth, sex, and residence address of the applicant;

(2) as may be required by the commissioner, contain a description of the applicant and any other facts pertaining to the applicant, the applicant's driving privileges, and the applicant's ability to operate a motor vehicle with safety;

(3) deleted text begin for a class C, class B, or class A driver's license, deleted text end state new text begin : new text end

new text begin (i) new text end the applicant's social security number deleted text begin or, for a class D driver's license, have a space for the applicant's social security number and state that providing the number is optional, or otherwise convey that the applicant is not required to enter the social security number deleted text end new text begin ; or new text end

new text begin (ii) if the applicant does not have a social security number and is applying for a Minnesota identification card, instruction permit, or class D provisional or driver's license, that the applicant certifies that the applicant does not have a social security number new text end ;

(4) contain a space where the applicant may indicate a desire to make an anatomical gift according to paragraph (b); and

(5) contain a notification to the applicant of the availability of a living will/health care directive designation on the license under section 171.07, subdivision 7.

(b) If the applicant does not indicate a desire to make an anatomical gift when the application is made, the applicant must be offered a donor document in accordance with section 171.07, subdivision 5. The application must contain statements sufficient to comply with the requirements of the Uniform Anatomical Gift Act (1987), sections 525.921 to 525.9224, so that execution of the application or donor document will make the anatomical gift as provided in section 171.07, subdivision 5, for those indicating a desire to make an anatomical gift. The application must be accompanied by information describing Minnesota laws regarding anatomical gifts and the need for and benefits of anatomical gifts, and the legal implications of making an anatomical gift, including the law governing revocation of anatomical gifts. The commissioner shall distribute a notice that must accompany all applications for and renewals of a driver's license or Minnesota identification card. The notice must be prepared in conjunction with a Minnesota organ procurement organization that is certified by the federal Department of Health and Human Services and must include:

(1) a statement that provides a fair and reasonable description of the organ donation process, the care of the donor body after death, and the importance of informing family members of the donation decision; and

(2) a telephone number in a certified Minnesota organ procurement organization that may be called with respect to questions regarding anatomical gifts.

(c) The application must be accompanied also by information containing relevant facts relating to:

(1) the effect of alcohol on driving ability;

(2) the effect of mixing alcohol with drugs;

(3) the laws of Minnesota relating to operation of a motor vehicle while under the influence of alcohol or a controlled substance; and

(4) the levels of alcohol-related fatalities and accidents in Minnesota and of arrests for alcohol-related violations.

Sec. 4.

Minnesota Statutes 2002, section 171.07, is amended by adding a subdivision to read:

new text begin Subd. 14. new text end

new text begin Use of social security number. new text end

new text begin An applicant's social security number must not be displayed, encrypted, or encoded on the driver's license or Minnesota identification card or included in a magnetic strip or bar code used to store data on the license or Minnesota identification card. new text end

Sec. 5.

Minnesota Statutes 2002, section 518.551, subdivision 12, is amended to read:

Subd. 12.

Occupational license suspension.

(a) Upon motion of an obligee, if the court finds that the obligor is or may be licensed by a licensing board listed in section 214.01 or other state, county, or municipal agency or board that issues an occupational license and the obligor is in arrears in court-ordered child support or maintenance payments or both in an amount equal to or greater than three times the obligor's total monthly support and maintenance payments and is not in compliance with a written payment agreement pursuant to section 518.553 that is approved by the court, a child support magistrate, or the public authority, the court shall direct the licensing board or other licensing agency to suspend the license under section 214.101. The court's order must be stayed for 90 days in order to allow the obligor to execute a written payment agreement pursuant to section 518.553. The payment agreement must be approved by either the court or the public authority responsible for child support enforcement. If the obligor has not executed or is not in compliance with a written payment agreement pursuant to section 518.553 after the 90 days expires, the court's order becomes effective. If the obligor is a licensed attorney, the court shall report the matter to the lawyers professional responsibility board for appropriate action in accordance with the rules of professional conduct. The remedy under this subdivision is in addition to any other enforcement remedy available to the court.

(b) If a public authority responsible for child support enforcement finds that the obligor is or may be licensed by a licensing board listed in section 214.01 or other state, county, or municipal agency or board that issues an occupational license and the obligor is in arrears in court-ordered child support or maintenance payments or both in an amount equal to or greater than three times the obligor's total monthly support and maintenance payments and is not in compliance with a written payment agreement pursuant to section 518.553 that is approved by the court, a child support magistrate, or the public authority, the court or the public authority shall direct the licensing board or other licensing agency to suspend the license under section 214.101. If the obligor is a licensed attorney, the public authority may report the matter to the lawyers professional responsibility board for appropriate action in accordance with the rules of professional conduct. The remedy under this subdivision is in addition to any other enforcement remedy available to the public authority.

(c) At least 90 days before notifying a licensing authority or the lawyers professional responsibility board under paragraph (b), the public authority shall mail a written notice to the license holder addressed to the license holder's last known address that the public authority intends to seek license suspension under this subdivision and that the license holder must request a hearing within 30 days in order to contest the suspension. If the license holder makes a written request for a hearing within 30 days of the date of the notice, a court hearing or a hearing under section 484.702 must be held. Notwithstanding any law to the contrary, the license holder must be served with 14 days' notice in writing specifying the time and place of the hearing and the allegations against the license holder. The notice may be served personally or by mail. If the public authority does not receive a request for a hearing within 30 days of the date of the notice, and the obligor does not execute a written payment agreement pursuant to section 518.553 that is approved by the public authority within 90 days of the date of the notice, the public authority shall direct the licensing board or other licensing agency to suspend the obligor's license under paragraph (b), or shall report the matter to the lawyers professional responsibility board.

(d) The public authority or the court shall notify the lawyers professional responsibility board for appropriate action in accordance with the rules of professional responsibility conduct or order the licensing board or licensing agency to suspend the license if the judge finds that:

(1) the person is licensed by a licensing board or other state agency that issues an occupational license;

(2) the person has not made full payment of arrearages found to be due by the public authority; and

(3) the person has not executed or is not in compliance with a payment plan approved by the court, a child support magistrate, or the public authority.

(e) Within 15 days of the date on which the obligor either makes full payment of arrearages found to be due by the court or public authority or executes and initiates good faith compliance with a written payment plan approved by the court, a child support magistrate, or the public authority, the court, a child support magistrate, or the public authority responsible for child support enforcement shall notify the licensing board or licensing agency or the lawyers professional responsibility board that the obligor is no longer ineligible for license issuance, reinstatement, or renewal under this subdivision.

(f) In addition to the criteria established under this section for the suspension of an obligor's occupational license, a court, a child support magistrate, or the public authority may direct the licensing board or other licensing agency to suspend the license of a party who has failed, after receiving notice, to comply with a subpoena relating to a paternity or child support proceeding. Notice to an obligor of intent to suspend must be served by first class mail at the obligor's last known address. The notice must inform the obligor of the right to request a hearing. If the obligor makes a written request within ten days of the date of the hearing, a hearing must be held. At the hearing, the only issues to be considered are mistake of fact and whether the obligor received the subpoena.

(g) The license of an obligor who fails to remain in compliance with an approved new text begin written new text end payment agreement may be suspended. deleted text begin Notice to the obligor of an intent to suspend under this paragraph must be served by first class mail at the obligor's last known address and must include a notice of hearing. The notice must be served upon the obligor not less than ten days before the date of the hearing. deleted text end new text begin Prior to suspending a license for noncompliance with an approved written payment agreement, the public authority must mail to the obligor's last known address a written notice that (1) the public authority intends to seek suspension of the obligor's occupational license under this paragraph, and (2) the obligor must request a hearing, within 30 days of the date of the notice, to contest the suspension. If, within 30 days of the date of the notice, the public authority does not receive a written request for a hearing and the obligor does not comply with an approved written payment agreement, the public authority must direct the licensing board or other licensing agency to suspend the obligor's license under paragraph (b), and, if the obligor is a licensed attorney, must report the matter to the lawyers professional responsibility board. If the obligor makes a written request for a hearing within 30 days of the date of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the obligor must be served with 14 days' notice in writing specifying the time and place of the hearing and the allegations against the obligor. The notice may be served personally or by mail to the obligor's last known address. new text end If the obligor appears at the hearing and the deleted text begin judge deleted text end new text begin court new text end determines that the obligor has failed to comply with an approved new text begin written new text end payment agreement, the deleted text begin judge shall deleted text end new text begin court or public authority must new text end notify the occupational licensing board or new text begin other licensing new text end agency to suspend the obligor's license under paragraph deleted text begin (c) deleted text end new text begin (b) and, if the obligor is a licensed attorney, must report the matter to the lawyers professional responsibility board new text end . If the obligor fails to appear at the hearing, the deleted text begin public authority may deleted text end new text begin court or public authority must new text end notify the occupational deleted text begin or deleted text end licensing board new text begin or other licensing agency new text end to suspend the obligor's license under paragraph deleted text begin (c) deleted text end new text begin (b), and if the obligor is a licensed attorney, must report the matter to the lawyers professional responsibility board new text end .

Sec. 6.

Minnesota Statutes 2002, section 518.551, subdivision 13, is amended to read:

Subd. 13.

Driver's license suspension.

(a) Upon motion of an obligee, which has been properly served on the obligor and upon which there has been an opportunity for hearing, if a court finds that the obligor has been or may be issued a driver's license by the commissioner of public safety and the obligor is in arrears in court-ordered child support or maintenance payments, or both, in an amount equal to or greater than three times the obligor's total monthly support and maintenance payments and is not in compliance with a written payment agreement pursuant to section 518.553 that is approved by the court, a child support magistrate, or the public authority, the court shall order the commissioner of public safety to suspend the obligor's driver's license. The court's order must be stayed for 90 days in order to allow the obligor to execute a written payment agreement pursuant to section 518.553. The payment agreement must be approved by either the court or the public authority responsible for child support enforcement. If the obligor has not executed or is not in compliance with a written payment agreement pursuant to section 518.553 after the 90 days expires, the court's order becomes effective and the commissioner of public safety shall suspend the obligor's driver's license. The remedy under this subdivision is in addition to any other enforcement remedy available to the court. An obligee may not bring a motion under this paragraph within 12 months of a denial of a previous motion under this paragraph.

(b) If a public authority responsible for child support enforcement determines that the obligor has been or may be issued a driver's license by the commissioner of public safety and the obligor is in arrears in court-ordered child support or maintenance payments or both in an amount equal to or greater than three times the obligor's total monthly support and maintenance payments and not in compliance with a written payment agreement pursuant to section 518.553 that is approved by the court, a child support magistrate, or the public authority, the public authority shall direct the commissioner of public safety to suspend the obligor's driver's license. The remedy under this subdivision is in addition to any other enforcement remedy available to the public authority.

(c) At least 90 days prior to notifying the commissioner of public safety according to paragraph (b), the public authority must mail a written notice to the obligor at the obligor's last known address, that it intends to seek suspension of the obligor's driver's license and that the obligor must request a hearing within 30 days in order to contest the suspension. If the obligor makes a written request for a hearing within 30 days of the date of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the obligor must be served with 14 days' notice in writing specifying the time and place of the hearing and the allegations against the obligor. The notice must include information that apprises the obligor of the requirement to develop a written payment agreement that is approved by a court, a child support magistrate, or the public authority responsible for child support enforcement regarding child support, maintenance, and any arrearages in order to avoid license suspension. The notice may be served personally or by mail. If the public authority does not receive a request for a hearing within 30 days of the date of the notice, and the obligor does not execute a written payment agreement pursuant to section 518.553 that is approved by the public authority within 90 days of the date of the notice, the public authority shall direct the commissioner of public safety to suspend the obligor's driver's license under paragraph (b).

(d) At a hearing requested by the obligor under paragraph (c), and on finding that the obligor is in arrears in court-ordered child support or maintenance payments or both in an amount equal to or greater than three times the obligor's total monthly support and maintenance payments, the district court or child support magistrate shall order the commissioner of public safety to suspend the obligor's driver's license or operating privileges unless the court or child support magistrate determines that the obligor has executed and is in compliance with a written payment agreement pursuant to section 518.553 that is approved by the court, a child support magistrate, or the public authority.

(e) An obligor whose driver's license or operating privileges are suspended may:

(1) provide proof to the public authority responsible for child support enforcement that the obligor is in compliance with all written payment agreements pursuant to section 518.553;

(2) bring a motion for reinstatement of the driver's license. At the hearing, if the court or child support magistrate orders reinstatement of the driver's license, the court or child support magistrate must establish a written payment agreement pursuant to section 518.553; or

(3) seek a limited license under section 171.30. A limited license issued to an obligor under section 171.30 expires 90 days after the date it is issued.

Within 15 days of the receipt of that proof or a court order, the public authority shall inform the commissioner of public safety that the obligor's driver's license or operating privileges should no longer be suspended.

(f) On January 15, 1997, and every two years after that, the commissioner of human services shall submit a report to the legislature that identifies the following information relevant to the implementation of this section:

(1) the number of child support obligors notified of an intent to suspend a driver's license;

(2) the amount collected in payments from the child support obligors notified of an intent to suspend a driver's license;

(3) the number of cases paid in full and payment agreements executed in response to notification of an intent to suspend a driver's license;

(4) the number of cases in which there has been notification and no payments or payment agreements;

(5) the number of driver's licenses suspended;

(6) the cost of implementation and operation of the requirements of this section; and

(7) the number of limited licenses issued and number of cases in which payment agreements are executed and cases are paid in full following issuance of a limited license.

(g) In addition to the criteria established under this section for the suspension of an obligor's driver's license, a court, a child support magistrate, or the public authority may direct the commissioner of public safety to suspend the license of a party who has failed, after receiving notice, to comply with a subpoena relating to a paternity or child support proceeding. Notice to an obligor of intent to suspend must be served by first class mail at the obligor's last known address. The notice must inform the obligor of the right to request a hearing. If the obligor makes a written request within ten days of the date of the hearing, a hearing must be held. At the hearing, the only issues to be considered are mistake of fact and whether the obligor received the subpoena.

(h) The license of an obligor who fails to remain in compliance with an approved new text begin written new text end payment agreement may be suspended. deleted text begin Notice to the obligor of an intent to suspend under this paragraph must be served by first class mail at the obligor's last known address and must include a notice of hearing. The notice must be served upon the obligor not less than ten days before the date of the hearing. deleted text end new text begin Prior to suspending a license for noncompliance with an approved written payment agreement, the public authority must mail to the obligor's last known address a written notice that (1) the public authority intends to seek suspension of the obligor's driver's license under this paragraph, and (2) the obligor must request a hearing, within 30 days of the date of the notice, to contest the suspension. If, within 30 days of the date of the notice, the public authority does not receive a written request for a hearing and the obligor does not comply with an approved written payment agreement, the public authority must direct the department of public safety to suspend the obligor's license under paragraph (b). If the obligor makes a written request for a hearing within 30 days of the date of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the obligor must be served with 14 days' notice in writing specifying the time and place of the hearing and the allegations against the obligor. The notice may be served personally or by mail at the obligor's last known address. new text end If the obligor appears at the hearing and the deleted text begin judge deleted text end new text begin court new text end determines that the obligor has failed to comply with an approved new text begin written new text end payment agreement, the deleted text begin judge deleted text end new text begin court or public authority new text end shall notify the department of public safety to suspend the obligor's license under paragraph deleted text begin (c) deleted text end new text begin (b) new text end . If the obligor fails to appear at the hearing, the deleted text begin public authority may deleted text end new text begin court or public authority must new text end notify the department of public safety to suspend the obligor's license under paragraph deleted text begin (c) deleted text end new text begin (b) new text end .

Sec. 7.

Laws 1997, chapter 245, article 2, section 11, is amended to read:

Sec. 11. [FEDERAL FUNDS FOR VISITATION AND ACCESS.]

The commissioner of human services may accept on behalf of the state any federal funding received under Public Law Number 104-193 for access and visitation programs, and deleted text begin shall transfer these funds to the state court administrator for the cooperation for the children pilot project and the parent education program under Minnesota Statutes, section 518.571 deleted text end new text begin must administer the funds for the activities allowed under federal law. The commissioner may distribute the funds on a competitive basis and must monitor, evaluate, and report on the access and visitation programs in accordance with any applicable regulations new text end .

ARTICLE 16

CRIMINAL JUSTICE APPROPRIATIONS AND POLICY PROVISIONS

Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.]

The sums shown in the columns marked "APPROPRIATIONS" are appropriated from the general fund, or another named fund, to the agencies and for the purposes specified in this act, to be available for the fiscal years indicated for each purpose. The figures "2004" and "2005," where used in this act, mean that the appropriation or appropriations listed under them are available for the year ending June 30, 2004, or June 30, 2005, respectively. The term "first year" means the fiscal year ending June 30, 2004, and the term "second year" means the fiscal year ending June 30, 2005. SUMMARY BY FUND 2004 2005 TOTAL General $ 421,424,000 $ 426,702,000 $ 848,126,000 Special Revenue Fund 1,000,000 1,000,000 2,000,000 TOTAL $ 422,424,000 $ 427,702,000 $ 850,126,000 APPROPRIATIONS Available for the Year Ending June 30 2004 2005 Sec. 2. CORRECTIONS Subdivision 1. Total Appropriation $368,229,000 $373,507,000 Summary by Fund General Fund 367,229,000 372,507,000 Special Revenue 1,000,000 1,000,000

The amounts that may be spent from this appropriation for each program are specified in the following subdivisions. Subd. 2. Correctional Institutions Summary by Fund General Fund 236,579,000 239,697,000 Special Revenue 630,000 630,000

If the commissioner contracts with other states, local units of government, or the federal government to rent beds in the Rush City correctional facility, the commissioner shall charge a per diem under the contract, to the extent possible, that is equal to or greater than the per diem cost of housing Minnesota inmates in the facility. The per diem cost for housing inmates of other states, local units of government, or the federal government at this facility shall be based on the assumption that the facility is at or near capacity. Notwithstanding any laws to the contrary, the commissioner may use the per diem appropriation to operate the state correctional system.

No portion of this appropriation may be used for the faith-based prerelease program described in Laws 2001, First Special Session chapter 9, article 18, section 3, subdivision 2. Subd. 3. Juvenile Services 13,035,000 13,035,000 Subd. 4. Community Services Summary by Fund General Fund 102,941,000 105,128,000 Special Revenue 120,000 120,000

Of the general fund appropriation, $3,300,000 the first year and $4,400,000 the second year are for grants to counties to assist them to incarcerate short-term offenders. The commissioner shall make the grants in an equitable manner based on the total amount available for the grants, each county's proportionate share of offenders affected by the changes made to Minnesota Statutes, section 609.105, in this article, and the actual number of bed days used by each county to incarcerate these offenders. The grants may not exceed the actual cost per day incurred by a county. A county seeking a grant shall report to the commissioner on offenders affected by the changes made to Minnesota Statutes, section 609.105, in this article. The report must include the number of these offenders for the reporting period, the actual number of bed days used for these offenders, the costs associated with this, and any other information requested by the commissioner. These reports are due on May 15, 2003, September 15, 2003, December 15, 2003, March 15, 2004, June 15, 2004, September 15, 2004, December 15, 2004, March 15, 2005, and June 15, 2005. The commissioner shall make the grants within a month of receiving the required reports from counties.

Of the general fund appropriation, $155,000 the first year and $155,000 the second year are for two agency positions to administer the restorative justice program.

Of the general fund appropriation, $475,000 the first year and $475,000 the second year are for restorative justice grants. Subd. 5. Operations Support Summary by Fund General Fund 14,674,000 14,647,000 Special Revenue 250,000 250,000

Of the general fund appropriation, $27,000 the first year is for payment under Minnesota Statutes, section 3.739, to service providers as indicated in full and final payment of claims against the state for medical services provided to individuals who were injured while performing community service or sentencing to service work for correctional purposes. Sec. 3. BOARD OF PUBLIC DEFENSE 53,759,000 53,759,000

Budget reductions must be allocated proportionately between operating costs and grant programs. Sec. 4. SENTENCING GUIDELINES COMMISSION 436,000 436,000

Sec. 5.

Minnesota Statutes 2002, section 243.53, subdivision 1, is amended to read:

Subdivision 1.

Separate cells.

(a) When there are sufficient cells available, each inmate shall be confined in a separate cell. Each inmate shall be confined in a separate cell in institutions classified by the commissioner as custody level deleted text begin five and deleted text end six institutions new text begin , except where the commissioner deems necessary new text end . deleted text begin This requirement does not apply to the following: deleted text end

deleted text begin (1) geriatric dormitory-type facilities; deleted text end

deleted text begin (2) honor dormitory-type facilities; and deleted text end

deleted text begin (3) any other multiple occupancy facility at a custody level five or six institution that confines inmates who could be confined in an institution at custody level four or lower. deleted text end

(b) Correctional institutions classified by the commissioner as custody level one, two, three, or four institutions must permit multiple occupancy, except segregation units, to the greatest extent possible.

new text begin (c) Correctional institutions classified by the commissioner as custody level five must permit multiple occupancy not to exceed the limits of facility infrastructure and programming space. new text end

Sec. 6.

new text begin [243.557] INMATE MEALS. new text end

new text begin Where inmates in a state correctional facility are not routinely absent from the facility for work or other purposes, the commissioner must make three meals available Monday through Friday, excluding holidays, and at least two meals available on Saturdays, Sundays, and holidays. new text end

[EFFECTIVE DATE.] new text begin This section is effective July 1, 2003. new text end

Sec. 7.

Minnesota Statutes 2002, section 260B.007, subdivision 3, is amended to read:

Subd. 3.

Child.

"Child" means an individual under 18 years of age and includes any minor alleged to have been delinquent deleted text begin or a juvenile traffic offender deleted text end prior to having become 18 years of age new text begin or a juvenile traffic offender prior to having become 16 years of age new text end .

Sec. 8.

Minnesota Statutes 2002, section 260B.007, subdivision 6, is amended to read:

Subd. 6.

Delinquent child.

(a) Except as otherwise provided in paragraph (b), "delinquent child" means a child:

(1) who has violated any state or local law, except as provided in section 260B.225, deleted text begin subdivision 1, deleted text end and except for juvenile offenders as described in subdivisions 16 to 18;

(2) who has violated a federal law or a law of another state and whose case has been referred to the juvenile court if the violation would be an act of delinquency if committed in this state or a crime or offense if committed by an adult;

(3) who has escaped from confinement to a state juvenile correctional facility after being committed to the custody of the commissioner of corrections; or

(4) who has escaped from confinement to a local juvenile correctional facility after being committed to the facility by the court.

(b) The term delinquent child does not include a child alleged to have committed murder in the first degree after becoming 16 years of age, but the term delinquent child does include a child alleged to have committed attempted murder in the first degree.

Sec. 9.

Minnesota Statutes 2002, section 260B.007, subdivision 16, is amended to read:

Subd. 16.

Juvenile petty offender; juvenile petty offense.

(a) "Juvenile petty offense" includes a juvenile alcohol offense, a juvenile controlled substance offense, a violation of section 609.685, or a violation of a local ordinance, which by its terms prohibits conduct by a child under the age of 18 years which would be lawful conduct if committed by an adult.

(b) Except as otherwise provided in paragraph (c), "juvenile petty offense" also includes an offense that would be a misdemeanor if committed by an adult.

(c) "Juvenile petty offense" does not include any of the following:

(1) a misdemeanor-level violation of section 518B.01, 588.20, 609.224, 609.2242, 609.324, 609.563, 609.576, 609.66, 609.746, 609.748, 609.79, or 617.23;

(2) a deleted text begin major deleted text end traffic offense deleted text begin or an adult court traffic offense deleted text end , as described in section 260B.225;

(3) a misdemeanor-level offense committed by a child whom the juvenile court previously has found to have committed a misdemeanor, gross misdemeanor, or felony offense; or

(4) a misdemeanor-level offense committed by a child whom the juvenile court has found to have committed a misdemeanor-level juvenile petty offense on two or more prior occasions, unless the county attorney designates the child on the petition as a juvenile petty offender notwithstanding this prior record. As used in this clause, "misdemeanor-level juvenile petty offense" includes a misdemeanor-level offense that would have been a juvenile petty offense if it had been committed on or after July 1, 1995.

(d) A child who commits a juvenile petty offense is a "juvenile petty offender."

Sec. 10.

Minnesota Statutes 2002, section 260B.101, subdivision 1, is amended to read:

Subdivision 1.

Children who are delinquent.

Except as provided in sections 260B.125 and 260B.225, the juvenile court has original and exclusive jurisdiction in proceedings concerning any child who is alleged to be delinquent, a juvenile traffic offender, a juvenile petty offender, and in proceedings concerning any minor alleged to have been a delinquent deleted text begin , deleted text end new text begin or new text end a juvenile petty offender deleted text begin , or a juvenile traffic offender deleted text end prior to having become 18 years of age new text begin or a juvenile traffic offender prior to having become 16 years of age new text end . The juvenile court shall deal with such a minor as it deals with any other child who is alleged to be delinquent or a juvenile traffic offender.

Sec. 11.

Minnesota Statutes 2002, section 260B.103, subdivision 1, is amended to read:

Subdivision 1.

Transfers required.

Except where a juvenile court has certified an alleged violation in accordance with the provisions of section 260B.125, the child is alleged to have committed murder in the first degree after becoming 16 years of age, or a court has original jurisdiction of a child who has committed deleted text begin an adult court deleted text end new text begin a new text end traffic offense, as defined in section 260B.225, subdivision 1, deleted text begin clause (c) deleted text end new text begin after becoming 16 years of age new text end , a court other than a juvenile court shall immediately transfer to the juvenile court of the county the case of a minor who appears before the court on a charge of violating any state or local law or ordinance and who is under 18 years of age or who was under 18 years of age at the time of the commission of the alleged offense.

Sec. 12.

Minnesota Statutes 2002, section 260B.105, subdivision 3, is amended to read:

Subd. 3.

Involving interstate compact.

Except when a child is alleged to have committed deleted text begin an adult court deleted text end new text begin a new text end traffic offense, as defined in section 260B.225, subdivision 1, deleted text begin clause (c) deleted text end new text begin after reaching 16 years of age new text end , if it appears at any stage of the proceeding that a child before the court is a resident of another state, the court may invoke the provisions of the Interstate Compact on Juveniles or, if it is in the best interests of the child or the public to do so, the court may place the child in the custody of the child's parent, guardian, or custodian, if the parent, guardian, or custodian agrees to accept custody of the child and return the child to the child's state.

Sec. 13.

Minnesota Statutes 2002, section 260B.171, subdivision 5, is amended to read:

Subd. 5.

Peace officer records of children.

(a) Except for records relating to an offense where proceedings are public under section 260B.163, subdivision 1, peace officers' records of children who are or may be delinquent or who may be engaged in criminal acts shall be kept separate from records of persons 18 years of age or older and are private data but shall be disseminated: (1) by order of the juvenile court, (2) as required by section 121A.28, (3) as authorized under section 13.82, subdivision 2, (4) to the child or the child's parent or guardian unless disclosure of a record would interfere with an ongoing investigation, (5) to the Minnesota crime victims reparations board as required by section 611A.56, subdivision 2, clause (f), for the purpose of processing claims for crime victims reparations, or (6) as otherwise provided in this subdivision. Except as provided in paragraph (c), no photographs of a child taken into custody may be taken without the consent of the juvenile court unless the child is alleged to have violated section 169A.20. Peace officers' records containing data about children who are victims of crimes or witnesses to crimes must be administered consistent with section 13.82, subdivisions 2, 3, 6, and 17. Any person violating any of the provisions of this subdivision shall be guilty of a misdemeanor.

In the case of computerized records maintained about juveniles by peace officers, the requirement of this subdivision that records about juveniles must be kept separate from adult records does not mean that a law enforcement agency must keep its records concerning juveniles on a separate computer system. Law enforcement agencies may keep juvenile records on the same computer as adult records and may use a common index to access both juvenile and adult records so long as the agency has in place procedures that keep juvenile records in a separate place in computer storage and that comply with the special data retention and other requirements associated with protecting data on juveniles.

(b) Nothing in this subdivision prohibits the exchange of information by law enforcement agencies if the exchanged information is pertinent and necessary for law enforcement purposes.

(c) A photograph may be taken of a child taken into custody pursuant to section 260B.175, subdivision 1, clause (b), provided that the photograph must be destroyed when the child reaches the age of 19 years. The commissioner of corrections may photograph juveniles whose legal custody is transferred to the commissioner. Photographs of juveniles authorized by this paragraph may be used only for institution management purposes, case supervision by parole agents, and to assist law enforcement agencies to apprehend juvenile offenders. The commissioner shall maintain photographs of juveniles in the same manner as juvenile court records and names under this section.

(d) Traffic investigation reports are open to inspection by a person who has sustained physical harm or economic loss as a result of the traffic accident. Identifying information on juveniles who are parties to traffic accidents may be disclosed as authorized under section 13.82, subdivision 4, and accident reports required under section 169.09 may be released under section 169.09, subdivision 13, unless the information would identify a juvenile who was taken into custody or who is suspected of committing an offense that would be a crime if committed by an adult, or would associate a juvenile with the offense, and the offense is not deleted text begin an adult court deleted text end new text begin a new text end traffic offense new text begin that the district court has jurisdiction over new text end under section 260B.225.

(e) The head of a law enforcement agency or a person specifically given the duty by the head of the law enforcement agency shall notify the superintendent or chief administrative officer of a juvenile's school of an incident occurring within the agency's jurisdiction if:

(1) the agency has probable cause to believe that the juvenile has committed an offense that would be a crime if committed as an adult, that the victim of the offense is a student or staff member of the school, and that notice to the school is reasonably necessary for the protection of the victim; or

(2) the agency has probable cause to believe that the juvenile has committed an offense described in subdivision 3, paragraph (a), clauses (1) to (3), that would be a crime if committed by an adult, regardless of whether the victim is a student or staff member of the school.

A law enforcement agency is not required to notify the school under this paragraph if the agency determines that notice would jeopardize an ongoing investigation. For purposes of this paragraph, "school" means a public or private elementary, middle, secondary, or charter school.

(f) In any county in which the county attorney operates or authorizes the operation of a juvenile prepetition or pretrial diversion program, a law enforcement agency or county attorney's office may provide the juvenile diversion program with data concerning a juvenile who is a participant in or is being considered for participation in the program.

(g) Upon request of a local social services agency, peace officer records of children who are or may be delinquent or who may be engaged in criminal acts may be disseminated to the agency to promote the best interests of the subject of the data.

(h) Upon written request, the prosecuting authority shall release investigative data collected by a law enforcement agency to the victim of a criminal act or alleged criminal act or to the victim's legal representative, except as otherwise provided by this paragraph. Data shall not be released if:

(1) the release to the individual subject of the data would be prohibited under section 13.821; or

(2) the prosecuting authority reasonably believes:

(i) that the release of that data will interfere with the investigation; or

(ii) that the request is prompted by a desire on the part of the requester to engage in unlawful activities.

Sec. 14.

Minnesota Statutes 2002, section 260B.225, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin definitions deleted text end new text begin definition new text end .

deleted text begin (a) deleted text end For purposes of this section, deleted text begin the following terms have the meanings given them. deleted text end

deleted text begin (b) deleted text end " deleted text begin Major deleted text end traffic offense" includes any violation of a state or local traffic law, ordinance, or regulation, or a federal, state, or local water traffic law deleted text begin not included within the provisions of paragraph (c) deleted text end .

deleted text begin (c) "Adult court traffic offense" means: deleted text end

deleted text begin (1) a petty misdemeanor violation of a state or local traffic law, ordinance, or regulation, or a petty misdemeanor violation of a federal, state, or local water traffic law; or deleted text end

deleted text begin (2) a violation of section 169A.20 or any other misdemeanor- or gross misdemeanor-level traffic violation committed as part of the same behavioral incident as a violation of section 169A.20. deleted text end

Sec. 15.

Minnesota Statutes 2002, section 260B.225, subdivision 2, is amended to read:

Subd. 2.

Juvenile highway traffic offender.

A child who commits a deleted text begin major deleted text end traffic offense new text begin before reaching the age of 16 new text end shall be adjudicated a "juvenile highway traffic offender" or a "juvenile water traffic offender," as the case may be, and shall not be adjudicated delinquent, unless, as in the case of any other child alleged to be delinquent, a petition is filed in the manner provided in section 260B.141, summons issued, notice given, a hearing held, and the court finds as a further fact that the child is also delinquent within the meaning and purpose of the laws relating to juvenile courts.

Sec. 16.

Minnesota Statutes 2002, section 260B.225, subdivision 3, is amended to read:

Subd. 3.

Adult traffic offense.

deleted text begin Except as provided in subdivision 4, deleted text end A child who commits deleted text begin an adult court deleted text end new text begin a new text end traffic offense and at the time of the offense was at least 16 years old shall be subject to the laws and court procedures controlling adult traffic violators and shall not be under the jurisdiction of the juvenile court. When a child is alleged to have committed deleted text begin an adult court deleted text end new text begin a new text end traffic offense and is at least 16 years old at the time of the offense, the peace officer making the charge shall follow the arrest procedures prescribed in section 169.91 and shall make reasonable effort to notify the child's parent or guardian of the nature of the charge.

Sec. 17.

Minnesota Statutes 2002, section 260B.225, subdivision 4, is amended to read:

Subd. 4.

Original jurisdiction; juvenile court.

The juvenile court has original jurisdiction over deleted text begin : deleted text end

deleted text begin (1) deleted text end all juveniles age 15 and under alleged to have committed any traffic offense deleted text begin ; and deleted text end new text begin . new text end

deleted text begin (2) 16- and 17-year-olds alleged to have committed any major traffic offense, except that the adult court has original jurisdiction over: deleted text end

deleted text begin (i) petty traffic misdemeanors not a part of the same behavioral incident of a misdemeanor being handled in juvenile court; and deleted text end

deleted text begin (ii) violations of section 169A.20 (driving while impaired), and any other misdemeanor or gross misdemeanor level traffic violations committed as part of the same behavioral incident as a violation of section 169A.20. deleted text end

Sec. 18.

Minnesota Statutes 2002, section 260B.225, subdivision 5, is amended to read:

Subd. 5.

deleted text begin major deleted text end traffic offense procedures.

When a child is alleged to have committed a deleted text begin major deleted text end traffic offense new text begin before reaching the age of 16 new text end , the peace officer making the charge shall file a signed copy of the notice to appear, as provided in section 169.91, with the juvenile court of the county in which the violation occurred, and the notice to appear has the effect of a petition and gives the juvenile court jurisdiction. Filing with the court a notice to appear containing the name and address of the child allegedly committing a deleted text begin major deleted text end traffic offense and specifying the offense charged, the time and place of the alleged violation shall have the effect of a petition and give the juvenile court jurisdiction. Any reputable person having knowledge of a child who commits a deleted text begin major deleted text end traffic offense may petition the juvenile court in the manner provided in section 260B.141. Whenever a notice to appear or petition is filed alleging that a child is a juvenile highway traffic offender or a juvenile water traffic offender, the court shall summon and notify the persons required to be summoned or notified as provided in sections 260B.151 and 260B.152. However, it is not necessary to (1) notify more than one parent, or (2) publish any notice, or (3) personally serve outside the state.

Sec. 19.

Minnesota Statutes 2002, section 260B.225, subdivision 6, is amended to read:

Subd. 6.

Disposition.

Before making a disposition of any child found to be a juvenile deleted text begin major deleted text end traffic offender or to have violated a misdemeanor- or gross misdemeanor-level traffic law, the court shall obtain from the department of public safety information of any previous traffic violation by this juvenile. In the case of a juvenile water traffic offender, the court shall obtain from the office where the information is now or hereafter may be kept information of any previous water traffic violation by the juvenile.

Sec. 20.

Minnesota Statutes 2002, section 260B.225, subdivision 7, is amended to read:

Subd. 7.

Transfer of cases.

If after a hearing the court finds that the welfare of a juvenile deleted text begin major deleted text end new text begin highway new text end traffic offender or a juvenile water traffic offender or the public safety would be better served under the laws controlling adult traffic violators, the court may transfer the case to any court of competent jurisdiction presided over by a salaried judge if there is one in the county. The juvenile court transfers the case by forwarding to the appropriate court the documents in the court's file together with an order to transfer. The court to which the case is transferred shall proceed with the case as if the jurisdiction of the juvenile court had never attached.

Sec. 21.

Minnesota Statutes 2002, section 260B.225, subdivision 8, is amended to read:

Subd. 8.

Criminal court dispositions; adult deleted text begin court deleted text end traffic deleted text begin offenders deleted text end new text begin offenses new text end .

(a) A juvenile who is charged with deleted text begin an adult court deleted text end new text begin a new text end traffic offense in district court shall be treated as an adult before trial, except that the juvenile may be held in secure, pretrial custody only in a secure juvenile detention facility.

(b) A juvenile who is convicted of deleted text begin an adult court deleted text end new text begin a new text end traffic offense in district court shall be treated as an adult for sentencing purposes, except that the court may order the juvenile placed out of the home only in a residential treatment facility or in a juvenile correctional facility.

(c) The disposition of deleted text begin an adult court deleted text end new text begin a new text end traffic offender remains with the county in which the adjudication occurred.

Sec. 22.

Minnesota Statutes 2002, section 260B.225, subdivision 9, is amended to read:

Subd. 9.

Juvenile deleted text begin major deleted text end highway or water traffic offender.

If the juvenile court finds that the child is a juvenile deleted text begin major deleted text end highway or water traffic offender, it may make any one or more of the following dispositions of the case:

(a) Reprimand the child and counsel with the child and the parents;

(b) Continue the case for a reasonable period under such conditions governing the child's use and operation of any motor vehicles or boat as the court may set;

(c) Require the child to attend a driver improvement school if one is available within the county;

(d) Recommend to the department of public safety suspension of the child's driver's license as provided in section 171.16;

(e) If the child is found to have committed two moving highway traffic violations or to have contributed to a highway accident involving death, injury, or physical damage in excess of $100, the court may recommend to the commissioner of public safety or to the licensing authority of another state the cancellation of the child's license until the child reaches the age of 18 years, and the commissioner of public safety is hereby authorized to cancel the license without hearing. At any time before the termination of the period of cancellation, the court may, for good cause, recommend to the commissioner of public safety, or to the licensing authority of another state, that the child's license be returned, and the commissioner of public safety is authorized to return the license;

(f) Place the child under the supervision of a probation officer in the child's own home under conditions prescribed by the court including reasonable rules relating to operation and use of motor vehicles or boats directed to the correction of the child's driving habits;

(g) If the child is found to have violated a state or local law or ordinance and the violation resulted in damage to the person or property of another, the court may order the child to make reasonable restitution for the damage;

(h) Require the child to pay a fine of up to $700. The court shall order payment of the fine in accordance with a time payment schedule which shall not impose an undue financial hardship on the child;

(i) If the court finds that the child committed an offense described in section 169A.20, the court shall order that a chemical use assessment be conducted and a report submitted to the court in the manner prescribed in section 169A.70. If the assessment concludes that the child meets the level of care criteria for placement under rules adopted under section 254A.03, subdivision 3, the report must recommend a level of care for the child. The court may require that level of care in its disposition order. In addition, the court may require any child ordered to undergo an assessment to pay a chemical dependency assessment charge of $75. The court shall forward the assessment charge to the commissioner of finance to be credited to the general fund. The state shall reimburse counties for the total cost of the assessment in the manner provided in section 169A.284.

Sec. 23.

Minnesota Statutes 2002, section 260C.007, subdivision 11, is amended to read:

Subd. 11.

Delinquent child.

"Delinquent child" means a child:

(1) who has violated any state or local law, except as provided in section 260B.225, deleted text begin subdivision 1, deleted text end and except for juvenile offenders as described in subdivisions 19 and 28; or

(2) who has violated a federal law or a law of another state and whose case has been referred to the juvenile court if the violation would be an act of delinquency if committed in this state or a crime or offense if committed by an adult.

Sec. 24.

Minnesota Statutes 2002, section 357.021, subdivision 6, is amended to read:

Subd. 6.

Surcharges on criminal and traffic offenders.

(a) The court shall impose and the court administrator shall collect a deleted text begin $35 deleted text end new text begin $60 new text end surcharge on every person convicted of any felony, gross misdemeanor, misdemeanor, or petty misdemeanor offense, other than a violation of a law or ordinance relating to vehicle parking new text begin , for which there shall be a $3 surcharge new text end . The surcharge shall be imposed whether or not the person is sentenced to imprisonment or the sentence is stayed.

(b) If the court fails to impose a surcharge as required by this subdivision, the court administrator shall show the imposition of the surcharge, collect the surcharge and correct the record.

(c) The court may not waive payment of the surcharge required under this subdivision. Upon a showing of indigency or undue hardship upon the convicted person or the convicted person's immediate family, the sentencing court may authorize payment of the surcharge in installments.

(d) The court administrator or other entity collecting a surcharge shall forward it to the state treasurer.

(e) If the convicted person is sentenced to imprisonment and has not paid the surcharge before the term of imprisonment begins, the chief executive officer of the correctional facility in which the convicted person is incarcerated shall collect the surcharge from any earnings the inmate accrues from work performed in the facility or while on conditional release. The chief executive officer shall forward the amount collected to the state treasurer.

Sec. 25.

Minnesota Statutes 2002, section 357.021, subdivision 7, is amended to read:

Subd. 7.

Disbursement of surcharges by state treasurer.

(a) Except as provided in paragraphs (b) and (c), the state treasurer shall disburse surcharges received under subdivision 6 and section 97A.065, subdivision 2, as follows:

(1) one percent shall be credited to the game and fish fund to provide peace officer training for employees of the department of natural resources who are licensed under sections 626.84 to 626.863, and who possess peace officer authority for the purpose of enforcing game and fish laws;

(2) 39 percent shall be credited to the peace officers training account in the special revenue fund; and

(3) 60 percent shall be credited to the general fund.

(b) The state treasurer shall credit $3 of each surcharge received under subdivision 6 and section 97A.065, subdivision 2, to a criminal justice special projects account in the special revenue fund. This account is available for appropriation to the commissioner of public safety for grants to law enforcement agencies and for other purposes authorized by the legislature.

(c) In addition to any amounts credited under paragraph (a), the state treasurer shall credit deleted text begin $7 deleted text end new text begin $32 new text end of each surcharge received under subdivision 6 and section 97A.065, subdivision 2, new text begin and the $3 parking surcharge, new text end to the general fund.

Sec. 26.

new text begin [481.011] SURCHARGE. new text end

new text begin (a) The supreme court is requested to impose an annual surcharge of $200 to be added to the fee set by the supreme court under section 481.01 for attorney license renewals. Money collected under the surcharge must be paid into the fund established by section 481.01 and is appropriated annually to the supreme court for the support of the public defender system established by chapter 611. new text end

new text begin (b) This section expires on June 30, 2007. new text end

Sec. 27.

Minnesota Statutes 2002, section 609.105, subdivision 1, is amended to read:

new text begin Subd. 1a. new text end

new text begin Definitions. new text end

new text begin (a) The terms in this subdivision apply to this section. new text end

new text begin (b) "Remaining term of imprisonment" as applied to inmates whose crimes were committed before August 1, 1993, is the period of time for which an inmate is committed to the custody of the commissioner of corrections minus earned good time and jail credit, if any. new text end

new text begin (c) "Remaining term of imprisonment" as applied to inmates whose crimes were committed on or after August 1, 1993, is the period of time equal to two-thirds of the inmate's executed sentence, minus jail credit, if any. new text end

Sec. 29.

Minnesota Statutes 2002, section 609.105, is amended by adding a subdivision to read:

new text begin Subd. 1b. new text end

new text begin Sentence to more than 180 days. new text end

new text begin A felony sentence to imprisonment when the warrant of commitment has a remaining term of imprisonment for more than 180 days shall commit the defendant to the custody of the commissioner of corrections. new text end

Sec. 30.

Minnesota Statutes 2002, section 609.145, is amended by adding a subdivision to read:

new text begin Subd. 3. new text end

new text begin Jail credit determination. new text end

new text begin The appropriate probation officer must provide to the court prior to the sentencing hearing the amount of time the offender has credit for prior imprisonment. The court must pronounce the amount of credit for prior imprisonment at the time of sentencing. new text end

Sec. 31.

Minnesota Statutes 2002, section 609.2231, is amended by adding a subdivision to read:

new text begin Subd. 7. new text end

new text begin Community crime prevention group members. new text end

new text begin (a) A person is guilty of a gross misdemeanor who: new text end

new text begin (1) assaults a community crime prevention group member while the member is engaged in neighborhood patrol; new text end

new text begin (2) should reasonably know that the victim is a community crime prevention group member engaged in neighborhood patrol; and new text end

new text begin (3) inflicts demonstrable bodily harm. new text end

new text begin (b) As used in this subdivision, "community crime prevention group" means a community group focused on community safety and crime prevention that: new text end

new text begin (1) is organized for the purpose of discussing community safety and patrolling community neighborhoods for criminal activity; new text end

new text begin (2) is designated and trained by the local law enforcement agency as a community crime prevention group; or new text end

new text begin (3) interacts with local law enforcement regarding community safety issues. new text end

Sec. 32.

new text begin [611.254] OVERSIGHT OF CORRECTIONAL FUNCTIONS. new text end

new text begin Subdivision 1. new text end [DEFINITION.] new text begin As used in this section, "administrative agency" or "agency" means any division, official, or employee of the department of corrections, including the commissioner of corrections, and any state correctional facility licensed or inspected by the commissioner of corrections, whether public or private, established and operated for the detention and confinement of adults or juveniles, but does not include: new text end

new text begin (1) any court or judge; new text end

new text begin (2) any member of the senate or house of representatives of the state of Minnesota; new text end

new text begin (3) the governor or the governor's personal staff; new text end

new text begin (4) any instrumentality of the federal government of the United States; or new text end

new text begin (5) any interstate compact. new text end

new text begin Subd. 2. new text end [INVESTIGATION.] new text begin The state public defender has the authority to investigate decisions, acts, and other matters of the department of corrections to promote the highest attainable standards of competence, efficiency, and justice in the administration of corrections. The state public defender may delegate any of this authority or these duties. new text end

new text begin Subd. 3. new text end [POWERS.] new text begin (a) The state public defender may: new text end

new text begin (1) prescribe the methods by which complaints are to be made, reviewed, and acted upon; provided, however, that the state public defender may not levy a complaint fee; new text end

new text begin (2) determine the scope and manner of investigations to be made; new text end

new text begin (3) except as otherwise provided, determine the form, frequency, and distribution of conclusions, recommendations, and proposals; new text end

new text begin (4) investigate, upon a complaint, any action of an administrative agency; new text end

new text begin (5) request and be given access to information in the possession of an administrative agency deemed necessary for the discharge of responsibilities; new text end

new text begin (6) examine the records and documents of an administrative agency; new text end

new text begin (7) enter and inspect, at any time, premises within the control of an administrative agency; new text end

new text begin (8) subpoena any person to appear, give testimony, or produce documentary or other evidence that the state public defender deems relevant to a matter under inquiry, and petition the appropriate state court to enforce the subpoena; provided, however, that any witness at a hearing or before an investigation possesses the same privileges reserved to a witness in the courts or under the laws of this state; and new text end

new text begin (9) bring an action in an appropriate state court to provide the operation of the powers provided in this subdivision. new text end

new text begin (b) The provisions of this section are in addition to other provisions of law under which any remedy or right of appeal or objection is provided for any person, or any procedure provided for inquiry or investigation concerning any matter. Nothing in this section shall be construed to limit or affect any other remedy or right of appeal or objection nor shall it be deemed part of an exclusionary process. new text end

new text begin Subd. 4. new text end [ACTIONS AGAINST STATE PUBLIC DEFENDER.] new text begin No proceeding or civil action shall be commenced against the state public defender or staff members, or a person delegated the state public defender's duties or authority under subdivision 2, for actions taken pursuant to the provisions of this section. new text end

new text begin Subd. 5. new text end [MATTERS APPROPRIATE FOR INVESTIGATION.] new text begin In selecting matters for attention, the state public defender should address particularly actions of an administrative agency, which might be: new text end

new text begin (1) contrary to law or rule; new text end

new text begin (2) unreasonable, unfair, oppressive, or inconsistent with any policy or judgment of an administrative agency; or new text end

new text begin (3) mistaken in law or arbitrary in the ascertainment of facts. new text end

new text begin Subd. 6. new text end [COMPLAINTS.] new text begin (a) The state public defender may receive a complaint from any source concerning an action of an administrative agency. new text end

new text begin (b) The state public defender may exercise powers without regard to the finality of any action of an administrative agency; however, the state public defender may require a complainant to pursue other remedies or channels of complaint open to the complainant before accepting or investigating the complaint. new text end

new text begin (c) After completing investigation of a complaint, the state public defender shall inform the complainant, the administrative agency, and the official or employee of the action taken. new text end

new text begin (d) A letter to the state public defender from a person in an institution under the control of an administrative agency must be forwarded immediately and unopened to the state public defender's office. A reply from the state public defender to the person must be delivered unopened to the person, promptly after its receipt by the institution. No complainant shall be punished nor shall the general condition of the complainant's confinement or treatment be unfavorably altered as a result of the complainant having made a complaint to the state public defender. new text end

new text begin Subd. 7. new text end [RECOMMENDATIONS.] new text begin (a) If, after duly considering a complaint and whatever material the state public defender deems pertinent, the state public defender is of the opinion that the complaint is valid, the state public defender may recommend that an administrative agency should: new text end

new text begin (1) consider the matter further; new text end

new text begin (2) modify or cancel its actions; new text end

new text begin (3) alter a ruling; new text end

new text begin (4) explain more fully the action in question; or new text end

new text begin (5) take any other step that the state public defender recommends to the administrative agency involved. new text end

new text begin (b) If the state public defender so requests, the agency shall within the time the state public defender specifies, inform the state public defender about the action taken on the state public defender's recommendation or the reasons for not complying with it. new text end

new text begin Subd. 8. new text end [ACCESS TO DATA.] new text begin Notwithstanding section 13.384 or 13.85, the state public defender has access to corrections and detention data and medical data maintained by an agency and classified as private data on individuals or confidential data on individuals when access to the data is necessary for the state public defender to perform the powers under this section. new text end

new text begin Subd. 9. new text end [PUBLICATION.] new text begin The state public defender may publish conclusions and suggestions by transmitting them to the office of the governor. Before announcing a conclusion or recommendation that expressly or impliedly criticizes an administrative agency, or any person, the state public defender shall consult with that agency or person. When publishing an opinion adverse to an administrative agency, or any person, the state public defender shall include in such publication any statement of reasonable length made to the state public defender by that agency or person in defense or mitigation of the action. new text end

new text begin Subd. 10. new text end [COMPELLED TESTIMONY.] new text begin Neither the state public defender nor any member of the state public defender's staff or a person delegated the state public defender's duties or authority under subdivision 2 shall be compelled to testify or to produce evidence in any judicial or administrative proceeding with respect to any matter involving the exercise of these official duties except as may be necessary to enforce the provisions of this section. new text end

Sec. 33.

new text begin [611A.0392] NOTICE TO COMMUNITY CRIME PREVENTION GROUP. new text end

new text begin Subdivision 1. new text end [DEFINITIONS.] new text begin (a) As used in this section, the following terms have the meanings given them. new text end

new text begin (b) "Cities of the first class" has the meaning given in section 410.01. new text end

new text begin (c) "Community crime prevention group" means a community group focused on community safety and crime prevention that: new text end

new text begin (1) meets regularly for the purpose of discussing community safety and patrolling community neighborhoods for criminal activity; new text end

new text begin (2) is previously designated by the local law enforcement agency as a community crime prevention group; and new text end

new text begin (3) interacts regularly with the police regarding community safety issues. new text end

new text begin Subd. 2. new text end [NOTICE.] new text begin (a) A law enforcement agency that is responsible for arresting individuals who commit crimes within cities of the first class shall make reasonable efforts to disclose certain information in a timely manner to the designated leader of a community crime prevention group that has reported criminal activity, excluding petty misdemeanors, to law enforcement. The law enforcement agency shall make reasonable efforts to disclose information on the final outcome of the investigation into the criminal activity including, but not limited to, where appropriate, the decision to arrest or not arrest the person and whether the matter was referred to a prosecuting authority. If the matter is referred to a prosecuting authority, the law enforcement agency must notify the prosecuting authority of the community crime prevention group's request for notice under this subdivision. new text end

new text begin (b) A prosecuting authority who is responsible for filing charges against or prosecuting a person arrested for a criminal offense in cities of the first class shall make reasonable efforts to disclose certain information in a timely manner to the designated leader of a community crime prevention group that has reported specific criminal activity to law enforcement. The prosecuting authority shall make reasonable efforts to disclose information on the final outcome of the criminal proceeding that resulted from the arrest including, but not limited to, where appropriate, the decision to dismiss or not file charges against the arrested person. new text end

new text begin (c) A community crime prevention group that would like to receive written or Internet notice under this subdivision must request the law enforcement agency and the prosecuting authority where the specific alleged criminal conduct occurred to provide notice to the community crime prevention group leader. The community crime prevention group must provide the law enforcement agency with the name, address, and telephone number of the community crime prevention group leader and the preferred method of communication. new text end

Sec. 34. new text begin REPEALER. new text end

new text begin Minnesota Statutes 2002, sections 241.41; 241.42; 241.43; 241.44; 241.441; and 241.45, are repealed. new text end

Sec. 35. new text begin EFFECTIVE DATES. new text end

new text begin Sections 5 and 31 are effective the day following final enactment, section 31 applies to crimes committed on or after that date. Sections 7 to 25, 30, and 33 are effective July 1, 2003, and apply to crimes committed on or after that date. Sections 27 to 29 are effective July 1, 2003, and apply to persons incarcerated or under correctional supervision and crimes committed on or after that date. new text end