Minnesota Legislature
SF 1532
1st Engrossment - 83rd Legislature (2003 - 2004) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to state government; making changes to public 1.3 assistance programs, health care programs, long-term 1.4 care, continuing care for persons with disabilities, 1.5 occupational licenses, children services, estate 1.6 recovery provisions for medical assistance, adult 1.7 mental health and alternative programs for offenders 1.8 with mental illness; changing health department 1.9 provisions; transferring programs and funding from the 1.10 department of children, families, and learning; 1.11 requiring certain correctional institutions to permit 1.12 multiple occupancy of cells; providing juvenile court 1.13 jurisdiction for juveniles alleged to have committed 1.14 traffic offenses; authorizing the state public 1.15 defender to investigate decisions of the department of 1.16 corrections; authorizing the state public defender to 1.17 recommend correctional agencies to take corrective 1.18 actions upon complaints; requiring defendants with 180 1.19 days or less remaining on terms of imprisonment to 1.20 serve those remaining terms in local correctional 1.21 facilities; requiring law enforcement agencies to 1.22 disclose certain information to community crime 1.23 prevention groups; making forecast adjustments; 1.24 appropriating money; amending Minnesota Statutes 2002, 1.25 sections 13.461, by adding a subdivision; 13.69, 1.26 subdivision 1; 62E.06, subdivision 1; 62J.17, 1.27 subdivision 2; 62J.23, by adding a subdivision; 1.28 62J.692, subdivisions 1, 2, 3, 4, 5, 7, 8; 62J.694, by 1.29 adding a subdivision; 62L.05, subdivision 4; 62Q.19, 1.30 subdivision 2; 116J.70, subdivision 2a; 119B.011, 1.31 subdivisions 5, 6, 15, 19, by adding a subdivision; 1.32 119B.02, subdivision 1; 119B.03, subdivisions 4, 9; 1.33 119B.05, subdivision 1; 119B.09, subdivision 7; 1.34 119B.11, subdivision 2a; 119B.12, subdivision 2; 1.35 119B.13, subdivisions 2, 6, by adding a subdivision; 1.36 119B.19, subdivision 7; 119B.21, subdivision 11; 1.37 124D.23, subdivision 1; 144.1222, by adding a 1.38 subdivision; 144.125; 144.128; 144.1488, subdivision 1.39 4; 144.1491, subdivision 1; 144.1502, subdivision 4; 1.40 144.335, subdivision 1; 144.35; 144.395, by adding a 1.41 subdivision; 144.396, subdivisions 7, 11, 12; 144.414, 1.42 subdivision 3; 144.551, subdivision 1; 144.99, 1.43 subdivision 1; 144A.071, subdivision 4c, as amended; 1.44 144A.4605, subdivision 4; 144E.29; 144E.50, 1.45 subdivision 5; 145.412, by adding a subdivision; 1.46 147A.08; 148.5194, subdivisions 1, 2, 3, by adding a 2.1 subdivision; 148.6445, subdivision 7; 148C.01, 2.2 subdivisions 2, 12, by adding subdivisions; 148C.03, 2.3 subdivision 1; 148C.0351, subdivision 1, by adding a 2.4 subdivision; 148C.04; 148C.05, subdivision 1, by 2.5 adding subdivisions; 148C.07; 148C.10, subdivisions 1, 2.6 2; 148C.11; 150A.05, subdivision 2; 151.47, 2.7 subdivision 1; 153A.17; 171.06, subdivision 3; 171.07, 2.8 by adding a subdivision; 243.53, subdivision 1; 2.9 245.4874; 245.493, subdivision 1a; 245A.035, 2.10 subdivision 3; 245A.04, subdivisions 3b, 3d; 245A.10; 2.11 245A.11, subdivision 2a; 252.27, subdivision 2a; 2.12 252.32, subdivisions 1, 1a, 3, 3c; 253B.05, by adding 2.13 a subdivision; 256.01, subdivision 2; 256.012; 2.14 256.046, subdivision 1; 256.0471, subdivision 1; 2.15 256.476, subdivisions 1, 3, 4, 5, 11; 256.955, 2.16 subdivision 2a; 256.9657, subdivisions 1, 4, by adding 2.17 a subdivision; 256.9685, by adding a subdivision; 2.18 256.969, subdivisions 2b, 3a; 256.975, by adding a 2.19 subdivision; 256.98, subdivision 8; 256.984, 2.20 subdivision 1; 256B.056, subdivisions 1a, 1c, 6; 2.21 256B.057, subdivisions 1, 1b, 2, 3b, 9, 10; 256B.0595, 2.22 subdivisions 1, 2, by adding subdivisions; 256B.061; 2.23 256B.0621, subdivision 4; 256B.0623, subdivisions 2, 2.24 4, 5, 6, 8; 256B.0625, subdivisions 9, 13, 17, 19c, by 2.25 adding subdivisions; 256B.0627, subdivisions 1, 4, 9; 2.26 256B.0635, subdivisions 1, 2; 256B.064, subdivision 2; 2.27 256B.0911, subdivision 4d; 256B.0913, subdivisions 2, 2.28 4, 5, 6, 7, 8, 10, 12; 256B.0915, subdivision 3, by 2.29 adding a subdivision; 256B.092, subdivision 5, by 2.30 adding a subdivision; 256B.0945, subdivisions 2, 4; 2.31 256B.15, subdivisions 1, 1a, 2, 3, 4, by adding 2.32 subdivisions; 256B.19, by adding a subdivision; 2.33 256B.195, subdivisions 3, 5; 256B.32, subdivision 1; 2.34 256B.431, subdivisions 2r, 32, by adding subdivisions; 2.35 256B.434, subdivision 4; 256B.437, subdivisions 2, 6; 2.36 256B.47, subdivision 2; 256B.5012, by adding a 2.37 subdivision; 256B.5013, by adding a subdivision; 2.38 256B.69, subdivisions 2, 4, 5, 5a, 5c, 5g, 6a, 6b, 8, 2.39 by adding a subdivision; 256B.75; 256B.76; 256B.761; 2.40 256B.82; 256D.03, subdivisions 3, 3a, 4; 256D.053, 2.41 subdivision 1; 256I.02; 256I.04, subdivision 3; 2.42 256I.05, subdivisions 1, 1a, 7c; 256J.02, subdivision 2.43 2; 256J.021; 256J.08, by adding subdivisions; 256J.09, 2.44 subdivisions 2, 3a, 10; 256J.21, subdivision 2; 2.45 256J.24, subdivision 3; 256J.37, subdivision 9; 2.46 256J.38, subdivision 3; 256J.40; 256J.42, subdivision 2.47 5; 256J.425, subdivisions 2, 3, 4, 6; 256J.50, 2.48 subdivisions 1, 8; 256J.55, subdivision 2; 256J.56; 2.49 256J.751, subdivisions 2, 5; 256L.05, subdivisions 3a, 2.50 4; 256L.06, subdivision 3; 256L.07, subdivisions 1, 3, 2.51 by adding a subdivision; 256L.12, subdivision 6; 2.52 256L.15, subdivision 3, by adding a subdivision; 2.53 257.0769; 259.21, subdivision 6; 259.67, subdivisions 2.54 4, 7; 260B.157, subdivision 1; 260B.176, subdivision 2.55 2; 260B.178, subdivision 1; 260B.193, subdivision 2; 2.56 260B.235, subdivision 6; 260C.141, subdivision 2; 2.57 295.53, subdivision 1; 297I.15, subdivisions 1, 4; 2.58 319B.40; 326.42; 357.021, subdivisions 6, 7; 393.07, 2.59 subdivisions 5, 10; 514.981, subdivision 6; 518.551, 2.60 subdivisions 12, 13; 524.3-805; 609.105, subdivision 2.61 1, by adding subdivisions; 609.145, by adding a 2.62 subdivision; 609.2231, by adding a subdivision; Laws 2.63 1997, chapter 245, article 2, section 11; proposing 2.64 coding for new law in Minnesota Statutes, chapters 2.65 62J; 62Q; 97A; 119B; 144; 144A; 148C; 243; 245; 245A; 2.66 246; 256; 256B; 256J; 481; 514; 609; 611; 611A; 2.67 proposing coding for new law as Minnesota Statutes, 2.68 chapter 150B; repealing Minnesota Statutes 2002, 2.69 sections 62J.15; 62J.152; 62J.451; 62J.452; 62J.66; 2.70 62J.68; 119B.061; 144.126; 144.1494; 144.1495; 2.71 144.1496; 144.1497; 144A.071, subdivision 5; 144A.35; 3.1 144A.36; 144A.38; 148.5194, subdivision 3a; 148.6445, 3.2 subdivision 9; 148C.0351, subdivision 2; 148C.05, 3.3 subdivisions 2, 3, 4; 148C.06; 148C.10, subdivision 3.4 1a; 241.41; 241.42; 241.43; 241.44; 241.441; 241.45; 3.5 252.32, subdivision 2; 256.482, subdivision 8; 3.6 256.955, subdivision 8; 256B.0625, subdivisions 5a, 3.7 35, 36; 256B.0917; 256B.0945, subdivision 10; 3.8 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 3.9 256B.0955; 256B.437, subdivision 2; 256B.5013, 3.10 subdivision 4; 256J.08, subdivision 70; 256J.425, 3.11 subdivision 7; 256J.47; Laws 1997, chapter 203, 3.12 article 9, section 21; Laws 1998, chapter 407, article 3.13 4, section 63; Laws 1998, chapter 407, article 6, 3.14 section 111; Laws 2000, chapter 488, article 10, 3.15 section 28; Laws 2000, chapter 488, article 10, 3.16 section 29; Laws 2001, First Special Session chapter 3.17 3, article 1, section 16; Laws 2001, First Special 3.18 Session chapter 9, article 10, section 62; Laws 2001, 3.19 First Special Session chapter 9, article 13, section 3.20 24; Laws 2002, chapter 374, article 9, section 8; 3.21 Minnesota Rules, parts 4747.0030, subparts 25, 28, 30; 3.22 4747.0040, subpart 3, item A; 4747.0060, subpart 1, 3.23 items A, B, D; 4747.0070, subparts 4, 5; 4747.0080; 3.24 4747.0090; 4747.0100; 4747.0300; 4747.0400, subparts 3.25 2, 3; 4747.0500; 4747.0600; 4747.1000; 4747.1100, 3.26 subpart 3; 4747.1600; 4763.0100; 4763.0110; 4763.0125; 3.27 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 3.28 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 3.29 4763.0230; 4763.0240; 4763.0250; 9505.0324; 9505.0326; 3.30 9505.0327; 9505.3045; 9505.3050; 9505.3055; 9505.3060; 3.31 9505.3068; 9505.3070; 9505.3075; 9505.3080; 9505.3090; 3.32 9505.3095; 9505.3100; 9505.3105; 9505.3107; 9505.3110; 3.33 9505.3115; 9505.3120; 9505.3125; 9505.3130; 9505.3138; 3.34 9505.3139; 9505.3140; 9505.3680; 9505.3690; 9505.3700. 3.35 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.36 ARTICLE 1 3.37 WELFARE REFORM 3.38 Section 1. Minnesota Statutes 2002, section 119B.03, 3.39 subdivision 4, is amended to read: 3.40 Subd. 4. [FUNDING PRIORITY.] (a) First priority for child 3.41 care assistance under the basic sliding fee program must be 3.42 given to eligible non-MFIP families who do not have a high 3.43 school or general equivalency diploma or who need remedial and 3.44 basic skill courses in order to pursue employment or to pursue 3.45 education leading to employment and who need child care 3.46 assistance to participate in the education program. Within this 3.47 priority, the following subpriorities must be used: 3.48 (1) child care needs of minor parents; 3.49 (2) child care needs of parents under 21 years of age; and 3.50 (3) child care needs of other parents within the priority 3.51 group described in this paragraph. 3.52 (b) Second priority must be given to parents who have 4.1 completed their MFIP or work first transition year, or parents 4.2 who are no longer receiving or eligible for diversionary work 4.3 program supports. 4.4 (c) Third priority must be given to families who are 4.5 eligible for portable basic sliding fee assistance through the 4.6 portability pool under subdivision 9. 4.7 Sec. 2. Minnesota Statutes 2002, section 256.984, 4.8 subdivision 1, is amended to read: 4.9 Subdivision 1. [DECLARATION.] Every application for public 4.10 assistance under this chapterand/oror chapters 256B, 256D, 4.11256K, MFIP program256J, and food stamps or food support under 4.12 chapter 393 shall be in writing or reduced to writing as 4.13 prescribed by the state agency and shall contain the following 4.14 declaration which shall be signed by the applicant: 4.15 "I declare under the penalties of perjury that this 4.16 application has been examined by me and to the best of my 4.17 knowledge is a true and correct statement of every material 4.18 point. I understand that a person convicted of perjury may 4.19 be sentenced to imprisonment of not more than five years or 4.20 to payment of a fine of not more than $10,000, or both." 4.21 Sec. 3. Minnesota Statutes 2002, section 256D.053, 4.22 subdivision 1, is amended to read: 4.23 Subdivision 1. [PROGRAM ESTABLISHED.] The Minnesota food 4.24 assistance program is established to provide food assistance to 4.25 legal noncitizens residing in this state who are ineligible to 4.26 participate in the federal Food Stamp Program solely due to the 4.27 provisions of section 402 or 403 of Public LawNumber104-193, 4.28 as authorized by Title VII of the 1997 Emergency Supplemental 4.29 Appropriations Act, Public LawNumber105-18, and as amended by 4.30 Public LawNumber105-185. 4.31Beginning July 1, 2003, the Minnesota food assistance4.32program is limited to those noncitizens described in this4.33subdivision who are 50 years of age or older.4.34 Sec. 4. Minnesota Statutes 2002, section 256J.02, 4.35 subdivision 2, is amended to read: 4.36 Subd. 2. [USE OF MONEY.] State money appropriated for 5.1 purposes of this section and TANF block grant money must be used 5.2 for: 5.3 (1) financial assistance to or on behalf of any minor child 5.4 who is a resident of this state under section 256J.12; 5.5 (2) employment and training services under this chapter or 5.6 chapter 256K; 5.7 (3) emergency financial assistance and services under 5.8 section 256J.48; 5.9 (4)diversionary assistance under section 256J.47;5.10(5)the health care and human services training and 5.11 retention program under chapter 116L, for costs associated with 5.12 families with children with incomes below 200 percent of the 5.13 federal poverty guidelines; 5.14(6)(5) the pathways program under section 116L.04, 5.15 subdivision 1a; 5.16(7)(6) welfare-to-work extended employment services for 5.17 MFIP participants with severe impairment to employment as 5.18 defined in section 268A.15, subdivision 1a; 5.19(8)(7) the family homeless prevention and assistance 5.20 program under section 462A.204; 5.21(9)(8) the rent assistance for family stabilization 5.22 demonstration project under section 462A.205; 5.23(10)(9) welfare to work transportation authorized under 5.24 Public LawNumber105-178; 5.25(11)(10) reimbursements for the federal share of child 5.26 support collections passed through to the custodial parent; 5.27(12)(11) reimbursements for the working family credit 5.28 under section 290.0671; 5.29(13)(12) intensive ESL grants under Laws 2000, chapter 5.30 489, article 1; 5.31(14)(13) transitional housing programs under section 5.32 119A.43; 5.33(15)(14) programs and pilot projects under chapter 256K; 5.34and5.35(16)(15) program administration under this chapter; and 5.36 (16) the diversionary work program under section 256J.95. 6.1 Sec. 5. Minnesota Statutes 2002, section 256J.021, is 6.2 amended to read: 6.3 256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 6.4 Beginning October 1, 2001, and each year thereafter, the 6.5 commissioner of human services must treatfinancial assistance6.6 MFIP expenditures made to or on behalf of any minor child under 6.7 section 256J.02, subdivision 2, clause (1), who is a resident of 6.8 this state under section 256J.12, and who is part of a 6.9 two-parent eligible household as expenditures under a separately 6.10 funded state program and report those expenditures to the 6.11 federal Department of Health and Human Services as separate 6.12 state program expenditures under Code of Federal Regulations, 6.13 title 45, section 263.5. 6.14 Sec. 6. Minnesota Statutes 2002, section 256J.08, is 6.15 amended by adding a subdivision to read: 6.16 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 6.17 "Diversionary work program" or "DWP" has the meaning given in 6.18 section 256J.95. 6.19 Sec. 7. Minnesota Statutes 2002, section 256J.08, is 6.20 amended by adding a subdivision to read: 6.21 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 6.22 illness, injury, or incapacity, a "qualified professional" means 6.23 a licensed physician, a physician's assistant, a nurse 6.24 practitioner, or in the case of spinal subluxation, a licensed 6.25 chiropractor. 6.26 (b) For mental retardation and intelligence testing, a 6.27 "qualified professional" means an individual qualified by 6.28 training and experience to administer the tests necessary to 6.29 make determinations, such as tests of intellectual functioning, 6.30 assessments of adaptive behavior, adaptive skills, and 6.31 developmental functioning. These professionals include licensed 6.32 psychologists, certified school psychologists, or certified 6.33 psychometrists working under the supervision of a licensed 6.34 psychologist. 6.35 (c) For learning disabilities, a "qualified professional" 6.36 means a licensed psychologist or school psychologist with 7.1 experience determining learning disabilities. 7.2 (d) For mental health, a "qualified professional" means a 7.3 licensed physician or a qualified mental health professional. A 7.4 "qualified mental health professional" means: 7.5 (1) for children, in psychiatric nursing, a registered 7.6 nurse who is licensed under sections 148.171 to 148.285, and who 7.7 is certified as a clinical specialist in child and adolescent 7.8 psychiatric or mental health nursing by a national nurse 7.9 certification organization or who has a master's degree in 7.10 nursing or one of the behavioral sciences or related fields from 7.11 an accredited college or university or its equivalent, with at 7.12 least 4,000 hours of post-master's supervised experience in the 7.13 delivery of clinical services in the treatment of mental 7.14 illness; 7.15 (2) for adults, in psychiatric nursing, a registered nurse 7.16 who is licensed under sections 148.171 to 148.285, and who is 7.17 certified as a clinical specialist in adult psychiatric and 7.18 mental health nursing by a national nurse certification 7.19 organization or who has a master's degree in nursing or one of 7.20 the behavioral sciences or related fields from an accredited 7.21 college or university or its equivalent, with at least 4,000 7.22 hours of post-master's supervised experience in the delivery of 7.23 clinical services in the treatment of mental illness; 7.24 (3) in clinical social work, a person licensed as an 7.25 independent clinical social worker under section 148B.21, 7.26 subdivision 6, or a person with a master's degree in social work 7.27 from an accredited college or university, with at least 4,000 7.28 hours of post-master's supervised experience in the delivery of 7.29 clinical services in the treatment of mental illness; 7.30 (4) in psychology, an individual licensed by the board of 7.31 psychology under sections 148.88 to 148.98, who has stated to 7.32 the board of psychology competencies in the diagnosis and 7.33 treatment of mental illness; 7.34 (5) in psychiatry, a physician licensed under chapter 147 7.35 and certified by the American Board of Psychiatry and Neurology 7.36 or eligible for board certification in psychiatry; and 8.1 (6) in marriage and family therapy, the mental health 8.2 professional must be a marriage and family therapist licensed 8.3 under sections 148B.29 to 148B.39, with at least two years of 8.4 post-master's supervised experience in the delivery of clinical 8.5 services in the treatment of mental illness. 8.6 Sec. 8. Minnesota Statutes 2002, section 256J.09, 8.7 subdivision 2, is amended to read: 8.8 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 8.9 INFORMATION.] When a person inquires about assistance, a county 8.10 agency must: 8.11 (1) explain the eligibility requirements of, and how to 8.12 apply for, diversionary assistance as provided in section8.13256J.47;emergency assistance as provided in section 256J.48; 8.14 MFIP as provided in section 256J.10; or any other assistance for 8.15 which the person may be eligible; and 8.16 (2) offer the person brochures developed or approved by the 8.17 commissioner that describe how to apply for assistance. 8.18 Sec. 9. Minnesota Statutes 2002, section 256J.09, 8.19 subdivision 3a, is amended to read: 8.20 Subd. 3a. [SCREENING.] The county agency, or at county 8.21 option, the county's employment and training service provider as 8.22 defined in section 256J.49, must screen each applicant to 8.23 determine immediate needs and to determine if the applicant may 8.24 be eligible for: 8.25 (1) another program that is not partially funded through 8.26 the federal temporary assistance to needy families block grant 8.27 under Title I of Public LawNumber104-193, including the 8.28 expedited issuance of food stamps under section 256J.28, 8.29 subdivision 1. If the applicant may be eligible for another 8.30 program, a county caseworker must provide the appropriate 8.31 referral to the program; 8.32(2) the diversionary assistance program under section8.33256J.47;or 8.34(3)(2) the emergency assistance program under section 8.35 256J.48. 8.36 Sec. 10. Minnesota Statutes 2002, section 256J.09, 9.1 subdivision 10, is amended to read: 9.2 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 9.3 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 9.4 applicant is not eligible for MFIP or the diversionary work 9.5 program under section 256J.95 because the applicant does not 9.6 meet eligibility requirements, the county agency must determine 9.7 whether the applicant is eligible for food stamps, medical 9.8 assistance,diversionary assistance,or has a need for emergency 9.9 assistance when the applicant meets the eligibility requirements 9.10 for those programs. 9.11 Sec. 11. Minnesota Statutes 2002, section 256J.21, 9.12 subdivision 2, is amended to read: 9.13 Subd. 2. [INCOME EXCLUSIONS.] The following must be 9.14 excluded in determining a family's available income: 9.15 (1) payments for basic care, difficulty of care, and 9.16 clothing allowances received for providing family foster care to 9.17 children or adults under Minnesota Rules, parts 9545.0010 to 9.18 9545.0260 and 9555.5050 to 9555.6265, and payments received and 9.19 used for care and maintenance of a third-party beneficiary who 9.20 is not a household member; 9.21 (2) reimbursements for employment training received through 9.22 theJob Training PartnershipWorkforce Investment Act of 1998, 9.23 United States Code, title2920, chapter1973,sections 15019.24to 1792bsection 9201; 9.25 (3) reimbursement for out-of-pocket expenses incurred while 9.26 performing volunteer services, jury duty, employment, or 9.27 informal carpooling arrangements directly related to employment; 9.28 (4) all educational assistance, except the county agency 9.29 must count graduate student teaching assistantships, 9.30 fellowships, and other similar paid work as earned income and, 9.31 after allowing deductions for any unmet and necessary 9.32 educational expenses, shall count scholarships or grants awarded 9.33 to graduate students that do not require teaching or research as 9.34 unearned income; 9.35 (5) loans, regardless of purpose, from public or private 9.36 lending institutions, governmental lending institutions, or 10.1 governmental agencies; 10.2 (6) loans from private individuals, regardless of purpose, 10.3 provided an applicant or participant documents that the lender 10.4 expects repayment; 10.5 (7)(i) state income tax refunds; and 10.6 (ii) federal income tax refunds; 10.7 (8)(i) federal earned income credits; 10.8 (ii) Minnesota working family credits; 10.9 (iii) state homeowners and renters credits under chapter 10.10 290A; and 10.11 (iv) federal or state tax rebates; 10.12 (9) funds received for reimbursement, replacement, or 10.13 rebate of personal or real property when these payments are made 10.14 by public agencies, awarded by a court, solicited through public 10.15 appeal, or made as a grant by a federal agency, state or local 10.16 government, or disaster assistance organizations, subsequent to 10.17 a presidential declaration of disaster; 10.18 (10) the portion of an insurance settlement that is used to 10.19 pay medical, funeral, and burial expenses, or to repair or 10.20 replace insured property; 10.21 (11) reimbursements for medical expenses that cannot be 10.22 paid by medical assistance; 10.23 (12) payments by a vocational rehabilitation program 10.24 administered by the state under chapter 268A, except those 10.25 payments that are for current living expenses; 10.26 (13) in-kind income, including any payments directly made 10.27 by a third party to a provider of goods and services; 10.28 (14) assistance payments to correct underpayments, but only 10.29 for the month in which the payment is received; 10.30 (15) emergency assistance payments; 10.31 (16) funeral and cemetery payments as provided by section 10.32 256.935; 10.33 (17) nonrecurring cash gifts of $30 or less, not exceeding 10.34 $30 per participant in a calendar month; 10.35 (18) any form of energy assistance payment made through 10.36 Public LawNumber97-35, Low-Income Home Energy Assistance Act 11.1 of 1981, payments made directly to energy providers by other 11.2 public and private agencies, and any form of credit or rebate 11.3 payment issued by energy providers; 11.4 (19) Supplemental Security Income (SSI), including 11.5 retroactive SSI payments and other income of an SSI recipient; 11.6 (20) Minnesota supplemental aid, including retroactive 11.7 payments; 11.8 (21) proceeds from the sale of real or personal property; 11.9 (22) adoption assistance payments under section 259.67; 11.10 (23) state-funded family subsidy program payments made 11.11 under section 252.32 to help families care for children with 11.12 mental retardation or related conditions, consumer support grant 11.13 funds under section 256.476, and resources and services for a 11.14 disabled household member under one of the home and 11.15 community-based waiver services programs under chapter 256B; 11.16 (24) interest payments and dividends from property that is 11.17 not excluded from and that does not exceed the asset limit; 11.18 (25) rent rebates; 11.19 (26) income earned by a minor caregiver, minor child 11.20 through age 6, or a minor child who is at least a half-time 11.21 student in an approved elementary or secondary education 11.22 program; 11.23 (27) income earned by a caregiver under age 20 who is at 11.24 least a half-time student in an approved elementary or secondary 11.25 education program; 11.26 (28) MFIP child care payments under section 119B.05; 11.27 (29) all other payments made through MFIP to support a 11.28 caregiver's pursuit of greater self-support; 11.29 (30) income a participant receives related to shared living 11.30 expenses; 11.31 (31) reverse mortgages; 11.32 (32) benefits provided by the Child Nutrition Act of 1966, 11.33 United States Code, title 42, chapter 13A, sections 1771 to 11.34 1790; 11.35 (33) benefits provided by the women, infants, and children 11.36 (WIC) nutrition program, United States Code, title 42, chapter 12.1 13A, section 1786; 12.2 (34) benefits from the National School Lunch Act, United 12.3 States Code, title 42, chapter 13, sections 1751 to 1769e; 12.4 (35) relocation assistance for displaced persons under the 12.5 Uniform Relocation Assistance and Real Property Acquisition 12.6 Policies Act of 1970, United States Code, title 42, chapter 61, 12.7 subchapter II, section 4636, or the National Housing Act, United 12.8 States Code, title 12, chapter 13, sections 1701 to 1750jj; 12.9 (36) benefits from the Trade Act of 1974, United States 12.10 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 12.11 (37) war reparations payments to Japanese Americans and 12.12 Aleuts under United States Code, title 50, sections 1989 to 12.13 1989d; 12.14 (38) payments to veterans or their dependents as a result 12.15 of legal settlements regarding Agent Orange or other chemical 12.16 exposure under Public LawNumber101-239, section 10405, 12.17 paragraph (a)(2)(E); 12.18 (39) income that is otherwise specifically excluded from 12.19 MFIP consideration in federal law, state law, or federal 12.20 regulation; 12.21 (40) security and utility deposit refunds; 12.22 (41) American Indian tribal land settlements excluded under 12.23 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 12.24 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 12.25 and Mille Lacs reservations and payments to members of the White 12.26 Earth Band, under United States Code, title 25, chapter 9, 12.27 section 331, and chapter 16, section 1407; 12.28 (42) all income of the minor parent's parents and 12.29 stepparents when determining the grant for the minor parent in 12.30 households that include a minor parent living with parents or 12.31 stepparents on MFIP with other children; 12.32 (43) income of the minor parent's parents and stepparents 12.33 equal to 200 percent of the federal poverty guideline for a 12.34 family size not including the minor parent and the minor 12.35 parent's child in households that include a minor parent living 12.36 with parents or stepparents not on MFIP when determining the 13.1 grant for the minor parent. The remainder of income is deemed 13.2 as specified in section 256J.37, subdivision 1b; 13.3 (44) payments made to children eligible for relative 13.4 custody assistance under section 257.85; 13.5 (45) vendor payments for goods and services made on behalf 13.6 of a client unless the client has the option of receiving the 13.7 payment in cash; and 13.8 (46) the principal portion of a contract for deed payment. 13.9 Sec. 12. Minnesota Statutes 2002, section 256J.24, 13.10 subdivision 3, is amended to read: 13.11 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 13.12 ASSISTANCE UNIT.] (a) The following individuals who are part of 13.13 the assistance unit determined under subdivision 2 are 13.14 ineligible to receive MFIP: 13.15 (1) individualsreceivingwho are recipients of 13.16 Supplemental Security Income or Minnesota supplemental aid; 13.17 (2) individuals disqualified from the food stamp program or 13.18 MFIP, until the disqualification ends; 13.19 (3) children on whose behalf federal, state or local foster 13.20 care payments are made, except as provided in sections 256J.13, 13.21 subdivision 2, and 256J.74, subdivision 2; and 13.22 (4) children receiving ongoing monthly adoption assistance 13.23 payments under section 259.67. 13.24 (b) The exclusion of a person under this subdivision does 13.25 not alter the mandatory assistance unit composition. 13.26 Sec. 13. Minnesota Statutes 2002, section 256J.37, 13.27 subdivision 9, is amended to read: 13.28 Subd. 9. [UNEARNED INCOME.](a)The county agency must 13.29 apply unearned income to the MFIP standard of need. When 13.30 determining the amount of unearned income, the county agency 13.31 must deduct the costs necessary to secure payments of unearned 13.32 income. These costs include legal fees, medical fees, and 13.33 mandatory deductions such as federal and state income taxes. 13.34(b) Effective July 1, 2003, the county agency shall count13.35$100 of the value of public and assisted rental subsidies13.36provided through the Department of Housing and Urban Development14.1(HUD) as unearned income. The full amount of the subsidy must14.2be counted as unearned income when the subsidy is less than $100.14.3(c) The provisions of paragraph (b) shall not apply to MFIP14.4participants who are exempt from the employment and training14.5services component because they are:14.6(i) individuals who are age 60 or older;14.7(ii) individuals who are suffering from a professionally14.8certified permanent or temporary illness, injury, or incapacity14.9which is expected to continue for more than 30 days and which14.10prevents the person from obtaining or retaining employment; or14.11(iii) caregivers whose presence in the home is required14.12because of the professionally certified illness or incapacity of14.13another member in the assistance unit, a relative in the14.14household, or a foster child in the household.14.15(d) The provisions of paragraph (b) shall not apply to an14.16MFIP assistance unit where the parental caregiver receives14.17supplemental security income.14.18 Sec. 14. Minnesota Statutes 2002, section 256J.38, 14.19 subdivision 3, is amended to read: 14.20 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER14.21PARTICIPANTS.] A county agency must initiate efforts to recover 14.22 overpayments paid to a former participant or caregiver.Adults14.23 Caregivers, both parental and nonparental, and minor caregivers 14.24 of an assistance unit at the time an overpayment occurs, whether 14.25 receiving assistance or not, are jointly and individually liable 14.26 for repayment of the overpayment. The county agency must 14.27 request repayment from the former participants and caregivers. 14.28 When an agreement for repayment is not completed within six 14.29 months of the date of discovery or when there is a default on an 14.30 agreement for repayment after six months, the county agency must 14.31 initiate recovery consistent with chapter 270A, or section 14.32 541.05. When a person has been convicted of fraud under section 14.33 256.98, recovery must be sought regardless of the amount of 14.34 overpayment. When an overpayment is less than $35, and is not 14.35 the result of a fraud conviction under section 256.98, the 14.36 county agency must not seek recovery under this subdivision. 15.1 The county agency must retain information about all overpayments 15.2 regardless of the amount. When an adult, adult caregiver, or 15.3 minor caregiver reapplies for assistance, the overpayment must 15.4 be recouped under subdivision 4. 15.5 Sec. 15. Minnesota Statutes 2002, section 256J.40, is 15.6 amended to read: 15.7 256J.40 [FAIR HEARINGS.] 15.8 Caregivers receiving a notice of intent to sanction or a 15.9 notice of adverse action that includes a sanction, reduction in 15.10 benefits, suspension of benefits, denial of benefits, or 15.11 termination of benefits may request a fair hearing. A request 15.12 for a fair hearing must be submitted in writing to the county 15.13 agency or to the commissioner and must be mailed within 30 days 15.14 after a participant or former participant receives written 15.15 notice of the agency's action or within 90 days when a 15.16 participant or former participant shows good cause for not 15.17 submitting the request within 30 days. A former participant who 15.18 receives a notice of adverse action due to an overpayment may 15.19 appeal the adverse action according to the requirements in this 15.20 section. Issues that may be appealed are: 15.21 (1) the amount of the assistance payment; 15.22 (2) a suspension, reduction, denial, or termination of 15.23 assistance; 15.24 (3) the basis for an overpayment, the calculated amount of 15.25 an overpayment, and the level of recoupment; 15.26 (4) the eligibility for an assistance payment; and 15.27 (5) the use of protective or vendor payments under section 15.28 256J.39, subdivision 2, clauses (1) to (3). 15.29 Except for benefits issued under section 256J.95, a county 15.30 agency must not reduce, suspend, or terminate payment when an 15.31 aggrieved participant requests a fair hearing prior to the 15.32 effective date of the adverse action or within ten days of the 15.33 mailing of the notice of adverse action, whichever is later, 15.34 unless the participant requests in writing not to receive 15.35 continued assistance pending a hearing decision. An appeal 15.36 request cannot extend benefits for the diversionary work program 16.1 under section 256J.95 beyond the four-month time limit. 16.2 Assistance issued pending a fair hearing is subject to recovery 16.3 under section 256J.38 when as a result of the fair hearing 16.4 decision the participant is determined ineligible for assistance 16.5 or the amount of the assistance received. A county agency may 16.6 increase or reduce an assistance payment while an appeal is 16.7 pending when the circumstances of the participant change and are 16.8 not related to the issue on appeal. The commissioner's order is 16.9 binding on a county agency. No additional notice is required to 16.10 enforce the commissioner's order. 16.11 A county agency shall reimburse appellants for reasonable 16.12 and necessary expenses of attendance at the hearing, such as 16.13 child care and transportation costs and for the transportation 16.14 expenses of the appellant's witnesses and representatives to and 16.15 from the hearing. Reasonable and necessary expenses do not 16.16 include legal fees. Fair hearings must be conducted at a 16.17 reasonable time and date by an impartial referee employed by the 16.18 department. The hearing may be conducted by telephone or at a 16.19 site that is readily accessible to persons with disabilities. 16.20 The appellant may introduce new or additional evidence 16.21 relevant to the issues on appeal. Recommendations of the 16.22 appeals referee and decisions of the commissioner must be based 16.23 on evidence in the hearing record and are not limited to a 16.24 review of the county agency action. 16.25 Sec. 16. Minnesota Statutes 2002, section 256J.42, 16.26 subdivision 5, is amended to read: 16.27 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 16.28 assistance received by an assistance unit does not count toward 16.29 the 60-month limit on assistance during a month in which the 16.30 caregiver isin the category inage 60 or older, including 16.31 months during which the caregiver was exempt under section 16.32 256J.56, paragraph (a), clause (1). 16.33 (b) From July 1, 1997, until the date MFIP is operative in 16.34 the caregiver's county of financial responsibility, any cash 16.35 assistance received by a caregiver who is complying with 16.36 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 17.1 Minnesota Statutes 1998, section 256.736, if applicable, does 17.2 not count toward the 60-month limit on assistance. Thereafter, 17.3 any cash assistance received by a minor caregiver who is 17.4 complying with the requirements of sections 256J.14 and 256J.54, 17.5 if applicable, does not count towards the 60-month limit on 17.6 assistance. 17.7 (c) Any diversionary assistance or emergency assistance 17.8 received does not count toward the 60-month limit. 17.9 (d) Any cash assistance received by an 18- or 19-year-old 17.10 caregiver who is complying with the requirements of section 17.11 256J.54 does not count toward the 60-month limit. 17.12 (e) Diversionary work program benefits provided under 17.13 section 256J.95 do not count toward the 60-month time limit. 17.14 Sec. 17. Minnesota Statutes 2002, section 256J.425, 17.15 subdivision 2, is amended to read: 17.16 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 17.17 subject to the time limit in section 256J.42, subdivision 1,in17.18which any participant has received 60 counted months of17.19assistance,is eligible to receive months of assistance under a 17.20 hardship extension if the participant who reached the time limit 17.21 belongs to any of the following groups: 17.22 (1) participants who are suffering froma professionally17.23certifiedan illness, injury, or incapacity which has been 17.24 certified by a qualified professional when the illness, injury, 17.25 or incapacity is expected to continue for more than 30 days 17.26 andwhichprevents the person from obtaining or retaining 17.27 employmentand who are following. These participants must 17.28 follow the treatment recommendations of thehealth care provider17.29 qualified professional certifying the illness, injury, or 17.30 incapacity; 17.31 (2) participants whose presence in the home is required as 17.32 a caregiver because ofa professionally certifiedthe illness or 17.33 incapacity of another member in the assistance unit, a relative 17.34 in the household, or a foster child in the householdandwhen 17.35 the illness or incapacity and the need for the participant's 17.36 presence in the home has been certified by a qualified 18.1 professional and is expected to continue for more than 30 days; 18.2 or 18.3 (3) caregivers with a child or an adult in the household 18.4 who meets the disability or medical criteria for home care 18.5 services under section 256B.0627, subdivision 1, paragraph (c), 18.6 or a home and community-based waiver services program under 18.7 chapter 256B, or meets the criteria for severe emotional 18.8 disturbance under section 245.4871, subdivision 6, or for 18.9 serious and persistent mental illness under section 245.462, 18.10 subdivision 20, paragraph (c). Caregivers in this category are 18.11 presumed to be prevented from obtaining or retaining employment. 18.12 (b) An assistance unit receiving assistance under a 18.13 hardship extension under this subdivision may continue to 18.14 receive assistance as long as the participant meets the criteria 18.15 in paragraph (a), clause (1), (2), or (3). 18.16 Sec. 18. Minnesota Statutes 2002, section 256J.425, 18.17 subdivision 3, is amended to read: 18.18 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 18.19 subject to the time limit in section 256J.42, subdivision 1,in18.20which any participant has received 60 counted months of18.21assistance,is eligible to receive months of assistance under a 18.22 hardship extension if the participant who reached the time limit 18.23 belongs to any of the following groups: 18.24 (1) a person who is diagnosed by a licensed physician, 18.25 psychological practitioner, or other qualified professional, as 18.26 mentally retarded or mentally ill, and that condition prevents 18.27 the person from obtaining or retaining unsubsidized employment; 18.28 (2) a person who: 18.29 (i) has been assessed by a vocational specialist or the 18.30 county agency to be unemployable for purposes of this 18.31 subdivision; or 18.32 (ii) has an IQ below 80 who has been assessed by a 18.33 vocational specialist or a county agency to be employable, but 18.34 not at a level that makes the participant eligible for an 18.35 extension under subdivision 4or,. The determination of IQ 18.36 level must be made by a qualified professional. In the case of 19.1 a non-English-speaking person for whom it is not possible to 19.2 provide a determination due to language barriers or absence of 19.3 culturally appropriate assessment tools, is determined by a 19.4 qualified professional to have an IQ below 80. A person is 19.5 considered employable if positions of employment in the local 19.6 labor market exist, regardless of the current availability of 19.7 openings for those positions, that the person is capable of 19.8 performing; 19.9 (3) a person who is determined bythe county agencya 19.10 qualified professional to be learning disabled or, in the case 19.11 of a non-English-speaking person for whom it is not possible to 19.12 provide a medical diagnosis due to language barriers or absence 19.13 of culturally appropriate assessment tools, is determined by a 19.14 qualified professional to have a learning disability. If a 19.15 rehabilitation plan for the person is developed or approved by 19.16 the county agency, the plan must be incorporated into the 19.17 employment plan. However, a rehabilitation plan does not 19.18 replace the requirement to develop and comply with an employment 19.19 plan under section 256J.52. For purposes of this section, 19.20 "learning disabled" means the applicant or recipient has a 19.21 disorder in one or more of the psychological processes involved 19.22 in perceiving, understanding, or using concepts through verbal 19.23 language or nonverbal means. The disability must severely limit 19.24 the applicant or recipient in obtaining, performing, or 19.25 maintaining suitable employment. Learning disabled does not 19.26 include learning problems that are primarily the result of 19.27 visual, hearing, or motor handicaps; mental retardation; 19.28 emotional disturbance; or due to environmental, cultural, or 19.29 economic disadvantage; or 19.30 (4) a person who is a victim of family violence as defined 19.31 in section 256J.49, subdivision 2, and who is participating in 19.32 an alternative employment plan under section 256J.49, 19.33 subdivision 1a. 19.34 Sec. 19. Minnesota Statutes 2002, section 256J.425, 19.35 subdivision 4, is amended to read: 19.36 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 20.1 subject to the time limit under section 256J.42, subdivision 1, 20.2in which any participant has received 60 months of assistance,20.3 is eligible to receive assistance under a hardship extension if 20.4 the participant who reached the time limit belongs to: 20.5 (1) a one-parent assistance unit in which the participant 20.6 is participating in work activities for at least 30 hours per 20.7 week, of which an average of at least 25 hours per week every 20.8 month are spent participating in employment; 20.9 (2) a two-parent assistance unit in which the participants 20.10 are participating in work activities for at least 55 hours per 20.11 week, of which an average of at least 45 hours per week every 20.12 month are spent participating in employment; or 20.13 (3) an assistance unit in which a participant is 20.14 participating in employment for fewer hours than those specified 20.15 in clause (1), and the participant submits verification from a 20.16health care providerqualified professional, in a form 20.17 acceptable to the commissioner, stating that the number of hours 20.18 the participant may work is limited due to illness or 20.19 disability, as long as the participant is participating in 20.20 employment for at least the number of hours specified by 20.21 thehealth care providerqualified professional. The 20.22 participant must be following the treatment recommendations of 20.23 thehealth care providerqualified professional providing the 20.24 verification. The commissioner shall develop a form to be 20.25 completed and signed by thehealth care providerqualified 20.26 professional, documenting the diagnosis and any additional 20.27 information necessary to document the functional limitations of 20.28 the participant that limit work hours. If the participant is 20.29 part of a two-parent assistance unit, the other parent must be 20.30 treated as a one-parent assistance unit for purposes of meeting 20.31 the work requirements under this subdivision. 20.32 (b) For purposes of this section, employment means: 20.33 (1) unsubsidized employment under section 256J.49, 20.34 subdivision 13, clause (1); 20.35 (2) subsidized employment under section 256J.49, 20.36 subdivision 13, clause (2); 21.1 (3) on-the-job training under section 256J.49, subdivision 21.2 13, clause (4); 21.3 (4) an apprenticeship under section 256J.49, subdivision 21.4 13, clause (19); 21.5 (5) supported work. For purposes of this section, 21.6 "supported work" means services supporting a participant on the 21.7 job which include, but are not limited to, supervision, job 21.8 coaching, and subsidized wages; 21.9 (6) a combination of clauses (1) to (5); or 21.10 (7) child care under section 256J.49, subdivision 13, 21.11 clause (25), if it is in combination with paid employment. 21.12 (c) If a participant is complying with a child protection 21.13 plan under chapter 260C, the number of hours required under the 21.14 child protection plan count toward the number of hours required 21.15 under this subdivision. 21.16 (d) The county shall provide the opportunity for subsidized 21.17 employment to participants needing that type of employment 21.18 within available appropriations. 21.19 (e) To be eligible for a hardship extension for employed 21.20 participants under this subdivision, a participant in a 21.21 one-parent assistance unit or both parents in a two-parent 21.22 assistance unit must be in compliance for at least ten out of 21.23 the 12 months immediately preceding the participant's 61st month 21.24 on assistance. If only one parent in a two-parent assistance 21.25 unit fails to be in compliance ten out of the 12 months 21.26 immediately preceding the participant's 61st month, the county 21.27 shall give the assistance unit the option of disqualifying the 21.28 noncompliant parent. If the noncompliant participant is 21.29 disqualified, the assistance unit must be treated as a 21.30 one-parent assistance unit for the purposes of meeting the work 21.31 requirements under this subdivision and the assistance unit's 21.32 MFIP grant shall be calculated using the shared household 21.33 standard under section 256J.08, subdivision 82a. 21.34 (f) The employment plan developed under section 256J.52, 21.35 subdivision 5, for participants under this subdivision must 21.36 contain the number of hours specified in paragraph (a) related 22.1 to employment and work activities. The job counselor and the 22.2 participant must sign the employment plan to indicate agreement 22.3 between the job counselor and the participant on the contents of 22.4 the plan. 22.5 (g) Participants who fail to meet the requirements in 22.6 paragraph (a), without good cause under section 256J.57, shall 22.7 be sanctioned or permanently disqualified under subdivision 6. 22.8 Good cause may only be granted for that portion of the month for 22.9 which the good cause reason applies. Participants must meet all 22.10 remaining requirements in the approved employment plan or be 22.11 subject to sanction or permanent disqualification. 22.12 (h) If the noncompliance with an employment plan is due to 22.13 the involuntary loss of employment, the participant is exempt 22.14 from the hourly employment requirement under this subdivision 22.15 for one month. Participants must meet all remaining 22.16 requirements in the approved employment plan or be subject to 22.17 sanction or permanent disqualification. This exemption is 22.18 available to one-parent assistance units two times in a 12-month 22.19 period, and two-parent assistance units, two times per parent in 22.20 a 12-month period. 22.21(i) This subdivision expires on June 30, 2004.22.22 Sec. 20. Minnesota Statutes 2002, section 256J.425, 22.23 subdivision 6, is amended to read: 22.24 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 22.25 both participants in an assistance unit receiving assistance 22.26 under subdivision 3 or 4 are not in compliance with the 22.27 employment and training service requirements in sections 256J.52 22.28 to 256J.55, the sanctions under this subdivision apply. For a 22.29 first occurrence of noncompliance, an assistance unit must be 22.30 sanctioned under section 256J.46, subdivision 1, paragraph (d), 22.31 clause (1). For a second orthirdsubsequent occurrence of 22.32 noncompliance, the assistance unit must be sanctioned under 22.33 section 256J.46, subdivision 1, paragraph (d), clause (2).For22.34a fourth occurrence of noncompliance, the assistance unit is22.35disqualified from MFIP. If a participant is determined to be22.36out of compliance, the participant may claim a good cause23.1exception under section 256J.57, however, the participant may23.2not claim an exemption under section 256J.56.23.3 (b) If both participants in a two-parent assistance unit 23.4 are out of compliance at the same time, it is considered one 23.5 occurrence of noncompliance. 23.6 Sec. 21. Minnesota Statutes 2002, section 256J.50, 23.7 subdivision 1, is amended to read: 23.8 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 23.9 OF MFIP.] (a)By January 1, 1998,Each county must develop and 23.10implementprovide an employment and training services component 23.11of MFIPwhich is designed to put participants on the most direct 23.12 path to unsubsidized employment. Participation in these 23.13 services is mandatory for all MFIP caregivers, unless the 23.14 caregiver is exempt under section 256J.56. 23.15 (b) A county must provide employment and training services 23.16 under sections 256J.515 to 256J.74 within 30 days after 23.17 thecaregiver's participation becomes mandatory under23.18subdivision 5 or within 30 days of receipt of a request for23.19services from a caregiver who under section 256J.42 is no longer23.20eligible to receive MFIP but whose income is below 120 percent23.21of the federal poverty guidelines for a family of the same23.22size. The request must be made within 12 months of the date the23.23caregivers' MFIP case was closedcaregiver is determined 23.24 eligible for MFIP, or within five days when the caregiver 23.25 participated in the diversionary work program under section 23.26 256J.95 within the past 12 months. 23.27 Sec. 22. Minnesota Statutes 2002, section 256J.50, 23.28 subdivision 8, is amended to read: 23.29 Subd. 8. [COUNTY DUTY TO ENSURE EMPLOYMENT AND TRAINING 23.30 CHOICES FOR PARTICIPANTS.] Each county, or group of counties 23.31 working cooperatively, shall make available to participants the 23.32 choice of at least two employment and training service providers 23.33 as defined under section 256J.49, subdivision 4, except in 23.34 counties utilizing workforce centers that use multiple 23.35 employment and training services, offer multiple services 23.36 options under a collaborative effort and can document that 24.1 participants have choice among employment and training services 24.2 designed to meet specialized needs. The requirements of this 24.3 subdivision do not apply to the diversionary work program under 24.4 section 256J.95. 24.5 Sec. 23. Minnesota Statutes 2002, section 256J.55, 24.6 subdivision 2, is amended to read: 24.7 Subd. 2. [DUTY TO REPORT.] The participant must inform the 24.8 job counselor withinthreeten working days regarding any 24.9 changes related to the participant's employment status. 24.10 Sec. 24. Minnesota Statutes 2002, section 256J.56, is 24.11 amended to read: 24.12 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 24.13 EXEMPTIONS.] 24.14 (a) An MFIP participant is exempt from the requirements of 24.15 sections 256J.52 to 256J.55 if the participant belongs to any of 24.16 the following groups: 24.17 (1) participants who are age 60 or older; 24.18 (2) participants who are suffering from aprofessionally24.19certifiedpermanent or temporary illness, injury, or incapacity 24.20 which has been certified by a qualified professional when the 24.21 illness, injury, or incapacity is expected to continue for more 24.22 than 30 days andwhichprevents the person from obtaining or 24.23 retaining employment. Persons in this category with a temporary 24.24 illness, injury, or incapacity must be reevaluated at least 24.25 quarterly; 24.26 (3) participants whose presence in the home is required as 24.27 a caregiver because ofa professionally certifiedthe illness or 24.28 incapacity of another member in the assistance unit, a relative 24.29 in the household, or a foster child in the householdandwhen 24.30 the illness or incapacity and the need for the participant's 24.31 presence in the home has been certified by a qualified 24.32 professional and is expected to continue for more than 30 days; 24.33 (4) women who are pregnant, if the pregnancy has resulted 24.34 ina professionally certifiedan incapacity that prevents the 24.35 woman from obtaining or retaining employment, and the incapacity 24.36 has been certified by a qualified professional; 25.1 (5) caregivers of a child under the age of one year who 25.2 personally provide full-time care for the child. This exemption 25.3 may be used for only 12 months in a lifetime. In two-parent 25.4 households, only one parent or other relative may qualify for 25.5 this exemption; 25.6 (6) participants experiencing a personal or family crisis 25.7 that makes them incapable of participating in the program, as 25.8 determined by the county agency. If the participant does not 25.9 agree with the county agency's determination, the participant 25.10 may seekprofessionalcertification from a qualified 25.11 professional, as defined in section 256J.08, that the 25.12 participant is incapable of participating in the program. 25.13 Persons in this exemption category must be reevaluated 25.14 every 60 days. A personal or family crisis related to family 25.15 violence, as determined by the county or a job counselor with 25.16 the assistance of a person trained in domestic violence, should 25.17 not result in an exemption, but should be addressed through the 25.18 development or revision of an alternative employment plan under 25.19 section 256J.52, subdivision 6; or 25.20 (7) caregivers with a child or an adult in the household 25.21 who meets the disability or medical criteria for home care 25.22 services under section 256B.0627, subdivision 1, paragraph (c), 25.23 or a home and community-based waiver services program under 25.24 chapter 256B, or meets the criteria for severe emotional 25.25 disturbance under section 245.4871, subdivision 6, or for 25.26 serious and persistent mental illness under section 245.462, 25.27 subdivision 20, paragraph (c). Caregivers in this exemption 25.28 category are presumed to be prevented from obtaining or 25.29 retaining employment. 25.30 A caregiver who is exempt under clause (5) must enroll in 25.31 and attend an early childhood and family education class, a 25.32 parenting class, or some similar activity, if available, during 25.33 the period of time the caregiver is exempt under this section. 25.34 Notwithstanding section 256J.46, failure to attend the required 25.35 activity shall not result in the imposition of a sanction. 25.36 (b) The county agency must provide employment and training 26.1 services to MFIP participants who are exempt under this section, 26.2 but who volunteer to participate. Exempt volunteers may request 26.3 approval for any work activity under section 256J.49, 26.4 subdivision 13. The hourly participation requirements for 26.5 nonexempt participants under section 256J.50, subdivision 5, do 26.6 not apply to exempt participants who volunteer to participate. 26.7 Sec. 25. Minnesota Statutes 2002, section 256J.751, 26.8 subdivision 2, is amended to read: 26.9 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 26.10 shall report quarterly to all counties on each county's 26.11 performance on the following measures: 26.12 (1) percent of MFIP caseload working in paid employment; 26.13 (2) percent of MFIP caseload receiving only the food 26.14 portion of assistance; 26.15 (3) number of MFIP cases that have left assistance; 26.16 (4) federal participation requirements as specified in 26.17 Title 1 of Public LawNumber104-193; 26.18 (5) median placement wage rate; and 26.19 (6) caseload by months of TANF assistance. 26.20 Sec. 26. Minnesota Statutes 2002, section 256J.751, 26.21 subdivision 5, is amended to read: 26.22 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 26.23 (a) If sanctions occur for failure to meet the performance 26.24 standards specified in title 1 of Public LawNumber104-193 of 26.25 the Personal Responsibility and Work Opportunity Act of 1996, 26.26 the state shall pay 88 percent of the sanction. The remaining 26.27 12 percent of the sanction will be paid by the counties. The 26.28 county portion of the sanction will be distributed across all 26.29 counties in proportion to each county's percentage of the MFIP 26.30 average monthly caseload during the period for which the 26.31 sanction was applied. 26.32 (b) If a county fails to meet the performance standards 26.33 specified in title 1 of Public LawNumber104-193 of the 26.34 Personal Responsibility and Work Opportunity Act of 1996 for any 26.35 year, the commissioner shall work with counties to organize a 26.36 joint state-county technical assistance team to work with the 27.1 county. The commissioner shall coordinate any technical 27.2 assistance with other departments and agencies including the 27.3 departments of economic security and children, families, and 27.4 learning as necessary to achieve the purpose of this paragraph. 27.5 Sec. 27. [256J.95] [DIVERSIONARY WORK PROGRAM.] 27.6 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 27.7 (DWP).] (a) The Personal Responsibility and Work Opportunity 27.8 Reconciliation Act of 1996, Public Law 104-193, establishes 27.9 block grants to states for temporary assistance for needy 27.10 families (TANF). TANF provisions allow states to use TANF 27.11 dollars for nonrecurrent, short-term diversionary benefits. The 27.12 diversionary work program established on July 1, 2003, is 27.13 Minnesota's TANF program to provide short-term diversionary 27.14 benefits to eligible recipients of the diversionary work program. 27.15 (b) The goal of the diversionary work program is to provide 27.16 short-term, necessary services and supports to families which 27.17 will lead to unsubsidized employment, increase economic 27.18 stability, and reduce the risk of those families needing longer 27.19 term assistance, under the Minnesota family investment program 27.20 (MFIP). 27.21 (c) When a family unit meets the eligibility criteria in 27.22 this section, the family must receive a diversionary work 27.23 program grant and is not eligible for MFIP. 27.24 (d) A family unit is eligible for the diversionary work 27.25 program for a maximum of four months only once in a 12-month 27.26 period. The 12-month period begins at the date of application 27.27 or the date eligibility is met, whichever is later. Counties 27.28 may provide supportive and other allowable services funded by 27.29 section 256J.62, including $75 for transportation-related 27.30 expenses, to eligible participants during the four-month 27.31 diversionary period. 27.32 Subd. 2. [DEFINITIONS.] The terms used in this section 27.33 have the following meanings. 27.34 (a) "Diversionary Work Program (DWP)" means the program 27.35 established under this section. 27.36 (b) "Employment plan" means a plan developed by the job 28.1 counselor and the participant which identifies the participant's 28.2 most direct path to unsubsidized employment, lists the specific 28.3 steps that the caregiver will take on that path, and includes a 28.4 timetable for the completion of each step. For participants who 28.5 request and qualify for a family violence waiver in section 28.6 256J.521, subdivision 3, an employment plan must be developed by 28.7 the job counselor, the participant and a person trained in 28.8 domestic violence and follow the employment plan provisions in 28.9 section 256J.521, subdivision 3. Employment plans under this 28.10 section shall be written for a period of time not to exceed four 28.11 months. 28.12 (c) "Employment services" means programs, activities, and 28.13 services in this section that are designed to assist 28.14 participants in obtaining and retaining employment. 28.15 (d) "Family maintenance needs" means current housing costs 28.16 including rent, manufactured home lot rental costs, or monthly 28.17 principal, interest, insurance premiums, and property taxes due 28.18 for mortgages or contracts for deed, association fees required 28.19 for homeownership, utility costs for current month expenses of 28.20 gas and electric, garbage, water and sewer, and a flat rate of 28.21 $35 for a telephone. 28.22 (e) "Family unit" means a group of people applying for or 28.23 receiving DWP benefits together. For the purposes of 28.24 determining eligibility for this program, the unit includes the 28.25 relationships in section 256J.24, subdivisions 2 and 4. 28.26 (f) "Minnesota family investment program (MFIP)" means the 28.27 assistance program as defined in section 256J.08, subdivision 57. 28.28 (g) "Personal needs allowance" means an allowance of $70 28.29 per month per DWP unit member to pay for expenses such as 28.30 household products and personal products, to the extent such 28.31 amounts are available when calculating the diversionary work 28.32 program grant under subdivision 10. 28.33 (h) "Work activities" means allowable work activities as 28.34 defined in section 256J.49, subdivision 13. 28.35 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 28.36 Individuals who apply for cash benefits and who meet MFIP 29.1 eligibility under sections 256J.11 to 256J.15, and have a high 29.2 school diploma or its equivalent and have participated in either 29.3 employment for 30 or more hours per week in four of the previous 29.4 12 months or are currently working at least 30 hours per week 29.5 must participate in the diversionary work program. 29.6 (b) Family units who are not eligible for the diversionary 29.7 work programs include: 29.8 (1) individuals who have no full-time work experience, 29.9 which equals at least 30 hours per week, in any of the past 12 29.10 months; 29.11 (2) child-only cases; 29.12 (3) a caregiver age 60 or older; 29.13 (4) a caregiver who has experienced a family crisis, 29.14 including domestic violence, which prevents employment; 29.15 (5) a minor caregiver or a caregiver 18 or 19 years of age 29.16 who is cooperating with an employment plan under section 29.17 256J.54; and 29.18 (6) a caregiver who has an eligible child six months old or 29.19 younger. 29.20 (c) Caregivers who do not fall under paragraph (a) or (b), 29.21 who meet MFIP eligibility, may volunteer to participate in the 29.22 diversionary work program. 29.23 Subd. 4. [SUBMITTING APPLICATION FORM.] The eligibility 29.24 date for the diversionary work program begins with the date the 29.25 signed combined application form (CAF) is received by the county 29.26 agency or the date diversionary work program eligibility 29.27 criteria are met, whichever is later. The county agency must 29.28 inform the applicant that any delay in submitting the 29.29 application will reduce the benefits paid for the month of 29.30 application. The county agency must inform a person that an 29.31 application may be submitted before the person has an interview 29.32 appointment. Upon receipt of a signed application, the county 29.33 agency must stamp the date of receipt on the face of the 29.34 application. The applicant may withdraw the application at any 29.35 time prior to approval by giving written or oral notice to the 29.36 county agency. The county agency must follow the notice 30.1 requirements in section 256J.09, subdivision 3, when issuing a 30.2 notice confirming the withdrawal. 30.3 Subd. 5. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 30.4 of the application, the county agency must determine if the 30.5 applicant may be eligible for other benefits as required in 30.6 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 30.7 and 5. The county must also follow the provisions in section 30.8 256J.09, subdivision 3b, clause (2). 30.9 Subd. 6. [PROGRAM AND PROCESSING STANDARDS.] (a) The 30.10 interview to determine financial eligibility for the 30.11 diversionary work program must be conducted within five working 30.12 days of the receipt of the cash application form. During the 30.13 intake interview the financial worker must discuss: 30.14 (1) the goals, requirements, and services of the 30.15 diversionary work program; 30.16 (2) the availability of child care assistance. If child 30.17 care is needed, the worker must obtain a completed application 30.18 for child care from the applicant before the interview is 30.19 terminated. The same day the application for child care is 30.20 received, the application must be forwarded to the appropriate 30.21 child care worker. For purposes of eligibility for child care 30.22 assistance under chapter 119B, DWP participants shall be 30.23 eligible for the same benefits as MFIP recipients; and 30.24 (3) if the applicant has not requested food support and 30.25 health care assistance on the application, the county agency 30.26 shall, during the interview process, talk with the applicant 30.27 about the availability of these benefits and inquire whether the 30.28 applicant wants to apply for these benefits. If the applicant 30.29 does want to apply, the county agency shall assist the applicant 30.30 in completing the applicable application form or forms. 30.31 (b) The county shall follow section 256J.74, subdivision 2, 30.32 paragraph (b), clauses (1) and (2), when an applicant or a 30.33 recipient of DWP has a person who is a member of more than one 30.34 assistance unit in a given payment month. 30.35 (c) The county agency must determine eligibility for the 30.36 diversionary work program according to the provisions in section 31.1 256J.09, subdivisions 5 and 6. A family unit whose application 31.2 is denied is eligible for a fair hearing under section 256J.40. 31.3 Subd. 7. [VERIFICATION REQUIREMENTS.] (a) A county agency 31.4 must only require verification of information necessary to 31.5 determine DWP eligibility and the amount of the payment. The 31.6 applicant or participant must document the information required 31.7 or authorize the county agency to verify the information. The 31.8 applicant or participant has the burden of providing documentary 31.9 evidence to verify eligibility. The county agency shall assist 31.10 the applicant or participant in obtaining required documents 31.11 when the applicant or participant is unable to do so. 31.12 (b) A county agency must not request information about an 31.13 applicant or participant that is not a matter of public record 31.14 from a source other than county agencies, the department of 31.15 human services, or the United States Department of Health and 31.16 Human Services without the person's prior written consent. An 31.17 applicant's signature on an application form constitutes consent 31.18 for contact with the sources specified on the application. A 31.19 county agency may use a single consent form to contact a group 31.20 of similar sources, but the sources to be contacted must be 31.21 identified by the county agency prior to requesting an 31.22 applicant's consent. 31.23 (c) Factors to be verified shall follow section 256J.32, 31.24 subdivision 4. Family maintenance needs must be verified before 31.25 the expense can be allowed in the calculation of the DWP grant. 31.26 Subd. 8. [PROPERTY AND INCOME LIMITATIONS.] The asset 31.27 limits and exclusions in section 256J.20, apply to applicants 31.28 and recipients of DWP. All payments, unless excluded in section 31.29 256J.21, must be counted as income to determine eligibility for 31.30 the diversionary work program. The county shall treat income as 31.31 outlined in section 256J.37, except for subdivision 3a. The 31.32 initial income test and the disregards in section 256J.21, 31.33 subdivision 3, shall be followed for determining eligibility for 31.34 the diversionary work program. 31.35 Subd. 9. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 31.36 be eligible for DWP, an applicant must comply with the 32.1 requirements of paragraphs (b) to (d). 32.2 (b) Applicants and participants must cooperate with the 32.3 requirements of the child support enforcement program, but will 32.4 not be charged a fee under section 518.551, subdivision 7. 32.5 (c) The applicant must provide each member of the family 32.6 unit's social security number to the county agency. This 32.7 requirement is satisfied when each member of the family unit 32.8 cooperates with the procedures for verification of numbers, 32.9 issuance of duplicate cards, and issuance of new numbers which 32.10 have been established jointly between the Social Security 32.11 Administration and the commissioner. 32.12 (d) Before DWP benefits can be issued to a family unit, the 32.13 caregiver must, in conjunction with a job counselor, develop and 32.14 sign an employment plan. In two-parent family units, both 32.15 parents must develop and sign employment plans before benefits 32.16 can be issued. Food support and health care benefits are not 32.17 contingent on the requirement for a signed employment plan. 32.18 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) To 32.19 determine the amount of cash benefits that a family unit is 32.20 eligible for, the county agency shall evaluate the income of the 32.21 family unit that is requesting payments under the diversionary 32.22 work program. Countable income means gross earned and unearned 32.23 income not excluded or disregarded under MFIP. The same 32.24 disregards for earned income that are allowed under MFIP are 32.25 allowed for the diversionary work program. 32.26 (b) The DWP grant is the difference between (1) the family 32.27 unit's family maintenance needs plus the personal needs 32.28 allowance for each member of the family unit and (2) the family 32.29 unit's countable income, not to exceed the cash portion of the 32.30 MFIP standard of need as defined in section 256J.08, subdivision 32.31 55a, for the family unit's size. For a family unit with earned 32.32 income, the DWP grant as calculated this in subdivision shall 32.33 not exceed the family wage level as defined in section 256J.08, 32.34 subdivision 35. 32.35 (c) Housing and utilities may be vendor paid. Unless 32.36 otherwise stated in this section, actual housing and utility 33.1 expenses shall be used when determining the amount of the DWP 33.2 grant. 33.3 (d) Once the county has determined a grant amount, the DWP 33.4 grant amount will not be decreased if the determination is based 33.5 on the best information available at the time of approval and 33.6 shall not be decreased because of any additional income to the 33.7 family unit. The grant can be increased if a participant later 33.8 verifies an increase in family maintenance needs or family unit 33.9 size. The minimum cash benefit amount, if income and asset 33.10 tests are met, is $10. Benefits of $10 shall not be vendor paid. 33.11 (e) When all criteria are met, including the development of 33.12 an employment plan as described in subdivision 14 and 33.13 eligibility exists for the month of application, the amount of 33.14 benefits for the diversionary work program retroactive to the 33.15 date of application is as specified in section 256J.35, 33.16 paragraph (a). 33.17 (f) Any month during the four-month DWP period that a 33.18 person receives a DWP benefit directly or through a vendor 33.19 payment made on the person's behalf, that person is ineligible 33.20 for MFIP or any other TANF cash program except for benefits 33.21 defined in section 256.48. 33.22 If during the four-month DWP period a family unit that 33.23 receives diversionary work program benefits moves to a county 33.24 that has not established a diversionary work program, the family 33.25 unit may be eligible for MFIP the month following the last month 33.26 of the issuance of the DWP benefit. 33.27 Subd. 11. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 33.28 time during the DWP application process or during the four-month 33.29 DWP eligibility period, it is determined that a participant is 33.30 unlikely to benefit from the diversionary work program, the 33.31 county shall convert or refer the participant to MFIP as 33.32 specified in paragraph (d). Participants who meet the criteria 33.33 in paragraph (b) shall be considered to be unlikely to benefit 33.34 from DWP, provided the necessary documentation is available to 33.35 support the determination. 33.36 (b) A participant who: 34.1 (1) has been determined by a qualified professional as 34.2 being unable to obtain or retain employment due to an illness, 34.3 injury, or incapacity that is expected to last at least 30 days; 34.4 (2) is determined by a qualified professional as being 34.5 needed in the home to care for a family member due to an 34.6 illness, injury, or incapacity that is expected to last at least 34.7 30 days; 34.8 (3) is determined by a qualified professional as being 34.9 needed in the home to care for a child or an adult in the 34.10 household meeting the special medical criteria in section 34.11 256J.425, subdivision 2, clause (3); 34.12 (4) is pregnant and is determined by a qualified 34.13 professional as being unable to obtain or retain employment due 34.14 to the pregnancy; or 34.15 (5) has applied for SSI or RSDI. 34.16 (c) In a two-parent family unit, both parents must be 34.17 determined to be unlikely to benefit from the diversionary work 34.18 program before the family unit can be converted or referred to 34.19 MFIP. 34.20 (d) A participant who is determined to be unlikely to 34.21 benefit from the diversionary work program shall be converted to 34.22 MFIP. If the determination is made within 30 days of the 34.23 initial application for benefits, a new combined application 34.24 form will not be required. If the determination is made more 34.25 than 30 days after the initial application, the participant must 34.26 submit a new combined application form. The county agency shall 34.27 process the combined application form by the first of the 34.28 following month to ensure that no gap in benefits is due to 34.29 delayed action by the county agency. In processing the combined 34.30 application form, the county must follow section 256J.32, 34.31 subdivision 1, except that the county agency shall not require 34.32 additional verification of the information in the case file from 34.33 the diversionary work program application unless the information 34.34 in the case file is inaccurate, questionable, or no longer 34.35 current. 34.36 Subd. 12. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 35.1 Within one working day of determination that the applicant is 35.2 eligible for the diversionary work program, but before benefits 35.3 are issued to or on behalf of the family unit, the county shall 35.4 refer all caregivers to employment services. The referral to 35.5 the DWP employment services must be in writing and must contain 35.6 the following information: 35.7 (1) notification that, as part of the application process, 35.8 applicants are required to develop an employment plan or the DWP 35.9 application will be denied; 35.10 (2) the employment services provider name and phone number; 35.11 (3) the date, time, and location of the scheduled 35.12 employment services interview; 35.13 (4) the immediate availability of supportive services, 35.14 including, but not limited to, child care, transportation, and 35.15 other work-related aid; and 35.16 (5) the rights, responsibilities, and obligations of 35.17 participants in the program, including, but not limited to, the 35.18 grounds for converting or referring a participant to MFIP under 35.19 subdivision 12,, the consequences of refusing or failing to 35.20 participate fully with program requirements, the grounds for 35.21 good cause for failing to comply with program requirements as 35.22 defined in sections 256.741 and 256J.57, and the appeal process. 35.23 Subd. 13. [EMPLOYMENT PLAN; DWP BENEFITS.] Within five 35.24 working days of being notified that a participant is financially 35.25 eligible for the diversionary work program, the employment 35.26 services provider and participant shall meet to develop an 35.27 employment plan. Once the employment plan has been developed 35.28 and signed by the participant and the job counselor, the 35.29 employment services provider shall notify the county within one 35.30 working day that the employment plan has been signed. The 35.31 county shall issue DWP benefits within one working day after 35.32 receiving notice that the employment plan has been signed. 35.33 Subd. 14. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 35.34 Except as specified in paragraphs (b) to (d), employment 35.35 activities listed in section 256J.49, subdivision 13, are 35.36 allowable under the diversionary work program. 36.1 (b) Work activities under section 256J.49, subdivision 13, 36.2 clause (5), shall be allowable only when in combination with 36.3 approved work activities under section 256J.49, subdivision 13, 36.4 clauses (1) to (4), and shall be limited to no more than 36.5 one-half of the hours required in the employment plan. 36.6 (c) In order for an English as a second language (ESL) 36.7 class to be an approved work activity, a participant must: 36.8 (1) be below a spoken language proficiency level of SPL6 or 36.9 its equivalent, as measured by a nationally recognized test; and 36.10 (2) not have been enrolled in ESL for more than 24 months 36.11 while previously participating in MFIP or DWP. A participant 36.12 who has been enrolled in ESL for 20 or more months may be 36.13 approved for ESL until the participant has received 24 total 36.14 months. 36.15 (d) Work activities under section 256J.49, subdivision 13, 36.16 clause (6), shall be allowable only when the training or 36.17 education program will be completed within the four-month DWP 36.18 period. Training or education programs that will not be 36.19 completed within the four-month DWP period shall not be approved. 36.20 Subd. 15. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 36.21 unit that includes a participant who fails to comply with DWP 36.22 employment service or child support enforcement requirements, 36.23 without good cause as defined in sections 256.741 and 256J.57, 36.24 shall be disqualified from the diversionary work program. The 36.25 county shall provide written notice as specified in section 36.26 256J.31 to the participant prior to disqualifying the family 36.27 unit due to noncompliance with employment service or child 36.28 support. The disqualification does not apply to food support or 36.29 health care benefits. 36.30 Subd. 16. [GOOD CAUSE FOR NOT COMPLYING WITH 36.31 REQUIREMENTS.] A participant who fails to comply with the 36.32 requirements of the diversionary work program may claim good 36.33 cause for reasons listed in sections 256.741 and 256J.57, 36.34 subdivision 1. The county shall not impose a disqualification 36.35 if good cause exists. 36.36 Subd. 17. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 37.1 participant who has been disqualified from the diversionary work 37.2 program due to noncompliance with employment services may regain 37.3 eligibility for the diversionary work program by complying with 37.4 program requirements. A participant who has been disqualified 37.5 from the diversionary work program due to noncooperation with 37.6 child support enforcement requirements may regain eligibility by 37.7 complying with child support requirements under section 37.8 256J.741. Once a participant has been reinstated, the county 37.9 shall issue prorated benefits for the remaining portion of the 37.10 month. A family unit that has been disqualified from the 37.11 diversionary work program due to noncompliance shall not be 37.12 eligible for MFIP or any other TANF cash program during the 37.13 period of time the participant remains noncompliant. In a 37.14 two-parent family, both parents must be in compliance before the 37.15 family unit can regain eligibility for benefits. 37.16 Subd. 18. [RECOVERY OF OVERPAYMENTS.] When an overpayment 37.17 or an ATM error is determined, the overpayment shall be recouped 37.18 or recovered as specified in section 256J.38. 37.19 Subd. 19. [IMPLEMENTATION OF DWP.] Counties may establish 37.20 a diversionary work program according to this section any time 37.21 on or after July 1, 2003. Prior to establishing a diversionary 37.22 work program, the county must notify the commissioner. All 37.23 counties must implement the provisions of this section no later 37.24 than July 1, 2004. 37.25 Sec. 28. Minnesota Statutes 2002, section 393.07, 37.26 subdivision 10, is amended to read: 37.27 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 37.28 CHILD NUTRITION ACT.] (a) The local social services agency shall 37.29 establish and administer the food stamp or support program 37.30 according to rules of the commissioner of human services, the 37.31 supervision of the commissioner as specified in section 256.01, 37.32 and all federal laws and regulations. The commissioner of human 37.33 services shall monitor food stamp or support program delivery on 37.34 an ongoing basis to ensure that each county complies with 37.35 federal laws and regulations. Program requirements to be 37.36 monitored include, but are not limited to, number of 38.1 applications, number of approvals, number of cases pending, 38.2 length of time required to process each application and deliver 38.3 benefits, number of applicants eligible for expedited issuance, 38.4 length of time required to process and deliver expedited 38.5 issuance, number of terminations and reasons for terminations, 38.6 client profiles by age, household composition and income level 38.7 and sources, and the use of phone certification and home 38.8 visits. The commissioner shall determine the county-by-county 38.9 and statewide participation rate. 38.10 (b) On July 1 of each year, the commissioner of human 38.11 services shall determine a statewide and county-by-county food 38.12 stamp program participation rate. The commissioner may 38.13 designate a different agency to administer the food stamp 38.14 program in a county if the agency administering the program 38.15 fails to increase the food stamp program participation rate 38.16 among families or eligible individuals, or comply with all 38.17 federal laws and regulations governing the food stamp program. 38.18 The commissioner shall review agency performance annually to 38.19 determine compliance with this paragraph. 38.20 (c) A person who commits any of the following acts has 38.21 violated section 256.98 or 609.821, or both, and is subject to 38.22 both the criminal and civil penalties provided under those 38.23 sections: 38.24 (1) obtains or attempts to obtain, or aids or abets any 38.25 person to obtain by means of a willful statement or 38.26 misrepresentation, or intentional concealment of a material 38.27 fact, food stamps or vouchers issued according to sections 38.28 145.891 to 145.897 to which the person is not entitled or in an 38.29 amount greater than that to which that person is entitled or 38.30 which specify nutritional supplements to which that person is 38.31 not entitled; or 38.32 (2) presents or causes to be presented, coupons or vouchers 38.33 issued according to sections 145.891 to 145.897 for payment or 38.34 redemption knowing them to have been received, transferred or 38.35 used in a manner contrary to existing state or federal law; or 38.36 (3) willfully uses, possesses, or transfers food stamp 39.1 coupons, authorization to purchase cards or vouchers issued 39.2 according to sections 145.891 to 145.897 in any manner contrary 39.3 to existing state or federal law, rules, or regulations; or 39.4 (4) buys or sells food stamp coupons, authorization to 39.5 purchase cards, other assistance transaction devices, vouchers 39.6 issued according to sections 145.891 to 145.897, or any food 39.7 obtained through the redemption of vouchers issued according to 39.8 sections 145.891 to 145.897 for cash or consideration other than 39.9 eligible food. 39.10 (d) A peace officer or welfare fraud investigator may 39.11 confiscate food stamps, authorization to purchase cards, or 39.12 other assistance transaction devices found in the possession of 39.13 any person who is neither a recipient of the food stamp program 39.14 nor otherwise authorized to possess and use such materials. 39.15 Confiscated property shall be disposed of as the commissioner 39.16 may direct and consistent with state and federal food stamp 39.17 law. The confiscated property must be retained for a period of 39.18 not less than 30 days to allow any affected person to appeal the 39.19 confiscation under section 256.045. 39.20 (e) Food stamp overpayment claims which are due in whole or 39.21 in part to client error shall be established by the county 39.22 agency for a period of six years from the date of any resultant 39.23 overpayment. 39.24 (f) With regard to the federal tax revenue offset program 39.25 only, recovery incentives authorized by the federal food and 39.26 consumer service shall be retained at the rate of 50 percent by 39.27 the state agency and 50 percent by the certifying county agency. 39.28 (g) A peace officer, welfare fraud investigator, federal 39.29 law enforcement official, or the commissioner of health may 39.30 confiscate vouchers found in the possession of any person who is 39.31 neither issued vouchers under sections 145.891 to 145.897, nor 39.32 otherwise authorized to possess and use such vouchers. 39.33 Confiscated property shall be disposed of as the commissioner of 39.34 health may direct and consistent with state and federal law. 39.35 The confiscated property must be retained for a period of not 39.36 less than 30 days. 40.1 Sec. 29. [REPEALER.] 40.2 (a) Minnesota Statutes 2002, sections 256J.08, subdivision 40.3 70; 256J.425, subdivision 7; and 256J.47, are repealed. 40.4 (b) Laws 1997, chapter 203, article 9, section 21, as 40.5 amended by Laws 1998, chapter 407, article 6, section 111, Laws 40.6 2000, chapter 488, article 10, section 28, and Laws 2001, First 40.7 Special Session chapter 9, article 10, section 62; and Laws 40.8 2000, chapter 488, article 10, section 29, are repealed. 40.9 ARTICLE 2 40.10 HEALTH CARE 40.11 Section 1. Minnesota Statutes 2002, section 13.461, is 40.12 amended by adding a subdivision to read: 40.13 Subd. 1a. [WHOLESALE DRUG DISTRIBUTOR REPORTS.] Pricing 40.14 information reported to the commissioner of human services is 40.15 defined as trade secret information under section 151.47, 40.16 subdivision 1, paragraph (g). 40.17 Sec. 2. Minnesota Statutes 2002, section 62J.692, 40.18 subdivision 8, is amended to read: 40.19 Subd. 8. [FEDERAL FINANCIAL PARTICIPATION.] (a) The 40.20 commissioner of human services shall seek to maximize federal 40.21 financial participation in payments for medical education and 40.22 research costs. If the commissioner of human services 40.23 determines that federal financial participation is available for 40.24 the medical education and research, the commissioner of health 40.25 shall transfer to the commissioner of human services the amount 40.26 of state funds necessary to maximize the federal funds 40.27 available. The amount transferred to the commissioner of human 40.28 services, plus the amount of federal financial participation, 40.29 shall be distributed to medical assistance providers in 40.30 accordance with the distribution methodology described in 40.31 subdivision 4. 40.32 (b) For the purposes of paragraph (a), the commissioner 40.33 shall use physician clinic rates where possible to maximize 40.34 federal financial participation. 40.35 Sec. 3. Minnesota Statutes 2002, section 151.47, 40.36 subdivision 1, is amended to read: 41.1 Subdivision 1. [REQUIREMENTS.] All wholesale drug 41.2 distributors are subject to the requirements in paragraphs (a) 41.3 to(f)(g). 41.4 (a) No person or distribution outlet shall act as a 41.5 wholesale drug distributor without first obtaining a license 41.6 from the board and paying the required fee. 41.7 (b) No license shall be issued or renewed for a wholesale 41.8 drug distributor to operate unless the applicant agrees to 41.9 operate in a manner prescribed by federal and state law and 41.10 according to the rules adopted by the board. 41.11 (c) The board may require a separate license for each 41.12 facility directly or indirectly owned or operated by the same 41.13 business entity within the state, or for a parent entity with 41.14 divisions, subsidiaries, or affiliate companies within the 41.15 state, when operations are conducted at more than one location 41.16 and joint ownership and control exists among all the entities. 41.17 (d) As a condition for receiving and retaining a wholesale 41.18 drug distributor license issued under sections 151.42 to 151.51, 41.19 an applicant shall satisfy the board that it has complied with 41.20 paragraph (g) and that it has and will continuously maintain: 41.21 (1) adequate storage conditions and facilities; 41.22 (2) minimum liability and other insurance as may be 41.23 required under any applicable federal or state law; 41.24 (3) a viable security system that includes an after hours 41.25 central alarm, or comparable entry detection capability; 41.26 restricted access to the premises; comprehensive employment 41.27 applicant screening; and safeguards against all forms of 41.28 employee theft; 41.29 (4) a system of records describing all wholesale drug 41.30 distributor activities set forth in section 151.44 for at least 41.31 the most recent two-year period, which shall be reasonably 41.32 accessible as defined by board regulations in any inspection 41.33 authorized by the board; 41.34 (5) principals and persons, including officers, directors, 41.35 primary shareholders, and key management executives, who must at 41.36 all times demonstrate and maintain their capability of 42.1 conducting business in conformity with sound financial practices 42.2 as well as state and federal law; 42.3 (6) complete, updated information, to be provided to the 42.4 board as a condition for obtaining and retaining a license, 42.5 about each wholesale drug distributor to be licensed, including 42.6 all pertinent corporate licensee information, if applicable, or 42.7 other ownership, principal, key personnel, and facilities 42.8 information found to be necessary by the board; 42.9 (7) written policies and procedures that assure reasonable 42.10 wholesale drug distributor preparation for, protection against, 42.11 and handling of any facility security or operation problems, 42.12 including, but not limited to, those caused by natural disaster 42.13 or government emergency, inventory inaccuracies or product 42.14 shipping and receiving, outdated product or other unauthorized 42.15 product control, appropriate disposition of returned goods, and 42.16 product recalls; 42.17 (8) sufficient inspection procedures for all incoming and 42.18 outgoing product shipments; and 42.19 (9) operations in compliance with all federal requirements 42.20 applicable to wholesale drug distribution. 42.21 (e) An agent or employee of any licensed wholesale drug 42.22 distributor need not seek licensure under this section. 42.23 (f) A wholesale drug distributor shall file with the board 42.24 an annual report, in a form and on the date prescribed by the 42.25 board, identifying all payments, honoraria, reimbursement or 42.26 other compensation authorized under section 151.461, clauses (3) 42.27 to (5), paid to practitioners in Minnesota during the preceding 42.28 calendar year. The report shall identify the nature and value 42.29 of any payments totaling $100 or more, to a particular 42.30 practitioner during the year, and shall identify the 42.31 practitioner. Reports filed under this provision are public 42.32 data. 42.33 (g) Manufacturers shall, on a quarterly basis, report by 42.34 National Drug Code the following pharmaceutical pricing criteria 42.35 to the board and the commissioner of human services for each of 42.36 their drugs: average wholesale price, wholesale acquisition 43.1 cost, average manufacturer price as defined in United States 43.2 Code, title 42, chapter 7, subchapter XIX, section 1396r-8(k), 43.3 and best price as defined in United States Code, title 42, 43.4 chapter 7, subchapter XIX, section 1396r-8(c)(1)(C). The 43.5 calculation of average wholesale price and wholesale acquisition 43.6 cost shall be the net of all volume discounts, prompt payment 43.7 discounts, chargebacks, short-dated product discounts, cash 43.8 discounts, free goods, rebates, and all other price concessions 43.9 or incentives provided to a purchaser that result in a reduction 43.10 in the ultimate cost to the purchaser. When reporting average 43.11 wholesale price, wholesale acquisition cost, average 43.12 manufacturer price, and best price, manufacturers shall also 43.13 include a detailed description of the methodology by which the 43.14 prices were calculated. When a manufacturer reports average 43.15 wholesale price, wholesale acquisition cost, average 43.16 manufacturer price, or best price, the president or chief 43.17 executive officer of the manufacturer shall certify to the 43.18 Medicaid program, on a form provided by the commissioner of 43.19 human services, that the reported prices are accurate. 43.20 Information reported under this paragraph is trade secret 43.21 information for purposes of section 13.37. 43.22 Sec. 4. Minnesota Statutes 2002, section 256.01, 43.23 subdivision 2, is amended to read: 43.24 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 43.25 section 241.021, subdivision 2, the commissioner of human 43.26 services shall: 43.27 (1) Administer and supervise all forms of public assistance 43.28 provided for by state law and other welfare activities or 43.29 services as are vested in the commissioner. Administration and 43.30 supervision of human services activities or services includes, 43.31 but is not limited to, assuring timely and accurate distribution 43.32 of benefits, completeness of service, and quality program 43.33 management. In addition to administering and supervising human 43.34 services activities vested by law in the department, the 43.35 commissioner shall have the authority to: 43.36 (a) require county agency participation in training and 44.1 technical assistance programs to promote compliance with 44.2 statutes, rules, federal laws, regulations, and policies 44.3 governing human services; 44.4 (b) monitor, on an ongoing basis, the performance of county 44.5 agencies in the operation and administration of human services, 44.6 enforce compliance with statutes, rules, federal laws, 44.7 regulations, and policies governing welfare services and promote 44.8 excellence of administration and program operation; 44.9 (c) develop a quality control program or other monitoring 44.10 program to review county performance and accuracy of benefit 44.11 determinations; 44.12 (d) require county agencies to make an adjustment to the 44.13 public assistance benefits issued to any individual consistent 44.14 with federal law and regulation and state law and rule and to 44.15 issue or recover benefits as appropriate; 44.16 (e) delay or deny payment of all or part of the state and 44.17 federal share of benefits and administrative reimbursement 44.18 according to the procedures set forth in section 256.017; 44.19 (f) make contracts with and grants to public and private 44.20 agencies and organizations, both profit and nonprofit, and 44.21 individuals, using appropriated funds; and 44.22 (g) enter into contractual agreements with federally 44.23 recognized Indian tribes with a reservation in Minnesota to the 44.24 extent necessary for the tribe to operate a federally approved 44.25 family assistance program or any other program under the 44.26 supervision of the commissioner. The commissioner shall consult 44.27 with the affected county or counties in the contractual 44.28 agreement negotiations, if the county or counties wish to be 44.29 included, in order to avoid the duplication of county and tribal 44.30 assistance program services. The commissioner may establish 44.31 necessary accounts for the purposes of receiving and disbursing 44.32 funds as necessary for the operation of the programs. 44.33 (2) Inform county agencies, on a timely basis, of changes 44.34 in statute, rule, federal law, regulation, and policy necessary 44.35 to county agency administration of the programs. 44.36 (3) Administer and supervise all child welfare activities; 45.1 promote the enforcement of laws protecting handicapped, 45.2 dependent, neglected and delinquent children, and children born 45.3 to mothers who were not married to the children's fathers at the 45.4 times of the conception nor at the births of the children; 45.5 license and supervise child-caring and child-placing agencies 45.6 and institutions; supervise the care of children in boarding and 45.7 foster homes or in private institutions; and generally perform 45.8 all functions relating to the field of child welfare now vested 45.9 in the state board of control. 45.10 (4) Administer and supervise all noninstitutional service 45.11 to handicapped persons, including those who are visually 45.12 impaired, hearing impaired, or physically impaired or otherwise 45.13 handicapped. The commissioner may provide and contract for the 45.14 care and treatment of qualified indigent children in facilities 45.15 other than those located and available at state hospitals when 45.16 it is not feasible to provide the service in state hospitals. 45.17 (5) Assist and actively cooperate with other departments, 45.18 agencies and institutions, local, state, and federal, by 45.19 performing services in conformity with the purposes of Laws 45.20 1939, chapter 431. 45.21 (6) Act as the agent of and cooperate with the federal 45.22 government in matters of mutual concern relative to and in 45.23 conformity with the provisions of Laws 1939, chapter 431, 45.24 including the administration of any federal funds granted to the 45.25 state to aid in the performance of any functions of the 45.26 commissioner as specified in Laws 1939, chapter 431, and 45.27 including the promulgation of rules making uniformly available 45.28 medical care benefits to all recipients of public assistance, at 45.29 such times as the federal government increases its participation 45.30 in assistance expenditures for medical care to recipients of 45.31 public assistance, the cost thereof to be borne in the same 45.32 proportion as are grants of aid to said recipients. 45.33 (7) Establish and maintain any administrative units 45.34 reasonably necessary for the performance of administrative 45.35 functions common to all divisions of the department. 45.36 (8) Act as designated guardian of both the estate and the 46.1 person of all the wards of the state of Minnesota, whether by 46.2 operation of law or by an order of court, without any further 46.3 act or proceeding whatever, except as to persons committed as 46.4 mentally retarded. For children under the guardianship of the 46.5 commissioner whose interests would be best served by adoptive 46.6 placement, the commissioner may contract with a licensed 46.7 child-placing agency or a Minnesota tribal social services 46.8 agency to provide adoption services. A contract with a licensed 46.9 child-placing agency must be designed to supplement existing 46.10 county efforts and may not replace existing county programs, 46.11 unless the replacement is agreed to by the county board and the 46.12 appropriate exclusive bargaining representative or the 46.13 commissioner has evidence that child placements of the county 46.14 continue to be substantially below that of other counties. 46.15 Funds encumbered and obligated under an agreement for a specific 46.16 child shall remain available until the terms of the agreement 46.17 are fulfilled or the agreement is terminated. 46.18 (9) Act as coordinating referral and informational center 46.19 on requests for service for newly arrived immigrants coming to 46.20 Minnesota. 46.21 (10) The specific enumeration of powers and duties as 46.22 hereinabove set forth shall in no way be construed to be a 46.23 limitation upon the general transfer of powers herein contained. 46.24 (11) Establish county, regional, or statewide schedules of 46.25 maximum fees and charges which may be paid by county agencies 46.26 for medical, dental, surgical, hospital, nursing and nursing 46.27 home care and medicine and medical supplies under all programs 46.28 of medical care provided by the state and for congregate living 46.29 care under the income maintenance programs. 46.30 (12) Have the authority to conduct and administer 46.31 experimental projects to test methods and procedures of 46.32 administering assistance and services to recipients or potential 46.33 recipients of public welfare. To carry out such experimental 46.34 projects, it is further provided that the commissioner of human 46.35 services is authorized to waive the enforcement of existing 46.36 specific statutory program requirements, rules, and standards in 47.1 one or more counties. The order establishing the waiver shall 47.2 provide alternative methods and procedures of administration, 47.3 shall not be in conflict with the basic purposes, coverage, or 47.4 benefits provided by law, and in no event shall the duration of 47.5 a project exceed four years. It is further provided that no 47.6 order establishing an experimental project as authorized by the 47.7 provisions of this section shall become effective until the 47.8 following conditions have been met: 47.9 (a) The secretary of health and human services of the 47.10 United States has agreed, for the same project, to waive state 47.11 plan requirements relative to statewide uniformity. 47.12 (b) A comprehensive plan, including estimated project 47.13 costs, shall be approved by the legislative advisory commission 47.14 and filed with the commissioner of administration. 47.15 (13) According to federal requirements, establish 47.16 procedures to be followed by local welfare boards in creating 47.17 citizen advisory committees, including procedures for selection 47.18 of committee members. 47.19 (14) Allocate federal fiscal disallowances or sanctions 47.20 which are based on quality control error rates for the aid to 47.21 families with dependent children program formerly codified in 47.22 sections 256.72 to 256.87, medical assistance, or food stamp 47.23 program in the following manner: 47.24 (a) One-half of the total amount of the disallowance shall 47.25 be borne by the county boards responsible for administering the 47.26 programs. For the medical assistance and the AFDC program 47.27 formerly codified in sections 256.72 to 256.87, disallowances 47.28 shall be shared by each county board in the same proportion as 47.29 that county's expenditures for the sanctioned program are to the 47.30 total of all counties' expenditures for the AFDC program 47.31 formerly codified in sections 256.72 to 256.87, and medical 47.32 assistance programs. For the food stamp program, sanctions 47.33 shall be shared by each county board, with 50 percent of the 47.34 sanction being distributed to each county in the same proportion 47.35 as that county's administrative costs for food stamps are to the 47.36 total of all food stamp administrative costs for all counties, 48.1 and 50 percent of the sanctions being distributed to each county 48.2 in the same proportion as that county's value of food stamp 48.3 benefits issued are to the total of all benefits issued for all 48.4 counties. Each county shall pay its share of the disallowance 48.5 to the state of Minnesota. When a county fails to pay the 48.6 amount due hereunder, the commissioner may deduct the amount 48.7 from reimbursement otherwise due the county, or the attorney 48.8 general, upon the request of the commissioner, may institute 48.9 civil action to recover the amount due. 48.10 (b) Notwithstanding the provisions of paragraph (a), if the 48.11 disallowance results from knowing noncompliance by one or more 48.12 counties with a specific program instruction, and that knowing 48.13 noncompliance is a matter of official county board record, the 48.14 commissioner may require payment or recover from the county or 48.15 counties, in the manner prescribed in paragraph (a), an amount 48.16 equal to the portion of the total disallowance which resulted 48.17 from the noncompliance, and may distribute the balance of the 48.18 disallowance according to paragraph (a). 48.19 (15) Develop and implement special projects that maximize 48.20 reimbursements and result in the recovery of money to the 48.21 state. For the purpose of recovering state money, the 48.22 commissioner may enter into contracts with third parties. Any 48.23 recoveries that result from projects or contracts entered into 48.24 under this paragraph shall be deposited in the state treasury 48.25 and credited to a special account until the balance in the 48.26 account reaches $1,000,000. When the balance in the account 48.27 exceeds $1,000,000, the excess shall be transferred and credited 48.28 to the general fund. All money in the account is appropriated 48.29 to the commissioner for the purposes of this paragraph. 48.30 (16) Have the authority to make direct payments to 48.31 facilities providing shelter to women and their children 48.32 according to section 256D.05, subdivision 3. Upon the written 48.33 request of a shelter facility that has been denied payments 48.34 under section 256D.05, subdivision 3, the commissioner shall 48.35 review all relevant evidence and make a determination within 30 48.36 days of the request for review regarding issuance of direct 49.1 payments to the shelter facility. Failure to act within 30 days 49.2 shall be considered a determination not to issue direct payments. 49.3 (17) Have the authority to establish and enforce the 49.4 following county reporting requirements: 49.5 (a) The commissioner shall establish fiscal and statistical 49.6 reporting requirements necessary to account for the expenditure 49.7 of funds allocated to counties for human services programs. 49.8 When establishing financial and statistical reporting 49.9 requirements, the commissioner shall evaluate all reports, in 49.10 consultation with the counties, to determine if the reports can 49.11 be simplified or the number of reports can be reduced. 49.12 (b) The county board shall submit monthly or quarterly 49.13 reports to the department as required by the commissioner. 49.14 Monthly reports are due no later than 15 working days after the 49.15 end of the month. Quarterly reports are due no later than 30 49.16 calendar days after the end of the quarter, unless the 49.17 commissioner determines that the deadline must be shortened to 49.18 20 calendar days to avoid jeopardizing compliance with federal 49.19 deadlines or risking a loss of federal funding. Only reports 49.20 that are complete, legible, and in the required format shall be 49.21 accepted by the commissioner. 49.22 (c) If the required reports are not received by the 49.23 deadlines established in clause (b), the commissioner may delay 49.24 payments and withhold funds from the county board until the next 49.25 reporting period. When the report is needed to account for the 49.26 use of federal funds and the late report results in a reduction 49.27 in federal funding, the commissioner shall withhold from the 49.28 county boards with late reports an amount equal to the reduction 49.29 in federal funding until full federal funding is received. 49.30 (d) A county board that submits reports that are late, 49.31 illegible, incomplete, or not in the required format for two out 49.32 of three consecutive reporting periods is considered 49.33 noncompliant. When a county board is found to be noncompliant, 49.34 the commissioner shall notify the county board of the reason the 49.35 county board is considered noncompliant and request that the 49.36 county board develop a corrective action plan stating how the 50.1 county board plans to correct the problem. The corrective 50.2 action plan must be submitted to the commissioner within 45 days 50.3 after the date the county board received notice of noncompliance. 50.4 (e) The final deadline for fiscal reports or amendments to 50.5 fiscal reports is one year after the date the report was 50.6 originally due. If the commissioner does not receive a report 50.7 by the final deadline, the county board forfeits the funding 50.8 associated with the report for that reporting period and the 50.9 county board must repay any funds associated with the report 50.10 received for that reporting period. 50.11 (f) The commissioner may not delay payments, withhold 50.12 funds, or require repayment under paragraph (c) or (e) if the 50.13 county demonstrates that the commissioner failed to provide 50.14 appropriate forms, guidelines, and technical assistance to 50.15 enable the county to comply with the requirements. If the 50.16 county board disagrees with an action taken by the commissioner 50.17 under paragraph (c) or (e), the county board may appeal the 50.18 action according to sections 14.57 to 14.69. 50.19 (g) Counties subject to withholding of funds under 50.20 paragraph (c) or forfeiture or repayment of funds under 50.21 paragraph (e) shall not reduce or withhold benefits or services 50.22 to clients to cover costs incurred due to actions taken by the 50.23 commissioner under paragraph (c) or (e). 50.24 (18) Allocate federal fiscal disallowances or sanctions for 50.25 audit exceptions when federal fiscal disallowances or sanctions 50.26 are based on a statewide random sample for the foster care 50.27 program under title IV-E of the Social Security Act, United 50.28 States Code, title 42, in direct proportion to each county's 50.29 title IV-E foster care maintenance claim for that period. 50.30 (19) Be responsible for ensuring the detection, prevention, 50.31 investigation, and resolution of fraudulent activities or 50.32 behavior by applicants, recipients, and other participants in 50.33 the human services programs administered by the department. 50.34 (20) Require county agencies to identify overpayments, 50.35 establish claims, and utilize all available and cost-beneficial 50.36 methodologies to collect and recover these overpayments in the 51.1 human services programs administered by the department. 51.2 (21) Have the authority to administer a drug rebate program 51.3 for drugs purchased pursuant to the prescription drug program 51.4 established under section 256.955 after the beneficiary's 51.5 satisfaction of any deductible established in the program. The 51.6 commissioner shall require a rebate agreement from all 51.7 manufacturers of covered drugs as defined in section 256B.0625, 51.8 subdivision 13. Rebate agreements for prescription drugs 51.9 delivered on or after July 1, 2002, must include rebates for 51.10 individuals covered under the prescription drug program who are 51.11 under 65 years of age. For each drug, the amount of the rebate 51.12 shall be equal to thebasicrebate as defined for purposes of 51.13 the federal rebate program in United States Code, title 42, 51.14 section 1396r-8(c)(1).This basic rebate shall be applied to51.15single-source and multiple-source drugs.The manufacturers must 51.16 provide full payment within 30 days of receipt of the state 51.17 invoice for the rebate within the terms and conditions used for 51.18 the federal rebate program established pursuant to section 1927 51.19 of title XIX of the Social Security Act. The manufacturers must 51.20 provide the commissioner with any information necessary to 51.21 verify the rebate determined per drug. The rebate program shall 51.22 utilize the terms and conditions used for the federal rebate 51.23 program established pursuant to section 1927 of title XIX of the 51.24 Social Security Act. 51.25 (22) Have the authority to administer the federal drug 51.26 rebate program for drugs purchased under the medical assistance 51.27 program as allowed by section 1927 of title XIX of the Social 51.28 Security Act and according to the terms and conditions of 51.29 section 1927. Rebates shall be collected for all drugs that 51.30 have been dispensed or administered in an outpatient setting and 51.31 that are from manufacturers who have signed a rebate agreement 51.32 with the United States Department of Health and Human Services. 51.33 (23) Have the authority to administer a supplemental drug 51.34 rebate program for drugs purchased under the medical assistance 51.35 program. The commissioner may enter into supplemental rebate 51.36 contracts with pharmaceutical manufacturers and may require 52.1 prior authorization for drugs that are from manufacturers that 52.2 have not signed a supplemental rebate contract. Prior 52.3 authorization of drugs shall be subject to the provisions of 52.4 section 256B.0625, subdivision 13. The commissioner shall 52.5 evaluate whether participation in a multistate preferred drug 52.6 list and supplemental rebate program reduces costs or improves 52.7 the operations of the medical assistance program. The 52.8 commissioner may enter into a contract with a vendor or other 52.9 states for the purposes of participating in a multistate 52.10 preferred drug list and supplemental rebate program. 52.11 (24) Operate the department's communication systems account 52.12 established in Laws 1993, First Special Session chapter 1, 52.13 article 1, section 2, subdivision 2, to manage shared 52.14 communication costs necessary for the operation of the programs 52.15 the commissioner supervises. A communications account may also 52.16 be established for each regional treatment center which operates 52.17 communications systems. Each account must be used to manage 52.18 shared communication costs necessary for the operations of the 52.19 programs the commissioner supervises. The commissioner may 52.20 distribute the costs of operating and maintaining communication 52.21 systems to participants in a manner that reflects actual usage. 52.22 Costs may include acquisition, licensing, insurance, 52.23 maintenance, repair, staff time and other costs as determined by 52.24 the commissioner. Nonprofit organizations and state, county, 52.25 and local government agencies involved in the operation of 52.26 programs the commissioner supervises may participate in the use 52.27 of the department's communications technology and share in the 52.28 cost of operation. The commissioner may accept on behalf of the 52.29 state any gift, bequest, devise or personal property of any 52.30 kind, or money tendered to the state for any lawful purpose 52.31 pertaining to the communication activities of the department. 52.32 Any money received for this purpose must be deposited in the 52.33 department's communication systems accounts. Money collected by 52.34 the commissioner for the use of communication systems must be 52.35 deposited in the state communication systems account and is 52.36 appropriated to the commissioner for purposes of this section. 53.1 (25) Receive any federal matching money that is made 53.2 available through the medical assistance program for the 53.3 consumer satisfaction survey. Any federal money received for 53.4 the survey is appropriated to the commissioner for this 53.5 purpose. The commissioner may expend the federal money received 53.6 for the consumer satisfaction survey in either year of the 53.7 biennium. 53.8 (26) Incorporate cost reimbursement claims from First Call 53.9 Minnesota and Greater Twin Cities United Way into the federal 53.10 cost reimbursement claiming processes of the department 53.11 according to federal law, rule, and regulations. Any 53.12 reimbursement received is appropriated to the commissioner and 53.13 shall be disbursed to First Call Minnesota and Greater Twin 53.14 Cities United Way according to normal department payment 53.15 schedules. 53.16 (27) Develop recommended standards for foster care homes 53.17 that address the components of specialized therapeutic services 53.18 to be provided by foster care homes with those services. 53.19 Sec. 5. Minnesota Statutes 2002, section 256.955, 53.20 subdivision 2a, is amended to read: 53.21 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 53.22 following requirements and the requirements described in 53.23 subdivision 2, paragraph (d), is eligible for the prescription 53.24 drug program: 53.25 (1) is at least 65 years of age or older; and 53.26 (2) is eligible as a qualified Medicare beneficiary 53.27 according to section 256B.057, subdivision 3,or 3a,or 3b,53.28clause (1),or is eligible under section 256B.057, subdivision 53.29 3,or 3a,or 3b, clause (1),and is also eligible for medical 53.30 assistance or general assistance medical care with a spenddown 53.31 as defined in section 256B.056, subdivision 5. 53.32 Sec. 6. Minnesota Statutes 2002, section 256.9685, is 53.33 amended by adding a subdivision to read: 53.34 Subd. 3. [LIMITATION ON PAYMENTS TO OUT-OF-STATE 53.35 PROVIDERS.] Payments under medical assistance, MinnesotaCare, 53.36 and general assistance medical care are prohibited to hospitals 54.1 located outside of Minnesota except under the following 54.2 circumstances: 54.3 (1) in cases of emergency. For purposes of this 54.4 subdivision, "emergency" means a condition that if not 54.5 immediately treated could cause a person serious physical or 54.6 mental disability, continuation of severe pain, or death. Labor 54.7 and delivery is an emergency if it meets this definition; 54.8 (2) when not receiving care outside of Minnesota would 54.9 endanger the health of the recipient; 54.10 (3) when care is more readily available in another state; 54.11 and 54.12 (4) when the local trade area includes a portion of another 54.13 state. 54.14 Sec. 7. Minnesota Statutes 2002, section 256.969, 54.15 subdivision 2b, is amended to read: 54.16 Subd. 2b. [OPERATING PAYMENT RATES.] (a) In determining 54.17 operating payment rates for admissions occurring on or after the 54.18 rate year beginning January 1, 1991, and every two years after, 54.19 or more frequently as determined by the commissioner, the 54.20 commissioner shall obtain operating data from an updated base 54.21 year and establish operating payment rates per admission for 54.22 each hospital based on the cost-finding methods and allowable 54.23 costs of the Medicare program in effect during the base year. 54.24 Rates under the general assistance medical care, medical 54.25 assistance, and MinnesotaCare programs shall not be rebased to 54.26 more current data on January 1, 1997. The base year operating 54.27 payment rate per admission is standardized by the case mix index 54.28 and adjusted by the hospital cost index, relative values, and 54.29 disproportionate population adjustment. The cost and charge 54.30 data used to establish operating rates shall only reflect 54.31 inpatient services covered by medical assistance and shall not 54.32 include property cost information and costs recognized in 54.33 outlier payments. 54.34 (b) The rebasing of rates scheduled to occur on January 1, 54.35 2005, shall be postponed until January 1, 2006. The rebasing of 54.36 rates scheduled to occur on January 1, 2007, shall be 55.1 implemented as scheduled. 55.2 Sec. 8. Minnesota Statutes 2002, section 256.969, 55.3 subdivision 3a, is amended to read: 55.4 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 55.5 under the medical assistance program must not be submitted until 55.6 the recipient is discharged. However, the commissioner shall 55.7 establish monthly interim payments for inpatient hospitals that 55.8 have individual patient lengths of stay over 30 days regardless 55.9 of diagnostic category. Except as provided in section 256.9693, 55.10 medical assistance reimbursement for treatment of mental illness 55.11 shall be reimbursed based on diagnostic classifications. 55.12 Individual hospital payments established under this section and 55.13 sections 256.9685, 256.9686, and 256.9695, in addition to third 55.14 party and recipient liability, for discharges occurring during 55.15 the rate year shall not exceed, in aggregate, the charges for 55.16 the medical assistance covered inpatient services paid for the 55.17 same period of time to the hospital. This payment limitation 55.18 shall be calculated separately for medical assistance and 55.19 general assistance medical care services. The limitation on 55.20 general assistance medical care shall be effective for 55.21 admissions occurring on or after July 1, 1991. Services that 55.22 have rates established under subdivision 11 or 12, must be 55.23 limited separately from other services. After consulting with 55.24 the affected hospitals, the commissioner may consider related 55.25 hospitals one entity and may merge the payment rates while 55.26 maintaining separate provider numbers. The operating and 55.27 property base rates per admission or per day shall be derived 55.28 from the best Medicare and claims data available when rates are 55.29 established. The commissioner shall determine the best Medicare 55.30 and claims data, taking into consideration variables of recency 55.31 of the data, audit disposition, settlement status, and the 55.32 ability to set rates in a timely manner. The commissioner shall 55.33 notify hospitals of payment rates by December 1 of the year 55.34 preceding the rate year. The rate setting data must reflect the 55.35 admissions data used to establish relative values. Base year 55.36 changes from 1981 to the base year established for the rate year 56.1 beginning January 1, 1991, and for subsequent rate years, shall 56.2 not be limited to the limits ending June 30, 1987, on the 56.3 maximum rate of increase under subdivision 1. The commissioner 56.4 may adjust base year cost, relative value, and case mix index 56.5 data to exclude the costs of services that have been 56.6 discontinued by the October 1 of the year preceding the rate 56.7 year or that are paid separately from inpatient services. 56.8 Inpatient stays that encompass portions of two or more rate 56.9 years shall have payments established based on payment rates in 56.10 effect at the time of admission unless the date of admission 56.11 preceded the rate year in effect by six months or more. In this 56.12 case, operating payment rates for services rendered during the 56.13 rate year in effect and established based on the date of 56.14 admission shall be adjusted to the rate year in effect by the 56.15 hospital cost index. 56.16 (b) For fee-for-service admissions occurring on or after 56.17 July 1, 2002, the total payment, before third-party liability 56.18 and spenddown, made to hospitals for inpatient services is 56.19 reduced by .5 percent from the current statutory rates. 56.20 (c) In addition to the reduction in paragraph (b), the 56.21 total payment for fee-for-service admissions occurring on or 56.22 after July 1, 2003, made to hospitals for inpatient services 56.23 before third-party liability and spenddown, is reduced five 56.24 percent from the current statutory rates. Mental health 56.25 services within diagnosis related groups 424 to 432, and 56.26 facilities defined under subdivision 16 are excluded from this 56.27 paragraph. 56.28 Sec. 9. Minnesota Statutes 2002, section 256.975, is 56.29 amended by adding a subdivision to read: 56.30 Subd. 9. [PRESCRIPTION DRUG ASSISTANCE.] The Minnesota 56.31 board on aging shall establish and administer a prescription 56.32 drug assistance program to assist individuals in accessing 56.33 programs offered by pharmaceutical manufacturers that provide 56.34 free or discounted prescription drugs or provide coverage for 56.35 prescription drugs. The board shall use computer software 56.36 programs to: 57.1 (1) list eligibility requirements for pharmaceutical 57.2 assistance programs offered by manufacturers; 57.3 (2) list drugs that are included in a supplemental rebate 57.4 contract between the commissioner and a pharmaceutical 57.5 manufacturer under section 256.01, subdivision 2, clause (23); 57.6 and 57.7 (3) link individuals with the pharmaceutical assistance 57.8 programs most appropriate for the individual. The board shall 57.9 make information on the prescription drug assistance program 57.10 available to interested individuals and health care providers 57.11 and shall coordinate the program with the statewide information 57.12 and assistance service provided through the Senior LinkAge Line 57.13 under subdivision 7. 57.14 Sec. 10. Minnesota Statutes 2002, section 256B.056, 57.15 subdivision 1a, is amended to read: 57.16 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 57.17 specifically required by state law or rule or federal law or 57.18 regulation, the methodologies used in counting income and assets 57.19 to determine eligibility for medical assistance for persons 57.20 whose eligibility category is based on blindness, disability, or 57.21 age of 65 or more years, the methodologies for the supplemental 57.22 security income program shall be used. Increases in benefits 57.23 under title II of the Social Security Act shall not be counted 57.24 as income for purposes of this subdivision until July 1 of each 57.25 year. Effective upon federal approval, for children eligible 57.26 under section 256B.055, subdivision 12, or for home and 57.27 community-based waiver services whose eligibility for medical 57.28 assistance is determined without regard to parental income, 57.29 child support payments, including any payments made by an 57.30 obligor in satisfaction of or in addition to a temporary or 57.31 permanent order for child support, and social security payments 57.32 are not counted as income. For families and children, which 57.33 includes all other eligibility categories, the methodologies 57.34 under the state's AFDC plan in effect as of July 16, 1996, as 57.35 required by the Personal Responsibility and Work Opportunity 57.36 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 58.1 shall be used, except that effectiveJuly 1, 2002, the $90 and58.2$30 and one-third earned income disregards shall not apply and58.3the disregard specified in subdivision 1c shall applyJuly 1, 58.4 2003, the earned income disregards and deductions are limited to 58.5 those in subdivision 1c. For these purposes, a "methodology" 58.6 does not include an asset or income standard, or accounting 58.7 method, or method of determining effective dates. 58.8 Sec. 11. Minnesota Statutes 2002, section 256B.056, 58.9 subdivision 1c, is amended to read: 58.10 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 58.11 (a)(1) For children ages one to five whose eligibility is 58.12 determined under section 256B.057, subdivision 2, 21 percent of 58.13 countable earned income shall be disregarded for up to four 58.14 months. This clause expires July 1, 2003. 58.15 (2) For children ages one through 18 whose eligibility is 58.16 determined under section 256B.057, subdivision 2, the following 58.17 deductions shall be applied to income counted toward the child's 58.18 eligibility as allowed under the state's AFDC plan in effect as 58.19 of July 16, 1996; $90 work expense, dependent care, and child 58.20 support paid under court order. This clause is effective July 58.21 1, 2003. 58.22 (b) For families with children whose eligibility is 58.23 determined using the standard specified in section 256B.056, 58.24 subdivision 4, paragraph (c), 17 percent of countable earned 58.25 income shall be disregarded for up to four months and the 58.26 following deductions shall be applied to each individual's 58.27 income counted toward eligibility as allowed under the state's 58.28 AFDC plan in effect as of July 16, 1996: dependent care and 58.29 child support paid under court order. 58.30 (c) If thedisregardfour-month disregard in paragraph (b) 58.31 has been applied to the wage earner's income for four months, 58.32 the disregard shall not be applied again until the wage earner's 58.33 income has not been considered in determining medical assistance 58.34 eligibility for 12 consecutive months. 58.35 [EFFECTIVE DATE.] The amendments to paragraphs (b) and (c) 58.36 are effective July 1, 2003. 59.1 Sec. 12. Minnesota Statutes 2002, section 256B.057, 59.2 subdivision 1, is amended to read: 59.3 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a) An infant 59.4 less than one year of age or a pregnant woman who has written 59.5 verification of a positive pregnancy test from a physician or 59.6 licensed registered nurse, is eligible for medical assistance if 59.7 countable family income is equal to or less than 275 percent of 59.8 the federal poverty guideline for the same family size. For 59.9 purposes of this subdivision, "countable family income" means 59.10 the amount of income considered available using the methodology 59.11 of the AFDC program under the state's AFDC plan as of July 16, 59.12 1996, as required by the Personal Responsibility and Work 59.13 Opportunity Reconciliation Act of 1996 (PRWORA), Public 59.14 LawNumber104-193, except for the earned income disregard and 59.15 employment deductions. 59.16An amount equal to the amount of earned income exceeding59.17275 percent of the federal poverty guideline, up to a maximum of59.18the amount by which the combined total of 185 percent of the59.19federal poverty guideline plus the earned income disregards and59.20deductions of the AFDC program under the state's AFDC plan as of59.21July 16, 1996, as required by the Personal Responsibility and59.22Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law59.23Number 104-193, exceeds 275 percent of the federal poverty59.24guideline will be deducted for pregnant women and infants less59.25than one year of age.59.26 (b) An infant born on or after January 1, 1991, to a woman 59.27 who was eligible for and receiving medical assistance on the 59.28 date of the child's birth shall continue to be eligible for 59.29 medical assistance without redetermination until the child's 59.30 first birthday, as long as the child remains in the woman's 59.31 household. 59.32 [EFFECTIVE DATE.] This section is effective July 1, 2003. 59.33 Sec. 13. Minnesota Statutes 2002, section 256B.057, 59.34 subdivision 1b, is amended to read: 59.35 Subd. 1b. [PREGNANT WOMEN AND INFANTS; EXPANSION.] (a) 59.36 This subdivision supersedes subdivision 1 as long as the 60.1 Minnesota health care reform waiver remains in effect. When the 60.2 waiver expires, the commissioner of human services shall publish 60.3 a notice in the State Register and notify the revisor of 60.4 statutes. An infant less than two years of age or a pregnant 60.5 woman who has written verification of a positive pregnancy test 60.6 from a physician or licensed registered nurse, is eligible for 60.7 medical assistance if countable family income is equal to or 60.8 less than 275 percent of the federal poverty guideline for the 60.9 same family size. For purposes of this subdivision, "countable 60.10 family income" means the amount of income considered available 60.11 using the methodology of the AFDC program under the state's AFDC 60.12 plan as of July 16, 1996, as required by the Personal 60.13 Responsibility and Work Opportunity Reconciliation Act of 1996 60.14 (PRWORA), Public LawNumber104-193, except for the earned 60.15 income disregard and employment deductions.An amount equal to60.16the amount of earned income exceeding 275 percent of the federal60.17poverty guideline, up to a maximum of the amount by which the60.18combined total of 185 percent of the federal poverty guideline60.19plus the earned income disregards and deductions of the AFDC60.20program under the state's AFDC plan as of July 16, 1996, as60.21required by the Personal Responsibility and Work Opportunity60.22Reconciliation Act of 1996 (PRWORA), Public Law Number 104-193,60.23exceeds 275 percent of the federal poverty guideline will be60.24deducted for pregnant women and infants less than two years of60.25age.60.26 (b) An infant born on or after January 1, 1991, to a woman 60.27 who was eligible for and receiving medical assistance on the 60.28 date of the child's birth shall continue to be eligible for 60.29 medical assistance without redetermination until the child's 60.30 second birthday, as long as the child remains in the woman's 60.31 household. 60.32 [EFFECTIVE DATE.] This section is effective July 1, 2003. 60.33 Sec. 14. Minnesota Statutes 2002, section 256B.057, 60.34 subdivision 2, is amended to read: 60.35 Subd. 2. [CHILDREN.] Except as specified in subdivision 60.36 1b, effective July 1,20022003, a child one through 18 years of 61.1 age in a family whose countable income is no greater than17061.2 150 percent of the federal poverty guidelines for the same 61.3 family size, is eligible for medical assistance. 61.4 Sec. 15. Minnesota Statutes 2002, section 256B.057, 61.5 subdivision 3b, is amended to read: 61.6 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 61.7 1998,to the extent of the federal allocation to Minnesota61.8 contingent upon federal funding, a person who would otherwise be 61.9 eligible as a qualified Medicare beneficiary under subdivision 61.10 3, except that the person's income is in excess of the limit, is 61.11 eligible as a qualifying individual according to the following 61.12 criteria: 61.13 (1) if the person's income is greater than 120 percent, but 61.14 less than 135 percent of the official federal poverty guidelines 61.15 for the applicable family size, the person is eligible for 61.16 medical assistance reimbursement of Medicare Part B premiums; or 61.17 (2) if the person's income is equal to or greater than 135 61.18 percent but less than 175 percent of the official federal 61.19 poverty guidelines for the applicable family size, the person is 61.20 eligible for medical assistance reimbursement of that portion of 61.21 the Medicare Part B premium attributable to an increase in Part 61.22 B expenditures which resulted from the shift of home care 61.23 services from Medicare Part A to Medicare Part B under Public 61.24 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 61.25 The commissioner shall limit enrollment of qualifying 61.26 individuals under this subdivision according to the requirements 61.27 of Public LawNumber105-33, section 4732. 61.28 [EFFECTIVE DATE.] This section is effective July 1, 2003. 61.29 Sec. 16. Minnesota Statutes 2002, section 256B.057, 61.30 subdivision 9, is amended to read: 61.31 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 61.32 assistance may be paid for a person who is employed and who: 61.33 (1) meets the definition of disabled under the supplemental 61.34 security income program; 61.35 (2) is at least 16 but less than 65 years of age; 61.36 (3) meets the asset limits in paragraph (b); and 62.1 (4) effective November 1, 2003, pays a premium,ifas 62.2 required, under paragraph(c)(d). 62.3 Any spousal income or assets shall be disregarded for purposes 62.4 of eligibility and premium determinations. 62.5 After the month of enrollment, a person enrolled in medical 62.6 assistance under this subdivision who: 62.7 (1) is temporarily unable to work and without receipt of 62.8 earned income due to a medical condition, as verified by a 62.9 physician, may retain eligibility for up to four calendar 62.10 months; or 62.11 (2) effective January 1, 2004, loses employment for reasons 62.12 not attributable to the enrollee, may retain eligibility for up 62.13 to four consecutive months after the month of job loss. To 62.14 receive a four-month extension, enrollees must verify the 62.15 medical condition or provide notification of job loss. All 62.16 other eligibility requirements must be met and the enrollee must 62.17 pay all calculated premium costs for continued eligibility. 62.18 (b) For purposes of determining eligibility under this 62.19 subdivision, a person's assets must not exceed $20,000, 62.20 excluding: 62.21 (1) all assets excluded under section 256B.056; 62.22 (2) retirement accounts, including individual accounts, 62.23 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 62.24 (3) medical expense accounts set up through the person's 62.25 employer. 62.26 (c)(1) Effective January 1, 2004, for purposes of 62.27 eligibility, there will be a $65 earned income disregard. To be 62.28 eligible, a person applying for medical assistance under this 62.29 subdivision must have earned income above the disregard level. 62.30 (2) Effective January 1, 2004, to be considered earned 62.31 income, Medicare, social security, and applicable state and 62.32 federal income taxes must be withheld. To be eligible, a person 62.33 must document earned income tax withholding. 62.34 (d)(1) A person whose earned and unearned income is equal 62.35 to or greater than 100 percent of federal poverty guidelines for 62.36 the applicable family size must pay a premium to be eligible for 63.1 medical assistance under this subdivision. The premium shall be 63.2 based on the person's gross earned and unearned income and the 63.3 applicable family size using a sliding fee scale established by 63.4 the commissioner, which begins at one percent of income at 100 63.5 percent of the federal poverty guidelines and increases to 7.5 63.6 percent of income for those with incomes at or above 300 percent 63.7 of the federal poverty guidelines. Annual adjustments in the 63.8 premium schedule based upon changes in the federal poverty 63.9 guidelines shall be effective for premiums due in July of each 63.10 year. 63.11 (2) Effective January 1, 2004, all enrollees must pay a 63.12 premium to be eligible for medical assistance under this 63.13 subdivision. An enrollee shall pay the greater of a $35 premium 63.14 or the premium calculated in clause (1). 63.15(d)(e) A person's eligibility and premium shall be 63.16 determined by the local county agency. Premiums must be paid to 63.17 the commissioner. All premiums are dedicated to the 63.18 commissioner. 63.19(e)(f) Any required premium shall be determined at 63.20 application and redeterminedannually at recertificationat the 63.21 enrollee's six-month income review or when a change in income or 63.22familyhousehold sizeoccursis reported. Enrollees must report 63.23 any change in income or household size within ten days of when 63.24 the change occurs. A decreased premium resulting from a 63.25 reported change in income or household size shall be effective 63.26 the first day of the next available billing month after the 63.27 change is reported. Except for changes occurring from annual 63.28 cost-of-living increases or verification of income under section 63.29 256B.061, paragraph (b), a change resulting in an increased 63.30 premium shall not affect the premium amount until the next 63.31 six-month review. 63.32(f)(g) Premium payment is due upon notification from the 63.33 commissioner of the premium amount required. Premiums may be 63.34 paid in installments at the discretion of the commissioner. 63.35(g)(h) Nonpayment of the premium shall result in denial or 63.36 termination of medical assistance unless the person demonstrates 64.1 good cause for nonpayment. Good cause exists if the 64.2 requirements specified in Minnesota Rules, part 9506.0040, 64.3 subpart 7, items B to D, are met. Except when an installment 64.4 agreement is accepted by the commissioner, all persons 64.5 disenrolled for nonpayment of a premium must pay any past due 64.6 premiums as well as current premiums due prior to being 64.7 reenrolled. Nonpayment shall include payment with a returned, 64.8 refused, or dishonored instrument. The commissioner may require 64.9 a guaranteed form of payment as the only means to replace a 64.10 returned, refused, or dishonored instrument. 64.11 [EFFECTIVE DATE.] This section is effective November 1, 64.12 2003, except the amendments to Minnesota Statutes 2002, section 64.13 256B.057, subdivision 9, paragraphs (f) and (h), are effective 64.14 July 1, 2003. 64.15 Sec. 17. Minnesota Statutes 2002, section 256B.061, is 64.16 amended to read: 64.17 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 64.18(a)If any individual has been determined to be eligible 64.19 for medical assistance, it will be made available for care and 64.20 services included under the plan and furnished in or after the 64.21 third month before the month in which the individual made 64.22 application for such assistance, if such individual was, or upon 64.23 application would have been, eligible for medical assistance at 64.24 the time the care and services were furnished. The commissioner 64.25 may limit, restrict, or suspend the eligibility of an individual 64.26 for up to one year upon that individual's conviction of a 64.27 criminal offense related to application for or receipt of 64.28 medical assistance benefits. 64.29(b) On the basis of information provided on the completed64.30application, an applicant who meets the following criteria shall64.31be determined eligible beginning in the month of application:64.32(1) whose gross income is less than 90 percent of the64.33applicable income standard;64.34(2) whose total liquid assets are less than 90 percent of64.35the asset limit;64.36(3) does not reside in a long-term care facility; and65.1(4) meets all other eligibility requirements.65.2The applicant must provide all required verifications within 3065.3days' notice of the eligibility determination or eligibility65.4shall be terminated.65.5 [EFFECTIVE DATE.] This section is repealed April 1, 2005, 65.6 if the HealthMatch system is operational. If the HealthMatch 65.7 system is not operational, this section is effective July 1, 65.8 2005. 65.9 Sec. 18. Minnesota Statutes 2002, section 256B.0625, 65.10 subdivision 9, is amended to read: 65.11 Subd. 9. [DENTAL SERVICES.] Medical assistance covers 65.12 dental services. Dental services include, with prior 65.13 authorization, fixed bridges that are cost-effective for persons 65.14 who cannot use removable dentures because of their medical 65.15 condition. Payments for dental services covered under medical 65.16 assistance that are provided by a licensed denturist shall be 80 65.17 percent of the rate paid to a licensed dentist. A licensed 65.18 denturist may only provide services that are within the scope of 65.19 practice of the denturist's license as defined in chapter 150B. 65.20 Sec. 19. Minnesota Statutes 2002, section 256B.0625, 65.21 subdivision 13, is amended to read: 65.22 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 65.23 except for fertility drugs when specifically used to enhance 65.24 fertility, if prescribed by a licensed practitioner and 65.25 dispensed by a licensed pharmacist, by a physician enrolled in 65.26 the medical assistance program as a dispensing physician, or by 65.27 a physician or a nurse practitioner employed by or under 65.28 contract with a community health board as defined in section 65.29 145A.02, subdivision 5, for the purposes of communicable disease 65.30 control. 65.31 (b) The commissioner, after receiving recommendations from 65.32 professional medical associations and professional 65.33pharmacistpharmacy associations, shall designate a formulary 65.34 committee toadvise the commissioner on the names of drugs for65.35which payment is made, recommend a system for reimbursing65.36providers on a set fee or charge basis rather than the present66.1system, and develop methods encouraging use of generic drugs66.2when they are less expensive and equally effective as trademark66.3drugs. The formulary committee shall consist of nine members,66.4four of whom shall be physicians who are not employed by the66.5department of human services, and a majority of whose practice66.6is for persons paying privately or through health insurance,66.7three of whom shall be pharmacists who are not employed by the66.8department of human services, and a majority of whose practice66.9is for persons paying privately or through health insurance, a66.10consumer representative, and a nursing home representativecarry 66.11 out duties as described in this subdivision. The formulary 66.12 committee shall be comprised of four licensed physicians 66.13 actively engaged in the practice of medicine in Minnesota one of 66.14 whom must be actively engaged in the treatment of persons with 66.15 mental illness; at least three licensed pharmacists actively 66.16 engaged in the practice of pharmacy in Minnesota; and one 66.17 consumer representative; the remainder to be made up of health 66.18 care professionals who are licensed in their field and have 66.19 recognized knowledge in the clinically appropriate prescribing, 66.20 dispensing, and monitoring of covered outpatient drugs. Members 66.21 of the formulary committee shall not be employed by the 66.22 department of human services. Committee members shall serve 66.23 three-year terms andshall serve without compensation. Members66.24 may be reappointedonceby the commissioner. The formulary 66.25 committee shall meet at least quarterly. The commissioner may 66.26 require more frequent formulary committee meetings as needed. 66.27 An honorarium of $100 per meeting and reimbursement for mileage 66.28 shall be paid to each committee member in attendance. 66.29(b)(c) The commissioner shall establish a drug formulary. 66.30 Its establishment and publication shall not be subject to the 66.31 requirements of the Administrative Procedure Act, but the 66.32 formulary committee shall review and comment on the formulary 66.33 contents. 66.34 The formulary shall not include: 66.35 (i) drugs or products for which there is no federal 66.36 funding; 67.1 (ii) over-the-counter drugs, exceptfor antacids,67.2acetaminophen, family planning products, aspirin, insulin,67.3products for the treatment of lice, vitamins for adults with67.4documented vitamin deficiencies, vitamins for children under the67.5age of seven and pregnant or nursing women, and any other67.6over-the-counter drug identified by the commissioner, in67.7consultation with the drug formulary committee, as necessary,67.8appropriate, and cost-effective for the treatment of certain67.9specified chronic diseases, conditions or disorders, and this67.10determination shall not be subject to the requirements of67.11chapter 14as provided in paragraph (g); 67.12 (iii)anorectics, except that medically necessary67.13anorectics shall be covered for a recipient previously diagnosed67.14as having pickwickian syndrome and currently diagnosed as having67.15diabetes and being morbidly obesedrugs used for weight loss; 67.16 (iv) drugs for which medical value has not been 67.17 established; and 67.18 (v) drugs from manufacturers who have not signed a rebate 67.19 agreement with the Department of Health and Human Services 67.20 pursuant to section 1927 of title XIX of the Social Security Act. 67.21 The commissioner shall publish conditions for prohibiting 67.22 payment for specific drugs after considering the formulary 67.23 committee's recommendations.An honorarium of $100 per meeting67.24and reimbursement for mileage shall be paid to each committee67.25member in attendance.67.26 (d) Prior authorization may be required by the commissioner 67.27 before certain formulary drugs are eligible for payment. The 67.28 formulary committee may recommend drugs for prior authorization 67.29 directly to the commissioner. The commissioner may also request 67.30 that the formulary committee review a drug for prior 67.31 authorization. Before the commissioner may require prior 67.32 authorization for a drug: 67.33 (1) the commissioner must provide information to the 67.34 formulary committee on the impact that placing the drug on prior 67.35 authorization may have on the quality of patient care and on 67.36 program costs, information regarding whether the drug is subject 68.1 to clinical abuse or misuse, and relevant data from the state 68.2 Medicaid program if such data is available; 68.3 (2) the formulary committee must review the drug, taking 68.4 into account medical and clinical data and the information 68.5 provided by the commissioner; and 68.6 (3) the formulary committee must hold a public forum and 68.7 receive public comment for an additional 15 days. 68.8 The commissioner must provide a 15-day notice period before 68.9 implementing the prior authorization. 68.10(c)(e) The dispensed quantity of a prescribed drug must 68.11 not exceed a 30-day supply. The basis for determining the 68.12 amount of payment shall be the lower of the actual acquisition 68.13 costs of the drugs plus a fixed dispensing fee; the maximum 68.14 allowable cost set by the federal government or by the 68.15 commissioner plus the fixed dispensing fee; or the usual and 68.16 customary price charged to the public. The amount of payment 68.17 basis must be reduced to reflect all discount amounts applied to 68.18 the charge by any provider/insurer agreement or contract for 68.19 submitted charges to medical assistance programs. The net 68.20 submitted charge may not be greater than the patient liability 68.21 for the service. The pharmacy dispensing fee shall be $3.65, 68.22 except that the dispensing fee for intravenous solutions which 68.23 must be compounded by the pharmacist shall be $8 per bag, $14 68.24 per bag for cancer chemotherapy products, and $30 per bag for 68.25 total parenteral nutritional products dispensed in one liter 68.26 quantities, or $44 per bag for total parenteral nutritional 68.27 products dispensed in quantities greater than one liter. Actual 68.28 acquisition cost includes quantity and other special discounts 68.29 except time and cash discounts. The actual acquisition cost of 68.30 a drug shall be estimated by the commissioner, at average 68.31 wholesale price minusnine14 percent, except that where a drug 68.32 has had its wholesale price reduced as a result of the actions 68.33 of the National Association of Medicaid Fraud Control Units, the 68.34 estimated actual acquisition cost shall be the reduced average 68.35 wholesale price, without thenine14 percent deduction. The 68.36 maximum allowable cost of a multisource drug may be set by the 69.1 commissioner and it shall be comparable to, but no higher than, 69.2 the maximum amount paid by other third-party payors in this 69.3 state who have maximum allowable cost programs.The69.4commissioner shall set maximum allowable costs for multisource69.5drugs that are not on the federal upper limit list as described69.6in United States Code, title 42, chapter 7, section 1396r-8(e),69.7the Social Security Act, and Code of Federal Regulations, title69.842, part 447, section 447.332.Establishment of the amount of 69.9 payment for drugs shall not be subject to the requirements of 69.10 the Administrative Procedure Act. An additional dispensing fee 69.11 of $.30 may be added to the dispensing fee paid to pharmacists 69.12 for legend drug prescriptions dispensed to residents of 69.13 long-term care facilities when a unit dose blister card system, 69.14 approved by the department, is used. Under this type of 69.15 dispensing system, the pharmacist must dispense a 30-day supply 69.16 of drug. The National Drug Code (NDC) from the drug container 69.17 used to fill the blister card must be identified on the claim to 69.18 the department. The unit dose blister card containing the drug 69.19 must meet the packaging standards set forth in Minnesota Rules, 69.20 part 6800.2700, that govern the return of unused drugs to the 69.21 pharmacy for reuse. The pharmacy provider will be required to 69.22 credit the department for the actual acquisition cost of all 69.23 unused drugs that are eligible for reuse. Over-the-counter 69.24 medications must be dispensed in the manufacturer's unopened 69.25 package. The commissioner may permit the drug clozapine to be 69.26 dispensed in a quantity that is less than a 30-day supply. 69.27 Whenever a generically equivalent product is available, payment 69.28 shall be on the basis of the actual acquisition cost of the 69.29 generic drug, unless the prescriber specifically indicates69.30"dispense as written - brand necessary" on the prescription as69.31required by section 151.21, subdivision 2.69.32(d) For purposes of this subdivision, "multisource drugs"69.33means covered outpatient drugs, excluding innovator multisource69.34drugs for which there are two or more drug products, which:69.35(1) are related as therapeutically equivalent under the69.36Food and Drug Administration's most recent publication of70.1"Approved Drug Products with Therapeutic Equivalence70.2Evaluations";or on the maximum allowable cost established by 70.3 the commissioner. The commissioner may require prior 70.4 authorization for brand-name drugs whenever a generically 70.5 equivalent product is available even if the prescriber 70.6 specifically indicates "dispense as written - brand necessary" 70.7 on the prescription as required by section 151.21, subdivision 70.8 2. The formulary committee shall establish general criteria to 70.9 be used for the prior authorization of brand-name drugs for 70.10 which generically equivalent drugs are available, but formulary 70.11 committee review of each brand-name drug for which a generically 70.12 equivalent drug is available shall not be required. 70.13(2) are pharmaceutically equivalent and bioequivalent as70.14determined by the Food and Drug Administration; and70.15(3) are sold or marketed in Minnesota.70.16"Innovator multisource drug" means a multisource drug that was70.17originally marketed under an original new drug application70.18approved by the Food and Drug Administration.70.19(e) The formulary committee shall review and recommend70.20drugs which require prior authorization. The formulary70.21committee may recommend drugs for prior authorization directly70.22to the commissioner, as long as opportunity for public input is70.23provided. Prior authorization may be requested by the70.24commissioner based on medical and clinical criteria and on cost70.25before certain drugs are eligible for payment. Before a drug70.26may be considered for prior authorization at the request of the70.27commissioner:70.28(1) the drug formulary committee must develop criteria to70.29be used for identifying drugs; the development of these criteria70.30is not subject to the requirements of chapter 14, but the70.31formulary committee shall provide opportunity for public input70.32in developing criteria;70.33(2) the drug formulary committee must hold a public forum70.34and receive public comment for an additional 15 days;70.35(3) the drug formulary committee must consider data from70.36the state Medicaid program if such data is available; and71.1(4) the commissioner must provide information to the71.2formulary committee on the impact that placing the drug on prior71.3authorization will have on the quality of patient care and on71.4program costs, and information regarding whether the drug is71.5subject to clinical abuse or misuse.71.6Prior authorization may be required by the commissioner71.7before certain formulary drugs are eligible for payment. If71.8prior authorization of a drug is required by the commissioner,71.9the commissioner must provide a 30-day notice period before71.10implementing the prior authorization. If a prior authorization71.11request is denied by the department, the recipient may appeal71.12the denial in accordance with section 256.045. If an appeal is71.13filed, the drug must be provided without prior authorization71.14until a decision is made on the appeal.71.15 (f) The basis for determining the amount of payment for 71.16 drugs administered in an outpatient setting shall be the lower 71.17 of the usual and customary cost submitted by the provider; the 71.18 average wholesale price minus five percent; or the maximum 71.19 allowable cost set by the federal government under United States 71.20 Code, title 42, chapter 7, section 1396r-8(e), and Code of 71.21 Federal Regulations, title 42, section 447.332, or by the 71.22 commissioner under paragraph(c)(e). 71.23 (g)Prior authorization shall not be required or utilized71.24for any antipsychotic drug prescribed for the treatment of71.25mental illness where there is no generically equivalent drug71.26available unless the commissioner determines that prior71.27authorization is necessary for patient safety. This paragraph71.28applies to any supplemental drug rebate program established or71.29administered by the commissioner.Medical assistance covers the 71.30 following over-the-counter drugs when prescribed by a licensed 71.31 practitioner, or when authorized by a licensed pharmacist who 71.32 meets standards established by the commissioner, in consultation 71.33 with the board of pharmacy: antacids, acetaminophen, family 71.34 planning products, aspirin, insulin, products for the treatment 71.35 of lice, vitamins for adults with documented vitamin 71.36 deficiencies, vitamins for children under the age of seven and 72.1 pregnant or nursing women, and any other over-the-counter drug 72.2 identified by the commissioner, in consultation with the 72.3 formulary committee, as necessary, appropriate, and cost 72.4 effective for the treatment of certain specified chronic 72.5 diseases, conditions, or disorders, and this determination shall 72.6 not be subject to the requirements of chapter 14. When 72.7 authorizing over-the-counter drugs under this paragraph, 72.8 licensed pharmacists must consult with the recipient to 72.9 determine necessity, provide drug counseling, review drug 72.10 therapy for potential adverse interactions, and make referrals 72.11 as needed to other health care professionals. 72.12 (h) Prior authorization shall not be required or utilized 72.13 for any antihemophilic factor drug prescribed for the treatment 72.14 of hemophilia and blood disorders where there is no generically 72.15 equivalent drug availableunless the commissioner determines72.16that prior authorization is necessary for patient safety. This72.17paragraph applies toif the prior authorization is used in 72.18 conjunction with any supplemental drug rebate program or 72.19 multistate preferred drug list established or administered by 72.20 the commissioner. This paragraph expires July 1,20032005. 72.21 (i) Prior authorization shall not be required or utilized 72.22 for any atypical antipsychotic drug prescribed for the treatment 72.23 of mental illness if: 72.24 (1) there is no generically equivalent drug available; and 72.25 (2) the drug was initially prescribed for the recipient 72.26 prior to July 1, 2003; or 72.27 (3) the drug is part of the recipient's current course of 72.28 treatment. 72.29 This paragraph applies to any multistate preferred drug list or 72.30 supplemental drug rebate program established or administered by 72.31 the commissioner. 72.32 Sec. 20. Minnesota Statutes 2002, section 256B.0625, is 72.33 amended by adding a subdivision to read: 72.34 Subd. 13c. [PHARMACEUTICAL CARE DEMONSTRATION PROJECT.] (a) 72.35 The commissioner shall develop, upon federal approval, a 72.36 demonstration project to provide culturally specific 73.1 pharmaceutical care to American Indian medical assistance 73.2 recipients who are age 55 and older. In developing the 73.3 demonstration project, the commissioner shall consult with 73.4 organizations and health care providers experienced in 73.5 developing and implementing culturally competent intervention 73.6 strategies to manage the use of prescription drugs, 73.7 over-the-counter drugs, other drug products, and native 73.8 therapies by American Indian elders. The commissioner shall 73.9 seek federal approval to implement the demonstration project. 73.10 (b) For purposes of this subdivision, "pharmaceutical care" 73.11 means the provision of drug therapy and native therapy for the 73.12 purpose of improving a patient's quality of life by: (1) curing 73.13 a disease; (2) eliminating or reducing a patient's symptoms; (3) 73.14 arresting or slowing a disease process; or (4) preventing a 73.15 disease or a symptom. Pharmaceutical care involves the 73.16 documented process through which a pharmacist cooperates with a 73.17 patient and other professionals in designing, implementing, and 73.18 monitoring a therapeutic plan that is expected to produce 73.19 specific therapeutic outcomes, through the identification, 73.20 resolution, and prevention of drug-related problems. Nothing in 73.21 this subdivision shall be construed to expand or modify the 73.22 scope of practice of the pharmacist as defined in section 73.23 151.01, subdivision 27. 73.24 [EFFECTIVE DATE.] This section is effective July 1, 2003, 73.25 or upon federal approval, whichever is later. 73.26 Sec. 21. Minnesota Statutes 2002, section 256B.0625, 73.27 subdivision 17, is amended to read: 73.28 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 73.29 covers transportation costs incurred solely for obtaining 73.30 emergency medical care or transportation costs incurred by 73.31nonambulatoryeligible persons in obtaining emergency or 73.32 nonemergency medical care when paid directly to an ambulance 73.33 company, common carrier, or other recognized providers of 73.34 transportation services.For the purpose of this subdivision, a73.35person who is incapable of transport by taxicab or bus shall be73.36considered to be nonambulatory.74.1 (b) Medical assistance covers special transportation, as 74.2 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 74.3 if theprovider receives and maintains a current physician's74.4order by the recipient's attending physician certifying that the74.5 recipient has a physical or mental impairment that would 74.6 prohibit the recipient from safely accessing and using a bus, 74.7 taxi, other commercial transportation, or private automobile. 74.8 The commissioner may use an order by the recipient's attending 74.9 physician to certify that the recipient requires special 74.10 transportation services. Special transportation includes 74.11 driver-assisted service to eligible individuals. 74.12 Driver-assisted service includes passenger pickup at and return 74.13 to the individual's residence or place of business, assistance 74.14 with admittance of the individual to the medical facility, and 74.15 assistance in passenger securement or in securing of wheelchairs 74.16 or stretchers in the vehicle.The commissioner shall establish74.17maximum medical assistance reimbursement rates for special74.18transportation services for persons who need a74.19wheelchair-accessible van or stretcher-accessible vehicle and74.20for those who do not need a wheelchair-accessible van or74.21stretcher-accessible vehicle. The average of these two rates74.22per trip must not exceed $15 for the base rate and $1.40 per74.23mile. Special transportation provided to nonambulatory persons74.24who do not need a wheelchair-accessible van or74.25stretcher-accessible vehicle, may be reimbursed at a lower rate74.26than special transportation provided to persons who need a74.27wheelchair-accessible van or stretcher-accessible74.28vehicle.Special transportation providers must obtain written 74.29 documentation from the health care service provider who is 74.30 serving the recipient being transported, identifying the time 74.31 that the recipient arrived. Special transportation providers 74.32 may not bill for separate base rates for the continuation of a 74.33 trip beyond the original destination. Special transportation 74.34 providers must take recipients to the nearest appropriate health 74.35 care provider, using the most direct route available. The 74.36 maximum medical assistance reimbursement rates for special 75.1 transportation services are: 75.2 (1) $18 for the base rate and $1.40 per mile for services 75.3 to eligible persons who need a wheelchair-accessible van; 75.4 (2) $12 for the base rate and $1.35 per mile for services 75.5 to eligible persons who do not need a wheelchair-accessible van; 75.6 and 75.7 (3) $36 for the base rate and $1.40 per mile, and an 75.8 attendant rate of $9 per trip, for services to eligible persons 75.9 who need a stretcher-accessible vehicle. 75.10 Sec. 22. Minnesota Statutes 2002, section 256B.0625, is 75.11 amended by adding a subdivision to read: 75.12 Subd. 45. [LIST OF HEALTH CARE SERVICES NOT ELIGIBLE FOR 75.13 COVERAGE.] (a) The commissioner of human services, in 75.14 consultation with the commissioner of health, shall biennially 75.15 establish a list of diagnosis/treatment pairings that are not 75.16 eligible for reimbursement under chapters 256B, 256D, and 256L, 75.17 effective for services provided on or after July 1, 2005. The 75.18 commissioner shall review the list in effect for the prior 75.19 biennium and shall make any additions or deletions from the list 75.20 as appropriate taking into consideration the following: 75.21 (1) scientific and medical information; 75.22 (2) clinical assessment; 75.23 (3) cost-effectiveness of treatment; 75.24 (4) prevention of future costs; and 75.25 (5) medical ineffectiveness. 75.26 (b) The commissioner may appoint an ad hoc advisory panel 75.27 made up of physicians, consumers, nurses, dentists, 75.28 chiropractors, and other experts to assist the commissioner in 75.29 reviewing and establishing the list. The commissioner shall 75.30 solicit comments and recommendations from any interested persons 75.31 and organizations and shall schedule at least one public hearing. 75.32 (c) The list must be established by October 1 of the 75.33 even-numbered years beginning October 1, 2004. The commissioner 75.34 shall publish the list in the State Register by November 1 of 75.35 the even-numbered years beginning November 1, 2004. The list 75.36 shall be submitted to the legislature by January 15 of the 76.1 odd-numbered years beginning January 15, 2005. 76.2 Sec. 23. Minnesota Statutes 2002, section 256B.0635, 76.3 subdivision 1, is amended to read: 76.4 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 76.5 2002, medical assistance may be paid for persons who received 76.6 MFIP or medical assistance for families and children in at least 76.7 three of six months preceding the month in which the person 76.8 became ineligible for MFIP or medical assistance, if the 76.9 ineligibility was due to an increase in hours of employment or 76.10 employment income or due to the loss of an earned income 76.11 disregard. In addition, to receive continued assistance under 76.12 this section, persons who received medical assistance for 76.13 families and children but did not receive MFIP must have had 76.14 income less than or equal to the assistance standard for their 76.15 family size under the state's AFDC plan in effect as of July 16, 76.16 1996, increased by three percent effective July 1, 2000, at the 76.17 time medical assistance eligibility began. A person who is 76.18 eligible for extended medical assistance is entitled to six 76.19 months of assistance without reapplication, unless the 76.20 assistance unit ceases to include a dependent child. For a 76.21 person under 21 years of age, medical assistance may not be 76.22 discontinued within the six-month period of extended eligibility 76.23 until it has been determined that the person is not otherwise 76.24 eligible for medical assistance. Medical assistance may be 76.25 continued for an additional six months if the person meets all 76.26 requirements for the additional six months, according to title 76.27 XIX of the Social Security Act, as amended by section 303 of the 76.28 Family Support Act of 1988, Public LawNumber100-485. 76.29 (b) Beginning July 1, 2002, contingent upon federal 76.30 funding, medical assistance for families and children may be 76.31 paid for persons who were eligible under section 256B.055, 76.32 subdivision 3a, in at least three of six months preceding the 76.33 month in which the person became ineligible under that section 76.34 if the ineligibility was due to an increase in hours of 76.35 employment or employment income or due to the loss of an earned 76.36 income disregard. A person who is eligible for extended medical 77.1 assistance is entitled to six months of assistance without 77.2 reapplication, unless the assistance unit ceases to include a 77.3 dependent child, except medical assistance may not be 77.4 discontinued for that dependent child under 21 years of age 77.5 within the six-month period of extended eligibility until it has 77.6 been determined that the person is not otherwise eligible for 77.7 medical assistance. Medical assistance may be continued for an 77.8 additional six months if the person meets all requirements for 77.9 the additional six months, according to title XIX of the Social 77.10 Security Act, as amended by section 303 of the Family Support 77.11 Act of 1988, Public LawNumber100-485. 77.12 [EFFECTIVE DATE.] This section is effective July 1, 2003. 77.13 Sec. 24. Minnesota Statutes 2002, section 256B.0635, 77.14 subdivision 2, is amended to read: 77.15 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 77.16 June 30, 2002, medical assistance may be paid for persons who 77.17 received MFIP or medical assistance for families and children in 77.18 at least three of the six months preceding the month in which 77.19 the person became ineligible for MFIP or medical assistance, if 77.20 the ineligibility was the result of the collection of child or 77.21 spousal support under part D of title IV of the Social Security 77.22 Act. In addition, to receive continued assistance under this 77.23 section, persons who received medical assistance for families 77.24 and children but did not receive MFIP must have had income less 77.25 than or equal to the assistance standard for their family size 77.26 under the state's AFDC plan in effect as of July 16, 1996, 77.27 increased by three percent effective July 1, 2000, at the time 77.28 medical assistance eligibility began. A person who is eligible 77.29 for extended medical assistance under this subdivision is 77.30 entitled to four months of assistance without reapplication, 77.31 unless the assistance unit ceases to include a dependent child, 77.32 except medical assistance may not be discontinued for that 77.33 dependent child under 21 years of age within the four-month 77.34 period of extended eligibility until it has been determined that 77.35 the person is not otherwise eligible for medical assistance. 77.36 (b) Beginning July 1, 2002, contingent upon federal 78.1 funding, medical assistance for families and children may be 78.2 paid for persons who were eligible under section 256B.055, 78.3 subdivision 3a, in at least three of the six months preceding 78.4 the month in which the person became ineligible under that 78.5 section if the ineligibility was the result of the collection of 78.6 child or spousal support under part D of title IV of the Social 78.7 Security Act. A person who is eligible for extended medical 78.8 assistance under this subdivision is entitled to four months of 78.9 assistance without reapplication, unless the assistance unit 78.10 ceases to include a dependent child, except medical assistance 78.11 may not be discontinued for that dependent child under 21 years 78.12 of age within the four-month period of extended eligibility 78.13 until it has been determined that the person is not otherwise 78.14 eligible for medical assistance. 78.15 [EFFECTIVE DATE.] This section is effective July 1, 2003. 78.16 Sec. 25. Minnesota Statutes 2002, section 256B.19, is 78.17 amended by adding a subdivision to read: 78.18 Subd. 4. [TEMPORARY COUNTY SHARE OF MEDICAL ASSISTANCE 78.19 COSTS.] (a) Except as otherwise provided in this chapter, for 78.20 the period January 1, 2005, to June 30, 2005, the county share 78.21 of medical assistance costs shall be 3.9 percent county funds. 78.22 (b) The county shall pay by the 20th of each month the 78.23 county portion of medical assistance costs under the temporary 78.24 share provided in this subdivision based upon billings from the 78.25 state agency to the county agency for expenditures for the 78.26 succeeding month. Payment shall be made monthly by the county 78.27 to the state for expenditures for each month. 78.28 (c) On or before July 31, 2005, the state shall reimburse 78.29 each county for the medical assistance payments made by that 78.30 county to the state under paragraph (b). 78.31 Sec. 26. Minnesota Statutes 2002, section 256B.195, 78.32 subdivision 3, is amended to read: 78.33 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a) 78.34 Effective July 15, 2001, the commissioner shall make the 78.35 following payments to the hospitals indicated after noon on the 78.36 15th of each month: 79.1 (1) to Hennepin County Medical Center, any federal matching 79.2 funds available to match the payments received by the medical 79.3 center under subdivision 2, to increase payments for medical 79.4 assistance admissions and to recognize higher medical assistance 79.5 costs in institutions that provide high levels of charity care; 79.6 and 79.7 (2) to Regions hospital, any federal matching funds 79.8 available to match the payments received by the hospital under 79.9 subdivision 2, to increase payments for medical assistance 79.10 admissions and to recognize higher medical assistance costs in 79.11 institutions that provide high levels of charity care. 79.12 (b) Effective July 15, 2001, the following percentages of 79.13 the transfers under subdivision 2 shall be retained by the 79.14 commissioner for deposit each month into the general fund: 79.15 (1) 18 percent, plus any federal matching funds, shall be 79.16 allocated for the following purposes: 79.17 (i) during the fiscal year beginning July 1, 2001, of the 79.18 amount available under this clause, 39.7 percent shall be 79.19 allocated to make increased hospital payments under section 79.20 256.969, subdivision 26; 34.2 percent shall be allocated to fund 79.21 the amounts due from small rural hospitals, as defined in 79.22 section 144.148, for overpayments under section 256.969, 79.23 subdivision 5a, resulting from a determination that medical 79.24 assistance and general assistance payments exceeded the charge 79.25 limit during the period from 1994 to 1997; and 26.1 percent 79.26 shall be allocated to the commissioner of health for rural 79.27 hospital capital improvement grants under section 144.148; and 79.28 (ii) during fiscal years beginning on or after July 1, 79.29 2002, of the amount available under this clause, 55 percent 79.30 shall be allocated to make increased hospital payments under 79.31 section 256.969, subdivision 26, and 45 percent shall be 79.32 allocated to the commissioner of health for rural hospital 79.33 capital improvement grants under section 144.148; and 79.34 (2) 11 percent shall be allocated to the commissioner of 79.35 health to fund community clinic grants under section 145.9268. 79.36 (c) This subdivision shall apply to fee-for-service 80.1 payments only and shall not increase capitation payments or 80.2 payments made based on average rates. 80.3 (d) Medical assistance rate or payment changes, including 80.4 those required to obtain federal financial participation under 80.5 section 62J.692, subdivision 8, shall precede the determination 80.6 of intergovernmental transfer amounts determined in this 80.7 subdivision. Participation in the intergovernmental transfer 80.8 program shall not result in the offset of any health care 80.9 provider's receipt of medical assistance payment increases other 80.10 than limits resulting from hospital-specific charge limits and 80.11 limits on disproportionate share hospital payments. 80.12 (e) Effective July 1, 2003, if the amount available for 80.13 allocation under paragraph (b) is greater than the amounts 80.14 available during March 2003, any additional amounts available 80.15 under this subdivision after reimbursement of the transfers 80.16 under subdivision 2, as a result of sections 62J.692, 80.17 subdivision 8, and 256.969, subdivision 3a; or from any other 80.18 source, shall be allocated to increase medical assistance 80.19 payments, subject to hospital-specific charge limits and limits 80.20 on disproportionate share hospital payments, as follows: 80.21 (1) if the payments under subdivision 5 have been approved, 80.22 67 percent shall be allocated to Hennepin County Medical Center 80.23 and 33 percent to Regions hospital; or 80.24 (2) if the payments under subdivision 5 have not been 80.25 approved, 51 percent shall be allocated to Hennepin County 80.26 Medical Center, 27 percent to Regions hospital, and 22 percent 80.27 to Fairview University Medical Center. 80.28 [EFFECTIVE DATE.] This section is effective July 1, 2003. 80.29 Sec. 27. Minnesota Statutes 2002, section 256B.195, 80.30 subdivision 5, is amended to read: 80.31 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 80.32 CENTER.] (a) Upon federal approval of theinclusion of Fairview80.33University Medical Center in the nonstate government80.34categorypayments in paragraph (b), the commissioner shall 80.35 establish an intergovernmental transfer with the University of 80.36 Minnesota in an amount determined by the commissioner based on 81.1 theincrease in theamount of Medicare upper payment limitdue81.2solely to the inclusion of Fairview University Medical Center as81.3a nonstate government hospital and limitedavailable for 81.4 nongovernment hospitals adjusted by hospital-specific charge 81.5 limits and the amount available under the hospital-specific 81.6 disproportionate share limit. 81.7 (b) The commissioner shall increase payments for medical 81.8 assistance admissions at Fairview University Medical Center by 81.971 percentthe amount of the transfer plus any federal matching 81.10 payments on that amount, to increase payments for medical 81.11 assistance admissions and to recognize higher medical assistance 81.12 costs in institutions that provide high levels of charity care. 81.13From this payment, Fairview University Medical Center shall pay81.14to the University of Minnesota the cost of the transfer, on the81.15same day the payment is received. Eighteen percent of the81.16transfer plus any federal matching payments shall be used as81.17specified in subdivision 3, paragraph (b), clause (1). Payments81.18under section 256.969, subdivision 26, may be increased above81.19the 90 percent level specified in that subdivision within the81.20limits of additional funding available under this subdivision.81.21Eleven percent of the transfer shall be used to increase the81.22grants under section 145.9268.81.23 Sec. 28. Minnesota Statutes 2002, section 256B.32, 81.24 subdivision 1, is amended to read: 81.25 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 81.26 commissioner shall establish a facility fee payment mechanism 81.27 that will pay a facility fee to all enrolled outpatient 81.28 hospitals for each emergency room or outpatient clinic visit 81.29 provided on or after July 1, 1989. This payment mechanism may 81.30 not result in an overall increase in outpatient payment rates. 81.31 This section does not apply to federally mandated maximum 81.32 payment limits, department approved program packages, or 81.33 services billed using a nonoutpatient hospital provider number. 81.34 (b) For fee-for-service services provided on or after July 81.35 1, 2002, the total payment, before third-party liability and 81.36 spenddown, made to hospitals for outpatient hospital facility 82.1 services is reduced by .5 percent from the current statutory 82.2 rates. 82.3 (c) In addition to the reduction in paragraph (b), the 82.4 total payment for fee-for-service services provided on or after 82.5 July 1, 2003, made to hospitals for outpatient hospital facility 82.6 services before third-party liability and spenddown, is reduced 82.7 five percent from the current statutory rates. Facilities 82.8 defined under section 256.969, subdivision 16, are excluded from 82.9 this paragraph. 82.10 Sec. 29. Minnesota Statutes 2002, section 256B.69, 82.11 subdivision 2, is amended to read: 82.12 Subd. 2. [DEFINITIONS.] For the purposes of this section, 82.13 the following terms have the meanings given. 82.14 (a) "Commissioner" means the commissioner of human services. 82.15 For the remainder of this section, the commissioner's 82.16 responsibilities for methods and policies for implementing the 82.17 project will be proposed by the project advisory committees and 82.18 approved by the commissioner. 82.19 (b) "Demonstration provider" means a health maintenance 82.20 organization, community integrated service network, or 82.21 accountable provider network authorized and operating under 82.22 chapter 62D, 62N, or 62T that participates in the demonstration 82.23 project according to criteria, standards, methods, and other 82.24 requirements established for the project and approved by the 82.25 commissioner. For purposes of this section, a county board, or 82.26 group of county boards operating under a joint powers agreement, 82.27 is considered a demonstration provider if the county or group of 82.28 county boards meets the requirements of section 256B.692. 82.29 Notwithstanding the above, Itasca county may continue to 82.30 participate as a demonstration provider until July 1, 2004. 82.31 (c) "Eligible individuals" means those persons eligible for 82.32 medical assistance benefits as defined in sections 256B.055, 82.33 256B.056, and 256B.06. 82.34 (d) "Limitation of choice" means suspending freedom of 82.35 choice while allowing eligible individuals to choose among the 82.36 demonstration providers. 83.1(e) This paragraph supersedes paragraph (c) as long as the83.2Minnesota health care reform waiver remains in effect. When the83.3waiver expires, this paragraph expires and the commissioner of83.4human services shall publish a notice in the State Register and83.5notify the revisor of statutes. "Eligible individuals" means83.6those persons eligible for medical assistance benefits as83.7defined in sections 256B.055, 256B.056, and 256B.06.83.8Notwithstanding sections 256B.055, 256B.056, and 256B.06, an83.9individual who becomes ineligible for the program because of83.10failure to submit income reports or recertification forms in a83.11timely manner, shall remain enrolled in the prepaid health plan83.12and shall remain eligible to receive medical assistance coverage83.13through the last day of the month following the month in which83.14the enrollee became ineligible for the medical assistance83.15program.83.16 [EFFECTIVE DATE.] This section is effective July 1, 2003. 83.17 Sec. 30. Minnesota Statutes 2002, section 256B.69, 83.18 subdivision 4, is amended to read: 83.19 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 83.20 shall develop criteria to determine when limitation of choice 83.21 may be implemented in the experimental counties. The criteria 83.22 shall ensure that all eligible individuals in the county have 83.23 continuing access to the full range of medical assistance 83.24 services as specified in subdivision 6. 83.25 (b) The commissioner shall exempt the following persons 83.26 from participation in the project, in addition to those who do 83.27 not meet the criteria for limitation of choice: 83.28 (1) persons eligible for medical assistance according to 83.29 section 256B.055, subdivision 1; 83.30 (2) persons eligible for medical assistance due to 83.31 blindness or disability as determined by the social security 83.32 administration or the state medical review team, unless: 83.33 (i) they are 65 years of age or older; or 83.34 (ii) they reside in Itasca county or they reside in a 83.35 county in which the commissioner conducts a pilot project under 83.36 a waiver granted pursuant to section 1115 of the Social Security 84.1 Act; 84.2 (3) recipients who currently have private coverage through 84.3 a health maintenance organization; 84.4 (4) recipients who are eligible for medical assistance by 84.5 spending down excess income for medical expenses other than the 84.6 nursing facility per diem expense; 84.7 (5) recipients who receive benefits under the Refugee 84.8 Assistance Program, established under United States Code, title 84.9 8, section 1522(e); 84.10 (6) children who are both determined to be severely 84.11 emotionally disturbed and receiving case management services 84.12 according to section 256B.0625, subdivision 20; 84.13 (7) adults who are both determined to be seriously and 84.14 persistently mentally ill and received case management services 84.15 according to section 256B.0625, subdivision 20;and84.16 (8) persons eligible for medical assistance according to 84.17 section 256B.057, subdivision 10; and 84.18 (9) persons with access to cost-effective 84.19 employer-sponsored private health insurance or persons enrolled 84.20 in an individual health plan determined to be cost-effective 84.21 according to section 256B.0625, subdivision 15. 84.22 Children under age 21 who are in foster placement may enroll in 84.23 the project on an elective basis. Individuals excluded under 84.24 clauses (6) and (7) may choose to enroll on an elective 84.25 basis. The commissioner may enroll recipients in the prepaid 84.26 medical assistance program for seniors who are (1) age 65 and 84.27 over, and (2) eligible for medical assistance by spending down 84.28 excess income. 84.29 (c) The commissioner may allow persons with a one-month 84.30 spenddown who are otherwise eligible to enroll to voluntarily 84.31 enroll or remain enrolled, if they elect to prepay their monthly 84.32 spenddown to the state. 84.33 (d) The commissioner may require those individuals to 84.34 enroll in the prepaid medical assistance program who otherwise 84.35 would have been excluded under paragraph (b), clauses (1), (3), 84.36 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 85.1 items H, K, and L. 85.2 (e) Before limitation of choice is implemented, eligible 85.3 individuals shall be notified and after notification, shall be 85.4 allowed to choose only among demonstration providers. The 85.5 commissioner may assign an individual with private coverage 85.6 through a health maintenance organization, to the same health 85.7 maintenance organization for medical assistance coverage, if the 85.8 health maintenance organization is under contract for medical 85.9 assistance in the individual's county of residence. After 85.10 initially choosing a provider, the recipient is allowed to 85.11 change that choice only at specified times as allowed by the 85.12 commissioner. If a demonstration provider ends participation in 85.13 the project for any reason, a recipient enrolled with that 85.14 provider must select a new provider but may change providers 85.15 without cause once more within the first 60 days after 85.16 enrollment with the second provider. 85.17 Sec. 31. Minnesota Statutes 2002, section 256B.69, 85.18 subdivision 5, is amended to read: 85.19 Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The 85.20 commissioner shall establish the method and amount of payments 85.21 for services. The commissioner shall annually contract with 85.22 demonstration providers to provide services consistent with 85.23 these established methods and amounts for payment. 85.24 If allowed by the commissioner, a demonstration provider 85.25 may contract with an insurer, health care provider, nonprofit 85.26 health service plan corporation, or the commissioner, to provide 85.27 insurance or similar protection against the cost of care 85.28 provided by the demonstration provider or to provide coverage 85.29 against the risks incurred by demonstration providers under this 85.30 section. The recipients enrolled with a demonstration provider 85.31 are a permissible group under group insurance laws and chapter 85.32 62C, the Nonprofit Health Service Plan Corporations Act. Under 85.33 this type of contract, the insurer or corporation may make 85.34 benefit payments to a demonstration provider for services 85.35 rendered or to be rendered to a recipient. Any insurer or 85.36 nonprofit health service plan corporation licensed to do 86.1 business in this state is authorized to provide this insurance 86.2 or similar protection. 86.3 Payments to providers participating in the project are 86.4 exempt from the requirements of sections 256.966 and 256B.03, 86.5 subdivision 2. The commissioner shall complete development of 86.6 capitation rates for payments before delivery of services under 86.7 this section is begun. For payments made during calendar year 86.8 1990 and later years, the commissioner shall contract with an 86.9 independent actuary to establish prepayment rates. 86.10 By January 15, 1996, the commissioner shall report to the 86.11 legislature on the methodology used to allocate to participating 86.12 counties available administrative reimbursement for advocacy and 86.13 enrollment costs. The report shall reflect the commissioner's 86.14 judgment as to the adequacy of the funds made available and of 86.15 the methodology for equitable distribution of the funds. The 86.16 commissioner must involve participating counties in the 86.17 development of the report. 86.18 Beginning July 1, 2004, the commissioner may include 86.19 payments for elderly waiver services and 180 days of nursing 86.20 home care in capitation payments for the prepaid medical 86.21 assistance program for seniors. Payments for elderly waiver 86.22 services shall be made no earlier than the month following the 86.23 month in which services were received. 86.24 Sec. 32. Minnesota Statutes 2002, section 256B.69, 86.25 subdivision 5a, is amended to read: 86.26 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 86.27 contracts under this section and sections 256L.12 and 256D.03, 86.28 shall be entered into or renewed on a calendar year basis 86.29 beginning January 1, 1996. Managed care contracts which were in 86.30 effect on June 30, 1995, and set to renew on July 1, 1995, shall 86.31 be renewed for the period July 1, 1995 through December 31, 1995 86.32 at the same terms that were in effect on June 30, 1995. The 86.33 commissioner may issue separate contracts with requirements 86.34 specific to services to medical assistance recipients age 65 and 86.35 older. 86.36 (b) A prepaid health plan providing covered health services 87.1 for eligible persons pursuant to chapters 256B, 256D, and 256L, 87.2 is responsible for complying with the terms of its contract with 87.3 the commissioner. Requirements applicable to managed care 87.4 programs under chapters 256B, 256D, and 256L, established after 87.5 the effective date of a contract with the commissioner take 87.6 effect when the contract is next issued or renewed. 87.7 (c) Effective for services rendered on or after January 1, 87.8 2003, the commissioner shall withhold five percent of managed 87.9 care plan payments under this section for the prepaid medical 87.10 assistance and general assistance medical care programs pending 87.11 completion of performance targets. The withheld funds must be 87.12 returned no sooner than July of the following year if 87.13 performance targets in the contract are achieved. The 87.14 commissioner may exclude special demonstration projects under 87.15 subdivision 23. A managed care plan may include as admitted 87.16 assets under section 62D.044 any amount withheld under this 87.17 paragraph that is reasonably expected to be returned. 87.18 Sec. 33. Minnesota Statutes 2002, section 256B.69, 87.19 subdivision 5c, is amended to read: 87.20 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 87.21 Except as provided in paragraph (c), the commissioner of human 87.22 services shall transfer each year to the medical education and 87.23 research fund established under section 62J.692, the following: 87.24 (1) an amount equal to the reduction in the prepaid medical 87.25 assistance and prepaid general assistance medical care payments 87.26 as specified in this clause. Until January 1, 2002, the county 87.27 medical assistance and general assistance medical care 87.28 capitation base rate prior to plan specific adjustments and 87.29 after the regional rate adjustments under section 256B.69, 87.30 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 87.31 percent for the remaining metropolitan counties, and no 87.32 reduction for nonmetropolitan Minnesota counties; and after 87.33 January 1, 2002, the county medical assistance and general 87.34 assistance medical care capitation base rate prior to plan 87.35 specific adjustments is reduced 6.3 percent for Hennepin county, 87.36 two percent for the remaining metropolitan counties, and 1.6 88.1 percent for nonmetropolitan Minnesota counties. Nursing 88.2 facility and elderly waiver payments and demonstration project 88.3 payments operating under subdivision 23 are excluded from this 88.4 reduction. The amount calculated under this clause shall not be 88.5 adjusted for periods already paid due to subsequent changes to 88.6 the capitation payments; 88.7 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 88.8 from the capitation rates paid under this section plus any 88.9 federal matching funds on this amount; 88.10 (3) beginning July 1, 2002, an additional $12,700,000 from 88.11 the capitation rates paid under this section; and 88.12 (4) beginning July 1, 2003, an additional $4,700,000 from 88.13 the capitation rates paid under this section. 88.14 (b) This subdivision shall be effective upon approval of a 88.15 federal waiver which allows federal financial participation in 88.16 the medical education and research fund. 88.17 (c) Effective July 1, 2003, the amount reduced from the 88.18 prepaid general assistance medical care payments under paragraph 88.19 (a), clause (1), shall be transferred to the general fund. 88.20 Sec. 34. Minnesota Statutes 2002, section 256B.69, 88.21 subdivision 5g, is amended to read: 88.22 Subd. 5g. [PAYMENT FOR COVERED SERVICES.] (a) For services 88.23 rendered on or after January 1, 2003, the total payment made to 88.24 managed care plans for providing covered services under the 88.25 medical assistance and general assistance medical care programs 88.26 is reduced by .5 percent from their current statutory rates. 88.27 (b) In addition to the reduction in paragraph (a), the 88.28 total payment made to managed care plans under the medical 88.29 assistance and general assistance medical care programs is 88.30 reduced by one percent for services rendered on or after October 88.31 1, 2003. 88.32 (c) Thisprovision excludessubdivision does not apply to 88.33 payments for nursing home services, home and community-based 88.34 waivers, and payments to demonstration projects for persons with 88.35 disabilities. 88.36 Sec. 35. Minnesota Statutes 2002, section 256B.69, 89.1 subdivision 6a, is amended to read: 89.2 Subd. 6a. [NURSING HOME SERVICES.] (a) Notwithstanding 89.3 Minnesota Rules, part 9500.1457, subpart 1, item B, up to90180 89.4 days of nursing facility services as defined in section 89.5 256B.0625, subdivision 2, which are provided in a nursing 89.6 facility certified by the Minnesota department of health for 89.7 services provided and eligible for payment under Medicaid, shall 89.8 be covered under the prepaid medical assistance program for 89.9 individuals who are not residing in a nursing facility at the 89.10 time of enrollment in the prepaid medical assistance 89.11 program. The commissioner may develop a schedule to phase in 89.12 implementation of the 180-day provision. 89.13 (b) For individuals enrolled in the Minnesota senior health 89.14 options project authorized under subdivision 23, nursing 89.15 facility services shall be covered according to the terms and 89.16 conditions of the federal agreement governing that demonstration 89.17 project. 89.18 Sec. 36. Minnesota Statutes 2002, section 256B.69, 89.19 subdivision 6b, is amended to read: 89.20 Subd. 6b. [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a) 89.21 For individuals enrolled in the Minnesota senior health options 89.22 project authorized under subdivision 23, elderly waiver services 89.23 shall be covered according to the terms and conditions of the 89.24 federal agreement governing that demonstration project. 89.25 (b) For individuals under age 65 enrolled in demonstrations 89.26 authorized under subdivision 23, home and community-based waiver 89.27 services shall be covered according to the terms and conditions 89.28 of the federal agreement governing that demonstration project. 89.29 (c) Notwithstanding Minnesota Rules, part 9500.1457, 89.30 subpart 1, item C, elderly waiver services shall be covered 89.31 under the prepaid medical assistance program for all individuals 89.32 who are eligible according to section 256B.0915. The 89.33 commissioner may develop a schedule to phase in implementation 89.34 of these waiver services. 89.35 Sec. 37. Minnesota Statutes 2002, section 256B.69, is 89.36 amended by adding a subdivision to read: 90.1 Subd. 6d. [PRESCRIPTION DRUGS.] Effective January 1, 2004, 90.2 the commissioner may exclude or modify coverage for prescription 90.3 drugs from the prepaid managed care contracts entered into under 90.4 this section in order to increase savings to the state by 90.5 collecting additional prescription drug rebates. The contracts 90.6 must maintain incentives for the managed care plan to manage 90.7 drug costs and utilization and may require that the managed care 90.8 plans maintain an open drug formulary. In order to manage drug 90.9 costs and utilization, the contracts may authorize the managed 90.10 care plans to use preferred drug lists and prior authorization. 90.11 This subdivision is contingent on federal approval of the 90.12 managed care contract changes and the collection of additional 90.13 prescription drug rebates. 90.14 Sec. 38. Minnesota Statutes 2002, section 256B.69, 90.15 subdivision 8, is amended to read: 90.16 Subd. 8. [PREADMISSION SCREENING WAIVER.] Except as 90.17 applicable to the project's operation, the provisions of section 90.18 256B.0911 are waived for the purposes of this section for 90.19 recipients enrolled with demonstration providers or in the 90.20 prepaid medical assistance program for seniors. 90.21 Sec. 39. Minnesota Statutes 2002, section 256B.75, is 90.22 amended to read: 90.23 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 90.24 (a) For outpatient hospital facility fee payments for 90.25 services rendered on or after October 1, 1992, the commissioner 90.26 of human services shall pay the lower of (1) submitted charge, 90.27 or (2) 32 percent above the rate in effect on June 30, 1992, 90.28 except for those services for which there is a federal maximum 90.29 allowable payment. Effective for services rendered on or after 90.30 January 1, 2000, payment rates for nonsurgical outpatient 90.31 hospital facility fees and emergency room facility fees shall be 90.32 increased by eight percent over the rates in effect on December 90.33 31, 1999, except for those services for which there is a federal 90.34 maximum allowable payment. Services for which there is a 90.35 federal maximum allowable payment shall be paid at the lower of 90.36 (1) submitted charge, or (2) the federal maximum allowable 91.1 payment. Total aggregate payment for outpatient hospital 91.2 facility fee services shall not exceed the Medicare upper 91.3 limit. If it is determined that a provision of this section 91.4 conflicts with existing or future requirements of the United 91.5 States government with respect to federal financial 91.6 participation in medical assistance, the federal requirements 91.7 prevail. The commissioner may, in the aggregate, prospectively 91.8 reduce payment rates to avoid reduced federal financial 91.9 participation resulting from rates that are in excess of the 91.10 Medicare upper limitations. 91.11 (b) Notwithstanding paragraph (a), payment for outpatient, 91.12 emergency, and ambulatory surgery hospital facility fee services 91.13 for critical access hospitals designated under section 144.1483, 91.14 clause (11), shall be paid on a cost-based payment system that 91.15 is based on the cost-finding methods and allowable costs of the 91.16 Medicare program. 91.17 (c) Effective for services provided on or after July 1, 91.18 2003, rates that are based on the Medicare outpatient 91.19 prospective payment system shall be replaced by a budget neutral 91.20 prospective payment system that is derived using medical 91.21 assistance data. The commissioner shall provide a proposal to 91.22 the 2003 legislature to define and implement this provision. 91.23 (d) For fee-for-service services provided on or after July 91.24 1, 2002, the total payment, before third-party liability and 91.25 spenddown, made to hospitals for outpatient hospital facility 91.26 services is reduced by .5 percent from the current statutory 91.27 rate. 91.28 (e) In addition to the reduction in paragraph (d), the 91.29 total payment for fee-for-service services provided on or after 91.30 July 1, 2003, made to hospitals for outpatient hospital facility 91.31 services before third-party liability and spenddown, is reduced 91.32 five percent from the current statutory rates. Facilities 91.33 defined under section 256.969, subdivision 16, are excluded from 91.34 this paragraph. 91.35 Sec. 40. Minnesota Statutes 2002, section 256B.76, is 91.36 amended to read: 92.1 256B.76 [PHYSICIANAND, DENTAL, AND OTHER PROVIDER 92.2 REIMBURSEMENT.] 92.3 (a) Effective for services rendered on or after October 1, 92.4 1992, the commissioner shall make payments for physician 92.5 services as follows: 92.6 (1) payment for level one Centers for Medicare and Medicaid 92.7 Services' common procedural coding system codes titled "office 92.8 and other outpatient services," "preventive medicine new and 92.9 established patient," "delivery, antepartum, and postpartum 92.10 care," "critical care," cesarean delivery and pharmacologic 92.11 management provided to psychiatric patients, and level three 92.12 codes for enhanced services for prenatal high risk, shall be 92.13 paid at the lower of (i) submitted charges, or (ii) 25 percent 92.14 above the rate in effect on June 30, 1992. If the rate on any 92.15 procedure code within these categories is different than the 92.16 rate that would have been paid under the methodology in section 92.17 256B.74, subdivision 2, then the larger rate shall be paid; 92.18 (2) payments for all other services shall be paid at the 92.19 lower of (i) submitted charges, or (ii) 15.4 percent above the 92.20 rate in effect on June 30, 1992; 92.21 (3) all physician rates shall be converted from the 50th 92.22 percentile of 1982 to the 50th percentile of 1989, less the 92.23 percent in aggregate necessary to equal the above increases 92.24 except that payment rates for home health agency services shall 92.25 be the rates in effect on September 30, 1992; 92.26 (4) effective for services rendered on or after January 1, 92.27 2000, payment rates for physician and professional services 92.28 shall be increased by three percent over the rates in effect on 92.29 December 31, 1999, except for home health agency and family 92.30 planning agency services; and 92.31 (5) the increases in clause (4) shall be implemented 92.32 January 1, 2000, for managed care. 92.33 (b) Effective for services rendered on or after October 1, 92.34 1992, the commissioner shall make payments for dental services 92.35 as follows: 92.36 (1) dental services shall be paid at the lower of (i) 93.1 submitted charges, or (ii) 25 percent above the rate in effect 93.2 on June 30, 1992; 93.3 (2) dental rates shall be converted from the 50th 93.4 percentile of 1982 to the 50th percentile of 1989, less the 93.5 percent in aggregate necessary to equal the above increases; 93.6 (3) effective for services rendered on or after January 1, 93.7 2000, payment rates for dental services shall be increased by 93.8 three percent over the rates in effect on December 31, 1999; 93.9 (4) the commissioner shall award grants to community 93.10 clinics or other nonprofit community organizations, political 93.11 subdivisions, professional associations, or other organizations 93.12 that demonstrate the ability to provide dental services 93.13 effectively to public program recipients. Grants may be used to 93.14 fund the costs related to coordinating access for recipients, 93.15 developing and implementing patient care criteria, upgrading or 93.16 establishing new facilities, acquiring furnishings or equipment, 93.17 recruiting new providers, or other development costs that will 93.18 improve access to dental care in a region. In awarding grants, 93.19 the commissioner shall give priority to applicants that plan to 93.20 serve areas of the state in which the number of dental providers 93.21 is not currently sufficient to meet the needs of recipients of 93.22 public programs or uninsured individuals. The commissioner 93.23 shall consider the following in awarding the grants: 93.24 (i) potential to successfully increase access to an 93.25 underserved population; 93.26 (ii) the ability to raise matching funds; 93.27 (iii) the long-term viability of the project to improve 93.28 access beyond the period of initial funding; 93.29 (iv) the efficiency in the use of the funding; and 93.30 (v) the experience of the proposers in providing services 93.31 to the target population. 93.32 The commissioner shall monitor the grants and may terminate 93.33 a grant if the grantee does not increase dental access for 93.34 public program recipients. The commissioner shall consider 93.35 grants for the following: 93.36(i)(A) implementation of new programs or continued 94.1 expansion of current access programs that have demonstrated 94.2 success in providing dental services in underserved areas; 94.3(ii)(B) a pilot program for utilizing hygienists outside 94.4 of a traditional dental office to provide dental hygiene 94.5 services; and 94.6(iii)(C) a program that organizes a network of volunteer 94.7 dentists, establishes a system to refer eligible individuals to 94.8 volunteer dentists, and through that network provides donated 94.9 dental care services to public program recipients or uninsured 94.10 individuals; 94.11 (5) beginning October 1, 1999, the payment for tooth 94.12 sealants and fluoride treatments shall be the lower of (i) 94.13 submitted charge, or (ii) 80 percent of median 1997 charges; 94.14 (6) the increases listed in clauses (3) and (5) shall be 94.15 implemented January 1, 2000, for managed care; and 94.16 (7) effective for services provided on or after January 1, 94.17 2002, payment for diagnostic examinations and dental x-rays 94.18 provided to children under age 21 shall be the lower of (i) the 94.19 submitted charge, or (ii) 85 percent of median 1999 charges. 94.20 (c) Effective for dental services rendered on or after 94.21 January 1, 2002, the commissioner may, within the limits of 94.22 available appropriation, increase reimbursements to dentists and 94.23 dental clinics deemed by the commissioner to be critical access 94.24 dental providers. Reimbursement to a critical access dental 94.25 provider may be increased by not more than 50 percent above the 94.26 reimbursement rate that would otherwise be paid to the 94.27 provider. Payments to health plan companies shall be adjusted 94.28 to reflect increased reimbursements to critical access dental 94.29 providers as approved by the commissioner. In determining which 94.30 dentists and dental clinics shall be deemed critical access 94.31 dental providers, the commissioner shall review: 94.32 (1) the utilization rate in the service area in which the 94.33 dentist or dental clinic operates for dental services to 94.34 patients covered by medical assistance, general assistance 94.35 medical care, or MinnesotaCare as their primary source of 94.36 coverage; 95.1 (2) the level of services provided by the dentist or dental 95.2 clinic to patients covered by medical assistance, general 95.3 assistance medical care, or MinnesotaCare as their primary 95.4 source of coverage; and 95.5 (3) whether the level of services provided by the dentist 95.6 or dental clinic is critical to maintaining adequate levels of 95.7 patient access within the service area. 95.8 In the absence of a critical access dental provider in a service 95.9 area, the commissioner may designate a dentist or dental clinic 95.10 as a critical access dental provider if the dentist or dental 95.11 clinic is willing to provide care to patients covered by medical 95.12 assistance, general assistance medical care, or MinnesotaCare at 95.13 a level which significantly increases access to dental care in 95.14 the service area. 95.15 (d) Effective July 1, 2001, the medical assistance rates 95.16 for outpatient mental health services provided by an entity that 95.17 operates: 95.18 (1) a Medicare-certified comprehensive outpatient 95.19 rehabilitation facility; and 95.20 (2) a facility that was certified prior to January 1, 1993, 95.21 with at least 33 percent of the clients receiving rehabilitation 95.22 services in the most recent calendar year who are medical 95.23 assistance recipients, will be increased by 38 percent, when 95.24 those services are provided within the comprehensive outpatient 95.25 rehabilitation facility and provided to residents of nursing 95.26 facilities owned by the entity. 95.27 (e) An entity that operates both a Medicare certified 95.28 comprehensive outpatient rehabilitation facility and a facility 95.29 which was certified prior to January 1, 1993, that is licensed 95.30 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 95.31 whom at least 33 percent of the clients receiving rehabilitation 95.32 services in the most recent calendar year are medical assistance 95.33 recipients, shall be reimbursed by the commissioner for 95.34 rehabilitation services at rates that are 38 percent greater 95.35 than the maximum reimbursement rate allowed under paragraph (a), 95.36 clause (2), when those services are (1) provided within the 96.1 comprehensive outpatient rehabilitation facility and (2) 96.2 provided to residents of nursing facilities owned by the entity. 96.3 (f) Effective for services rendered on or after January 1, 96.4 2007, the commissioner shall make payments for physician and 96.5 professional services based on the Medicare relative value units 96.6 (RVUs). This change shall be budget neutral and the cost of 96.7 implementing RVUs will be incorporated in the established 96.8 conversion factor. 96.9 (g) An entity that operates a Medicare certified 96.10 rehabilitation facility that was designated by the commissioner 96.11 of health as an essential community provider under section 96.12 62Q.19 as of January 1, 2000, and for whom at least 25 percent 96.13 of the clients receiving rehabilitation services at the facility 96.14 or in their homes in the most recent calendar year are medical 96.15 assistance recipients, shall be reimbursed by the commissioner 96.16 for rehabilitation services provided on or after July 1, 2003, 96.17 at rates that are 50 percent greater than the maximum 96.18 reimbursement rate that would otherwise be allowed for 96.19 rehabilitation services provided by a Medicare certified 96.20 rehabilitation facility. For purposes of this paragraph, 96.21 "rehabilitation services" means physical therapy, occupational 96.22 therapy, speech-language pathology, and audiology services. In 96.23 order to qualify for the reimbursement rate authorized by this 96.24 paragraph, a facility must annually certify, in the time and 96.25 manner specified by the commissioner, that the medical 96.26 assistance percentage of caseload requirement was satisfied in 96.27 the most recent calendar year. 96.28 Sec. 41. Minnesota Statutes 2002, section 256D.03, 96.29 subdivision 3, is amended to read: 96.30 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 96.31 (a) General assistance medical care may be paid for any person 96.32 who is not eligible for medical assistance under chapter 256B, 96.33 including eligibility for medical assistance based on a 96.34 spenddown of excess income according to section 256B.056, 96.35 subdivision 5, or MinnesotaCare as defined in paragraph (b), 96.36 except as provided in paragraph (c); and: 97.1 (1) who is receiving assistance under section 256D.05, 97.2 except for families with children who are eligible under 97.3 Minnesota family investment program (MFIP), who is having a 97.4 payment made on the person's behalf under sections 256I.01 to 97.5 256I.06, or who resides in group residential housing as defined 97.6 in chapter 256I and can meet a spenddown using the cost of 97.7 remedial services received through group residential housing; or 97.8 (2)(i) who is a resident of Minnesota; and whose equity in 97.9 assets is not in excess of $1,000 per assistance unit. Exempt 97.10 assets, the reduction of excess assets, and the waiver of excess 97.11 assets must conform to the medical assistance program in chapter 97.12 256B, with the following exception: the maximum amount of 97.13 undistributed funds in a trust that could be distributed to or 97.14 on behalf of the beneficiary by the trustee, assuming the full 97.15 exercise of the trustee's discretion under the terms of the 97.16 trust, must be applied toward the asset maximum; and 97.17 (ii) who has countable income not in excess of the 97.18 assistance standards established in section 256B.056, 97.19 subdivision 5c, paragraph (b), or whose excess income is spent 97.20 down to that standard using a six-month budget period. The 97.21 method for calculating earned income disregards and deductions 97.22 for a person who resides with a dependent child under age 21 97.23 shall follow the AFDC income disregard and deductions in effect 97.24 under the July 16, 1996, AFDC state plan. The earned income and 97.25 work expense deductions for a person who does not reside with a 97.26 dependent child under age 21 shall be the same as the method 97.27 used to determine eligibility for a person under section 97.28 256D.06, subdivision 1, except the disregard of the first $50 of 97.29 earned income is not allowed; 97.30 (3) who would be eligible for medical assistance except 97.31 that the person resides in a facility that is determined by the 97.32 commissioner or the federal Centers for Medicare and Medicaid 97.33 Services to be an institution for mental diseases; or 97.34 (4) who is ineligible for medical assistance under chapter 97.35 256B or general assistance medical care under any other 97.36 provision of this section, and is receiving care and 98.1 rehabilitation services from a nonprofit center established to 98.2 serve victims of torture. These individuals are eligible for 98.3 general assistance medical care only for the period during which 98.4 they are receiving services from the center. During this period 98.5 of eligibility, individuals eligible under this clause shall not 98.6 be required to participate in prepaid general assistance medical 98.7 care. 98.8 (b) Beginning January 1, 2000, applicants or recipients who 98.9 meet all eligibility requirements of MinnesotaCare as defined in 98.10 sections 256L.01 to 256L.16, and are: 98.11 (i) adults with dependent children under 21 whose gross 98.12 family income is equal to or less than 275 percent of the 98.13 federal poverty guidelines; or 98.14 (ii) adults without children with earned income and whose 98.15 family gross income is between 75 percent of the federal poverty 98.16 guidelines and the amount set by section 256L.04, subdivision 7, 98.17 shall be terminated from general assistance medical care upon 98.18 enrollment in MinnesotaCare. Earned income is deemed available 98.19 to family members as defined in section 256D.02, subdivision 8. 98.20 (c) For services rendered on or after July 1, 1997, 98.21 eligibility is limited to one month prior to application if the 98.22 person is determined eligible in the prior month. A 98.23 redetermination of eligibility must occur every 12 months. 98.24 Beginning January 1, 2000, Minnesota health care program 98.25 applications completed by recipients and applicants who are 98.26 persons described in paragraph (b), may be returned to the 98.27 county agency to be forwarded to the department of human 98.28 services or sent directly to the department of human services 98.29 for enrollment in MinnesotaCare. If all other eligibility 98.30 requirements of this subdivision are met, eligibility for 98.31 general assistance medical care shall be available in any month 98.32 during which a MinnesotaCare eligibility determination and 98.33 enrollment are pending. Upon notification of eligibility for 98.34 MinnesotaCare, notice of termination for eligibility for general 98.35 assistance medical care shall be sent to an applicant or 98.36 recipient. If all other eligibility requirements of this 99.1 subdivision are met, eligibility for general assistance medical 99.2 care shall be available until enrollment in MinnesotaCare 99.3 subject to the provisions of paragraph (e). 99.4 (d) The date of an initial Minnesota health care program 99.5 application necessary to begin a determination of eligibility 99.6 shall be the date the applicant has provided a name, address, 99.7 and social security number, signed and dated, to the county 99.8 agency or the department of human services. If the applicant is 99.9 unable to provide an initial application when health care is 99.10 delivered due to a medical condition or disability, a health 99.11 care provider may act on the person's behalf to complete the 99.12 initial application. The applicant must complete the remainder 99.13 of the application and provide necessary verification before 99.14 eligibility can be determined. The county agency must assist 99.15 the applicant in obtaining verification if necessary.On the99.16basis of information provided on the completed application, an99.17applicant who meets the following criteria shall be determined99.18eligible beginning in the month of application:99.19(1) has gross income less than 90 percent of the applicable99.20income standard;99.21(2) has liquid assets that total within $300 of the asset99.22standard;99.23(3) does not reside in a long-term care facility; and99.24(4) meets all other eligibility requirements.99.25The applicant must provide all required verifications within 3099.26days' notice of the eligibility determination or eligibility99.27shall be terminated.99.28 (e) County agencies are authorized to use all automated 99.29 databases containing information regarding recipients' or 99.30 applicants' income in order to determine eligibility for general 99.31 assistance medical care or MinnesotaCare. Such use shall be 99.32 considered sufficient in order to determine eligibility and 99.33 premium payments by the county agency. 99.34 (f) General assistance medical care is not available for a 99.35 person in a correctional facility unless the person is detained 99.36 by law for less than one year in a county correctional or 100.1 detention facility as a person accused or convicted of a crime, 100.2 or admitted as an inpatient to a hospital on a criminal hold 100.3 order, and the person is a recipient of general assistance 100.4 medical care at the time the person is detained by law or 100.5 admitted on a criminal hold order and as long as the person 100.6 continues to meet other eligibility requirements of this 100.7 subdivision. 100.8 (g) General assistance medical care is not available for 100.9 applicants or recipients who do not cooperate with the county 100.10 agency to meet the requirements of medical assistance. General 100.11 assistance medical care is limited to payment of emergency 100.12 services only for applicants or recipients as described in 100.13 paragraph (b), whose MinnesotaCare coverage is denied or 100.14 terminated for nonpayment of premiums as required by sections 100.15 256L.06 and 256L.07. 100.16 (h) In determining the amount of assets of an individual, 100.17 there shall be included any asset or interest in an asset, 100.18 including an asset excluded under paragraph (a), that was given 100.19 away, sold, or disposed of for less than fair market value 100.20 within the 60 months preceding application for general 100.21 assistance medical care or during the period of eligibility. 100.22 Any transfer described in this paragraph shall be presumed to 100.23 have been for the purpose of establishing eligibility for 100.24 general assistance medical care, unless the individual furnishes 100.25 convincing evidence to establish that the transaction was 100.26 exclusively for another purpose. For purposes of this 100.27 paragraph, the value of the asset or interest shall be the fair 100.28 market value at the time it was given away, sold, or disposed 100.29 of, less the amount of compensation received. For any 100.30 uncompensated transfer, the number of months of ineligibility, 100.31 including partial months, shall be calculated by dividing the 100.32 uncompensated transfer amount by the average monthly per person 100.33 payment made by the medical assistance program to skilled 100.34 nursing facilities for the previous calendar year. The 100.35 individual shall remain ineligible until this fixed period has 100.36 expired. The period of ineligibility may exceed 30 months, and 101.1 a reapplication for benefits after 30 months from the date of 101.2 the transfer shall not result in eligibility unless and until 101.3 the period of ineligibility has expired. The period of 101.4 ineligibility begins in the month the transfer was reported to 101.5 the county agency, or if the transfer was not reported, the 101.6 month in which the county agency discovered the transfer, 101.7 whichever comes first. For applicants, the period of 101.8 ineligibility begins on the date of the first approved 101.9 application. 101.10 (i) When determining eligibility for any state benefits 101.11 under this subdivision, the income and resources of all 101.12 noncitizens shall be deemed to include their sponsor's income 101.13 and resources as defined in the Personal Responsibility and Work 101.14 Opportunity Reconciliation Act of 1996, title IV, Public 101.15 LawNumber104-193, sections 421 and 422, and subsequently set 101.16 out in federal rules. 101.17 (j)(1) An undocumented noncitizen or a nonimmigrant is 101.18 ineligible for general assistance medical care other than 101.19 emergency services. For purposes of this subdivision, a 101.20 nonimmigrant is an individual in one or more of the classes 101.21 listed in United States Code, title 8, section 1101(a)(15), and 101.22 an undocumented noncitizen is an individual who resides in the 101.23 United States without the approval or acquiescence of the 101.24 Immigration and Naturalization Service. 101.25 (2) This paragraph does not apply to a child under age 18, 101.26 to a Cuban or Haitian entrant as defined in Public LawNumber101.27 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 101.28 aged, blind, or disabled as defined in Code of Federal 101.29 Regulations, title 42, sections 435.520, 435.530, 435.531, 101.30 435.540, and 435.541, or effective October 1, 1998, to an 101.31 individual eligible for general assistance medical care under 101.32 paragraph (a), clause (4), who cooperates with the Immigration 101.33 and Naturalization Service to pursue any applicable immigration 101.34 status, including citizenship, that would qualify the individual 101.35 for medical assistance with federal financial participation. 101.36 (k) For purposes of paragraphs (g) and (j), "emergency 102.1 services" has the meaning given in Code of Federal Regulations, 102.2 title 42, section 440.255(b)(1), except that it also means 102.3 services rendered because of suspected or actual pesticide 102.4 poisoning. 102.5 (l) Notwithstanding any other provision of law, a 102.6 noncitizen who is ineligible for medical assistance due to the 102.7 deeming of a sponsor's income and resources, is ineligible for 102.8 general assistance medical care. 102.9 [EFFECTIVE DATE.] This section is repealed April 1, 2005, 102.10 if the HealthMatch system is operational. If the HealthMatch 102.11 system is not operational, this section is effective July 1, 102.12 2005. 102.13 Sec. 42. Minnesota Statutes 2002, section 256D.03, 102.14 subdivision 4, is amended to read: 102.15 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 102.16 For a person who is eligible under subdivision 3, paragraph (a), 102.17 clause (3), general assistance medical care covers, except as 102.18 provided in paragraph (c): 102.19 (1) inpatient hospital services; 102.20 (2) outpatient hospital services; 102.21 (3) services provided by Medicare certified rehabilitation 102.22 agencies; 102.23 (4) prescription drugs and other products recommended 102.24 through the process established in section 256B.0625, 102.25 subdivision 13; 102.26 (5) equipment necessary to administer insulin and 102.27 diagnostic supplies and equipment for diabetics to monitor blood 102.28 sugar level; 102.29 (6) eyeglasses and eye examinations provided by a physician 102.30 or optometrist; 102.31 (7) hearing aids; 102.32 (8) prosthetic devices; 102.33 (9) laboratory and X-ray services; 102.34 (10) physician's services; 102.35 (11) medical transportation; 102.36 (12) chiropractic services as covered under the medical 103.1 assistance program; 103.2 (13) podiatric services; 103.3 (14) dental services; 103.4 (15) outpatient services provided by a mental health center 103.5 or clinic that is under contract with the county board and is 103.6 established under section 245.62; 103.7 (16) day treatment services for mental illness provided 103.8 under contract with the county board; 103.9 (17) prescribed medications for persons who have been 103.10 diagnosed as mentally ill as necessary to prevent more 103.11 restrictive institutionalization; 103.12 (18) psychological services, medical supplies and 103.13 equipment, and Medicare premiums, coinsurance and deductible 103.14 payments; 103.15 (19) medical equipment not specifically listed in this 103.16 paragraph when the use of the equipment will prevent the need 103.17 for costlier services that are reimbursable under this 103.18 subdivision; 103.19 (20) services performed by a certified pediatric nurse 103.20 practitioner, a certified family nurse practitioner, a certified 103.21 adult nurse practitioner, a certified obstetric/gynecological 103.22 nurse practitioner, a certified neonatal nurse practitioner, or 103.23 a certified geriatric nurse practitioner in independent 103.24 practice, if (1) the service is otherwise covered under this 103.25 chapter as a physician service, (2) the service provided on an 103.26 inpatient basis is not included as part of the cost for 103.27 inpatient services included in the operating payment rate, and 103.28 (3) the service is within the scope of practice of the nurse 103.29 practitioner's license as a registered nurse, as defined in 103.30 section 148.171; 103.31 (21) services of a certified public health nurse or a 103.32 registered nurse practicing in a public health nursing clinic 103.33 that is a department of, or that operates under the direct 103.34 authority of, a unit of government, if the service is within the 103.35 scope of practice of the public health nurse's license as a 103.36 registered nurse, as defined in section 148.171; and 104.1 (22) telemedicine consultations, to the extent they are 104.2 covered under section 256B.0625, subdivision 3b. 104.3 (b) Except as provided in paragraph (c), for a recipient 104.4 who is eligible under subdivision 3, paragraph (a), clause (1) 104.5 or (2), general assistance medical care covers the services 104.6 listed in paragraph (a) with the exception of special 104.7 transportation services. 104.8 (c) Gender reassignment surgery and related services are 104.9 not covered services under this subdivision unless the 104.10 individual began receiving gender reassignment services prior to 104.11 July 1, 1995. 104.12 (d) In order to contain costs, the commissioner of human 104.13 services shall select vendors of medical care who can provide 104.14 the most economical care consistent with high medical standards 104.15 and shall where possible contract with organizations on a 104.16 prepaid capitation basis to provide these services. The 104.17 commissioner shall consider proposals by counties and vendors 104.18 for prepaid health plans, competitive bidding programs, block 104.19 grants, or other vendor payment mechanisms designed to provide 104.20 services in an economical manner or to control utilization, with 104.21 safeguards to ensure that necessary services are provided. 104.22 Before implementing prepaid programs in counties with a county 104.23 operated or affiliated public teaching hospital or a hospital or 104.24 clinic operated by the University of Minnesota, the commissioner 104.25 shall consider the risks the prepaid program creates for the 104.26 hospital and allow the county or hospital the opportunity to 104.27 participate in the program in a manner that reflects the risk of 104.28 adverse selection and the nature of the patients served by the 104.29 hospital, provided the terms of participation in the program are 104.30 competitive with the terms of other participants considering the 104.31 nature of the population served. Payment for services provided 104.32 pursuant to this subdivision shall be as provided to medical 104.33 assistance vendors of these services under sections 256B.02, 104.34 subdivision 8, and 256B.0625. For payments made during fiscal 104.35 year 1990 and later years, the commissioner shall consult with 104.36 an independent actuary in establishing prepayment rates, but 105.1 shall retain final control over the rate methodology. 105.2Notwithstanding the provisions of subdivision 3, an individual105.3who becomes ineligible for general assistance medical care105.4because of failure to submit income reports or recertification105.5forms in a timely manner, shall remain enrolled in the prepaid105.6health plan and shall remain eligible for general assistance105.7medical care coverage through the last day of the month in which105.8the enrollee became ineligible for general assistance medical105.9care.105.10 (e) There shall be no co-payment required of any recipient 105.11 of benefits for any services provided under this subdivision. A 105.12 hospital receiving a reduced payment as a result of this section 105.13 may apply the unpaid balance toward satisfaction of the 105.14 hospital's bad debts. 105.15 (f) Any county may, from its own resources, provide medical 105.16 payments for which state payments are not made. 105.17 (g) Chemical dependency services that are reimbursed under 105.18 chapter 254B must not be reimbursed under general assistance 105.19 medical care. 105.20 (h) The maximum payment for new vendors enrolled in the 105.21 general assistance medical care program after the base year 105.22 shall be determined from the average usual and customary charge 105.23 of the same vendor type enrolled in the base year. 105.24 (i) The conditions of payment for services under this 105.25 subdivision are the same as the conditions specified in rules 105.26 adopted under chapter 256B governing the medical assistance 105.27 program, unless otherwise provided by statute or rule. 105.28 Sec. 43. Minnesota Statutes 2002, section 256L.05, 105.29 subdivision 3a, is amended to read: 105.30 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 105.31 1, 1999, an enrollee's eligibility must be renewed every 12 105.32 months. The 12-month period begins in the month after the month 105.33 the application is approved. 105.34 (b) Beginning October 1, 2004, an enrollee's eligibility 105.35 must be renewed every six months. The first six-month period of 105.36 eligibility begins in the month after the month the application 106.1 is approved. Each new period of eligibility must take into 106.2 account any changes in circumstances that impact eligibility and 106.3 premium amount. An enrollee must provide all the information 106.4 needed to redetermine eligibility by the first day of the month 106.5 that ends the eligibility period. The premium for the new 106.6 period of eligibility must be received as provided in section 106.7 256L.06 in order for eligibility to continue. 106.8 Sec. 44. Minnesota Statutes 2002, section 256L.05, 106.9 subdivision 4, is amended to read: 106.10 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 106.11 human services shall determine an applicant's eligibility for 106.12 MinnesotaCare no more than 30 days from the date that the 106.13 application is received by the department of human services. 106.14 Beginning January 1, 2000, this requirement also applies to 106.15 local county human services agencies that determine eligibility 106.16 for MinnesotaCare.Once annually at application or106.17reenrollment, to prevent processing delays, applicants or106.18enrollees who, from the information provided on the application,106.19appear to meet eligibility requirements shall be enrolled upon106.20timely payment of premiums. The enrollee must provide all106.21required verifications within 30 days of notification of the106.22eligibility determination or coverage from the program shall be106.23terminated. Enrollees who are determined to be ineligible when106.24verifications are provided shall be disenrolled from the program.106.25 [EFFECTIVE DATE.] This section is effective April 1, 2005, 106.26 if the HealthMatch system is operational. If the HealthMatch 106.27 system is not operational on April 1, 2005, then this section is 106.28 effective July 1, 2005. 106.29 Sec. 45. Minnesota Statutes 2002, section 256L.06, 106.30 subdivision 3, is amended to read: 106.31 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 106.32 are dedicated to the commissioner for MinnesotaCare. 106.33 (b) The commissioner shall develop and implement procedures 106.34 to: (1) require enrollees to report changes in income; (2) 106.35 adjust sliding scale premium payments, based upon changes in 106.36 enrollee income;and(3) disenroll enrollees from MinnesotaCare 107.1 for failure to pay required premiums; and (4) collect the 107.2 premiums from employers choosing to participate in the 107.3 employer-subsidized coverage exemption as described in section 107.4 256L.15, subdivision 4. Failure to pay includes payment with a 107.5 dishonored check, a returned automatic bank withdrawal, or a 107.6 refused credit card or debit card payment. The commissioner may 107.7 demand a guaranteed form of payment, including a cashier's check 107.8 or a money order, as the only means to replace a dishonored, 107.9 returned, or refused payment. 107.10 (c) Premiums are calculated on a calendar month basis and 107.11 may be paid on a monthly, quarterly, orannualsemiannual basis, 107.12 with the first payment due upon notice from the commissioner of 107.13 the premium amount required. The commissioner shall inform 107.14 applicants and enrollees of these premium payment options. 107.15 Premium payment is required before enrollment is complete and to 107.16 maintain eligibility in MinnesotaCare. Premium payments 107.17 received before noon are credited the same day. Premium 107.18 payments received after noon are credited on the next working 107.19 day. 107.20 (d) Nonpayment of the premium will result in disenrollment 107.21 from the plan effective for the calendar month for which the 107.22 premium was due. Persons disenrolled for nonpayment or who 107.23 voluntarily terminate coverage from the program may not reenroll 107.24 until four calendar months have elapsed. Persons disenrolled 107.25 for nonpayment who pay all past due premiums as well as current 107.26 premiums due, including premiums due for the period of 107.27 disenrollment, within 20 days of disenrollment, shall be 107.28 reenrolled retroactively to the first day of disenrollment. 107.29 Persons disenrolled for nonpayment or who voluntarily terminate 107.30 coverage from the program may not reenroll for four calendar 107.31 months unless the person demonstrates good cause for 107.32 nonpayment. Good cause does not exist if a person chooses to 107.33 pay other family expenses instead of the premium. The 107.34 commissioner shall define good cause in rule. 107.35 [EFFECTIVE DATE.] Subdivision 3, paragraph (c), is 107.36 effective October 1, 2004. 108.1 Sec. 46. Minnesota Statutes 2002, section 256L.07, 108.2 subdivision 1, is amended to read: 108.3 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 108.4 enrolled in the original children's health plan as of September 108.5 30, 1992, children who enrolled in the MinnesotaCare program 108.6 after September 30, 1992, pursuant to Laws 1992, chapter 549, 108.7 article 4, section 17, and children who have family gross 108.8 incomes that are equal to or less than175150 percent of the 108.9 federal poverty guidelines are eligible without meeting the 108.10 requirements of subdivision 2 or the four-month requirement in 108.11 subdivision 3, as long as they maintain continuous coverage in 108.12 the MinnesotaCare program or medical assistance or they meet the 108.13 requirements of subdivision 5.Children who apply for108.14MinnesotaCare on or after the implementation date of the108.15employer-subsidized health coverage program as described in Laws108.161998, chapter 407, article 5, section 45, who have family gross108.17incomes that are equal to or less than 175 percent of the108.18federal poverty guidelines, must meet the requirements of108.19subdivision 2 to be eligible for MinnesotaCare.108.20 (b) Families enrolled in MinnesotaCare under section 108.21 256L.04, subdivision 1, whose income increases above 275 percent 108.22 of the federal poverty guidelines, are no longer eligible for 108.23 the program and shall be disenrolled by the commissioner. 108.24 Individuals enrolled in MinnesotaCare under section 256L.04, 108.25 subdivision 7, whose income increases above 175 percent of the 108.26 federal poverty guidelines are no longer eligible for the 108.27 program and shall be disenrolled by the commissioner. For 108.28 persons disenrolled under this subdivision, MinnesotaCare 108.29 coverage terminates the last day of the calendar month following 108.30 the month in which the commissioner determines that the income 108.31 of a family or individual exceeds program income limits. 108.32 (c) Notwithstanding paragraph (b), individuals and families 108.33 may remain enrolled in MinnesotaCare if ten percent of their 108.34 annual income is less than the annual premium for a policy with 108.35 a $500 deductible available through the Minnesota comprehensive 108.36 health association. Individuals and families who are no longer 109.1 eligible for MinnesotaCare under this subdivision shall be given 109.2 an 18-month notice period from the date that ineligibility is 109.3 determined before disenrollment. 109.4 Sec. 47. Minnesota Statutes 2002, section 256L.07, 109.5 subdivision 3, is amended to read: 109.6 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 109.7 individuals enrolled in the MinnesotaCare program must have no 109.8 health coverage while enrolled or for at least four months prior 109.9 to application and renewal. Children enrolled in the original 109.10 children's health plan and children in families with income 109.11 equal to or less than175150 percent of the federal poverty 109.12 guidelines, who have other health insurance, are eligible if the 109.13 coverage: 109.14 (1) lacks two or more of the following: 109.15 (i) basic hospital insurance; 109.16 (ii) medical-surgical insurance; 109.17 (iii) prescription drug coverage; 109.18 (iv) dental coverage; or 109.19 (v) vision coverage; 109.20 (2) requires a deductible of $100 or more per person per 109.21 year; or 109.22 (3) lacks coverage because the child has exceeded the 109.23 maximum coverage for a particular diagnosis or the policy 109.24 excludes a particular diagnosis. 109.25 The commissioner may change this eligibility criterion for 109.26 sliding scale premiums in order to remain within the limits of 109.27 available appropriations. The requirement of no health coverage 109.28 does not apply to newborns. 109.29 (b) Medical assistance, general assistance medical care, 109.30 and the Civilian Health and Medical Program of the Uniformed 109.31 Service, CHAMPUS, or other coverage provided under United States 109.32 Code, title 10, subtitle A, part II, chapter 55, are not 109.33 considered insurance or health coverage for purposes of the 109.34 four-month requirement described in this subdivision. 109.35 (c) For purposes of this subdivision, Medicare Part A or B 109.36 coverage under title XVIII of the Social Security Act, United 110.1 States Code, title 42, sections 1395c to 1395w-4, is considered 110.2 health coverage. An applicant or enrollee may not refuse 110.3 Medicare coverage to establish eligibility for MinnesotaCare. 110.4 (d) Applicants who were recipients of medical assistance or 110.5 general assistance medical care within one month of application 110.6 must meet the provisions of this subdivision and subdivision 2. 110.7 (e) Effective October 1, 2003, applicants who were 110.8 recipients of medical assistance and had cost-effective health 110.9 insurance which was paid for by medical assistance are exempt 110.10 from the four-month requirement under this subdivision. 110.11 Sec. 48. Minnesota Statutes 2002, section 256L.07, is 110.12 amended by adding a subdivision to read: 110.13 Subd. 5. [EMPLOYER-SUBSIDIZED COVERAGE 110.14 EXEMPTION.] Children in families with family gross income equal 110.15 to or less than 170 percent of the federal poverty guidelines 110.16 who have access to employer-subsidized coverage as defined in 110.17 subdivision 2 are eligible for MinnesotaCare without meeting the 110.18 requirements of subdivision 2 if the following requirements are 110.19 met: 110.20 (1) all eligibility requirements except for the 110.21 requirements of subdivision 2 are met by the child; 110.22 (2) any premiums owed as determined under section 256L.15 110.23 are paid in accordance with section 256L.06; and 110.24 (3) the employer meets the requirements described in 110.25 section 256L.15, subdivision 4. 110.26 Sec. 49. Minnesota Statutes 2002, section 256L.15, 110.27 subdivision 3, is amended to read: 110.28 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 110.29 of $48 is required for all children in families with income at 110.30 or less than175150 percent of federal poverty guidelines. 110.31 Sec. 50. Minnesota Statutes 2002, section 256L.15, is 110.32 amended by adding a subdivision to read: 110.33 Subd. 4. [EMPLOYER-SUBSIDIZED INSURANCE EXCEPTION.] Any 110.34 employer of a parent of a child who may be eligible for 110.35 MinnesotaCare under section 256L.07, subdivision 5, must choose 110.36 to contribute 25 percent of the total cost of the coverage as 111.1 calculated under subdivision 2 for the child to be eligible for 111.2 MinnesotaCare under section 256L.07, subdivision 5. Any 111.3 employer who chooses to participate must pay the premium owed to 111.4 the commissioner in accordance with section 256L.06. 111.5 Sec. 51. Minnesota Statutes 2002, section 295.53, 111.6 subdivision 1, is amended to read: 111.7 Subdivision 1. [EXEMPTIONS.] (a) The following payments 111.8 are excluded from the gross revenues subject to the hospital, 111.9 surgical center, or health care provider taxes under sections 111.10 295.50 to 295.57: 111.11 (1) payments received for services provided under the 111.12 Medicare program, including payments received from the 111.13 government, and organizations governed by sections 1833 and 1876 111.14 of title XVIII of the federal Social Security Act, United States 111.15 Code, title 42, section 1395, and enrollee deductibles, 111.16 coinsurance, and co-payments, whether paid by the Medicare 111.17 enrollee or by a Medicare supplemental coverage as defined in 111.18 section 62A.011, subdivision 3, clause (10). Payments for 111.19 services not covered by Medicare are taxable; 111.20 (2)medical assistance payments including payments received111.21directly from the government or from a prepaid plan;111.22(3)payments received for home health care services; 111.23(4)(3) payments received from hospitals or surgical 111.24 centers for goods and services on which liability for tax is 111.25 imposed under section 295.52 or the source of funds for the 111.26 payment is exempt under clause (1),(2), (7), (8),111.27(10)(7),(13)(10), or(20)(17); 111.28(5)(4) payments received from health care providers for 111.29 goods and services on which liability for tax is imposed under 111.30 this chapter or the source of funds for the payment is exempt 111.31 under clause (1),(2), (7), (8), (10)(7),(13)(10), 111.32 or(20)(17); 111.33(6)(5) amounts paid for legend drugs, other than 111.34 nutritional products, to a wholesale drug distributor who is 111.35 subject to tax under section 295.52, subdivision 3, reduced by 111.36 reimbursements received for legend drugs otherwise exempt under 112.1 this chapter; 112.2(7) payments received under the general assistance medical112.3care program including payments received directly from the112.4government or from a prepaid plan;112.5(8) payments received for providing services under the112.6MinnesotaCare program including payments received directly from112.7the government or from a prepaid plan and enrollee deductibles,112.8coinsurance, and copayments. For purposes of this clause,112.9coinsurance means the portion of payment that the enrollee is112.10required to pay for the covered service;112.11(9)(6) payments received by a health care provider or the 112.12 wholly owned subsidiary of a health care provider for care 112.13 provided outside Minnesota; 112.14(10)(7) payments received from the chemical dependency 112.15 fund under chapter 254B; 112.16(11)(8) payments received in the nature of charitable 112.17 donations that are not designated for providing patient services 112.18 to a specific individual or group; 112.19(12)(9) payments received for providing patient services 112.20 incurred through a formal program of health care research 112.21 conducted in conformity with federal regulations governing 112.22 research on human subjects. Payments received from patients or 112.23 from other persons paying on behalf of the patients are subject 112.24 to tax; 112.25(13)(10) payments received from any governmental agency 112.26 for services benefiting the public, not including payments made 112.27 by the government in its capacity as an employer or insurer or 112.28 payments made by the government for services provided under 112.29 medical assistance, general assistance medical care, or the 112.30 MinnesotaCare program; 112.31(14)(11) payments received for services provided by 112.32 community residential mental health facilities licensed under 112.33 Minnesota Rules, parts 9520.0500 to 9520.0690, community support 112.34 programs and family community support programs approved under 112.35 Minnesota Rules, parts 9535.1700 to 9535.1760, and community 112.36 mental health centers as defined in section 245.62, subdivision 113.1 2; 113.2(15)(12) government payments received by a regional 113.3 treatment center; 113.4(16)(13) payments received for hospice care services; 113.5(17)(14) payments received by a health care provider for 113.6 hearing aids and related equipment or prescription eyewear 113.7 delivered outside of Minnesota; 113.8(18)(15) payments received by an educational institution 113.9 from student tuition, student activity fees, health care service 113.10 fees, government appropriations, donations, or grants. Fee for 113.11 service payments and payments for extended coverage are taxable; 113.12(19)(16) payments received for services provided by: 113.13 assisted living programs and congregate housing programs; and 113.14(20)(17) payments received under the federal Employees 113.15 Health Benefits Act, United States Code, title 5, section 113.16 8909(f), as amended by the Omnibus Reconciliation Act of 1990. 113.17 (b) Payments received by wholesale drug distributors for 113.18 legend drugs sold directly to veterinarians or veterinary bulk 113.19 purchasing organizations are excluded from the gross revenues 113.20 subject to the wholesale drug distributor tax under sections 113.21 295.50 to 295.59. 113.22 Sec. 52. Minnesota Statutes 2002, section 297I.15, 113.23 subdivision 1, is amended to read: 113.24 Subdivision 1. [GOVERNMENT PAYMENTS.] Premiums under 113.25medical assistance, general assistance medical care, the113.26MinnesotaCare program, andthe Minnesota comprehensive health 113.27 insurance plan and all payments, revenues, and reimbursements 113.28 received from the federal government for Medicare-related 113.29 coverage as defined in section 62A.31, subdivision 3, are not 113.30 subject to tax under this chapter. 113.31 Sec. 53. Minnesota Statutes 2002, section 297I.15, 113.32 subdivision 4, is amended to read: 113.33 Subd. 4. [PREMIUMS PAID TO HEALTH CARRIERS BY STATE.] A 113.34 health carrier as defined in section 62A.011 is exempt from the 113.35 taxes imposed under this chapter on premiums paid to it by the 113.36 state. Premiums paid by the state under medical assistance, 114.1 general assistance medical care, and the MinnesotaCare program 114.2 are not exempt under this subdivision. 114.3 Sec. 54. [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 114.4 CRITERIA AND POTENTIAL COST SAVINGS.] 114.5 The commissioner of human services, in consultation with 114.6 the commissioner of transportation and special transportation 114.7 service providers, shall review eligibility criteria for medical 114.8 assistance special transportation services and shall evaluate 114.9 whether the level of special transportation services provided 114.10 should be based on the degree of impairment of the client, as 114.11 well as the medical diagnosis. The commissioner shall also 114.12 evaluate methods for reducing the cost of special transportation 114.13 services, including, but not limited to: 114.14 (1) requiring providers to maintain a daily log book 114.15 confirming delivery of clients to medical facilities; 114.16 (2) requiring providers to implement commercially available 114.17 computer mapping programs to calculate mileage for purposes of 114.18 reimbursement; 114.19 (3) restricting special transportation service from being 114.20 provided solely for trips to pharmacies; 114.21 (4)modifying eligibility for special transportation; 114.22 (5) expanding alternatives to the use of special 114.23 transportation services; 114.24 (6) improving the process of certifying persons as eligible 114.25 for special transportation services; and 114.26 (7) examining the feasibility and benefits of licensing 114.27 special transportation providers. 114.28 The commissioner shall present recommendations for changes 114.29 in the eligibility criteria and potential cost-savings for 114.30 special transportation services to the chairs and ranking 114.31 minority members of the house and senate committees having 114.32 jurisdiction over health and human services spending by January 114.33 15, 2004. The commissioner is prohibited from using a broker or 114.34 coordinator to manage special transportation services until July 114.35 1, 2005, except for the purposes of checking for recipient 114.36 eligibility, authorizing recipients for appropriate level of 115.1 transportation, and monitoring provider compliance with section 115.2 256B.0625, subdivision 17. This prohibition does not apply to 115.3 the purchase or management of common carrier transportation. 115.4 Sec. 55. [WITHHOLD EXEMPTION.] 115.5 The commissioner of human services may exempt from the five 115.6 percent withhold in Minnesota Statutes, section 256B.69, 115.7 subdivision 5a, paragraph (c), and the .5 percent withhold in 115.8 Minnesota Statutes, section 256L.12, subdivision 9, paragraph 115.9 (b), a managed care plan that has entered into a managed care 115.10 contract with the commissioner in accordance with Minnesota 115.11 Statutes, section 256B.69 or 256L.12, if the contract was the 115.12 initial contract between the managed care plan and the 115.13 commissioner, and it was entered into after January 1, 2000. 115.14 If an exemption is given, the exemption shall only apply 115.15 for the first five years of operation of the managed care plan. 115.16 Sec. 56. [PHARMACY PLUS WAIVER.] 115.17 (a) The commissioner of human services shall seek a 115.18 pharmacy plus federal waiver for the prescription drug program 115.19 in Minnesota Statutes, section 256.955. If the waiver is 115.20 approved and federal funds are received for the prescription 115.21 drug program, the commissioner shall expand eligibility for the 115.22 program in the following order: 115.23 (1) increase income eligibility up to 135 percent of the 115.24 federal poverty guidelines for individuals eligible under 115.25 Minnesota Statutes, section 256.955, subdivision 2a; and 115.26 (2) increase income eligibility up to 135 percent of the 115.27 federal poverty guidelines for individuals eligible under 115.28 Minnesota Statutes, section 256.955, subdivision 2b. 115.29 (b) If eligibility is increased, the commissioner shall 115.30 publish the new income eligibility levels for the program in the 115.31 State Register and shall inform the agencies and organizations 115.32 serving senior citizens and persons with disabilities. 115.33 Sec. 57. [DRUG PURCHASING PROGRAM.] 115.34 The commissioner of human services, in consultation with 115.35 other state agencies, shall evaluate whether participation in a 115.36 multistate or multiagency drug purchasing program can reduce 116.1 costs or improve the operations of the drug benefit programs 116.2 administered by the commissioner and other state agencies. The 116.3 commissioner shall also evaluate the possibility of contracting 116.4 with a vendor or other states for purposes of participating in a 116.5 multistate or multiagency drug purchasing program. The 116.6 commissioner shall submit the recommendations to the legislature 116.7 by January 15, 2004. 116.8 Sec. 58. [MAIL ORDER DISPENSING OF PRESCRIPTION DRUGS.] 116.9 The commissioner of human services shall assess the cost 116.10 savings that could be generated by the mail order dispensing of 116.11 prescription drugs to recipients of medical assistance, general 116.12 assistance medical care, and the prescription drug program. The 116.13 report shall include the viability of contracting with mail 116.14 order pharmacy vendors to provide mail order dispensing for 116.15 state public programs. The commissioner shall report to the 116.16 chairs and ranking minority members of the health and human 116.17 services finance committees by January 7, 2004. 116.18 Sec. 59. [NONPROFIT FOUNDATION GRANTS.] 116.19 (a) The commissioner of human services may accept grants or 116.20 donations from a nonprofit charitable foundation for the purpose 116.21 of increasing dental access in the medical assistance program. 116.22 (b) The commissioner may increase the critical access 116.23 dental payments under Minnesota Statutes, section 256B.76, 116.24 paragraph (c), and use any money received under paragraph (a) 116.25 for the nonfederal state share of the medical assistance cost. 116.26 Sec. 60. [LIMITING COVERAGE OF HEALTH CARE SERVICES FOR 116.27 MEDICAL ASSISTANCE, GENERAL ASSISTANCE MEDICAL CARE, AND 116.28 MINNESOTACARE PROGRAMS.] 116.29 Subdivision 1. [GENERAL ASSISTANCE MEDICAL CARE AND 116.30 MINNESOTACARE.] (a) Effective July 1, 2003, the 116.31 diagnosis/treatment pairings described in subdivision 3 shall 116.32 not be covered under the general assistance medical care program 116.33 and under the MinnesotaCare program for persons eligible under 116.34 Minnesota Statutes, section 256L.04, subdivision 7. 116.35 (b) This subdivision expires July 1, 2005. 116.36 Subd. 2. [PRIOR AUTHORIZATION OF SERVICES FOR MEDICAL 117.1 ASSISTANCE.] (a) Effective July 1, 2003, prior authorization 117.2 shall be required for the diagnosis/treatment pairings described 117.3 in subdivision 3 for reimbursement under Minnesota Statutes, 117.4 chapter 256B, and under the MinnesotaCare program for persons 117.5 eligible under Minnesota Statutes, section 256L.04, subdivision 117.6 1. 117.7 (b) This subdivision expires July 1, 2005. 117.8 Subd. 3. [LIST OF DIAGNOSIS/TREATMENT PAIRINGS.] (a)(1) 117.9 Diagnosis: TRIGEMINAL AND OTHER NERVE DISORDERS 117.10 Treatment: MEDICAL AND SURGICAL TREATMENT 117.11 ICD-9: 350,352 117.12 (2) Diagnosis: DISRUPTIONS OF THE LIGAMENTS AND TENDONS OF 117.13 THE ARMS AND LEGS, EXCLUDING THE KNEE, GRADE II AND III 117.14 Treatment: REPAIR 117.15 ICD-9: 726.5, 727.59, 727.62-727.65, 727.68-727.69, 728.83, 117.16 728.89, 840.0-840.3, 840.5-840.9, 841-843, 845.0 117.17 (3) Diagnosis: DISORDERS OF SHOULDER 117.18 Treatment: REPAIR/RECONSTRUCTION 117.19 ICD-9: 718.01, 718.11, 718.21, 718.31, 718.41, 718.51, 718.81, 117.20 726.0, 726.10-726.11, 726.19, 726.2, 727.61, 840.4, 840.7 117.21 (4) Diagnosis: INTERNAL DERANGEMENT OF KNEE AND 117.22 LIGAMENTOUS DISRUPTIONS OF THE KNEE, GRADE II AND III 117.23 Treatment: REPAIR, MEDICAL THERAPY 117.24 ICD-9: 717.0-717.4, 717.6-717.8, 718.26, 718.36, 718.46, 117.25 718.56, 727.66, 836.0-836.2, 844 117.26 (5) Diagnosis: MALUNION AND NONUNION OF FRACTURE 117.27 Treatment: SURGICAL TREATMENT 117.28 ICD-9: 733.8 117.29 (6) Diagnosis: FOREIGN BODY IN UTERUS, VULVA AND VAGINA 117.30 Treatment: MEDICAL AND SURGICAL TREATMENT 117.31 ICD-9: 939.1-939.2 117.32 (7) Diagnosis: UTERINE PROLAPSE; CYSTOCELE 117.33 Treatment: SURGICAL REPAIR 117.34 ICD-9: 618 117.35 (8) Diagnosis: OSTEOARTHRITIS AND ALLIED DISORDERS 117.36 Treatment: MEDICAL THERAPY, INJECTIONS 118.1 ICD-9: 713.5, 715, 716.0-716.1, 716.5-716.6 118.2 (9) Diagnosis: METABOLIC BONE DISEASE 118.3 Treatment: MEDICAL THERAPY 118.4 ICD-9: 731.0, 733.0 118.5 (10) Diagnosis: SYMPTOMATIC IMPACTED TEETH 118.6 Treatment: SURGERY 118.7 ICD-9: 520.6, 524.3-524.4 118.8 (11) Diagnosis: UNSPECIFIED DISEASE OF HARD TISSUES OF 118.9 TEETH (AVULSION) 118.10 Treatment: INTERDENTAL WIRING 118.11 ICD-9: 525.9 118.12 (12) Diagnosis: ABSCESSES AND CYSTS OF BARTHOLIN'S GLAND 118.13 AND VULVA 118.14 Treatment: INCISION AND DRAINAGE, MEDICAL THERAPY 118.15 ICD-9: 616.2-616.9 118.16 (13) Diagnosis: CERVICITIS, ENDOCERVICITIS, HEMATOMA OF 118.17 VULVA, AND NONINFLAMMATORY DISORDERS OF THE VAGINA 118.18 Treatment: MEDICAL AND SURGICAL TREATMENT 118.19 ICD-9: 616.0, 623.6, 623.8-623.9, 624.5 118.20 (14) Diagnosis: DENTAL CONDITIONS (e.g,. TOOTH LOSS) 118.21 Treatment: SPACE MAINTENANCE AND PERIODONTAL MAINTENANCE 118.22 ICD-9: V72.2 118.23 (15) Diagnosis: URINARY INCONTINENCE 118.24 Treatment: MEDICAL AND SURGICAL TREATMENT 118.25 ICD-9: 599.81, 625.6, 788.31-788.33 118.26 (16) Diagnosis: HYPOSPADIAS AND EPISPADIAS 118.27 Treatment: REPAIR 118.28 ICD-9: 752.6 118.29 (17) Diagnosis: RESIDUAL FOREIGN BODY IN SOFT TISSUE 118.30 Treatment: REMOVAL 118.31 ICD-9: 374.86, 729.6, 883.1-883.2 118.32 (18) Diagnosis: BRANCHIAL CLEFT CYST 118.33 Treatment: EXCISION, MEDICAL THERAPY 118.34 ICD-9: 744.41-744.46, 744.49, 759.2 118.35 (19) Diagnosis: EXFOLIATION OF TEETH DUE TO SYSTEMIC 118.36 CAUSES; SPECIFIC DISORDERS OF THE TEETH AND SUPPORTING 119.1 STRUCTURES 119.2 Treatment: EXCISION OF DENTOALVEOLAR STRUCTURE 119.3 ICD-9: 525.0, 525.8, 525.11 119.4 (20) Diagnosis: PTOSIS (ACQUIRED) WITH VISION IMPAIRMENT 119.5 Treatment: PTOSIS REPAIR 119.6 ICD-9: 374.2-374.3, 374.41, 374.43, 374.46 119.7 (21) Diagnosis: SIMPLE AND SOCIAL PHOBIAS 119.8 Treatment: MEDICAL/PSYCHOTHERAPY 119.9 ICD-9: 300.23, 300.29 119.10 (22) Diagnosis: RETAINED DENTAL ROOT 119.11 Treatment: EXCISION OF DENTOALVEOLAR STRUCTURE 119.12 ICD-9: 525.3 119.13 (23) Diagnosis: PERIPHERAL NERVE ENTRAPMENT 119.14 Treatment: MEDICAL AND SURGICAL TREATMENT 119.15 ICD-9: 354.0, 354.2, 355.5, 723.3, 728.6 119.16 (24) Diagnosis: INCONTINENCE OF FECES 119.17 Treatment: MEDICAL AND SURGICAL TREATMENT 119.18 ICD-9: 787.6 119.19 (25) Diagnosis: RECTAL PROLAPSE 119.20 Treatment: PARTIAL COLECTOMY 119.21 ICD-9: 569.1-569.2 119.22 (26) Diagnosis: BENIGN NEOPLASM OF KIDNEY AND OTHER 119.23 URINARY ORGANS 119.24 Treatment: MEDICAL AND SURGICAL TREATMENT 119.25 ICD-9: 223 119.26 (27) Diagnosis: URETHRAL FISTULA 119.27 Treatment: EXCISION, MEDICAL THERAPY 119.28 ICD-9: 599.1-599.2, 599.4 119.29 (28) Diagnosis: THROMBOSED AND COMPLICATED HEMORRHOIDS 119.30 Treatment: HEMORRHOIDECTOMY, INCISION 119.31 ICD-9: 455.1-455.2, 455.4-455.5, 455.7-455.8 119.32 (29) Diagnosis: VAGINITIS, TRICHOMONIASIS 119.33 Treatment: MEDICAL THERAPY 119.34 ICD-9: 112.1, 131, 616.1, 623.5 119.35 (30) Diagnosis: BALANOPOSTHITIS AND OTHER DISORDERS OF 119.36 PENIS 120.1 Treatment: MEDICAL AND SURGICAL TREATMENT 120.2 ICD-9: 607.1, 607.81-607.83, 607.89 120.3 (31) Diagnosis: CHRONIC ANAL FISSURE; ANAL FISTULA 120.4 Treatment: SPHINCTEROTOMY, FISSURECTOMY, FISTULECTOMY, MEDICAL 120.5 THERAPY 120.6 ICD-9: 565.0-565.1 120.7 (32) Diagnosis: CHRONIC OTITIS MEDIA 120.8 Treatment: PE TUBES/ADENOIDECTOMY/TYMPANOPLASTY, MEDICAL 120.9 THERAPY 120.10 ICD-9: 380.5, 381.1-381.8, 382.1-382.3, 382.9, 383.1-383.2, 120.11 383.30-383.31, 383.9, 384.2, 384.8-384.9 120.12 (33) Diagnosis: ACUTE CONJUNCTIVITIS 120.13 Treatment: MEDICAL THERAPY 120.14 ICD-9: 077, 372.00 120.15 (34) Diagnosis: CERUMEN IMPACTION, FOREIGN BODY IN EAR & 120.16 NOSE 120.17 Treatment: REMOVAL OF FOREIGN BODY 120.18 ICD-9: 380.4, 931-932 120.19 (35) Diagnosis: VERTIGINOUS SYNDROMES AND OTHER DISORDERS 120.20 OF VESTIBULAR SYSTEM 120.21 Treatment: MEDICAL AND SURGICAL TREATMENT 120.22 ICD-9: 379.54, 386.1-386.2, 386.4-386.9, 438.6-438.7, 120.23 438.83-438.85 120.24 (36) Diagnosis: UNSPECIFIED URINARY OBSTRUCTION AND BENIGN 120.25 PROSTATIC HYPERPLASIA WITHOUT OBSTRUCTION 120.26 Treatment: MEDICAL THERAPY 120.27 ICD-9: 599.6, 600 120.28 (37) Diagnosis: PHIMOSIS 120.29 Treatment: SURGICAL TREATMENT 120.30 ICD-9: 605 120.31 (38) Diagnosis: CONTACT DERMATITIS, ATOPIC DERMATITIS AND 120.32 OTHER ECZEMA 120.33 Treatment: MEDICAL THERAPY 120.34 ICD-9: 691.8, 692.0-692.6, 692.70-692.74, 692.79, 692.8-692.9 120.35 (39) Diagnosis: PSORIASIS AND SIMILAR DISORDERS 120.36 Treatment: MEDICAL THERAPY 121.1 ICD-9: 696.1-696.2, 696.8 121.2 (40) Diagnosis: CYSTIC ACNE 121.3 Treatment: MEDICAL AND SURGICAL TREATMENT 121.4 ICD-9: 705.83, 706.0-706.1 121.5 (41) Diagnosis: CLOSED FRACTURE OF GREAT TOE 121.6 Treatment: MEDICAL AND SURGICAL TREATMENT 121.7 ICD-9: 826.0 121.8 (42) Diagnosis: SYMPTOMATIC URTICARIA 121.9 Treatment: MEDICAL THERAPY 121.10 ICD-9: 708.0-708.1, 708.5, 708.8, 995.7 121.11 (43) Diagnosis: PERIPHERAL NERVE DISORDERS 121.12 Treatment: SURGICAL TREATMENT 121.13 ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 355.4, 121.14 355.7-355.8, 723.2 121.15 (44) Diagnosis: DYSFUNCTION OF NASOLACRIMAL SYSTEM; 121.16 LACRIMAL SYSTEM LACERATION 121.17 Treatment: MEDICAL AND SURGICAL TREATMENT; CLOSURE 121.18 ICD-9: 370.33, 375, 870.2 121.19 (45) Diagnosis: NASAL POLYPS, OTHER DISORDERS OF NASAL 121.20 CAVITY AND SINUSES 121.21 Treatment: MEDICAL AND SURGICAL TREATMENT 121.22 ICD-9: 471, 478.1, 993.1 121.23 (46) Diagnosis: SIALOLITHIASIS, MUCOCELE, DISTURBANCE OF 121.24 SALIVARY SECRETION, OTHER AND UNSPECIFIED DISEASES OF SALIVARY 121.25 GLANDS 121.26 Treatment: MEDICAL AND SURGICAL TREATMENT 121.27 ICD-9: 527.5-527.9 121.28 (47) Diagnosis: DENTAL CONDITIONS (e.g., BROKEN APPLIANCES) 121.29 Treatment: PERIODONTICS AND COMPLEX PROSTHETICS 121.30 ICD-9: 522.6, 522.8, V72.2 121.31 (48) Diagnosis: IMPULSE DISORDERS 121.32 Treatment: MEDICAL/PSYCHOTHERAPY 121.33 ICD-9: 312.31-312.39 121.34 (49) Diagnosis: BENIGN NEOPLASM BONE AND ARTICULAR 121.35 CARTILAGE, INCLUDING OSTEOID OSTEOMAS; BENIGN NEOPLASM OF 121.36 CONNECTIVE AND OTHER SOFT TISSUE 122.1 Treatment: MEDICAL AND SURGICAL TREATMENT 122.2 ICD-9: 213, 215, 526.0-526.1, 526.81, 719.2, 733.2 122.3 (50) Diagnosis: SEXUAL DYSFUNCTION 122.4 Treatment: MEDICAL AND SURGICAL TREATMENT, PSYCHOTHERAPY 122.5 ICD-9: 302.7, 607.84 122.6 (51) Diagnosis: STOMATITIS AND DISEASES OF LIPS 122.7 Treatment: INCISION AND DRAINAGE/MEDICAL THERAPY 122.8 ICD-9: 528.0, 528.5, 528.9, 529.0 122.9 (52) Diagnosis: BELL'S PALSY, EXPOSURE 122.10 KERATOCONJUNCTIVITIS 122.11 Treatment: TARSORRHAPHY 122.12 ICD-9: 351.0-351.1, 351.8-351.9, 370.34, 374.44, 374.45, 374.89 122.13 (53) Diagnosis: HORDEOLUM AND OTHER DEEP INFLAMMATION OF 122.14 EYELID; CHALAZION 122.15 Treatment: INCISION AND DRAINAGE/MEDICAL THERAPY 122.16 ICD-9: 373.11-373.12, 373.2, 374.50, 374.54, 374.56, 374.84 122.17 (54) Diagnosis: ECTROPION, TRICHIASIS OF EYELID, BENIGN 122.18 NEOPLASM OF EYELID 122.19 Treatment: ECTROPION REPAIR 122.20 ICD-9: 216.1, 224, 372.63, 374.1, 374.85 122.21 (55) Diagnosis: CHONDROMALACIA 122.22 Treatment: MEDICAL THERAPY 122.23 ICD-9: 733.92 122.24 (56) Diagnosis: DYSMENORRHEA 122.25 Treatment: MEDICAL AND SURGICAL TREATMENT 122.26 ICD-9: 625.3 122.27 (57) Diagnosis: SPASTIC DIPLEGIA 122.28 Treatment: RHIZOTOMY 122.29 ICD-9: 343.0 122.30 (58) Diagnosis: ATROPHY OF EDENTULOUS ALVEOLAR RIDGE 122.31 Treatment: VESTIBULOPLASTY, GRAFTS, IMPLANTS 122.32 ICD-9: 525.2 122.33 (59) Diagnosis: DEFORMITIES OF UPPER BODY AND ALL LIMBS 122.34 Treatment: REPAIR/REVISION/RECONSTRUCTION/RELOCATION/MEDICAL 122.35 THERAPY 122.36 ICD-9: 718.02-718.05, 718.13-718.15, 718.42-718.46, 123.1 718.52-718.56, 718.65, 718.82-718.86, 728.79, 732.3, 732.6, 123.2 732.8-732.9, 733.90-733.91, 736.00-736.04, 736.07, 736.09, 123.3 736.1, 736.20, 736.29, 736.30, 736.39, 736.4, 736.6, 736.76, 123.4 736.79, 736.89, 736.9, 738.6, 738.8, 754.42-754.44, 754.61, 123.5 754.8, 755.50-755.53, 755.56-755.57, 755.59, 755.60, 123.6 755.63-755.64, 755.69, 755.8, 756.82-756.83, 756.89 123.7 (60) Diagnosis: DEFORMITIES OF FOOT 123.8 Treatment: FASCIOTOMY/INCISION/REPAIR/ARTHRODESIS 123.9 ICD-9: 718.07, 718.47, 718.57, 718.87, 727.1, 732.5, 123.10 735.0-735.2, 735.3-735.9, 736.70-736.72, 754.50, 754.59, 754.60, 123.11 754.69, 754.70, 754.79, 755.65-755.67 123.12 (61) Diagnosis: PERITONEAL ADHESION 123.13 Treatment: SURGICAL TREATMENT 123.14 ICD-9: 568.0, 568.82-568.89, 568.9 123.15 (62) Diagnosis: PELVIC PAIN SYNDROME, DYSPAREUNIA 123.16 Treatment: MEDICAL AND SURGICAL TREATMENT 123.17 ICD-9: 300.81, 614.1, 614.6, 620.6, 625.0-625.2, 625.5, 123.18 625.8-625.9 123.19 (63) Diagnosis: TENSION HEADACHES 123.20 Treatment: MEDICAL THERAPY 123.21 ICD-9: 307.81, 784.0 123.22 (64) Diagnosis: CHRONIC BRONCHITIS 123.23 Treatment: MEDICAL THERAPY 123.24 ICD-9: 490, 491.0, 491.8-491.9 123.25 (65) Diagnosis: DISORDERS OF FUNCTION OF STOMACH AND OTHER 123.26 FUNCTIONAL DIGESTIVE DISORDERS 123.27 Treatment: MEDICAL THERAPY 123.28 ICD-9: 536.0-536.3, 536.8-536.9, 537.1-537.2, 537.5-537.6, 123.29 537.89, 537.9, 564.0-564.7, 564.9 123.30 (66) Diagnosis: TMJ DISORDER 123.31 Treatment: TMJ SPLINTS 123.32 ICD-9: 524.6, 848.1 123.33 (67) Diagnosis: URETHRITIS, NONSEXUALLY TRANSMITTED 123.34 Treatment: MEDICAL THERAPY 123.35 ICD-9: 597.8, 599.3-599.5, 599.9 123.36 (68) Diagnosis: LESION OF PLANTAR NERVE; PLANTAR FASCIAL 124.1 FIBROMATOSIS 124.2 Treatment: MEDICAL THERAPY, EXCISION 124.3 ICD-9: 355.6, 728.71 124.4 (69) Diagnosis: GRANULOMA OF MUSCLE, GRANULOMA OF SKIN AND 124.5 SUBCUTANEOUS TISSUE 124.6 Treatment: REMOVAL OF GRANULOMA 124.7 ICD-9: 709.4, 728.82 124.8 (70) Diagnosis: DERMATOPHYTOSIS OF NAIL, GROIN, AND FOOT 124.9 AND OTHER DERMATOMYCOSIS 124.10 Treatment: MEDICAL AND SURGICAL TREATMENT 124.11 ICD-9: 110.0-110.6, 110.8-110.9, 111 124.12 (71) Diagnosis: INTERNAL DERANGEMENT OF JOINT OTHER THAN 124.13 KNEE 124.14 Treatment: REPAIR, MEDICAL THERAPY 124.15 ICD-9: 718.09, 718.19, 718.29, 718.48, 718.59, 718.88-718.89, 124.16 719.81-719.85, 719.87-719.89 124.17 (72) Diagnosis: STENOSIS OF NASOLACRIMAL DUCT (ACQUIRED) 124.18 Treatment: DACRYOCYSTORHINOSTOMY 124.19 ICD-9: 375.02, 375.30, 375.32, 375.4, 375.56-375.57, 375.61, 124.20 771.6 124.21 (73) Diagnosis: PERIPHERAL NERVE DISORDERS 124.22 Treatment: SURGICAL TREATMENT 124.23 ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 355.4, 124.24 355.7-355.8, 723.2 124.25 (74) Diagnosis: CAVUS DEFORMITY OF FOOT; FLAT FOOT; 124.26 POLYDACTYLY AND SYNDACTYLY OF TOES 124.27 Treatment: MEDICAL THERAPY, ORTHOTIC 124.28 ICD-9: 734, 736.73, 755.00, 755.02, 755.10, 755.13-755.14 124.29 (75) Diagnosis: PERIPHERAL ENTHESOPATHIES 124.30 Treatment: SURGICAL TREATMENT 124.31 ICD-9: 726.12, 726.3-726.9, 728.81 124.32 (76) Diagnosis: PERIPHERAL ENTHESOPATHIES 124.33 Treatment: MEDICAL THERAPY 124.34 ICD-9: 726.12, 726.3-726.4, 726.6-726.9, 728.81 124.35 (77) Diagnosis: DISORDERS OF SOFT TISSUE 124.36 Treatment: MEDICAL THERAPY 125.1 ICD-9: 729.0-729.2, 729.31-729.39, 729.4-729.9 125.2 (78) Diagnosis: ENOPHTHALMOS 125.3 Treatment: ORBITAL IMPLANT 125.4 ICD-9: 372.64, 376.5 125.5 (79) Diagnosis: MACROMASTIA 125.6 Treatment: SUBCUTANEOUS TOTAL MASTECTOMY, BREAST REDUCTION 125.7 ICD-9: 611.1 125.8 (80) Diagnosis: GALACTORRHEA, MASTODYNIA, ATROPHY, BENIGN 125.9 NEOPLASMS AND UNSPECIFIED DISORDERS OF THE BREAST 125.10 Treatment: MEDICAL AND SURGICAL TREATMENT 125.11 ICD-9: 217, 611.3, 611.4, 611.6, 611.71, 611.9, 757.6 125.12 (81) Diagnosis: ACUTE AND CHRONIC DISORDERS OF SPINE 125.13 WITHOUT NEUROLOGIC IMPAIRMENT 125.14 Treatment: MEDICAL AND SURGICAL TREATMENT 125.15 ICD-9: 721.0, 721.2-721.3, 721.7-721.8, 721.90, 722.0-722.6, 125.16 722.8-722.9, 723.1, 723.5-723.9, 724.1-724.2, 724.5-724.9, 739, 125.17 839.2, 847 125.18 (82) Diagnosis: CYSTS OF ORAL SOFT TISSUES 125.19 Treatment: INCISION AND DRAINAGE 125.20 ICD-9: 527.1, 528.4, 528.8 125.21 (83) Diagnosis: FEMALE INFERTILITY, MALE INFERTILITY 125.22 Treatment: ARTIFICIAL INSEMINATION, MEDICAL THERAPY 125.23 ICD-9: 606, 628.4-628.9, 629.9, V26.1-V26.2, V26.8-V26.9 125.24 (84) Diagnosis: INFERTILITY DUE TO ANNOVULATION 125.25 Treatment: MEDICAL THERAPY 125.26 ICD-9: 626.0-626.1, 628.0, 628.1 125.27 (85) Diagnosis: POSTCONCUSSION SYNDROME 125.28 Treatment: MEDICAL THERAPY 125.29 ICD-9: 310.2 125.30 (86) Diagnosis: SIMPLE AND UNSPECIFIED GOITER, NONTOXIC 125.31 NODULAR GOITER 125.32 Treatment: MEDICAL THERAPY, THYROIDECTOMY 125.33 ICD-9: 240-241 125.34 (87) Diagnosis: CONDUCTIVE HEARING LOSS 125.35 Treatment: AUDIANT BONE CONDUCTORS 125.36 ICD-9: 389.0, 389.2 126.1 (88) Diagnosis: CANCER OF LIVER AND INTRAHEPATIC BILE 126.2 DUCTS 126.3 Treatment: LIVER TRANSPLANT 126.4 ICD-9: 155.0-155.1, 996.82 126.5 (89) Diagnosis: HYPOTENSION 126.6 Treatment: MEDICAL THERAPY 126.7 ICD-9: 458 126.8 (90) Diagnosis: VIRAL HEPATITIS, EXCLUDING CHRONIC VIRAL 126.9 HEPATITIS B AND VIRAL HEPATITIS C WITHOUT HEPATIC COMA 126.10 Treatment: MEDICAL THERAPY 126.11 ICD-9: 070.0-070.2, 070.30-070.31, 070.33, 070.4, 126.12 070.52-070.53, 070.59, 070.6-070.9 126.13 (91) Diagnosis: BENIGN NEOPLASMS OF SKIN AND OTHER SOFT 126.14 TISSUES 126.15 Treatment: MEDICAL THERAPY 126.16 ICD-9: 210, 214, 216, 221, 222.1, 222.4, 228.00-228.01, 228.1, 126.17 229, 686.1, 686.9 126.18 (92) Diagnosis: REDUNDANT PREPUCE 126.19 Treatment: ELECTIVE CIRCUMCISION 126.20 ICD-9: 605, V50.2 126.21 (93) Diagnosis: BENIGN NEOPLASMS OF DIGESTIVE SYSTEM 126.22 Treatment: SURGICAL TREATMENT 126.23 ICD-9: 211.0-211.2, 211.5-211.6, 211.8-211.9 126.24 (94) Diagnosis: OTHER NONINFECTIOUS GASTROENTERITIS AND 126.25 COLITIS 126.26 Treatment: MEDICAL THERAPY 126.27 ICD-9: 558 126.28 (95) Diagnosis: FACTITIOUS DISORDERS 126.29 Treatment: CONSULTATION 126.30 ICD-9: 300.10, 300.16, 300.19, 301.51 126.31 (96) Diagnosis: HYPOCHONDRIASIS; SOMATOFORM DISORDER, NOS 126.32 AND UNDIFFERENTIATED 126.33 Treatment: CONSULTATION 126.34 ICD-9: 300.7, 300.9, 306 126.35 (97) Diagnosis: CONVERSION DISORDER, ADULT 126.36 Treatment: MEDICAL/PSYCHOTHERAPY 127.1 ICD-9: 300.11 127.2 (98) Diagnosis: SPINAL DEFORMITY, NOT CLINICALLY 127.3 SIGNIFICANT 127.4 Treatment: ARTHRODESIS/REPAIR/RECONSTRUCTION, MEDICAL THERAPY 127.5 ICD-9: 721.5-721.6, 723.0, 724.0, 731.0, 737.0-737.3, 127.6 737.8-737.9, 738.4-738.5, 754.1-754.2, 756.10-756.12, 127.7 756.13-756.17, 756.19, 756.3 127.8 (99) Diagnosis: ASYMPTOMATIC URTICARIA 127.9 Treatment: MEDICAL THERAPY 127.10 ICD-9: 708.2-708.4, 708.9 127.11 (100) Diagnosis: CIRCUMSCRIBED SCLERODERMA; SENILE PURPURA 127.12 Treatment: MEDICAL THERAPY 127.13 ICD-9: 287.2, 287.8-287.9, 701.0 127.14 (101) Diagnosis: DERMATITIS DUE TO SUBSTANCES TAKEN 127.15 INTERNALLY 127.16 Treatment: MEDICAL THERAPY 127.17 ICD-9: 693 127.18 (102) Diagnosis: ALLERGIC RHINITIS AND CONJUNCTIVITIS, 127.19 CHRONIC RHINITIS 127.20 Treatment: MEDICAL THERAPY 127.21 ICD-9: 372.01-372.05, 372.14, 372.54, 372.56, 472, 477, 955.3, 127.22 V07.1 127.23 (103) Diagnosis: PLEURISY 127.24 Treatment: MEDICAL THERAPY 127.25 ICD-9: 511.0, 511.9 127.26 (104) Diagnosis: CONJUNCTIVAL CYST 127.27 Treatment: EXCISION OF CONJUNCTIVAL CYST 127.28 ICD-9: 372.61-372.62, 372.71-372.72, 372.74-372.75 127.29 (105) Diagnosis: HEMATOMA OF AURICLE OR PINNA AND HEMATOMA 127.30 OF EXTERNAL EAR 127.31 Treatment: DRAINAGE 127.32 ICD-9: 380.3, 380.8, 738.7 127.33 (106) Diagnosis: ACUTE NONSUPPURATIVE LABYRINTHITIS 127.34 Treatment: MEDICAL THERAPY 127.35 ICD-9: 386.30-386.32, 386.34-386.35 127.36 (107) Diagnosis: INFECTIOUS MONONUCLEOSIS 128.1 Treatment: MEDICAL THERAPY 128.2 ICD-9: 075 128.3 (108) Diagnosis: ASEPTIC MENINGITIS 128.4 Treatment: MEDICAL THERAPY 128.5 ICD-9: 047-049 128.6 (109) Diagnosis: CONGENITAL ANOMALIES OF FEMALE GENITAL 128.7 ORGANS, EXCLUDING VAGINA 128.8 Treatment: SURGICAL TREATMENT 128.9 ICD-9: 752.0-752.3, 752.41 128.10 (110) Diagnosis: CONGENITAL DEFORMITIES OF KNEE 128.11 Treatment: ARTHROSCOPIC REPAIR 128.12 ICD-9: 755.64, 727.83 128.13 (111) Diagnosis: UNCOMPLICATED HERNIA IN ADULTS AGE 18 OR 128.14 OVER 128.15 Treatment: REPAIR 128.16 ICD-9: 550.9, 553.0-553.2, 553.8-553.9 128.17 (112) Diagnosis: ACUTE ANAL FISSURE 128.18 Treatment: FISSURECTOMY, MEDICAL THERAPY 128.19 ICD-9: 565.0 128.20 (113) Diagnosis: CYST OF KIDNEY, ACQUIRED 128.21 Treatment: MEDICAL AND SURGICAL TREATMENT 128.22 ICD-9: 593.2 128.23 (114) Diagnosis: PICA 128.24 Treatment: MEDICAL/PSYCHOTHERAPY 128.25 ICD-9: 307.52 128.26 (115) Diagnosis: DISORDERS OF SLEEP WITHOUT SLEEP APNEA 128.27 Treatment: MEDICAL THERAPY 128.28 ICD-9: 307.41-307.45, 307.47-307.49, 780.50, 780.52, 128.29 780.54-780.56, 780.59 128.30 (116) Diagnosis: CYST, HEMORRHAGE, AND INFARCTION OF 128.31 THYROID 128.32 Treatment: SURGERY - EXCISION 128.33 ICD-9: 246.2, 246.3, 246.9 128.34 (117) Diagnosis: DEVIATED NASAL SEPTUM, ACQUIRED DEFORMITY 128.35 OF NOSE, OTHER DISEASES OF UPPER RESPIRATORY TRACT 128.36 Treatment: EXCISION OF CYST/RHINECTOMY/PROSTHESIS 129.1 ICD-9: 470, 478.0, 738.0, 754.0 129.2 (118) Diagnosis: ERYTHEMA MULTIFORM 129.3 Treatment: MEDICAL THERAPY 129.4 ICD-9: 695.1 129.5 (119) Diagnosis: HERPES SIMPLEX WITHOUT COMPLICATIONS 129.6 Treatment: MEDICAL THERAPY 129.7 ICD-9: 054.2, 054.6, 054.73, 054.9 129.8 (120) Diagnosis: CONGENITAL ANOMALIES OF THE EAR WITHOUT 129.9 IMPAIRMENT OF HEARING; UNILATERAL ANOMALIES OF THE EAR 129.10 Treatment: OTOPLASTY, REPAIR AND AMPUTATION 129.11 ICD-9: 744.00-744.04, 744.09, 744.1-744.3 129.12 (121) Diagnosis: BLEPHARITIS 129.13 Treatment: MEDICAL THERAPY 129.14 ICD-9: 373.0, 373.8-373.9, 374.87 129.15 (122) Diagnosis: HYPERTELORISM OF ORBIT 129.16 Treatment: ORBITOTOMY 129.17 ICD-9: 376.41 129.18 (123) Diagnosis: INFERTILITY DUE TO TUBAL DISEASE 129.19 Treatment: MICROSURGERY 129.20 ICD-9: 608.85, 622.5, 628.2-628.3, 629.9, V26.0 129.21 (124) Diagnosis: KERATODERMA, ACANTHOSIS NIGRICANS, STRIAE 129.22 ATROPHICAE, AND OTHER HYPERTROPHIC OR ATROPHIC CONDITIONS OF 129.23 SKIN 129.24 Treatment: MEDICAL THERAPY 129.25 ICD-9: 373.3, 690, 698, 701.1-701.3, 701.8, 701.9 129.26 (125) Diagnosis: LICHEN PLANUS 129.27 Treatment: MEDICAL THERAPY 129.28 ICD-9: 697 129.29 (126) Diagnosis: OBESITY 129.30 Treatment: NUTRITIONAL AND LIFE STYLE COUNSELING 129.31 ICD-9: 278.0 129.32 (127) Diagnosis: MORBID OBESITY 129.33 Treatment: GASTROPLASTY 129.34 ICD-9: 278.01 129.35 (128) Diagnosis: CHRONIC DISEASE OF TONSILS AND ADENOIDS 129.36 Treatment: TONSILLECTOMY AND ADENOIDECTOMY 130.1 ICD-9: 474.0, 474.1-474.2, 474.9 130.2 (129) Diagnosis: HYDROCELE 130.3 Treatment: MEDICAL THERAPY, EXCISION 130.4 ICD-9: 603, 608.84, 629.1, 778.6 130.5 (130) Diagnosis: KELOID SCAR; OTHER ABNORMAL GRANULATION 130.6 TISSUE 130.7 Treatment: INTRALESIONAL INJECTIONS/DESTRUCTION/EXCISION, 130.8 RADIATION THERAPY 130.9 ICD-9: 701.4-701.5 130.10 (131) Diagnosis: NONINFLAMMATORY DISORDERS OF CERVIX; 130.11 HYPERTROPHY OF LABIA 130.12 Treatment: MEDICAL THERAPY 130.13 ICD-9: 622.4, 622.6-622.9, 623.4, 624.2-624.3, 624.6-624.9 130.14 (132) Diagnosis: SPRAINS OF JOINTS AND ADJACENT MUSCLES, 130.15 GRADE I 130.16 Treatment: MEDICAL THERAPY 130.17 ICD-9: 355.1-355.3, 355.9, 717, 718.26, 718.36, 718.46, 718.56, 130.18 836.0-836.2, 840-843, 844.0-844.3, 844.8-844.9, 845.00-845.03, 130.19 845.1, 846, 848.3, 848.40-848.42, 848.49, 848.5, 848.8-848.9, 130.20 905.7 130.21 (133) Diagnosis: SYNOVITIS AND TENOSYNOVITIS 130.22 Treatment: MEDICAL THERAPY 130.23 ICD-9: 726.12, 727.00, 727.03-727.09 130.24 (134) Diagnosis: OTHER DISORDERS OF SYNOVIUM, TENDON AND 130.25 BURSA, COSTOCHONDRITIS, AND CHONDRODYSTROPHY 130.26 Treatment: MEDICAL THERAPY 130.27 ICD-9: 719.5-719.6, 719.80, 719.86, 727.2-727.3, 727.50, 130.28 727.60, 727.82, 727.9, 733.5-733.7, 756.4 130.29 (135) Diagnosis: DISEASE OF NAILS, HAIR, AND HAIR 130.30 FOLLICLES 130.31 Treatment: MEDICAL THERAPY 130.32 ICD-9: 703.8-703.9, 704.0, 704.1-704.9, 706.3, 706.9, 130.33 757.4-757.5, V50.0 130.34 (136) Diagnosis: CANDIDIASIS OF MOUTH, SKIN, AND NAILS 130.35 Treatment: MEDICAL THERAPY 130.36 ICD-9: 112.0, 112.3, 112.9 131.1 (137) Diagnosis: BENIGN LESIONS OF TONGUE 131.2 Treatment: EXCISION 131.3 ICD-9: 529.1-529.6, 529.8-529.9 131.4 (138) Diagnosis: MINOR BURNS 131.5 Treatment: MEDICAL THERAPY 131.6 ICD-9: 692.76, 941.0-941.2, 942.0-942.2, 943.0-943.2, 131.7 944.0-944.2, 945.0-945.2, 946.0-946.2, 949.0-949.1 131.8 (139) Diagnosis: MINOR HEAD INJURY: HEMATOMA/EDEMA WITH 131.9 NO LOSS OF CONSCIOUSNESS 131.10 Treatment: MEDICAL THERAPY 131.11 ICD-9: 800.00-800.01, 801.00-801.01, 803.00-803.01, 850.0, 131.12 850.9, 851.00-851.01, 851.09, 851.20-851.21, 851.29, 131.13 851.40-851.41, 851.49, 851.60-851.61, 851.69, 851.80-851.81, 131.14 851.89 131.15 (140) Diagnosis: CONGENITAL DEFORMITY OF KNEE 131.16 Treatment: MEDICAL THERAPY 131.17 ICD-9: 755.64 131.18 (141) Diagnosis: PHLEBITIS AND THROMBOPHLEBITIS, 131.19 SUPERFICIAL 131.20 Treatment: MEDICAL THERAPY 131.21 ICD-9: 451.0, 451.2, 451.82, 451.84, 451.89, 451.9 131.22 (142) Diagnosis: PROLAPSED URETHRAL MUCOSA 131.23 Treatment: SURGICAL TREATMENT 131.24 ICD-9: 599.3, 599.5 131.25 (143) Diagnosis: RUPTURE OF SYNOVIUM 131.26 Treatment: REMOVAL OF BAKER'S CYST 131.27 ICD-9: 727.51 131.28 (144) Diagnosis: PERSONALITY DISORDERS, EXCLUDING 131.29 BORDERLINE, SCHIZOTYPAL AND ANTISOCIAL 131.30 Treatment: MEDICAL/PSYCHOTHERAPY 131.31 ICD-9: 301.0, 301.10-301.12, 301.20-301.21, 301.3-301.4, 131.32 301.50, 301.59, 301.6, 301.81-301.82, 301.84, 301.89, 301.9 131.33 (145) Diagnosis: GENDER IDENTIFICATION DISORDER, 131.34 PARAPHILIAS AND OTHER PSYCHOSEXUAL DISORDERS 131.35 Treatment: MEDICAL/PSYCHOTHERAPY 131.36 ICD-9: 302.0-302.4, 302.50, 302.6, 302.85, 302.9 132.1 (146) Diagnosis: FINGERTIP AVULSION 132.2 Treatment: REPAIR WITHOUT PEDICLE GRAFT 132.3 ICD-9: 883.0 132.4 (147) Diagnosis: ANOMALIES OF RELATIONSHIP OF JAW TO 132.5 CRANIAL BASE, MAJOR ANOMALIES OF JAW SIZE, OTHER SPECIFIED AND 132.6 UNSPECIFIED DENTOFACIAL ANOMALIES 132.7 Treatment: OSTEOPLASTY, MAXILLA/MANDIBLE 132.8 ICD-9: 524.0-524.2, 524.5, 524.7-524.8, 524.9 132.9 (148) Diagnosis: CERVICAL RIB 132.10 Treatment: SURGICAL TREATMENT 132.11 ICD-9: 756.2 132.12 (149) Diagnosis: GYNECOMASTIA 132.13 Treatment: MASTECTOMY 132.14 ICD-9: 611.1 132.15 (150) Diagnosis: VIRAL, SELF-LIMITING ENCEPHALITIS, 132.16 MYELITIS AND ENCEPHALOMYELITIS 132.17 Treatment: MEDICAL THERAPY 132.18 ICD-9: 056.0, 056.71, 323.8-323.9 132.19 (151) Diagnosis: GALLSTONES WITHOUT CHOLECYSTITIS 132.20 Treatment: MEDICAL THERAPY, CHOLECYSTECTOMY 132.21 ICD-9: 574.2, 575.8 132.22 (152) Diagnosis: BENIGN NEOPLASM OF NASAL CAVITIES, MIDDLE 132.23 EAR AND ACCESSORY SINUSES 132.24 Treatment: EXCISION, RECONSTRUCTION 132.25 ICD-9: 212.0 132.26 (153) Diagnosis: ACUTE TONSILLITIS OTHER THAN 132.27 BETA-STREPTOCOCCAL 132.28 Treatment: MEDICAL THERAPY 132.29 ICD-9: 463 132.30 (154) Diagnosis: EDEMA AND OTHER CONDITIONS INVOLVING THE 132.31 INTEGUMENT OF THE FETUS AND NEWBORN 132.32 Treatment: MEDICAL THERAPY 132.33 ICD-9: 778.5, 778.7-778.9 132.34 (155) Diagnosis: ACUTE UPPER RESPIRATORY INFECTIONS AND 132.35 COMMON COLD 132.36 Treatment: MEDICAL THERAPY 133.1 ICD-9: 460, 465 133.2 (156) Diagnosis: DIAPER RASH 133.3 Treatment: MEDICAL THERAPY 133.4 ICD-9: 691.0 133.5 (157) Diagnosis: DISORDERS OF SWEAT GLANDS 133.6 Treatment: MEDICAL THERAPY 133.7 ICD-9: 705.0-705.1, 705.81-705.83, 705.89, 705.9, 780.8 133.8 (158) Diagnosis: OTHER VIRAL INFECTIONS, EXCLUDING 133.9 PNEUMONIA DUE TO RESPIRATORY SYNCYTIAL VIRUS IN PERSONS UNDER 133.10 AGE 3 133.11 Treatment: MEDICAL THERAPY 133.12 ICD-9: 052, 055, 056.79, 056.8-056.9, 057, 072, 074, 078.0, 133.13 078.2, 078.4-078.8, 079.0-079.6, 079.88-079.89, 079.9, 480, 487 133.14 (159) Diagnosis: PHARYNGITIS AND LARYNGITIS AND OTHER 133.15 DISEASES OF VOCAL CORDS 133.16 Treatment: MEDICAL THERAPY 133.17 ICD-9: 462, 464.00, 464.50, 476, 478.5 133.18 (160) Diagnosis: CORNS AND CALLUSES 133.19 Treatment: MEDICAL THERAPY 133.20 ICD-9: 700 133.21 (161) Diagnosis: VIRAL WARTS, EXCLUDING VENEREAL WARTS 133.22 Treatment: MEDICAL AND SURGICAL TREATMENT, CRYOSURGERY 133.23 ICD-9: 078.0, 078.10, 078.19 133.24 (162) Diagnosis: OLD LACERATION OF CERVIX AND VAGINA 133.25 Treatment: MEDICAL THERAPY 133.26 ICD-9: 621.5, 622.3, 624.4 133.27 (163) Diagnosis: TONGUE TIE AND OTHER ANOMALIES OF TONGUE 133.28 Treatment: FRENOTOMY, TONGUE TIE 133.29 ICD-9: 529.5, 750.0-750.1 133.30 (164) Diagnosis: OPEN WOUND OF INTERNAL STRUCTURES OF 133.31 MOUTH WITHOUT COMPLICATION 133.32 Treatment: REPAIR SOFT TISSUES 133.33 ICD-9: 525.10, 525.12, 525.13, 525.19, 873.6 133.34 (165) Diagnosis: CENTRAL SEROUS RETINOPATHY 133.35 Treatment: LASER SURGERY 133.36 ICD-9: 362.40-362.41, 362.6-362.7 134.1 (166) Diagnosis: SEBORRHEIC KERATOSIS, DYSCHROMIA, AND 134.2 VASCULAR DISORDERS, SCAR CONDITIONS, AND FIBROSIS OF SKIN 134.3 Treatment: MEDICAL AND SURGICAL TREATMENT 134.4 ICD-9: 278.1, 702.1-702.8, 709.1-709.3, 709.8-709.9 134.5 (167) Diagnosis: UNCOMPLICATED HEMORRHOIDS 134.6 Treatment: HEMORRHOIDECTOMY, MEDICAL THERAPY 134.7 ICD-9: 455.0, 455.3, 455.6, 455.9 134.8 (168) Diagnosis: GANGLION 134.9 Treatment: EXCISION 134.10 ICD-9: 727.02, 727.4 134.11 (169) Diagnosis: CHRONIC CONJUNCTIVITIS, 134.12 BLEPHAROCONJUNCTIVITIS 134.13 Treatment: MEDICAL THERAPY 134.14 ICD-9: 372.10-372.13, 372.2-372.3, 372.53, 372.73, 374.55 134.15 (170) Diagnosis: TOXIC ERYTHEMA, ACNE ROSACEA, DISCOID 134.16 LUPUS 134.17 Treatment: MEDICAL THERAPY 134.18 ICD-9: 695.0, 695.2-695.9 134.19 (171) Diagnosis: PERIPHERAL NERVE DISORDERS 134.20 Treatment: MEDICAL THERAPY 134.21 ICD-9: 337.2, 353, 354.1, 354.3-354.9, 355.0, 355.3, 134.22 355.7-355.8, 357.5-357.9, 723.2 134.23 (172) Diagnosis: OTHER COMPLICATIONS OF A PROCEDURE 134.24 Treatment: MEDICAL AND SURGICAL TREATMENT 134.25 ICD-9: 371.82, 457.0, 998.81, 998.9 134.26 (173) Diagnosis: RAYNAUD'S SYNDROME 134.27 Treatment: MEDICAL THERAPY 134.28 ICD-9: 443.0, 443.89, 443.9 134.29 (174) Diagnosis: TMJ DISORDERS 134.30 Treatment: TMJ SURGERY 134.31 ICD-9: 524.5, 524.6, 718.08, 718.18, 718.28, 718.38, 718.58 134.32 (175) Diagnosis: VARICOSE VEINS OF LOWER EXTREMITIES 134.33 WITHOUT ULCER OR INFLAMMATION 134.34 Treatment: STRIPPING/SCLEROTHERAPY 134.35 ICD-9: 454.9, 459, 607.82 134.36 (176) Diagnosis: VULVAL VARICES 135.1 Treatment: VASCULAR SURGERY 135.2 ICD-9: 456.6 135.3 (177) Diagnosis: CHRONIC PANCREATITIS 135.4 Treatment: SURGICAL TREATMENT 135.5 ICD-9: 577.1 135.6 (178) Diagnosis: CHRONIC PROSTATITIS, OTHER DISORDERS OF 135.7 PROSTATE 135.8 Treatment: MEDICAL THERAPY 135.9 ICD-9: 601.1, 601.3, 601.9, 602 135.10 (179) Diagnosis: MUSCULAR CALCIFICATION AND OSSIFICATION 135.11 Treatment: MEDICAL THERAPY 135.12 ICD-9: 728.1 135.13 (180) Diagnosis: CANCER OF VARIOUS SITES WHERE TREATMENT 135.14 WILL NOT RESULT IN A FIVE PERCENT FIVE-YEAR SURVIVAL 135.15 Treatment: CURATIVE MEDICAL AND SURGICAL TREATMENT 135.16 ICD-9: 140-208 135.17 (181) Diagnosis: AGENESIS OF LUNG 135.18 Treatment: MEDICAL THERAPY 135.19 ICD-9: 748.5 135.20 (182) Diagnosis: DISEASE OF CAPILLARIES 135.21 Treatment: EXCISION 135.22 ICD-9: 448.1-448.9 135.23 (183) Diagnosis: BENIGN POLYPS OF VOCAL CORDS 135.24 Treatment: MEDICAL THERAPY, STRIPPING 135.25 ICD-9: 478.4 135.26 (184) Diagnosis: FRACTURES OF RIBS AND STERNUM, CLOSED 135.27 Treatment: MEDICAL THERAPY 135.28 ICD-9: 807.0, 807.2, 805.6, 839.41 135.29 (185) Diagnosis: CLOSED FRACTURE OF ONE OR MORE PHALANGES 135.30 OF THE FOOT, NOT INCLUDING THE GREAT TOE 135.31 Treatment: MEDICAL AND SURGICAL TREATMENT 135.32 ICD-9: 826.0 135.33 (186) Diagnosis: DISEASES OF THYMUS GLAND 135.34 Treatment: MEDICAL THERAPY 135.35 ICD-9: 254 135.36 (187) Diagnosis: DENTAL CONDITIONS WHERE TREATMENT RESULTS 136.1 IN MARGINAL IMPROVEMENT 136.2 Treatment: ELECTIVE DENTAL SERVICES 136.3 ICD-9: 520.7, V72.2 136.4 (188) Diagnosis: ANTISOCIAL PERSONALITY DISORDER 136.5 Treatment: MEDICAL/PSYCHOTHERAPY 136.6 ICD-9: 301.7 136.7 (189) Diagnosis: SEBACEOUS CYST 136.8 Treatment: MEDICAL AND SURGICAL THERAPY 136.9 ICD-9: 685.1, 706.2, 744.47 136.10 (190) Diagnosis: CENTRAL RETINAL ARTERY OCCLUSION 136.11 Treatment: PARACENTESIS OF AQUEOUS 136.12 ICD-9: 362.31-362.33 136.13 (191) Diagnosis: ORAL APHTHAE 136.14 Treatment: MEDICAL THERAPY 136.15 ICD-9: 528.2 136.16 (192) Diagnosis: SUBLINGUAL, SCROTAL, AND PELVIC VARICES 136.17 Treatment: VENOUS INJECTION, VASCULAR SURGERY 136.18 ICD-9: 456.3-456.5 136.19 (193) Diagnosis: SUPERFICIAL WOUNDS WITHOUT INFECTION AND 136.20 CONTUSIONS 136.21 Treatment: MEDICAL THERAPY 136.22 ICD-9: 910.0, 910.2, 910.4, 910.6, 910.8, 911.0, 911.2, 911.4, 136.23 91.6, 911.8, 912.0, 912.2, 912.4, 912.6, 912.8, 913.0, 913.2, 136.24 913.4, 913.6, 913.8, 914.0, 914.2, 914.4, 914.6, 914.8, 915.0, 136.25 915.2, 915.4, 915.6, 915.8, 916.0, 916.2, 916.4, 916.6, 916.8, 136.26 917.0, 917.2, 917.4, 917.6, 917.8, 919.0, 919.2, 919.4, 919.6, 136.27 919.8, 920-924, 959.0-959.8 136.28 (194) Diagnosis: UNSPECIFIED RETINAL VASCULAR OCCLUSION 136.29 Treatment: LASER SURGERY 136.30 ICD-9: 362.30 136.31 (195) Diagnosis: BENIGN NEOPLASM OF EXTERNAL FEMALE 136.32 GENITAL ORGANS 136.33 Treatment: EXCISION 136.34 ICD-9: 221.1-221.9 136.35 (196) Diagnosis: BENIGN NEOPLASM OF MALE GENITAL ORGANS: 136.36 TESTIS, PROSTATE, EPIDIDYMIS 137.1 Treatment: MEDICAL AND SURGICAL TREATMENT 137.2 ICD-9: 222.0, 222.2, 222.3, 222.8, 222.9 137.3 (197) Diagnosis: XEROSIS 137.4 Treatment: MEDICAL THERAPY 137.5 ICD-9: 706.8 137.6 (198) Diagnosis: CONGENITAL CYSTIC LUNG - SEVERE 137.7 Treatment: LUNG RESECTION 137.8 ICD-9: 748.4 137.9 (199) Diagnosis: ICHTHYOSIS 137.10 Treatment: MEDICAL THERAPY 137.11 ICD-9: 757.1 137.12 (200) Diagnosis: LYMPHEDEMA 137.13 Treatment: MEDICAL THERAPY, OTHER OPERATION ON LYMPH CHANNEL 137.14 ICD-9: 457.1-457.9, 757.0 137.15 (201) Diagnosis: DERMATOLOGICAL CONDITIONS WITH NO 137.16 EFFECTIVE TREATMENT OR NO TREATMENT NECESSARY 137.17 Treatment: MEDICAL AND SURGICAL TREATMENT 137.18 ICD-9: 696.3-696.5, 709.0, 757.2-757.3, 757.8-757.9 137.19 (202) Diagnosis: INFECTIOUS DISEASES WITH NO EFFECTIVE 137.20 TREATMENTS OR NO TREATMENT NECESSARY 137.21 Treatment: EVALUATION 137.22 ICD-9: 071, 136.0, 136.9 137.23 (203) Diagnosis: RESPIRATORY CONDITIONS WITH NO EFFECTIVE 137.24 TREATMENTS OR NO TREATMENT NECESSARY 137.25 Treatment: EVALUATION 137.26 ICD-9: 519.3, 519.9, 748.60, 748.69, 748.9 137.27 (204) Diagnosis: GENITOURINARY CONDITIONS WITH NO 137.28 EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 137.29 Treatment: EVALUATION 137.30 ICD-9: 593.0-593.1, 593.6, 607.9, 608.3, 608.9, 621.6, 137.31 621.8-621.9, 626.9, 629.8, 752.9 137.32 (205) Diagnosis: CARDIOVASCULAR CONDITIONS WITH NO 137.33 EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 137.34 Treatment: EVALUATION 137.35 ICD-9: 429.3, 429.81-429.82, 429.89, 429.9, 747.9 137.36 (206) Diagnosis: MUSCULOSKELETAL CONDITIONS WITH NO 138.1 EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 138.2 Treatment: EVALUATION 138.3 ICD-9: 716.9, 718.00, 718.10, 718.20, 718.40, 718.50, 718.60, 138.4 718.80, 718.9, 719.7, 719.9, 728.5, 728.84, 728.9, 731.2, 138.5 738.2-738.3, 738.9, 744.5-744.9, 748.1, 755.9, 756.9 138.6 (207) Diagnosis: INTRACRANIAL CONDITIONS WITH NO EFFECTIVE 138.7 TREATMENTS OR NO TREATMENT NECESSARY 138.8 Treatment: EVALUATION 138.9 ICD-9: 348.2, 377.01, 377.02, 377.2, 377.3, 377.5, 377.7, 138.10 437.7-437.8 138.11 (208) Diagnosis: SENSORY ORGAN CONDITIONS WITH NO 138.12 EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 138.13 Treatment: EVALUATION 138.14 ICD-9: 360.30-360.31, 360.33, 362.37, 362.42-362.43, 138.15 362.8-362.9, 363.21, 364.5, 364.60, 364.9, 371.20, 371.22, 138.16 371.24, 371.3, 371.81, 371.89, 371.9, 372.40-372.42, 138.17 372.44-372.45, 372.50-372.52, 372.55, 372.8-372.9, 138.18 374.52-374.53, 374.81-374.83, 374.9, 376.82, 376.89, 376.9, 138.19 377.03, 377.1, 377.4, 377.6, 379.24, 379.29, 379.4-379.8, 380.9, 138.20 747.47 138.21 (209) Diagnosis: ENDOCRINE AND METABOLIC CONDITIONS WITH 138.22 NO EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 138.23 Treatment: EVALUATION 138.24 ICD-9: 251.1-251.2, 259.4, 259.8-259.9, 277.3, 759.1 138.25 (210) Diagnosis: GASTROINTESTINAL CONDITIONS WITH NO 138.26 EFFECTIVE TREATMENTS OR NO TREATMENT NECESSARY 138.27 Treatment: EVALUATION 138.28 ICD-9: 527.0, 569.9, 573.9 138.29 (211) Diagnosis: MENTAL DISORDERS WITH NO EFFECTIVE 138.30 TREATMENTS OR NO TREATMENT NECESSARY 138.31 Treatment: EVALUATION 138.32 ICD-9: 313.1, 313.3, 313.83 138.33 (212) Diagnosis: NEUROLOGIC CONDITIONS WITH NO EFFECTIVE 138.34 TREATMENTS OR NO TREATMENT NECESSARY 138.35 Treatment: EVALUATION 138.36 ICD-9: 333.82, 333.84, 333.91, 333.93 139.1 (213) Diagnosis: DENTAL CONDITIONS (e.g., ORTHODONTICS) 139.2 Treatment: COSMETIC DENTAL SERVICES 139.3 ICD-9: 520.0-520.5, 520.8-520.9, 521.1-521.9, 522.3, V72.2 139.4 (214) Diagnosis: TUBAL DYSFUNCTION AND OTHER CAUSES OF 139.5 INFERTILITY 139.6 Treatment: IN-VITRO FERTILIZATION, GIFT 139.7 ICD-9: 256 139.8 (215) Diagnosis: HEPATORENAL SYNDROME 139.9 Treatment: MEDICAL THERAPY 139.10 ICD-9: 572.4 139.11 (216) Diagnosis: SPASTIC DYSPHONIA 139.12 Treatment: MEDICAL THERAPY 139.13 ICD-9: 478.79 139.14 (217) Diagnosis: DISORDERS OF REFRACTION AND ACCOMMODATION 139.15 Treatment: RADIAL KERATOTOMY 139.16 ICD-9: 367, 368.1-368.9 139.17 (b) The commissioner of human services shall identify the 139.18 related CPT codes that correspond with the diagnosis/treatment 139.19 pairings described in this section. The identification of the 139.20 related CPT codes is not subject to the requirements of 139.21 Minnesota Statutes, chapter 14. 139.22 Subd. 4. [FEDERAL APPROVAL.] The commissioner of human 139.23 services shall seek federal approval to eliminate medical 139.24 assistance coverage for the diagnosis/treatment pairings 139.25 described in subdivision 3. 139.26 Subd. 5. [NONEXPANSION OF COVERED SERVICES.] Nothing in 139.27 this section shall be construed to expand medical assistance 139.28 coverage to services that are not currently covered under the 139.29 medical assistance program as of June 30, 2003. 139.30 Sec. 61. [REPEALER.] 139.31 Minnesota Statutes 2002, sections 256.955, subdivision 8; 139.32 and 256B.0625, subdivision 5a, are repealed July 1, 2003. 139.33 ARTICLE 3 139.34 HEALTH MISCELLANEOUS 139.35 Section 1. Minnesota Statutes 2002, section 62E.06, 139.36 subdivision 1, is amended to read: 140.1 Subdivision 1. [NUMBER THREE PLAN.] A plan of health 140.2 coverage shall be certified as a number three qualified plan if 140.3 it otherwise meets the requirements established by chapters 62A, 140.4 62C, and 62Q, and the other laws of this state, whether or not 140.5 the policy is issued in Minnesota, and meets or exceeds the 140.6 following minimum standards: 140.7 (a) The minimum benefits for a covered individual shall, 140.8 subject to the other provisions of this subdivision, be equal to 140.9 at least 80 percent of the cost of covered services in excess of 140.10 an annual deductible which does not exceed $150 per person. The 140.11 coverage shall include a limitation of $3,000 per person on 140.12 total annual out-of-pocket expenses for services covered under 140.13 this subdivision. The coverage shall be subject to a maximum 140.14 lifetime benefit of not less than $1,000,000. 140.15 The $3,000 limitation on total annual out-of-pocket 140.16 expenses and the $1,000,000 maximum lifetime benefit shall not 140.17 be subject to change or substitution by use of an actuarially 140.18 equivalent benefit. 140.19 (b) Covered expenses shall be the usual and customary 140.20 charges for the following services and articles when prescribed 140.21 by a physician: 140.22 (1) hospital services; 140.23 (2) professional services for the diagnosis or treatment of 140.24 injuries, illnesses, or conditions, other than dental, which are 140.25 rendered by a physician or at the physician's direction; 140.26 (3) drugs requiring a physician's prescription; 140.27 (4) services of a nursing home for not more than 120 days 140.28 in a year if the services would qualify as reimbursable services 140.29 under Medicare; 140.30 (5) services of a home health agency if the services would 140.31 qualify as reimbursable services under Medicare; 140.32 (6) use of radium or other radioactive materials; 140.33 (7) oxygen; 140.34 (8) anesthetics; 140.35 (9) prostheses other than dental but including scalp hair 140.36 prostheses worn for hair loss suffered as a result of alopecia 141.1 areata; 141.2 (10) rental or purchase, as appropriate, of durable medical 141.3 equipment other than eyeglasses and hearing aids, unless 141.4 coverage is required under section 62Q.675; 141.5 (11) diagnostic x-rays and laboratory tests; 141.6 (12) oral surgery for partially or completely unerupted 141.7 impacted teeth, a tooth root without the extraction of the 141.8 entire tooth, or the gums and tissues of the mouth when not 141.9 performed in connection with the extraction or repair of teeth; 141.10 (13) services of a physical therapist; 141.11 (14) transportation provided by licensed ambulance service 141.12 to the nearest facility qualified to treat the condition; or a 141.13 reasonable mileage rate for transportation to a kidney dialysis 141.14 center for treatment; and 141.15 (15) services of an occupational therapist. 141.16 (c) Covered expenses for the services and articles 141.17 specified in this subdivision do not include the following: 141.18 (1) any charge for care for injury or disease either (i) 141.19 arising out of an injury in the course of employment and subject 141.20 to a workers' compensation or similar law, (ii) for which 141.21 benefits are payable without regard to fault under coverage 141.22 statutorily required to be contained in any motor vehicle, or 141.23 other liability insurance policy or equivalent self-insurance, 141.24 or (iii) for which benefits are payable under another policy of 141.25 accident and health insurance, Medicare, or any other 141.26 governmental program except as otherwise provided by section 141.27 62A.04, subdivision 3, clause (4); 141.28 (2) any charge for treatment for cosmetic purposes other 141.29 than for reconstructive surgery when such service is incidental 141.30 to or follows surgery resulting from injury, sickness, or other 141.31 diseases of the involved part or when such service is performed 141.32 on a covered dependent child because of congenital disease or 141.33 anomaly which has resulted in a functional defect as determined 141.34 by the attending physician; 141.35 (3) care which is primarily for custodial or domiciliary 141.36 purposes which would not qualify as eligible services under 142.1 Medicare; 142.2 (4) any charge for confinement in a private room to the 142.3 extent it is in excess of the institution's charge for its most 142.4 common semiprivate room, unless a private room is prescribed as 142.5 medically necessary by a physician, provided, however, that if 142.6 the institution does not have semiprivate rooms, its most common 142.7 semiprivate room charge shall be considered to be 90 percent of 142.8 its lowest private room charge; 142.9 (5) that part of any charge for services or articles 142.10 rendered or prescribed by a physician, dentist, or other health 142.11 care personnel which exceeds the prevailing charge in the 142.12 locality where the service is provided; and 142.13 (6) any charge for services or articles the provision of 142.14 which is not within the scope of authorized practice of the 142.15 institution or individual rendering the services or articles. 142.16 (d) The minimum benefits for a qualified plan shall 142.17 include, in addition to those benefits specified in clauses (a) 142.18 and (e), benefits for well baby care, effective July 1, 1980, 142.19 subject to applicable deductibles, coinsurance provisions, and 142.20 maximum lifetime benefit limitations. 142.21 (e) Effective July 1, 1979, the minimum benefits of a 142.22 qualified plan shall include, in addition to those benefits 142.23 specified in clause (a), a second opinion from a physician on 142.24 all surgical procedures expected to cost a total of $500 or more 142.25 in physician, laboratory, and hospital fees, provided that the 142.26 coverage need not include the repetition of any diagnostic tests. 142.27 (f) Effective August 1, 1985, the minimum benefits of a 142.28 qualified plan must include, in addition to the benefits 142.29 specified in clauses (a), (d), and (e), coverage for special 142.30 dietary treatment for phenylketonuria when recommended by a 142.31 physician. 142.32 (g) Outpatient mental health coverage is subject to section 142.33 62A.152, subdivision 2. 142.34 [EFFECTIVE DATE.] This section is effective August 1, 2003, 142.35 and applies to policies and plans issued or renewed to provide 142.36 coverage to Minnesota residents on or after that date. 143.1 Sec. 2. Minnesota Statutes 2002, section 62J.17, 143.2 subdivision 2, is amended to read: 143.3 Subd. 2. [DEFINITIONS.] For purposes of this section, the 143.4 terms defined in this subdivision have the meanings given. 143.5 (a) "Access" means the financial, temporal, and geographic 143.6 availability of health care to individuals who need it. 143.7 (b) "Capital expenditure" means an expenditure which, 143.8 under generally accepted accounting principles, is not properly 143.9 chargeable as an expense of operation and maintenance. 143.10 (c) "Cost" means the amount paid by consumers or third 143.11 party payers for health care services or products. 143.12 (d) "Date of the major spending commitment" means the date 143.13 the provider formally obligated itself to the major spending 143.14 commitment. The obligation may be incurred by entering into a 143.15 contract, making a down payment, issuing bonds or entering a 143.16 loan agreement to provide financing for the major spending 143.17 commitment, or taking some other formal, tangible action 143.18 evidencing the provider's intention to make the major spending 143.19 commitment. 143.20 (e) "Health care service" means: 143.21 (1) a service or item that would be covered by the medical 143.22 assistance program under chapter 256B if provided in accordance 143.23 with medical assistance requirements to an eligible medical 143.24 assistance recipient; and 143.25 (2) a service or item that would be covered by medical 143.26 assistance except that it is characterized as experimental, 143.27 cosmetic, or voluntary. 143.28 "Health care service" does not include retail, 143.29 over-the-counter sales of nonprescription drugs and other retail 143.30 sales of health-related products that are not generally paid for 143.31 by medical assistance and other third-party coverage. 143.32 (f) "Major spending commitment" means an expenditure in 143.33 excess of $500,000, but less than or equal to $2,000,000, for: 143.34 (1) acquisition of a unit of medical equipment; 143.35 (2) a capital expenditure for a single project for the 143.36 purposes of providing health care services, other than for the 144.1 acquisition of medical equipment; 144.2 (3) offering a new specialized service not offered before; 144.3 (4) planning for an activity that would qualify as a major 144.4 spending commitment under this paragraph; or 144.5 (5) a project involving a combination of two or more of the 144.6 activities in clauses (1) to (4). 144.7 The cost of acquisition of medical equipment, and the 144.8 amount of a capital expenditure, is the total cost to the 144.9 provider regardless of whether the cost is distributed over time 144.10 through a lease arrangement or other financing or payment 144.11 mechanism. 144.12 (g) "Medical equipment" means fixed and movable equipment 144.13 that is used by a provider in the provision of a health care 144.14 service. "Medical equipment" includes, but is not limited to, 144.15 the following: 144.16 (1) an extracorporeal shock wave lithotripter; 144.17 (2) a computerized axial tomography (CAT) scanner; 144.18 (3) a magnetic resonance imaging (MRI) unit; 144.19 (4) a positron emission tomography (PET) scanner; and 144.20 (5) emergency and nonemergency medical transportation 144.21 equipment and vehicles. 144.22 (h) "New specialized service" means a specialized health 144.23 care procedure or treatment regimen offered by a provider that 144.24 was not previously offered by the provider, including, but not 144.25 limited to: 144.26 (1) cardiac catheterization services involving high-risk 144.27 patients as defined in the Guidelines for Coronary Angiography 144.28 established by the American Heart Association and the American 144.29 College of Cardiology; 144.30 (2) heart, heart-lung, liver, kidney, bowel, or pancreas 144.31 transplantation service, or any other service for 144.32 transplantation of any other organ; 144.33 (3) megavoltage radiation therapy; 144.34 (4) open heart surgery; 144.35 (5) neonatal intensive care services; and 144.36 (6) any new medical technology for which premarket approval 145.1 has been granted by the United States Food and Drug 145.2 Administration, excluding implantable and wearable devices. 145.3 Sec. 3. [62J.18] [PROVIDER REPORTING IN EXCESS OF 145.4 $2,000,000.] 145.5 Subdivision 1. [APPLICABILITY; DEFINITIONS.] (a) This 145.6 section applies to providers and to persons who would become 145.7 providers after making the expenditures described in subdivision 145.8 2. 145.9 (b) For purposes of this section, the terms used have the 145.10 meanings given in section 62J.17, subdivision 2, except that 145.11 "major spending commitment" means an expenditure in excess of 145.12 $2,000,000. 145.13 Subd. 2. [REPORTING REQUIREMENT.] (a) A provider that 145.14 intends to make a major spending commitment in excess of 145.15 $2,000,000 for the acquisition, by purchase or lease, of a unit 145.16 of medical equipment or in excess of $2,000,000 for a single 145.17 capital project for the purposes of providing health care 145.18 services must file a report with the commissioner at least 60 145.19 days before committing to make the expenditure. The report must 145.20 contain the information described in section 62J.17, subdivision 145.21 4a, paragraphs (b) and (c). 145.22 (b) The commissioner shall maintain a database to track 145.23 expenditures reported under this subdivision. 145.24 (c) The commissioner shall maintain a list of all persons 145.25 who have registered with the commissioner for the purpose of 145.26 receiving notice by electronic mail of a report filed under this 145.27 subdivision. The commissioner shall, within 15 days of 145.28 receiving an expenditure report, provide notice of such report 145.29 by electronic mail to all persons on its list, and by 145.30 publication in the State Register. The notice must include 145.31 either a copy of the report or an easily understandable 145.32 description of the proposed expenditure in the report. The 145.33 notice in the State Register must include a copy of the report, 145.34 along with an easily understandable description of the proposed 145.35 expenditure in the report. In addition, the commissioner shall 145.36 make reasonable efforts to notify persons or classes of persons 146.1 who may be significantly affected by the proposed expenditure in 146.2 the report. The commissioner may recover the reasonable costs 146.3 incurred in providing notice provided in this paragraph through 146.4 costs paid by third parties involved in proceedings provided in 146.5 this section. 146.6 (d) No provider may commit to making the expenditure until 146.7 the procedures described in this section are completed. 146.8 Subd. 3. [PUBLIC MEETING.] (a) Within 30 days from the 146.9 date the notice requirements of subdivision 2, paragraph (c), 146.10 are satisfied, a third party may request a public meeting on 146.11 expenditures that exceed $2,000,000. The public meeting shall 146.12 serve as an informational forum for the provider to answer 146.13 inquiries of interested third parties. 146.14 (b) The commissioner shall arrange for and coordinate the 146.15 meeting on an expedited basis. The party requesting the meeting 146.16 shall pay the commissioner for the commissioner's cost of the 146.17 meeting, as determined by the commissioner. Money received by 146.18 the commissioner for reimbursement under this section is 146.19 appropriated to the commissioner for the purpose of 146.20 administering this section. 146.21 Subd. 4. [PUBLIC MEETING EXCEPTIONS.] (a) Subdivisions 3, 146.22 5, and 6 do not apply to an expenditure: 146.23 (1) to replace existing equipment with comparable equipment 146.24 used for direct patient care. Upgrades of equipment beyond the 146.25 current model or comparable model are subject to subdivisions 3, 146.26 5, and 6; 146.27 (2) made by a research and teaching institution for 146.28 purposes of conducting medical education, medical research 146.29 supported or sponsored by a medical school or by a federal or 146.30 foundation grant, or clinical trials; 146.31 (3) to repair, remodel, or replace existing buildings or 146.32 fixtures if, in the judgment of the commissioner, the project 146.33 does not involve a substantial expansion of service capacity or 146.34 a substantial change in the nature of health care services 146.35 provided; 146.36 (4) for building maintenance including heating, water, 147.1 electricity, and other maintenance-related expenditures; 147.2 (5) for activities not directly related to the delivery of 147.3 patient care services, including food service, laundry, 147.4 housekeeping, and other service-related activities; and 147.5 (6) for computer equipment or data systems not directly 147.6 related to the delivery of patient care services, including 147.7 computer equipment or data systems related to medical record 147.8 automation. 147.9 (b) In addition to the exceptions listed in paragraph (a), 147.10 subdivisions 3, 5, and 6 do not apply to mergers, acquisitions, 147.11 and other changes in ownership or control that, in the judgment 147.12 of the commissioner, do not involve a substantial expansion of 147.13 service capacity or a substantial change in the nature of health 147.14 care services provided. 147.15 Subd. 5. [HEARING.] (a) Within 30 days from the date of a 147.16 public meeting under subdivision 3, a third party may request 147.17 that the planned expenditure be subject to a hearing before the 147.18 commissioner. The hearing and review of the planned expenditure 147.19 shall be according to the relevant provisions of the 147.20 Administrative Procedure Act, except as otherwise provided in 147.21 this subdivision. 147.22 (b) A hearing under this subdivision shall be a public 147.23 proceeding. 147.24 (c) A party to the hearing must pay for the party's 147.25 representation before the commissioner. The party requesting 147.26 the hearing must pay the commissioner for the commissioner's 147.27 cost of the hearing, as determined by the commissioner. Costs 147.28 of the hearing shall include, but not be limited to, the cost of 147.29 the hearing and costs related to the commissioner's findings and 147.30 order as provided in this section. Money received by the 147.31 commissioner for reimbursement under this section is 147.32 appropriated to the commissioner for the purpose of 147.33 administering this section. Reimbursement by the party shall 147.34 not be contingent upon and shall not affect the commissioner's 147.35 findings and order under this section. 147.36 (d) A hearing requested under this subdivision must proceed 148.1 on an expedited basis. 148.2 Subd. 6. [HEARING CRITERIA; DECISION; RULES.] (a) The 148.3 commissioner shall consider the following criteria: 148.4 (1) need and access, including but not limited to: 148.5 (i) the need of the population served or to be served by 148.6 the proposed health services for those services; 148.7 (ii) the project's contribution to meeting the needs of the 148.8 medically underserved, including persons in rural areas, 148.9 low-income persons, racial and ethnic minorities, persons with 148.10 disabilities, and the elderly, as well as the extent to which 148.11 medically underserved residents in the provider's service area 148.12 are likely to have access to the proposed health service; and 148.13 (iii) the distance, convenience, cost of transportation, 148.14 and accessibility to health services for those to be served by 148.15 the proposed health services; 148.16 (2) quality of health care, including but not limited to: 148.17 (i) the impact of the proposed service on the quality of 148.18 health services available to those proposed to be served by the 148.19 project; and 148.20 (ii) the impact of the proposed service on the quality of 148.21 health services offered by other providers; 148.22 (3) cost of health care, including but not limited to: 148.23 (i) the financial feasibility of the proposal; 148.24 (ii) probable impact of the proposal on the costs of and 148.25 charges for providing health services by the person proposing 148.26 the service; 148.27 (iii) probable impact of the proposal on the costs of and 148.28 charges for health services provided by other providers; 148.29 (iv) probable impact of the proposal on reimbursement for 148.30 the proposed services; and 148.31 (v) the relationship, including the organizational 148.32 relationship, of the proposed health services to ancillary or 148.33 support services; 148.34 (4) alternatives available to the provider, including but 148.35 not limited to: 148.36 (i) the availability of alternative, less costly, or more 149.1 effective methods of providing the proposed health services; 149.2 (ii) the relationship of the proposed project to the 149.3 long-range development plan, if any, of the person or entity 149.4 providing or proposing the services; and 149.5 (iii) possible sharing or cooperative arrangements among 149.6 existing facilities and providers; and 149.7 (5) other considerations, including but not limited to: 149.8 (i) the best interests of the patients, including conflicts 149.9 of interest that may be present in influencing the utilization 149.10 of the services, facility, or equipment relating to the 149.11 expenditures; 149.12 (ii) special needs and circumstances of those entities that 149.13 provide a substantial portion of their services or resources, or 149.14 both, to individuals not residing in the immediate geographic 149.15 area in which the entities are located, which entities may 149.16 include but are not limited to medical and other health 149.17 professional schools, multidisciplinary clinics, and specialty 149.18 centers; 149.19 (iii) the special needs and circumstances of biomedical and 149.20 behavioral research projects designed to meet a national need 149.21 and for which local conditions offer special advantages; and 149.22 (iv) the impact of the proposed project on fostering 149.23 competition between providers. 149.24 (b) The commissioner may adopt rules to establish 149.25 additional hearing criteria. 149.26 (c) After applying the criteria under this subdivision, the 149.27 commissioner shall make findings of fact as to whether the 149.28 planned expenditure is needed to ensure quality health care. If 149.29 the commissioner finds that the planned expenditure is not 149.30 needed to ensure quality health care, the commissioner shall 149.31 obtain an injunction prohibiting the provider from making the 149.32 planned expenditure. The order of the commissioner constitutes 149.33 the final decision in the case as applicable under section 149.34 14.62. A final decision in the case is entitled to judicial 149.35 review under the provisions of sections 14.63 to 14.69. In an 149.36 event of an appeal, each party must pay the party's respective 150.1 costs, except that the party bringing the appeal must pay all 150.2 costs if the appeal is unsuccessful. 150.3 Subd. 7. [ENFORCEMENT.] The commissioner may enforce this 150.4 section by denying or refusing to reissue the permit, license, 150.5 registration, or certificate of a provider that does not comply 150.6 with this section, according to section 144.99, subdivision 8. 150.7 Compliance with this section is a condition of medical 150.8 assistance reimbursement. The commissioner of employee 150.9 relations shall not permit a provider that does not comply with 150.10 this section to provide services to state employees. In 150.11 addition, the commissioner may assess fines against a provider 150.12 that incurs an expenditure that is found by the commissioner as 150.13 not needed to ensure quality health care pursuant to the 150.14 provisions of this section in an amount up to triple the amount 150.15 of the expenditure. 150.16 Subd. 8. [RETROSPECTIVE REVIEW.] Nothing in this section 150.17 or in section 62J.17 shall be construed to prohibit the 150.18 commissioner from conducting a retrospective review of an 150.19 expenditure in excess of $2,000,000 in accordance with section 150.20 62J.17, subdivision 5a. 150.21 Sec. 4. Minnesota Statutes 2002, section 62J.23, is 150.22 amended by adding a subdivision to read: 150.23 Subd. 5. [AUDITS OF EXEMPT PROVIDERS.] The commissioner 150.24 may audit the referral patterns of providers that qualify for 150.25 exceptions under the federal Stark Law, United States Code, 150.26 title 42, section 1395nn. The commissioner has access to 150.27 provider records according to section 144.99, subdivision 2. 150.28 The commissioner shall report to the legislature any audit 150.29 results that reveal a pattern of referrals by a provider for the 150.30 furnishing of health services to an entity with which the 150.31 provider has a direct or indirect financial relationship. 150.32 Sec. 5. Minnesota Statutes 2002, section 62J.692, 150.33 subdivision 1, is amended to read: 150.34 Subdivision 1. [DEFINITIONS.] For purposes of this 150.35 section, the following definitions apply: 150.36 (a) "Accredited clinical training" means the clinical 151.1 training provided by a medical education program that is 151.2 accredited through an organization recognized by the department 151.3 of education, the Centers for Medicare and Medicaid Services, or 151.4 another national body who reviews the accrediting organizations 151.5 for multiple disciplines and whose standards for recognizing 151.6 accrediting organizations are reviewed and approved by the 151.7 commissioner of health in consultation with the medical 151.8 education and research advisory committee. 151.9 (b) "Commissioner" means the commissioner of health. 151.10 (c) "Clinical medical education program" means the 151.11 accredited clinical training of physicians (medical students and 151.12 residents), doctor of pharmacy practitioners,doctors of151.13chiropractic,dentists, advanced practice nurses (clinical nurse 151.14 specialists, certified registered nurse anesthetists, nurse 151.15 practitioners, and certified nurse midwives), and physician 151.16 assistants. 151.17 (d) "Sponsoring institution" means a hospital, school, or 151.18 consortium located in Minnesota that sponsors and maintains 151.19 primary organizational and financial responsibility for a 151.20 clinical medical education program in Minnesota and which is 151.21 accountable to the accrediting body. 151.22 (e) "Teaching institution" means a hospital, medical 151.23 center, clinic, or other organization that conducts a clinical 151.24 medical education program in Minnesota. 151.25 (f) "Trainee" means a student or resident involved in a 151.26 clinical medical education program. 151.27 (g) "Eligible trainee FTEs" means the number of trainees, 151.28 as measured by full-time equivalent counts, that are at training 151.29 sites located in Minnesota with a medical assistance provider 151.30 number where training occurs in either an inpatient or 151.31 ambulatory patient care setting and where the training is 151.32 funded, in part, by patient care revenues. 151.33 Sec. 6. Minnesota Statutes 2002, section 62J.692, 151.34 subdivision 2, is amended to read: 151.35 Subd. 2. [MEDICAL EDUCATION AND RESEARCH ADVISORY 151.36 COMMITTEE.] The commissioner shall appoint an advisory committee 152.1 to provide advice and oversight on the distribution of funds 152.2 appropriated for distribution under this section. In appointing 152.3 the members, the commissioner shall: 152.4 (1) consider the interest of all stakeholders; 152.5 (2) appoint members that represent both urban and rural 152.6 interests; and 152.7 (3) appoint members that represent ambulatory care as well 152.8 as inpatient perspectives. 152.9 The commissioner shall appoint to the advisory committee 152.10 representatives of the following groups to ensure appropriate 152.11 representation of all eligible provider groups and other 152.12 stakeholders: public and private medical researchers; public 152.13 and private academic medical centers, including representatives 152.14 from academic centers offering accredited training programs for 152.15 physicians, pharmacists,chiropractors,dentists, nurses, and 152.16 physician assistants; managed care organizations; employers; 152.17 consumers and other relevant stakeholders. The advisory 152.18 committee is governed by section 15.059. 152.19 Sec. 7. Minnesota Statutes 2002, section 62J.692, 152.20 subdivision 3, is amended to read: 152.21 Subd. 3. [APPLICATION PROCESS.] (a) A clinical medical 152.22 education program conducted in Minnesota by a teaching 152.23 institution to train physicians, doctor of pharmacy 152.24 practitioners, dentists, or physician assistants is eligible for 152.25 funds under subdivision 4 if the program: 152.26 (1) is funded, in part, by patient care revenues; 152.27 (2) occurs in patient care settings that face increased 152.28 financial pressure as a result of competition with nonteaching 152.29 patient care entities; and 152.30 (3) emphasizes primary care or specialties that are in 152.31 undersupply in Minnesota. 152.32 (b) A clinical medical education program for advanced 152.33 practice nursing is eligible for funds under subdivision 4 if 152.34 the program meets the eligibility requirements in paragraph (a), 152.35 clauses (1) to (3), and is sponsored by the University of 152.36 Minnesota Academic Health Center, the Mayo Foundation, or 153.1 institutions that are part of the Minnesota state colleges and 153.2 universities system. 153.3 (c) Applications must be submitted to the commissioner by a 153.4 sponsoring institution on behalf of an eligible clinical medical 153.5 education program and must be received by October 31 of each 153.6 year for distribution in the following year. An application for 153.7 funds must contain the following information: 153.8 (1) the official name and address of the sponsoring 153.9 institution and the official name and site address of the 153.10 clinical medical education programs on whose behalf the 153.11 sponsoring institution is applying; 153.12 (2) the name, title, and business address of those persons 153.13 responsible for administering the funds; 153.14 (3) for each clinical medical education program for which 153.15 funds are being sought; the type and specialty orientation of 153.16 trainees in the program; the name, site address, and medical 153.17 assistance provider number of each training site used in the 153.18 program; the total number of trainees at each training site; and 153.19 the total number of eligible trainee FTEs at each site. Only 153.20 those training sites that host 0.5 FTE or more eligible trainees 153.21 for a program may be included in the program's application; and 153.22 (4) other supporting information the commissioner deems 153.23 necessary to determine program eligibility based on the criteria 153.24 inparagraphparagraphs (a) and (b) and to ensure the equitable 153.25 distribution of funds. 153.26(c)(d) An application must include the information 153.27 specified in clauses (1) to (3) for each clinical medical 153.28 education program on an annual basis for three consecutive 153.29 years. After that time, an application must include the 153.30 information specified in clauses (1) to (3) in the first year of 153.31 each biennium: 153.32 (1) audited clinical training costs per trainee for each 153.33 clinical medical education program when available or estimates 153.34 of clinical training costs based on audited financial data; 153.35 (2) a description of current sources of funding for 153.36 clinical medical education costs, including a description and 154.1 dollar amount of all state and federal financial support, 154.2 including Medicare direct and indirect payments; and 154.3 (3) other revenue received for the purposes of clinical 154.4 training. 154.5(d)(e) An applicant that does not provide information 154.6 requested by the commissioner shall not be eligible for funds 154.7 for the current funding cycle. 154.8 Sec. 8. Minnesota Statutes 2002, section 62J.692, 154.9 subdivision 4, is amended to read: 154.10 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 154.11 shall annually distribute 90 percent of available medical 154.12 education funds to all qualifying applicants based onthe154.13following criteriaa distribution formula that reflects a 154.14 summation of two factors: 154.15 (1)total medical education funds available for154.16distribution;an education factor, which is determined by the 154.17 total number of eligible trainee FTEs and the total statewide 154.18 average costs per trainee, by type of trainee, in each clinical 154.19 medical education program; and 154.20 (2)total number of eligible trainee FTEs in each clinical154.21medical education program; and154.22(3) the statewide average cost per trainee as determined by154.23the application information provided in the first year of the154.24biennium, by type of trainee, in each clinical medical education154.25program.a public program volume factor, which is determined by 154.26 the total volume of public program revenue received by each 154.27 training site as a percentage of all public program revenue 154.28 received by all training sites in the fund pool. 154.29 In this formula, the education factor is weighted at 67 154.30 percent and the public program volume factor is weighted at 33 154.31 percent. 154.32 Public program revenue for the distribution formula 154.33 includes revenue from medical assistance, prepaid medical 154.34 assistance, general assistance medical care, and prepaid general 154.35 assistance medical care. Training sites that receive no public 154.36 program revenue are ineligible for funds available under this 155.1 paragraph. Total statewide average costs per trainee for 155.2 medical residents is based on audited clinical training costs 155.3 per trainee in primary care clinical medical education programs 155.4 for medical residents. Total statewide average costs per 155.5 trainee for dental residents is based on audited clinical 155.6 training costs per trainee in clinical medical education 155.7 programs for dental students. Total statewide average costs per 155.8 trainee for pharmacy residents is based on audited clinical 155.9 training costs per trainee in clinical medical education 155.10 programs for pharmacy students. 155.11 (b) The commissioner shall annually distribute ten percent 155.12 of total available medical education funds to all qualifying 155.13 applicants based on the percentage received by each applicant 155.14 under paragraph (a). These funds are to be used to offset 155.15 clinical education costs at eligible clinical training sites 155.16 based on criteria developed by the clinical medical education 155.17 program. Applicants may choose to distribute funds allocated 155.18 under this paragraph based on the distribution formula described 155.19 in paragraph (a). 155.20 (c) Funds distributed shall not be used to displace current 155.21 funding appropriations from federal or state sources. 155.22(c)(d) Funds shall be distributed to the sponsoring 155.23 institutions indicating the amount to be distributed to each of 155.24 the sponsor's clinical medical education programs based on the 155.25 criteria in this subdivision and in accordance with the 155.26 commissioner's approval letter. Each clinical medical education 155.27 program must distribute funds allocated under paragraph (a) to 155.28 the training sites as specified in the commissioner's approval 155.29 letter. Sponsoring institutions, which are accredited through 155.30 an organization recognized by the department of education or the 155.31 Centers for Medicare and Medicaid Services, may contract 155.32 directly with training sites to provide clinical training. To 155.33 ensure the quality of clinical training, those accredited 155.34 sponsoring institutions must: 155.35 (1) develop contracts specifying the terms, expectations, 155.36 and outcomes of the clinical training conducted at sites; and 156.1 (2) take necessary action if the contract requirements are 156.2 not met. Action may include the withholding of payments under 156.3 this section or the removal of students from the site. 156.4(d)(e) Any funds not distributed in accordance with the 156.5 commissioner's approval letter must be returned to the medical 156.6 education and research fund within 30 days of receiving notice 156.7 from the commissioner. The commissioner shall distribute 156.8 returned funds to the appropriate training sites in accordance 156.9 with the commissioner's approval letter. 156.10(e) The commissioner shall distribute by June 30 of each156.11year an amount equal to the funds transferred under section156.1262J.694, subdivision 2a, paragraph (b), plus five percent156.13interest to the University of Minnesota board of regents for the156.14costs of the academic health center as specified under section156.1562J.694, subdivision 2a, paragraph (a).156.16 Sec. 9. Minnesota Statutes 2002, section 62J.692, 156.17 subdivision 5, is amended to read: 156.18 Subd. 5. [REPORT.] (a) Sponsoring institutions receiving 156.19 funds under this section must sign and submit a medical 156.20 education grant verification report (GVR) to verify that the 156.21 correct grant amount was forwarded to each eligible training 156.22 site. If the sponsoring institution fails to submit the GVR by 156.23 the stated deadline, or to request and meet the deadline for an 156.24 extension, the sponsoring institution is required to return the 156.25 full amount of funds received to the commissioner within 30 days 156.26 of receiving notice from the commissioner. The commissioner 156.27 shall distribute returned funds to the appropriate training 156.28 sites in accordance with the commissioner's approval letter. 156.29 (b) The reports must provide verification of the 156.30 distribution of the funds and must include: 156.31 (1) the total number of eligible trainee FTEs in each 156.32 clinical medical education program; 156.33 (2) the name of each funded program and, for each program, 156.34 the dollar amount distributed to each training site; 156.35 (3) documentation of any discrepancies between the initial 156.36 grant distribution notice included in the commissioner's 157.1 approval letter and the actual distribution; 157.2 (4) a statement by the sponsoring institution describing 157.3 the distribution of funds allocated under subdivision 4, 157.4 paragraph (b), including information on which clinical training 157.5 sites received funding and the rationale used for determining 157.6 funding priorities; 157.7 (5) a statement by the sponsoring institution stating that 157.8 the completed grant verification report is valid and accurate; 157.9 and 157.10(5)(6) other information the commissioner, with advice 157.11 from the advisory committee, deems appropriate to evaluate the 157.12 effectiveness of the use of funds for medical education. 157.13 (c) By February 15 of each year, the commissioner, with 157.14 advice from the advisory committee, shall provide an annual 157.15 summary report to the legislature on the implementation of this 157.16 section. 157.17 Sec. 10. Minnesota Statutes 2002, section 62J.692, 157.18 subdivision 7, is amended to read: 157.19 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 157.20 SERVICES.] (a) The amount transferred according to section 157.21 256B.69, subdivision 5c, paragraph (a), clause (1), shall be 157.22 distributed by the commissioner annually to clinical medical 157.23 education programs that meet the qualifications of subdivision 3 157.24 based ona distribution formula that reflects a summation of two157.25factors:the formula in subdivision 4, paragraph (a). 157.26(1) an education factor, which is determined by the total157.27number of eligible trainee FTEs and the total statewide average157.28costs per trainee, by type of trainee, in each clinical medical157.29education program; and157.30(2) a public program volume factor, which is determined by157.31the total volume of public program revenue received by each157.32training site as a percentage of all public program revenue157.33received by all training sites in the fund pool created under157.34this subdivision.157.35In this formula, the education factor shall be weighted at157.3650 percent and the public program volume factor shall be158.1weighted at 50 percent.158.2Public program revenue for the distribution formula shall158.3include revenue from medical assistance, prepaid medical158.4assistance, general assistance medical care, and prepaid general158.5assistance medical care. Training sites that receive no public158.6program revenue shall be ineligible for funds available under158.7this paragraph.158.8 (b) Fifty percent of the amount transferred according to 158.9 section 256B.69, subdivision 5c, paragraph (a), clause (2), 158.10 shall be distributed by the commissioner to the University of 158.11 Minnesota board of regents for the purposes described in 158.12 sections 137.38 to 137.40. Of the remaining amount transferred 158.13 according to section 256B.69, subdivision 5c, paragraph (a), 158.14 clause (2), 24 percent of the amount shall be distributed by the 158.15 commissioner to the Hennepin County Medical Center for clinical 158.16 medical education. The remaining 26 percent of the amount 158.17 transferred shall be distributed by the commissioner in 158.18 accordance with subdivision 7a. If the federal approval is not 158.19 obtained for the matching funds under section 256B.69, 158.20 subdivision 5c, paragraph (a), clause (2), 100 percent of the 158.21 amount transferred under this paragraph shall be distributed by 158.22 the commissioner to the University of Minnesota board of regents 158.23 for the purposes described in sections 137.38 to 137.40. 158.24 (c) The amount transferred according to section 256B.69, 158.25 subdivision 5c, paragraph (a), clause (3), shall be distributed 158.26 by the commissioner upon receipt to the University of Minnesota 158.27 board of regents for the purposes of clinical graduate medical 158.28 education. 158.29 Sec. 11. Minnesota Statutes 2002, section 62J.694, is 158.30 amended by adding a subdivision to read: 158.31 Subd. 5. [EFFECTIVE DATE.] This section is only in effect 158.32 if there are funds available in the medical education endowment 158.33 fund. 158.34 Sec. 12. Minnesota Statutes 2002, section 62L.05, 158.35 subdivision 4, is amended to read: 158.36 Subd. 4. [BENEFITS.] The medical services and supplies 159.1 listed in this subdivision are the benefits that must be covered 159.2 by the small employer plans described in subdivisions 2 and 3. 159.3 Benefits under this subdivision may be provided through the 159.4 managed care procedures practiced by health carriers: 159.5 (1) inpatient and outpatient hospital services, excluding 159.6 services provided for the diagnosis, care, or treatment of 159.7 chemical dependency or a mental illness or condition, other than 159.8 those conditions specified in clauses (10), (11), and (12). The 159.9 health care services required to be covered under this clause 159.10 must also be covered if rendered in a nonhospital environment, 159.11 on the same basis as coverage provided for those same treatments 159.12 or services if rendered in a hospital, provided, however, that 159.13 this sentence must not be interpreted as expanding the types or 159.14 extent of services covered; 159.15 (2) physician, chiropractor, and nurse practitioner 159.16 services for the diagnosis or treatment of illnesses, injuries, 159.17 or conditions; 159.18 (3) diagnostic x-rays and laboratory tests; 159.19 (4) ground transportation provided by a licensed ambulance 159.20 service to the nearest facility qualified to treat the 159.21 condition, or as otherwise required by the health carrier; 159.22 (5) services of a home health agency if the services 159.23 qualify as reimbursable services under Medicare; 159.24 (6) services of a private duty registered nurse if 159.25 medically necessary, as determined by the health carrier; 159.26 (7) the rental or purchase, as appropriate, of durable 159.27 medical equipment, other than eyeglasses and hearing aids, 159.28 unless coverage is required under section 62Q.675; 159.29 (8) child health supervision services up to age 18, as 159.30 defined in section 62A.047; 159.31 (9) maternity and prenatal care services, as defined in 159.32 sections 62A.041 and 62A.047; 159.33 (10) inpatient hospital and outpatient services for the 159.34 diagnosis and treatment of certain mental illnesses or 159.35 conditions, as defined by the International Classification of 159.36 Diseases-Clinical Modification (ICD-9-CM), seventh edition 160.1 (1990) and as classified as ICD-9 codes 295 to 299; 160.2 (11) ten hours per year of outpatient mental health 160.3 diagnosis or treatment for illnesses or conditions not described 160.4 in clause (10); 160.5 (12) 60 hours per year of outpatient treatment of chemical 160.6 dependency; and 160.7 (13) 50 percent of eligible charges for prescription drugs, 160.8 up to a separate annual maximum out-of-pocket expense of $1,000 160.9 per individual for prescription drugs, and 100 percent of 160.10 eligible charges thereafter. 160.11 [EFFECTIVE DATE.] This section is effective August 1, 2003, 160.12 and applies to policies and plans issued or renewed to provide 160.13 coverage to Minnesota residents on or after that date. 160.14 Sec. 13. Minnesota Statutes 2002, section 62Q.19, 160.15 subdivision 2, is amended to read: 160.16 Subd. 2. [APPLICATION.] (a) Any provider may apply to the 160.17 commissioner for designation as an essential community provider 160.18 by submitting an application form developed by the 160.19 commissioner. Except as provided inparagraph160.20 paragraphs (d) and (e), applications must be accepted within two 160.21 years after the effective date of the rules adopted by the 160.22 commissioner to implement this section. 160.23 (b) Each application submitted must be accompanied by an 160.24 application fee in an amount determined by the commissioner. 160.25 The fee shall be no more than what is needed to cover the 160.26 administrative costs of processing the application. 160.27 (c) The name, address, contact person, and the date by 160.28 which the commissioner's decision is expected to be made shall 160.29 be classified as public data under section 13.41. All other 160.30 information contained in the application form shall be 160.31 classified as private data under section 13.41 until the 160.32 application has been approved, approved as modified, or denied 160.33 by the commissioner. Once the decision has been made, all 160.34 information shall be classified as public data unless the 160.35 applicant designates and the commissioner determines that the 160.36 information contains trade secret information. 161.1 (d) The commissioner shall accept an application for 161.2 designation as an essential community provider until June 30, 161.3 2001, from: 161.4 (1) one applicant that is a nonprofit community health care 161.5 facility, certified as a medical assistance provider effective 161.6 April 1, 1998, that provides culturally competent health care to 161.7 an underserved Southeast Asian immigrant and refugee population 161.8 residing in the immediate neighborhood of the facility; 161.9 (2) one applicant that is a nonprofit home health care 161.10 provider, certified as a Medicare and a medical assistance 161.11 provider that provides culturally competent home health care 161.12 services to a low-income culturally diverse population; 161.13 (3) up to five applicants that are nonprofit community 161.14 mental health centers certified as medical assistance providers 161.15 that provide mental health services to children with serious 161.16 emotional disturbance and their families or to adults with 161.17 serious and persistent mental illness; and 161.18 (4) one applicant that is a nonprofit provider certified as 161.19 a medical assistance provider that provides mental health, child 161.20 development, and family services to children with physical and 161.21 mental health disorders and their families. 161.22 (e) The commissioner shall accept an application for 161.23 designation as an essential community provider until June 30, 161.24 2003, from one applicant that is a nonprofit community clinic 161.25 located in Hennepin county that provides health care to an 161.26 underserved American Indian population and that is collaborating 161.27 with other neighboring organizations on a community diabetes 161.28 project and an immunization project. 161.29 [EFFECTIVE DATE.] This section is effective the day 161.30 following final enactment. 161.31 Sec. 14. [62Q.675] [COMMUNICATION DEVICES; PERSONS 18 OR 161.32 YOUNGER.] 161.33 A health plan must cover communication aids or devices, 161.34 including hearing aids, for individuals 18 years of age or 161.35 younger for hearing loss due to functional congenital 161.36 malformation of the ears that is not correctable by other 162.1 covered procedures. No special deductible, coinsurance, 162.2 copayment, or other limitation on the coverage under this 162.3 section that is not generally applicable to other coverages 162.4 under the plan may be imposed. 162.5 [EFFECTIVE DATE.] This section is effective August 1, 2003, 162.6 and applies to policies and plans issued or renewed to provide 162.7 coverage to Minnesota residents on or after that date. 162.8 Sec. 15. Minnesota Statutes 2002, section 144.1222, is 162.9 amended by adding a subdivision to read: 162.10 Subd. 1a. [FEES.] All plans and specifications for public 162.11 swimming pool and spa construction, installation, or alteration 162.12 or requests for a variance that are submitted to the 162.13 commissioner according to Minnesota Rules, part 4717.3975, shall 162.14 be accompanied by the appropriate fees. If the commissioner 162.15 determines, upon review of the plans, that inadequate fees were 162.16 paid, the necessary additional fees shall be paid before plan 162.17 approval. For purposes of determining fees, a project is 162.18 defined as a proposal to construct or install a public pool, 162.19 spa, special purpose pool, or wading pool and all associated 162.20 water treatment equipment and drains, gutters, decks, water 162.21 recreation features, spray pads, and those design and safety 162.22 features that are within five feet of any pool or spa. The 162.23 commissioner shall charge the following fees for plan review and 162.24 inspection of public pools and spas and for requests for 162.25 variance from the public pool and spa rules: 162.26 (1) each spa pool, $500; 162.27 (2) projects valued at $250,000 or less, a minimum of $800 162.28 plus: 162.29 (i) for each slide, an additional $400; and 162.30 (ii) for each spa pool, an additional $500; 162.31 (3) projects valued at $250,000 or more, 0.5 percent of 162.32 documented estimated project cost to a maximum fee of $10,000; 162.33 (4) alterations to an existing pool without changing the 162.34 size or configuration of the pool, $400; 162.35 (5) removal or replacement of pool disinfection equipment 162.36 only, $75; and 163.1 (6) request for variance from the public pool and spa 163.2 rules, $500. 163.3 Sec. 16. Minnesota Statutes 2002, section 144.125, is 163.4 amended to read: 163.5 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS163.6 HERITABLE AND CONGENITAL DISORDERS.] 163.7 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 163.8 of (1) the administrative officer or other person in charge of 163.9 each institution caring for infants 28 days or less of age, (2) 163.10 the person required in pursuance of the provisions of section 163.11 144.215, to register the birth of a child, or (3) the nurse 163.12 midwife or midwife in attendance at the birth, to arrange to 163.13 have administered to every infant or child in its care tests for 163.14inborn errors of metabolism in accordance withheritable and 163.15 congenital disorders according to subdivision 2 and rules 163.16 prescribed by the state commissioner of health.In determining163.17which tests must be administered, the commissioner shall take163.18into consideration the adequacy of laboratory methods to detect163.19the inborn metabolic error, the ability to treat or prevent163.20medical conditions caused by the inborn metabolic error, and the163.21severity of the medical conditions caused by the inborn163.22metabolic error.Testing and the recording and reporting of 163.23 test results shall be performed at the times and in the manner 163.24 prescribed by the commissioner of health. The commissioner 163.25 shall charge laboratory service fees so that the total of fees 163.26 collected will approximate the costs of conducting the tests and 163.27 implementing and maintaining a system to follow-up infants with 163.28inborn metabolic errorsheritable or congenital disorders. The 163.29 laboratory service fee is $61 per specimen except for recipients 163.30 of medical assistance, general assistance medical care, or 163.31 MinnesotaCare in which the laboratory service fee is $21 per 163.32 specimen. Costs associated with capital expenditures and the 163.33 development of new procedures may be prorated over a three-year 163.34 period when calculating the amount of the fees. 163.35 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 163.36 commissioner shall periodically revise the list of tests to be 164.1 administered for determining the presence of a heritable or 164.2 congenital disorder. Revisions to the list shall reflect 164.3 advances in medical science, new and improved testing methods, 164.4 or other factors that will improve the public health. In 164.5 determining whether a test must be administered, the 164.6 commissioner shall take into consideration the adequacy of 164.7 laboratory methods to detect the heritable or congenital 164.8 disorder, the ability to treat or prevent medical conditions 164.9 caused by the heritable or congenital disorder, and the severity 164.10 of the medical conditions caused by the heritable or congenital 164.11 disorder. The list of tests to be performed may be revised if 164.12 the changes are recommended by the advisory committee 164.13 established under section 144.1255, approved by the 164.14 commissioner, and published in the State Register. The revision 164.15 is exempt from the rulemaking requirements in chapter 14 and 164.16 sections 14.385 and 14.386 do not apply. 164.17 Subd. 3. [OBJECTION OF PARENTS TO TEST.] If the parents of 164.18 an infant object in writing to testing for heritable and 164.19 congenital disorders as being in conflict with their personal 164.20 beliefs or religious tenets and practice, the objection shall be 164.21 recorded on a form that is signed by a parent or legal guardian 164.22 and made part of the infant's medical record. A written 164.23 objection exempts an infant from the requirements of this 164.24 section and section 144.128. 164.25 Sec. 17. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 164.26 CONGENITAL DISORDERS.] 164.27 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 164.28 2003, the commissioner of health shall appoint an advisory 164.29 committee to provide advice and recommendations to the 164.30 commissioner concerning tests and treatments for heritable and 164.31 congenital disorders found in newborn children. Membership of 164.32 the committee shall include, but not be limited to, at least one 164.33 member from each of the following representative groups: 164.34 (1) parents and other consumers; 164.35 (2) primary care providers; 164.36 (3) clinicians and researchers specializing in newborn 165.1 diseases and disorders; 165.2 (4) genetic counselors; 165.3 (5) birth hospital representatives; 165.4 (6) newborn screening laboratory professionals; 165.5 (7) nutritionists; and 165.6 (8) other experts as needed representing related fields 165.7 such as emerging technologies and health insurance. 165.8 (b) The terms and removal of members are governed by 165.9 section 15.059. Members shall not receive per diems but shall 165.10 be compensated for expenses. Notwithstanding section 15.059, 165.11 subdivision 5, the advisory committee does not expire. 165.12 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 165.13 activities include, but are not limited to: 165.14 (1) collection of information on the efficacy and 165.15 reliability of various tests for heritable and congenital 165.16 disorders; 165.17 (2) collection of information on the availability and 165.18 efficacy of treatments for heritable and congenital disorders; 165.19 (3) collection of information on the severity of medical 165.20 conditions caused by heritable and congenital disorders; 165.21 (4) discussion and assessment of the benefits of performing 165.22 tests for heritable or congenital disorders as compared to the 165.23 costs, treatment limitations, or other potential disadvantages 165.24 of requiring the tests; 165.25 (5) discussion and assessment of ethical considerations 165.26 surrounding the testing, treatment, and handling of data and 165.27 specimens generated by the testing requirements of sections 165.28 144.125 to 144.128; and 165.29 (6) providing advice and recommendations to the 165.30 commissioner concerning tests and treatments for heritable and 165.31 congenital disorders found in newborn children. 165.32 [EFFECTIVE DATE.] This section is effective the day 165.33 following final enactment. 165.34 Sec. 18. Minnesota Statutes 2002, section 144.128, is 165.35 amended to read: 165.36 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF166.1CASESCOMMISSIONER'S DUTIES.] 166.2 The commissioner shall: 166.3 (1) makearrangementsreferrals for the necessary treatment 166.4 of diagnosed cases ofhemoglobinopathy, phenylketonuria, and166.5other inborn errors of metabolismheritable or congenital 166.6 disorders when treatment is indicatedand the family is166.7uninsured and, because of a lack of available income, is unable166.8to pay the cost of the treatment; 166.9 (2) maintain a registry of the cases ofhemoglobinopathy,166.10phenylketonuria, and other inborn errors of metabolismheritable 166.11 and congenital disorders detected by the screening program for 166.12 the purpose of follow-up services; and 166.13 (3) adopt rules to carry outsection 144.126 and this166.14sectionsections 144.125 to 144.128. 166.15 Sec. 19. Minnesota Statutes 2002, section 144.1488, 166.16 subdivision 4, is amended to read: 166.17 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 166.18 eligible to apply to the commissioner for the loan repayment 166.19 program, health professionals must be citizens or nationals of 166.20 the United States, must not have any unserved obligations for 166.21 service to a federal, state, or local government, or other 166.22 entity, must have a current and unrestricted Minnesota license 166.23 to practice, and must be ready to begin full-time clinical 166.24 practice upon signing a contract for obligated service. 166.25 (b) Eligible providers are those specified by the federal 166.26 Bureau ofPrimary Health CareHealth Professionals in the policy 166.27 information notice for the state's current federal grant 166.28 application. A health professional selected for participation 166.29 is not eligible for loan repayment until the health professional 166.30 has an employment agreement or contract with an eligible loan 166.31 repayment site and has signed a contract for obligated service 166.32 with the commissioner. 166.33 Sec. 20. Minnesota Statutes 2002, section 144.1491, 166.34 subdivision 1, is amended to read: 166.35 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 166.36 program participant who fails to completetwothe required years 167.1 of obligated service shall repay the amount paid, as well as a 167.2 financial penaltybased upon the length of the service167.3obligation not fulfilled. If the participant has served at167.4least one year, the financial penalty is the number of unserved167.5months multiplied by $1,000. If the participant has served less167.6than one year, the financial penalty is the total number of167.7obligated months multiplied by $1,000specified by the federal 167.8 Bureau of Health Professionals in the policy information notice 167.9 for the state's current federal grant application. The 167.10 commissioner shall report to the appropriate health-related 167.11 licensing board a participant who fails to complete the service 167.12 obligation and fails to repay the amount paid or fails to pay 167.13 any financial penalty owed under this subdivision. 167.14 Sec. 21. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 167.15 FORGIVENESS PROGRAM.] 167.16 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 167.17 section, the following definitions apply. 167.18 (b) "Designated rural area" means: 167.19 (1) an area in Minnesota outside the counties of Anoka, 167.20 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 167.21 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 167.22 and St. Cloud; or 167.23 (2) a municipal corporation, as defined under section 167.24 471.634, that is physically located, in whole or in part, in an 167.25 area defined as a designated rural area under clause (1). 167.26 (c) "Emergency circumstances" means those conditions that 167.27 make it impossible for the participant to fulfill the service 167.28 commitment, including death, total and permanent disability, or 167.29 temporary disability lasting more than two years. 167.30 (d) "Medical resident" means an individual participating in 167.31 a medical residency in family practice, internal medicine, 167.32 obstetrics and gynecology, pediatrics, or psychiatry. 167.33 (e) "Midlevel practitioner" means a nurse practitioner, 167.34 nurse-midwife, nurse anesthetist, advanced clinical nurse 167.35 specialist, or physician assistant. 167.36 (f) "Nurse" means an individual who has completed training 168.1 and received all licensing or certification necessary to perform 168.2 duties as a licensed practical nurse or registered nurse. 168.3 (g) "Nurse-midwife" means a registered nurse who has 168.4 graduated from a program of study designed to prepare registered 168.5 nurses for advanced practice as nurse-midwives. 168.6 (h) "Nurse practitioner" means a registered nurse who has 168.7 graduated from a program of study designed to prepare registered 168.8 nurses for advanced practice as nurse practitioners. 168.9 (i) "Physician" means an individual who is licensed to 168.10 practice medicine in the areas of family practice, internal 168.11 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 168.12 (j) "Physician assistant" means a person registered under 168.13 chapter 147A. 168.14 (k) "Qualified educational loan" means a government, 168.15 commercial, or foundation loan for actual costs paid for 168.16 tuition, reasonable education expenses, and reasonable living 168.17 expenses related to the graduate or undergraduate education of a 168.18 health care professional. 168.19 (l) "Underserved urban community" means a Minnesota urban 168.20 area or population included in the list of designated primary 168.21 medical care health professional shortage areas (HPSAs), 168.22 medically underserved areas (MUAs), or medically underserved 168.23 populations (MUPs) maintained and updated by the United States 168.24 Department of Health and Human Services. 168.25 Subd. 2. [CREATION OF ACCOUNT.] A health professional 168.26 education loan forgiveness program account is established. The 168.27 commissioner of health shall use money from the account to 168.28 establish a loan forgiveness program for medical residents 168.29 agreeing to practice in designated rural areas or underserved 168.30 urban communities, for midlevel practitioners agreeing to 168.31 practice in designated rural areas, and for nurses who agree to 168.32 practice in a Minnesota nursing home or intermediate care 168.33 facility for persons with mental retardation or related 168.34 conditions. Appropriations made to the account do not cancel 168.35 and are available until expended, except that at the end of each 168.36 biennium, any remaining balance in the account that is not 169.1 committed by contract and not needed to fulfill existing 169.2 obligations shall cancel to the fund. 169.3 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 169.4 in the loan forgiveness program, an individual must: 169.5 (1) be a medical resident or be enrolled in a midlevel 169.6 practitioner, registered nurse, or a licensed practical nurse 169.7 training program; and 169.8 (2) submit an application to the commissioner of health. 169.9 (b) An applicant selected to participate must sign a 169.10 contract to agree to serve a minimum three-year full-time 169.11 service obligation according to subdivision 2, which shall begin 169.12 no later than March 31 following completion of required training. 169.13 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 169.14 may select applicants each year for participation in the loan 169.15 forgiveness program, within the limits of available funding. 169.16 The commissioner shall distribute available funds for loan 169.17 forgiveness proportionally among the eligible professions 169.18 according to the vacancy rate for each profession in the 169.19 required geographic area or facility type specified in 169.20 subdivision 2. The commissioner shall allocate funds for 169.21 physician loan forgiveness so that 75 percent of the funds 169.22 available are used for rural physician loan forgiveness and 25 169.23 percent of the funds available are used for underserved urban 169.24 communities loan forgiveness. If the commissioner does not 169.25 receive enough qualified applicants each year to use the entire 169.26 allocation of funds for urban underserved communities, the 169.27 remaining funds may be allocated for rural physician loan 169.28 forgiveness. Applicants are responsible for securing their own 169.29 qualified educational loans. The commissioner shall select 169.30 participants based on their suitability for practice serving the 169.31 required geographic area or facility type specified in 169.32 subdivision 2, as indicated by experience or training. The 169.33 commissioner shall give preference to applicants closest to 169.34 completing their training. For each year that a participant 169.35 meets the service obligation required under subdivision 3, up to 169.36 a maximum of four years, the commissioner shall make annual 170.1 disbursements directly to the participant equivalent to 15 170.2 percent of the average educational debt for indebted graduates 170.3 in their profession in the year closest to the applicant's 170.4 selection for which information is available, not to exceed the 170.5 balance of the participant's qualifying educational loans. 170.6 Before receiving loan repayment disbursements and as requested, 170.7 the participant must complete and return to the commissioner an 170.8 affidavit of practice form provided by the commissioner 170.9 verifying that the participant is practicing as required under 170.10 subdivisions 2 and 3. The participant must provide the 170.11 commissioner with verification that the full amount of loan 170.12 repayment disbursement received by the participant has been 170.13 applied toward the designated loans. After each disbursement, 170.14 verification must be received by the commissioner and approved 170.15 before the next loan repayment disbursement is made. 170.16 Participants who move their practice remain eligible for loan 170.17 repayment as long as they practice as required under subdivision 170.18 2. 170.19 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 170.20 does not fulfill the required minimum commitment of service 170.21 according to subdivision 3, the commissioner of health shall 170.22 collect from the participant the total amount paid to the 170.23 participant under the loan forgiveness program plus interest at 170.24 a rate established according to section 270.75. The 170.25 commissioner shall deposit the money collected in the health 170.26 care access fund to be credited to the health professional 170.27 education loan forgiveness program account established in 170.28 subdivision 2. The commissioner shall allow waivers of all or 170.29 part of the money owed the commissioner as a result of a 170.30 nonfulfillment penalty if emergency circumstances prevented 170.31 fulfillment of the minimum service commitment. 170.32 Subd. 6. [RULES.] The commissioner may adopt rules to 170.33 implement this section. 170.34 Sec. 22. Minnesota Statutes 2002, section 144.1502, 170.35 subdivision 4, is amended to read: 170.36 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 171.1 may acceptup to 14applicantspereach year for participation 171.2 in the loan forgiveness program, within the limits of available 171.3 funding. Applicants are responsible for securing their own 171.4 loans. The commissioner shall select participants based on 171.5 their suitability for practice serving public program patients, 171.6 as indicated by experience or training. The commissioner shall 171.7 give preference to applicants who have attended a Minnesota 171.8 dentistry educational institution and to applicants closest to 171.9 completing their training. For each year that a participant 171.10 meets the service obligation required under subdivision 3, up to 171.11 a maximum of four years, the commissioner shall make annual 171.12 disbursements directly to the participant equivalent to$10,000171.13per year of service, not to exceed $40,00015 percent of the 171.14 average educational debt for indebted dental school graduates in 171.15 the year closest to the applicant's selection for which 171.16 information is available or the balance of the qualifying 171.17 educational loans, whichever is less. Before receiving loan 171.18 repayment disbursements and as requested, the participant must 171.19 complete and return to the commissioner an affidavit of practice 171.20 form provided by the commissioner verifying that the participant 171.21 is practicing as required under subdivision 3. The participant 171.22 must provide the commissioner with verification that the full 171.23 amount of loan repayment disbursement received by the 171.24 participant has been applied toward the designated loans. After 171.25 each disbursement, verification must be received by the 171.26 commissioner and approved before the next loan repayment 171.27 disbursement is made. Participants who move their practice 171.28 remain eligible for loan repayment as long as they practice as 171.29 required under subdivision 3. 171.30 Sec. 23. Minnesota Statutes 2002, section 144.35, is 171.31 amended to read: 171.32 144.35 [POLLUTION OF WATER.] 171.33 (a) No sewage or other matter that will impair the 171.34 healthfulness of water shall be deposited where it will fallor, 171.35 drain, or leach into any pondor, stream, or groundwater used as 171.36 a source of water supply for domestic use. The commissioner 172.1 shall have general charge of all springs, wells, ponds, and 172.2 streams so used and take all necessary and proper steps to 172.3 preserve the same from such pollution as may endanger the public 172.4 health. In case of violation of any of the provisions of this 172.5 section, the commissioner may, with or without a hearing, order 172.6 any person to desist from causing such pollution and to comply 172.7 with such direction as the commissioner may deem proper and 172.8 expedient in the premises. Such order shall be served forthwith 172.9 upon the person found to have violated such provisions. 172.10 (b) For purposes of enforcing this section, the 172.11 commissioner has access to any record maintained under section 172.12 18B.37, subdivision 2. Section 18B.37, subdivision 5, applies 172.13 to the inspection, classification, and release of the records by 172.14 the commissioner, except that the commissioner may release 172.15 information to a licensed health care provider for the limited 172.16 purpose of determining appropriate medical care for an 172.17 individual who may have been exposed to a pesticide or for 172.18 evaluating a possible public health threat. A health care 172.19 provider who receives this information shall maintain the 172.20 information in accordance with chapter 13 and the information 172.21 must not be disclosed by the provider, except for the purposes 172.22 described in this paragraph. A health care provider who 172.23 violates this requirement is subject to the remedies and 172.24 penalties in sections 13.08 and 13.09. 172.25 Sec. 24. Minnesota Statutes 2002, section 144.395, is 172.26 amended by adding a subdivision to read: 172.27 Subd. 4. [EFFECTIVE DATE.] This section is only in effect 172.28 if there are funds available in the tobacco use prevention and 172.29 local public health endowment fund. 172.30 Sec. 25. Minnesota Statutes 2002, section 144.396, 172.31 subdivision 7, is amended to read: 172.32 Subd. 7. [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.] 172.33 The commissioner shall distributethefundsavailable under172.34section 144.395, subdivision 2, paragraph (c), clause172.35(3)appropriated for the purpose of local health promotion and 172.36 protection activities to community health boardsfor local173.1health promotion and protection activitiesfor local health 173.2 initiatives other than tobacco prevention aimed at high risk 173.3 health behaviors among youth. The commissioner shall distribute 173.4 these funds to the community health boards based on demographics 173.5 and other need-based factors relating to health. 173.6 Sec. 26. Minnesota Statutes 2002, section 144.396, 173.7 subdivision 11, is amended to read: 173.8 Subd. 11. [AUDITS.] The legislative auditorshallmay 173.9 audit tobacco use prevention and local public healthendowment173.10fundexpenditures to ensure that the money is spent for tobacco 173.11 use prevention measures and public health initiatives. 173.12 Sec. 27. Minnesota Statutes 2002, section 144.396, 173.13 subdivision 12, is amended to read: 173.14 Subd. 12. [ENDOWMENT FUNDFUNDS NOT TO SUPPLANT EXISTING 173.15 FUNDING.]Appropriations from the tobacco use prevention and173.16local public health endowment fundFunds appropriated to the 173.17 statewide tobacco prevention grants, local tobacco prevention 173.18 grants, or the local public health promotion and prevention must 173.19 not be used as a substitute for traditional sources of funding 173.20 tobacco use prevention activities or public health initiatives. 173.21 Any local unit of government receiving money under this section 173.22 must ensure that existing local financial efforts remain in 173.23 place. 173.24 Sec. 28. Minnesota Statutes 2002, section 144.414, 173.25 subdivision 3, is amended to read: 173.26 Subd. 3. [HEALTH CARE FACILITIES AND CLINICS.] (a) Smoking 173.27 is prohibited in any area of a hospital, health care clinic, 173.28 doctor's office, or other health care-related facility, other 173.29 than a nursing home, boarding care facility, or licensed 173.30 residential facility, except as allowed in this subdivision. 173.31 (b)Smoking by patients in a chemical dependency treatment173.32program or mental health program may be allowed in a separated173.33well-ventilated area pursuant to a policy established by the173.34administrator of the program that identifies circumstances in173.35which prohibiting smoking would interfere with the treatment of173.36persons recovering from chemical dependency or mental illness.174.1(c)Smoking by participants in peer reviewed scientific 174.2 studies related to the health effects of smoking may be allowed 174.3 in a separated room ventilated at a rate of 60 cubic feet per 174.4 minute per person pursuant to a policy that is approved by the 174.5 commissioner and is established by the administrator of the 174.6 program to minimize exposure of nonsmokers to smoke. 174.7 [EFFECTIVE DATE.] This section is effective January 1, 2004. 174.8 Sec. 29. Minnesota Statutes 2002, section 144.99, 174.9 subdivision 1, is amended to read: 174.10 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 174.11 chapters 103I and 157 and sections 62J.18; 62J.23; 115.71 to 174.12 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), 174.13 (10), (12), (13), (14), and (15); 144.1201 to 144.1204; 144.121; 174.14 144.1222; 144.35; 144.381 to 144.385; 144.411 to 144.417; 174.15 144.495; 144.71 to 144.74; 144.9501 to 144.9509; 144.992; 326.37 174.16 to 326.45; 326.57 to 326.785; 327.10 to 327.131; and 327.14 to 174.17 327.28 and all rules, orders, stipulation agreements, 174.18 settlements, compliance agreements, licenses, registrations, 174.19 certificates, and permits adopted or issued by the department or 174.20 under any other law now in force or later enacted for the 174.21 preservation of public health may, in addition to provisions in 174.22 other statutes, be enforced under this section. 174.23 Sec. 30. Minnesota Statutes 2002, section 144E.29, is 174.24 amended to read: 174.25 144E.29 [FEES.] 174.26 (a) The board shall charge the following fees: 174.27 (1) initial application for and renewal of an ambulance 174.28 service license,$150$200; 174.29 (2) each ambulance operated by a licensee,$96$125. The 174.30 licensee shall pay an additional$96$125 fee for the full 174.31 licensing period or$4$10 per month for any fraction of the 174.32 period for each ambulance added to the ambulance service during 174.33 the licensing period; 174.34 (3) initial application for and renewal of approval for a 174.35 training program,$100$150; and 174.36 (4) duplicate of an original license, certification, or 175.1 approval, $25. 175.2 (b) With the exception of paragraph (a), clause (4), all 175.3 fees are for a two-year period. All fees are nonrefundable. 175.4 (c) Fees collected by the board shall be deposited as 175.5 nondedicated receipts in the general fund. 175.6 Sec. 31. Minnesota Statutes 2002, section 144E.50, 175.7 subdivision 5, is amended to read: 175.8 Subd. 5. [DISTRIBUTION.] Money from the fund shall be 175.9 distributed according to this subdivision.Ninety-three and175.10one-thirdNinety-five percent of the fund shall be distributed 175.11 annually on a contract for services basis with each of the eight 175.12 regional emergency medical services systems designated by the 175.13 board. The systems shall be governed by a body consisting of 175.14 appointed representatives from each of the counties in that 175.15 region and shall also include representatives from emergency 175.16 medical services organizations. The board shall contract with a 175.17 regional entity only if the contract proposal satisfactorily 175.18 addresses proposed emergency medical services activities in the 175.19 following areas: personnel training, transportation 175.20 coordination, public safety agency cooperation, communications 175.21 systems maintenance and development, public involvement, health 175.22 care facilities involvement, and system management. If each of 175.23 the regional emergency medical services systems submits a 175.24 satisfactory contract proposal, then this part of the fund shall 175.25 be distributed evenly among the regions. If one or more of the 175.26 regions does not contract for the full amount of its even share 175.27 or if its proposal is unsatisfactory, then the board may 175.28 reallocate the unused funds to the remaining regions on a pro 175.29 rata basis.Six and two-thirdsFive percent of the fund shall 175.30 be used by the board to support regionwide reporting systems and 175.31 to provide other regional administration and technical 175.32 assistance. 175.33 Sec. 32. Minnesota Statutes 2002, section 145.412, is 175.34 amended by adding a subdivision to read: 175.35 Subd. 5. [CONTRACEPTION INFORMATION.] Before an abortion 175.36 is performed, a woman shall be offered information on all 176.1 FDA-approved methods of contraception including natural family 176.2 planning. 176.3 Sec. 33. Minnesota Statutes 2002, section 147A.08, is 176.4 amended to read: 176.5 147A.08 [EXEMPTIONS.] 176.6 (a) This chapter does not apply to, control, prevent, or 176.7 restrict the practice, service, or activities of persons listed 176.8 in section 147.09, clauses (1) to (6) and (8) to (13), persons 176.9 regulated under section 214.01, subdivision 2, or persons 176.10 defined in section144.1495144.1501, subdivision 1, 176.11 paragraphs(a) to (d)(e), (g), and (h). 176.12 (b) Nothing in this chapter shall be construed to require 176.13 registration of: 176.14 (1) a physician assistant student enrolled in a physician 176.15 assistant or surgeon assistant educational program accredited by 176.16 the Committee on Allied Health Education and Accreditation or by 176.17 its successor agency approved by the board; 176.18 (2) a physician assistant employed in the service of the 176.19 federal government while performing duties incident to that 176.20 employment; or 176.21 (3) technicians, other assistants, or employees of 176.22 physicians who perform delegated tasks in the office of a 176.23 physician but who do not identify themselves as a physician 176.24 assistant. 176.25 Sec. 34. Minnesota Statutes 2002, section 148.5194, 176.26 subdivision 1, is amended to read: 176.27 Subdivision 1. [FEE PRORATION.] The commissioner shall 176.28 prorate the registration fee for clinical fellowship, temporary, 176.29 and first time registrants according to the number of months 176.30 that have elapsed between the date registration is issued and 176.31 the date registration expires or must be renewed under section 176.32 148.5191, subdivision 4. 176.33 Sec. 35. Minnesota Statutes 2002, section 148.5194, 176.34 subdivision 2, is amended to read: 176.35 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 176.36 registration and biennial registration, clinical fellowship 177.1 registration, temporary registration, or renewal is $200. 177.2 Sec. 36. Minnesota Statutes 2002, section 148.5194, 177.3 subdivision 3, is amended to read: 177.4 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 177.5 REGISTRATION.] The fee for initial registration and biennial 177.6 registration, clinical fellowship registration, temporary 177.7 registration, or renewal is $200. 177.8 Sec. 37. Minnesota Statutes 2002, section 148.5194, is 177.9 amended by adding a subdivision to read: 177.10 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 177.11 verification of credentialed status is $25. 177.12 Sec. 38. Minnesota Statutes 2002, section 148.6445, 177.13 subdivision 7, is amended to read: 177.14 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 177.15 fee forcertificationverification of licensure to other states 177.16 is $25. 177.17 Sec. 39. Minnesota Statutes 2002, section 153A.17, is 177.18 amended to read: 177.19 153A.17 [EXPENSES; FEES.] 177.20 The expenses for administering the certification 177.21 requirements including the complaint handling system for hearing 177.22 aid dispensers in sections 153A.14 and 153A.15 and the consumer 177.23 information center under section 153A.18 must be paid from 177.24 initial application and examination fees, renewal fees, 177.25 penalties, and fines. All fees are nonrefundable. The 177.26 certificate application fee is$165 for audiologists registered177.27under section 148.511 and $490 for all others$350, the 177.28 examination fee is$200$250 for the written portion and 177.29$200$250 for the practical portion each time one or the other 177.30 is taken, and the trainee application fee 177.31 is$100$200.Notwithstanding the policy set forth in section177.3216A.1285, subdivision 2, a surcharge of $165 for audiologists177.33registered under section 148.511 and $330 for all others shall177.34be paid at the time of application or renewal until June 30,177.352003, to recover the commissioner's accumulated direct177.36expenditures for administering the requirements of this178.1chapter.The penalty fee for late submission of a renewal 178.2 application is $200. The fee for verification of certification 178.3 to other jurisdictions or entities is $25. All fees, penalties, 178.4 and fines received must be deposited in the state government 178.5 special revenue fund. The commissioner may prorate the 178.6 certification fee for new applicants based on the number of 178.7 quarters remaining in the annual certification period. 178.8 Sec. 40. [246.0141] [TOBACCO USE PROHIBITED.] 178.9 No patient, staff, guest, or visitor on the grounds or in a 178.10 state regional treatment center, the Minnesota security 178.11 hospital, the Minnesota sex offender program, or the Minnesota 178.12 extended treatment options program may possess or use tobacco or 178.13 a tobacco related device. For the purposes of this section, 178.14 "tobacco" and "tobacco related device" have the meanings given 178.15 in section 609.685, subdivision 1. This section does not 178.16 prohibit the possession or use of tobacco or a tobacco related 178.17 device by an adult as part of a traditional Indian spiritual or 178.18 cultural ceremony. For purposes of this section, an Indian is a 178.19 person who is a member of an Indian tribe as defined in section 178.20 260.755, subdivision 12. 178.21 [EFFECTIVE DATE.] This section is effective January 1, 2004. 178.22 Sec. 41. Minnesota Statutes 2002, section 326.42, is 178.23 amended to read: 178.24 326.42 [APPLICATIONS, FEES.] 178.25 Subdivision 1. [APPLICATION.] Applications for plumber's 178.26 license shall be made to the state commissioner of health, with 178.27 fee. Unless the applicant is entitled to a renewal, the 178.28 applicant shall be licensed by the state commissioner of health 178.29 only after passing a satisfactory examination by the examiners 178.30 showing fitness. Examination fees for both journeyman and 178.31 master plumbers shall be in an amount prescribed by the state 178.32 commissioner of health pursuant to section 144.122. Upon being 178.33 notified that of having successfully passed the examination for 178.34 original license the applicant shall submit an application, with 178.35 the license fee herein provided. License fees shall be in an 178.36 amount prescribed by the state commissioner of health pursuant 179.1 to section 144.122. Licenses shall expire and be renewed as 179.2 prescribed by the commissioner pursuant to section 144.122. 179.3 Subd. 2. [FEES.] Plumbing system plans and specifications 179.4 that are submitted to the commissioner for review shall be 179.5 accompanied by the appropriate plan examination fees. If the 179.6 commissioner determines, upon review of the plans, that 179.7 inadequate fees were paid, the necessary additional fees shall 179.8 be paid prior to plan approval. The commissioner shall charge 179.9 the following fees for plan reviews and audits of plumbing 179.10 installations for public, commercial, and industrial buildings: 179.11 (1) systems with both water distribution and drain, waste, 179.12 and vent systems and having: 179.13 (i) 25 or fewer drainage fixture units, $150; 179.14 (ii) 26 to 50 drainage fixture units, $250; 179.15 (iii) 51 to 150 drainage fixture units, $350; 179.16 (iv) 151 to 249 drainage fixture units, $500; 179.17 (v) 250 or more drainage fixture units, $3 per drainage 179.18 fixture unit to a maximum of $4,000; and 179.19 (vi) interceptors, separators, or catch basins, $70 per 179.20 interceptor, separator, or catch basin; 179.21 (2) building sewer service only, $150; 179.22 (3) building water service only, $150; 179.23 (4) building water distribution system only, no drainage 179.24 system, $5 per supply fixture unit or $150, whichever is 179.25 greater; 179.26 (5) storm drainage system, a minimum fee of $150 or: 179.27 (i) $50 per drain opening, up to a maximum of $500; and 179.28 (ii) $70 per interceptor, separator, or catch basin; 179.29 (6) manufactured home park or campground, 1 to 25 sites, 179.30 $300; 179.31 (7) manufactured home park or campground, 26 to 50 sites, 179.32 $350; 179.33 (8) manufactured home park or campground, 51 to 125 sites, 179.34 $400; 179.35 (9) manufactured home park or campground, more than 125 179.36 sites, $500; 180.1 (10) accelerated review, double the regular fee, one-half 180.2 to be refunded if no response from the commissioner within 15 180.3 business days; and 180.4 (11) revision to previously reviewed or incomplete plans: 180.5 (i) review of plans for which commissioner has issued two 180.6 or more requests for additional information, per review, $100 or 180.7 ten percent of the original fee, whichever is greater; 180.8 (ii) proposer-requested revision with no increase in 180.9 project scope, $50 or ten percent of original fee, whichever is 180.10 greater; and 180.11 (iii) proposer-requested revision with an increase in 180.12 project scope, $50 plus the difference between the original 180.13 project fee and the revised project fee. 180.14 Sec. 42. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 180.15 (a) The commissioner's authority to collect the certificate 180.16 application fee from hearing instrument dispensers under 180.17 Minnesota Statutes, section 153A.17, is suspended for certified 180.18 hearing instrument dispensers renewing certification in fiscal 180.19 year 2004. 180.20 (b) The commissioner's authority to collect the license 180.21 renewal fee from occupational therapy practitioners under 180.22 Minnesota Statutes, section 148.6445, subdivision 2, is 180.23 suspended for fiscal years 2004 and 2005. 180.24 Sec. 43. [REVISOR'S INSTRUCTION.] 180.25 (a) The revisor of statutes shall delete the reference to 180.26 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 180.27 "144.1501." 180.28 (b) For sections in Minnesota Statutes and Minnesota Rules 180.29 affected by the repealed sections in this article, the revisor 180.30 shall delete internal cross-references where appropriate and 180.31 make changes necessary to correct the punctuation, grammar, or 180.32 structure of the remaining text and preserve its meaning. 180.33 Sec. 44. [REPEALER.] 180.34 (a) Minnesota Statutes 2002, sections 62J.15; 62J.152; 180.35 62J.451; 62J.452; 144.126; 144.1494; 144.1495; 144.1496; 180.36 144.1497; 144A.36; 144A.38; 148.5194, subdivision 3a; and 181.1 148.6445, subdivision 9, are repealed. 181.2 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 181.3 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 181.4 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 181.5 4763.0230; 4763.0240; 4763.0250, are repealed. 181.6 ARTICLE 4 181.7 LONG-TERM CARE 181.8 Section 1. Minnesota Statutes 2002, section 144A.071, 181.9 subdivision 4c, as added by Laws 2003, chapter 16, section 1, is 181.10 amended to read: 181.11 Subd. 4c. [EXCEPTIONS FOR REPLACEMENT BEDS AFTER JUNE 30, 181.12 2003.] (a) The commissioner of health, in coordination with the 181.13 commissioner of human services, may approve the renovation, 181.14 replacement, upgrading, or relocation of a nursing home or 181.15 boarding care home, under the following conditions: 181.16 (1) to license and certify an 80-bed city-owned facility in 181.17 Nicollet county to be constructed on the site of a new 181.18 city-owned hospital to replace an existing 85-bed facility 181.19 attached to a hospital that is also being replaced. The 181.20 threshold allowed for this project under section 144A.073 shall 181.21 be the maximum amount available to pay the additional medical 181.22 assistance costs of the new facility; and 181.23 (2) to license and certify 29 beds to be added to an 181.24 existing 69-bed facility in St. Louis county, provided that the 181.25 29 beds must be transferred from active or layaway status at an 181.26 existing 235-bed facility in St. Louis county. 181.27 The licensed capacity at the 235-bed facility must be reduced to 181.28 206 beds, but the payment rate at that facility shall not be 181.29 adjusted as a result of this transfer. The operating payment 181.30 rate of the facility adding beds after completion of this 181.31 project shall be the same as it was on the day prior to the day 181.32 the beds are licensed and certified. This project shall not 181.33 proceed unless it is approved and financed under the provisions 181.34 of section 144A.073. The commissioner of health shall give 181.35 priority under section 144A.073 to the project approved under 181.36 this clause. 182.1 (b) Projects approved under this subdivision shall be 182.2 treated in a manner equivalent to projects approved under 182.3 subdivision 4a. 182.4 Sec. 2. Minnesota Statutes 2002, section 144A.4605, 182.5 subdivision 4, is amended to read: 182.6 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 182.7 establishment registered under chapter 144D that is required to 182.8 obtain a home care license must obtain an assisted living home 182.9 care license according to this section or a class A or class E 182.10 license according to rule. A housing with services 182.11 establishment that obtains a class E license under this 182.12 subdivision remains subject to the payment limitations in 182.13 sections 256B.0913, subdivision55f, paragraph(h)(b), and 182.14 256B.0915, subdivision3, paragraph (g)3d. 182.15 (b) A board and lodging establishment registered for 182.16 special services as of December 31, 1996, and also registered as 182.17 a housing with services establishment under chapter 144D, must 182.18 deliver home care services according to sections 144A.43 to 182.19 144A.47, and may apply for a waiver from requirements under 182.20 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 182.21 licensed agency under the standards of section 157.17. Such 182.22 waivers as may be granted by the department will expire upon 182.23 promulgation of home care rules implementing section 144A.4605. 182.24 (c) An adult foster care provider licensed by the 182.25 department of human services and registered under chapter 144D 182.26 may continue to provide health-related services under its foster 182.27 care license until the promulgation of home care rules 182.28 implementing this section. 182.29 (d) An assisted living home care provider licensed under 182.30 this section must comply with the disclosure provisions of 182.31 section 325F.72 to the extent they are applicable. 182.32 Sec. 3. Minnesota Statutes 2002, section 256.9657, 182.33 subdivision 1, is amended to read: 182.34 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 182.35 Effective July 1, 1993, each non-state-operated nursing home 182.36 licensed under chapter 144A shall pay to the commissioner an 183.1 annual surcharge according to the schedule in subdivision 4. 183.2 The surcharge shall be calculated as $620 per licensed bed. If 183.3 the number of licensed beds is reduced, the surcharge shall be 183.4 based on the number of remaining licensed beds the second month 183.5 following the receipt of timely notice by the commissioner of 183.6 human services that beds have been delicensed. The nursing home 183.7 must notify the commissioner of health in writing when beds are 183.8 delicensed. The commissioner of health must notify the 183.9 commissioner of human services within ten working days after 183.10 receiving written notification. If the notification is received 183.11 by the commissioner of human services by the 15th of the month, 183.12 the invoice for the second following month must be reduced to 183.13 recognize the delicensing of beds. Beds on layaway status 183.14 continue to be subject to the surcharge. The commissioner of 183.15 human services must acknowledge a medical care surcharge appeal 183.16 within 30 days of receipt of the written appeal from the 183.17 provider. 183.18 (b) Effective July 1, 1994, the surcharge in paragraph (a) 183.19 shall be increased to $625. 183.20 (c) Effective August 15, 2002, the surcharge under 183.21 paragraph (b) shall be increased to $990. 183.22 (d) Effective July 15, 2003, the surcharge under paragraph 183.23 (c) shall be increased to $2,700. 183.24 (e) The commissioner may reduce, and may subsequently 183.25 restore, the surcharge under paragraph (d) based on the 183.26 commissioner's determination of a permissible surcharge. 183.27 (f) Between April 1, 2002, and August 15,20032004, a 183.28 facility governed by this subdivision may elect to assume full 183.29 participation in the medical assistance program by agreeing to 183.30 comply with all of the requirements of the medical assistance 183.31 program, including the rate equalization law in section 256B.48, 183.32 subdivision 1, paragraph (a), and all other requirements 183.33 established in law or rule, and to begin intake of new medical 183.34 assistance recipients. Rates will be determined under Minnesota 183.35 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 183.36 256B.431, subdivision 27, paragraph (i), rate calculations will 184.1 be subject to limits as prescribed in rule and law. Other than 184.2 the adjustments in sections 256B.431, subdivisions 30 and 32; 184.3 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 184.4 9549.0057, and any other applicable legislation enacted prior to 184.5 the finalization of rates, facilities assuming full 184.6 participation in medical assistance under this paragraph are not 184.7 eligible for any rate adjustments until the July 1 following 184.8 their settle-up period. 184.9 [EFFECTIVE DATE.] This section is effective June 30, 2003. 184.10 Sec. 4. Minnesota Statutes 2002, section 256B.0913, 184.11 subdivision 2, is amended to read: 184.12 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 184.13 services are available to Minnesotans age 65 or olderwho are184.14not eligible for medical assistance without a spenddown or184.15waiver obligation butwho would be eligible for medical 184.16 assistance within 180 days of admission to a nursing facility 184.17 and subject to subdivisions 4 to 13. 184.18 Sec. 5. Minnesota Statutes 2002, section 256B.0913, 184.19 subdivision 4, is amended to read: 184.20 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 184.21 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 184.22 under the alternative care program is available to persons who 184.23 meet the following criteria: 184.24 (1) the person has been determined by a community 184.25 assessment under section 256B.0911 to be a person who would 184.26 require the level of care provided in a nursing facility, but 184.27 for the provision of services under the alternative care 184.28 program; 184.29 (2) the person is age 65 or older; 184.30 (3) the person would be eligible for medical assistance 184.31 within 180 days of admission to a nursing facility; 184.32 (4) the person is not ineligible for the medical assistance 184.33 program due to an asset transfer penalty; 184.34 (5) the person needs services that are not funded through 184.35 other state or federal funding; and 184.36 (6) the monthly cost of the alternative care services 185.1 funded by the program for this person does not exceed 75 percent 185.2 of thestatewide weighted average monthly nursing facility rate185.3of the case mix resident class to which the individual185.4alternative care client would be assigned under Minnesota Rules,185.5parts 9549.0050 to 9549.0059, less the recipient's maintenance185.6needs allowance as described in section 256B.0915, subdivision185.71d, paragraph (a), until the first day of the state fiscal year185.8in which the resident assessment system, under section 256B.437,185.9for nursing home rate determination is implemented. Effective185.10on the first day of the state fiscal year in which a resident185.11assessment system, under section 256B.437, for nursing home rate185.12determination is implemented and the first day of each185.13subsequent state fiscal year, the monthly cost of alternative185.14care services for this person shall not exceed the alternative185.15care monthly cap for the case mix resident class to which the185.16alternative care client would be assigned under Minnesota Rules,185.17parts 9549.0050 to 9549.0059, which was in effect on the last185.18day of the previous state fiscal year, and adjusted by the185.19greater of any legislatively adopted home and community-based185.20services cost-of-living percentage increase or any legislatively185.21adopted statewide percent rate increase for nursing185.22facilitiesmonthly limit described under section 256B.0915, 185.23 subdivision 3a. This monthly limit does not prohibit the 185.24 alternative care client from payment for additional services, 185.25 but in no case may the cost of additional services purchased 185.26 under this section exceed the difference between the client's 185.27 monthly service limit defined under section 256B.0915, 185.28 subdivision 3, and the alternative care program monthly service 185.29 limit defined in this paragraph. If medical supplies and 185.30 equipment or environmental modifications are or will be 185.31 purchased for an alternative care services recipient, the costs 185.32 may be prorated on a monthly basis for up to 12 consecutive 185.33 months beginning with the month of purchase. If the monthly 185.34 cost of a recipient's other alternative care services exceeds 185.35 the monthly limit established in this paragraph, the annual cost 185.36 of the alternative care services shall be determined. In this 186.1 event, the annual cost of alternative care services shall not 186.2 exceed 12 times the monthly limit described in this paragraph. 186.3 (b) Alternative care funding under this subdivision is not 186.4 available for a person who is a medical assistance recipient or 186.5 who would be eligible for medical assistance without a spenddown 186.6 or waiver obligation. A person whose initial application for 186.7 medical assistance and the elderly waiver program is being 186.8 processed may be served under the alternative care program for a 186.9 period up to 60 days. If the individual is found to be eligible 186.10 for medical assistance, medical assistance must be billed for 186.11 services payable under the federally approved elderly waiver 186.12 plan and delivered from the date the individual was found 186.13 eligible for the federally approved elderly waiver plan. 186.14 Notwithstanding this provision,upon federal approval,186.15 alternative care funds may not be used to pay for any service 186.16 the cost of which (i) is payable by medical assistanceor which, 186.17 (ii) is used by a recipient to meet amedical assistance income186.18spenddown orwaiver obligation, or (iii) is used to pay a 186.19 medical assistance income spenddown for a person who is eligible 186.20 to participate in the federally approved elderly waiver program 186.21 under the special income standard provisions. 186.22 (c) Alternative care funding is not available for a person 186.23 who resides in a licensed nursing home, certified boarding care 186.24 home, hospital, or intermediate care facility, except for case 186.25 management services which are provided in support of the 186.26 discharge planning processtofor a nursing home resident or 186.27 certified boarding care home resident to assist with a 186.28 relocation process to a community-based setting. 186.29 (d) Alternative care funding is not available for a person 186.30 whose income is greater than the maintenance needs allowance 186.31 under section 256B.0915, subdivision 1d, but equal to or less 186.32 than 120 percent of the federal poverty guideline effective July 186.33 1, in the year for which alternative care eligibility is 186.34 determined, who would be eligible for the elderly waiver with a 186.35 waiver obligation. 186.36 Sec. 6. Minnesota Statutes 2002, section 256B.0913, 187.1 subdivision 5, is amended to read: 187.2 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)187.3 Alternative care funding may be used for payment of costs of: 187.4 (1) adult foster care; 187.5 (2) adult day care; 187.6 (3) home health aide; 187.7 (4) homemaker services; 187.8 (5) personal care; 187.9 (6) case management; 187.10 (7) respite care; 187.11 (8) assisted living; 187.12 (9) residential care services; 187.13 (10) care-related supplies and equipment; 187.14 (11) meals delivered to the home; 187.15 (12) transportation; 187.16 (13) nursing services; 187.17 (14) chore services; 187.18 (15) companion services; 187.19 (16) nutrition services; 187.20 (17) training for direct informal caregivers; 187.21 (18) telehome caredevicestomonitor recipientsprovide 187.22 services in their own homesas an alternative to hospital care,187.23nursing home care, or homein conjunction with in-home visits; 187.24 (19)other services which includesdiscretionaryfunds and187.25direct cash payments to clients,services, for which counties 187.26 may make payment from their alternative care program allocation 187.27 or services not otherwise defined in this section or section 187.28 256B.0625, following approval by the commissioner, subject to187.29the provisions of paragraph (j). Total annual payments for187.30"other services" for all clients within a county may not exceed187.3125 percent of that county's annual alternative care program base187.32allocation;and187.33 (20) environmental modifications.; and 187.34 (21) direct cash payments for which counties may make 187.35 payment from their alternative care program allocation to 187.36 clients for the purpose of purchasing services, following 188.1 approval by the commissioner, and subject to the provisions of 188.2 subdivision 5h, until approval and implementation of 188.3 consumer-directed services through the federally approved 188.4 elderly waiver plan. Upon implementation, consumer-directed 188.5 services under the alternative care program are available 188.6 statewide and limited to the average monthly expenditures 188.7 representative of all alternative care program participants for 188.8 the same case mix resident class assigned in the most recent 188.9 fiscal year for which complete expenditure data is available. 188.10 Total annual payments for discretionary services and direct 188.11 cash payments, until the federally approved consumer-directed 188.12 service option is implemented statewide, for all clients within 188.13 a county may not exceed 25 percent of that county's annual 188.14 alternative care program base allocation. Thereafter, 188.15 discretionary services are limited to 25 percent of the county's 188.16 annual alternative care program base allocation. 188.17 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 188.18 STANDARDS.] (a) Unless specified in statute, the services, 188.19 service definitions, and standards for alternative care services 188.20 shall be the same as the services, service definitions, and 188.21 standards specified in the federally approved elderly waiver 188.22 plan, except for transitional support services. 188.23 (b) The county agency must ensure that the funds are not 188.24 used to supplant services available through other public 188.25 assistance or services programs. 188.26(c) Unless specified in statute, the services, service188.27definitions, and standards for alternative care services shall188.28be the same as the services, service definitions, and standards188.29specified in the federally approved elderly waiver plan. Except188.30for the county agencies' approval of direct cash payments to188.31clients as described in paragraph (j) orFor a provider of 188.32 supplies and equipment when the monthly cost of the supplies and 188.33 equipment is less than $250, persons or agencies must be 188.34 employed by or under a contract with the county agency or the 188.35 public health nursing agency of the local board of health in 188.36 order to receive funding under the alternative care program. 189.1 Supplies and equipment may be purchased from a vendor not 189.2 certified to participate in the Medicaid program if the cost for 189.3 the item is less than that of a Medicaid vendor. 189.4 (c) Personal care services must meet the service standards 189.5 defined in the federally approved elderly waiver plan, except 189.6 that a county agency may contract with a client's relative who 189.7 meets the relative hardship waiver requirements or a relative 189.8 who meets the criteria and is also the responsible party under 189.9 an individual service plan that ensures the client's health and 189.10 safety and supervision of the personal care services by a 189.11 qualified professional as defined in section 256B.0625, 189.12 subdivision 19c. Relative hardship is established by the county 189.13 when the client's care causes a relative caregiver to do any of 189.14 the following: resign from a paying job, reduce work hours 189.15 resulting in lost wages, obtain a leave of absence resulting in 189.16 lost wages, incur substantial client-related expenses, provide 189.17 services to address authorized, unstaffed direct care time, or 189.18 meet special needs of the client unmet in the formal service 189.19 plan. 189.20(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 189.21 care rate shall be considered a difficulty of care payment and 189.22 shall not include room and board. The adult foster care rate 189.23 shall be negotiated between the county agency and the foster 189.24 care provider. The alternative care payment for the foster care 189.25 service in combination with the payment for other alternative 189.26 care services, including case management, must not exceed the 189.27 limit specified in subdivision 4, paragraph (a), clause (6). 189.28(e) Personal care services must meet the service standards189.29defined in the federally approved elderly waiver plan, except189.30that a county agency may contract with a client's relative who189.31meets the relative hardship waiver requirement as defined in189.32section 256B.0627, subdivision 4, paragraph (b), clause (10), to189.33provide personal care services if the county agency ensures189.34supervision of this service by a qualified professional as189.35defined in section 256B.0625, subdivision 19c.189.36(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 190.1 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 190.2 section, residential care services are services which are 190.3 provided to individuals living in residential care homes. 190.4 Residential care homes are currently licensed as board and 190.5 lodging establishments under section 157.16, and are registered 190.6 with the department of health as providing special services 190.7 under section 157.17and are not subject to registrationexcept 190.8 settings that are currently registered under chapter 144D. 190.9 Residential care services are defined as "supportive services" 190.10 and "health-related services." "Supportive services" meansthe190.11provision of up to 24-hour supervision and oversight.190.12Supportive services includes: (1) transportation, when provided190.13by the residential care home only; (2) socialization, when190.14socialization is part of the plan of care, has specific goals190.15and outcomes established, and is not diversional or recreational190.16in nature; (3) assisting clients in setting up meetings and190.17appointments; (4) assisting clients in setting up medical and190.18social services; (5) providing assistance with personal laundry,190.19such as carrying the client's laundry to the laundry room.190.20Assistance with personal laundry does not include any laundry,190.21such as bed linen, that is included in the room and board rate190.22 services as defined in section 157.17, subdivision 1, paragraph 190.23 (a). "Health-related services"are limited to minimal190.24assistance with dressing, grooming, and bathing and providing190.25reminders to residents to take medications that are190.26self-administered or providing storage for medications, if190.27requestedmeans services covered in section 157.17, subdivision 190.28 1, paragraph (b). Individuals receiving residential care 190.29 services cannot receive homemaking services funded under this 190.30 section. 190.31(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 190.32 of this section, "assisted living" refers to supportive services 190.33 provided by a single vendor to clients who reside in the same 190.34 apartment building of three or more units which are not subject 190.35 to registration under chapter 144D and are licensed by the 190.36 department of health as a class A home care provider or a class 191.1 E home care provider. Assisted living services are defined as 191.2 up to 24-hour supervision,andoversight, and supportive 191.3 services as defined inclause (1)section 157.17, subdivision 1, 191.4 paragraph (a), individualized home care aide tasks as defined in 191.5clause (2)Minnesota Rules, part 4668.0110, and individualized 191.6 home management tasks as defined inclause (3)Minnesota Rules, 191.7 part 4668.0120 provided to residents of a residential center 191.8 living in their units or apartments with a full kitchen and 191.9 bathroom. A full kitchen includes a stove, oven, refrigerator, 191.10 food preparation counter space, and a kitchen utensil storage 191.11 compartment. Assisted living services must be provided by the 191.12 management of the residential center or by providers under 191.13 contract with the management or with the county. 191.14(1) Supportive services include:191.15(i) socialization, when socialization is part of the plan191.16of care, has specific goals and outcomes established, and is not191.17diversional or recreational in nature;191.18(ii) assisting clients in setting up meetings and191.19appointments; and191.20(iii) providing transportation, when provided by the191.21residential center only.191.22(2) Home care aide tasks means:191.23(i) preparing modified diets, such as diabetic or low191.24sodium diets;191.25(ii) reminding residents to take regularly scheduled191.26medications or to perform exercises;191.27(iii) household chores in the presence of technically191.28sophisticated medical equipment or episodes of acute illness or191.29infectious disease;191.30(iv) household chores when the resident's care requires the191.31prevention of exposure to infectious disease or containment of191.32infectious disease; and191.33(v) assisting with dressing, oral hygiene, hair care,191.34grooming, and bathing, if the resident is ambulatory, and if the191.35resident has no serious acute illness or infectious disease.191.36Oral hygiene means care of teeth, gums, and oral prosthetic192.1devices.192.2(3) Home management tasks means:192.3(i) housekeeping;192.4(ii) laundry;192.5(iii) preparation of regular snacks and meals; and192.6(iv) shopping.192.7 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 192.8 Individuals receiving assisted living services shall not receive 192.9 both assisted living services and homemaking services. 192.10 Individualized means services are chosen and designed 192.11 specifically for each resident's needs, rather than provided or 192.12 offered to all residents regardless of their illnesses, 192.13 disabilities, or physical conditions. Assisted living services 192.14 as defined in this section shall not be authorized in boarding 192.15 and lodging establishments licensed according to sections 192.16 157.011 and 157.15 to 157.22. 192.17(h)(b) For establishments registered under chapter 144D, 192.18 assisted living services under this section means either the 192.19 services described inparagraph (g)subdivision 5d and delivered 192.20 by a class E home care provider licensed by the department of 192.21 health or the services described under section 144A.4605 and 192.22 delivered by an assisted living home care provider or a class A 192.23 home care provider licensed by the commissioner of health. 192.24(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 192.25 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 192.26 and residential care services shall be a monthly rate negotiated 192.27 and authorized by the county agency based on an individualized 192.28 service plan for each resident and may not cover direct rent or 192.29 food costs. 192.30(1)(b) The individualized monthly negotiated payment for 192.31 assisted living services as described inparagraph192.32(g)subdivision 5d or(h)5e, paragraph (b), and residential 192.33 care services as described inparagraph (f)subdivision 5c, 192.34 shall not exceed the nonfederal share in effect on July 1 of the 192.35 state fiscal year for which the rate limit is being calculated 192.36 of the greater of either the statewide or any of the geographic 193.1groups' weighted average monthly nursing facility payment rate193.2of the case mix resident class to which the alternative care193.3eligible client would be assigned under Minnesota Rules, parts193.49549.0050 to 9549.0059, less the maintenance needs allowance as193.5described in section 256B.0915, subdivision 1d, paragraph (a),193.6until the first day of the state fiscal year in which a resident193.7assessment system, under section 256B.437, of nursing home rate193.8determination is implemented. Effective on the first day of the193.9state fiscal year in which a resident assessment system, under193.10section 256B.437, of nursing home rate determination is193.11implemented and the first day of each subsequent state fiscal193.12year, the individualized monthly negotiated payment for the193.13services described in this clause shall not exceed the limit193.14described in this clause which was in effect on the last day of193.15the previous state fiscal year and which has been adjusted by193.16the greater of any legislatively adopted home and193.17community-based services cost-of-living percentage increase or193.18any legislatively adopted statewide percent rate increase for193.19nursing facilitiesgroups according to subdivision 4, paragraph 193.20 (a), clause (6). 193.21(2)(c) The individualized monthly negotiated payment for 193.22 assisted living services described under section 144A.4605 and 193.23 delivered by a provider licensed by the department of health as 193.24 a class A home care provider or an assisted living home care 193.25 provider and provided in a building that is registered as a 193.26 housing with services establishment under chapter 144D and that 193.27 provides 24-hour supervision in combination with the payment for 193.28 other alternative care services, including case management, must 193.29 not exceed the limit specified in subdivision 4, paragraph (a), 193.30 clause (6). 193.31(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 193.32 A county agency may make payment from their alternative care 193.33 program allocation for"other services" which include use of193.34"discretionary funds" for services that are not otherwise193.35defined in this section anddirect cash payments to the client 193.36 for the purpose of purchasing the services. The following 194.1 provisions apply to payments under thisparagraphsubdivision: 194.2 (1) a cash payment to a client under this provision cannot 194.3 exceed the monthly payment limit for that client as specified in 194.4 subdivision 4, paragraph (a), clause (6); and 194.5 (2) a county may not approve any cash payment for a client 194.6 who meets either of the following: 194.7 (i) has been assessed as having a dependency in 194.8 orientation, unless the client has an authorized 194.9 representative. An "authorized representative" means an 194.10 individual who is at least 18 years of age and is designated by 194.11 the person or the person's legal representative to act on the 194.12 person's behalf. This individual may be a family member, 194.13 guardian, representative payee, or other individual designated 194.14 by the person or the person's legal representative, if any, to 194.15 assist in purchasing and arranging for supports; or 194.16 (ii) is concurrently receiving adult foster care, 194.17 residential care, or assisted living services;. 194.18(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 194.19 payments to a person or a person's family will be provided 194.20 through a monthly payment and be in the form of cash, voucher, 194.21 or direct county payment to a vendor. Fees or premiums assessed 194.22 to the person for eligibility for health and human services are 194.23 not reimbursable through this service option. Services and 194.24 goods purchased through cash payments must be identified in the 194.25 person's individualized care plan and must meet all of the 194.26 following criteria: 194.27(i)(1) they must be over and above the normal cost of 194.28 caring for the person if the person did not have functional 194.29 limitations; 194.30(ii)(2) they must be directly attributable to the person's 194.31 functional limitations; 194.32(iii)(3) they must have the potential to be effective at 194.33 meeting the goals of the program; and 194.34(iv)(4) they must be consistent with the needs identified 194.35 in the individualized service plan. The service plan shall 194.36 specify the needs of the person and family, the form and amount 195.1 of payment, the items and services to be reimbursed, and the 195.2 arrangements for management of the individual grant; and. 195.3(v)(b) The person, the person's family, or the legal 195.4 representative shall be provided sufficient information to 195.5 ensure an informed choice of alternatives. The local agency 195.6 shall document this information in the person's care plan, 195.7 including the type and level of expenditures to be reimbursed;. 195.8 (c) Persons receiving grants under this section shall have 195.9 the following responsibilities: 195.10 (1) spend the grant money in a manner consistent with their 195.11 individualized service plan with the local agency; 195.12 (2) notify the local agency of any necessary changes in the 195.13 grant expenditures; 195.14 (3) arrange and pay for supports; and 195.15 (4) inform the local agency of areas where they have 195.16 experienced difficulty securing or maintaining supports. 195.17 (d) The county shall report client outcomes, services, and 195.18 costs under this paragraph in a manner prescribed by the 195.19 commissioner. 195.20(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 195.21 lead agency under contract, or tribal government under contract 195.22 to administer the alternative care program shall not be liable 195.23 for damages, injuries, or liabilities sustained through the 195.24 purchase of direct supports or goods by the person, the person's 195.25 family, or the authorized representative with funds received 195.26 through the cash payments under this section. Liabilities 195.27 include, but are not limited to, workers' compensation, the 195.28 Federal Insurance Contributions Act (FICA), or the Federal 195.29 Unemployment Tax Act (FUTA);. 195.30(5) persons receiving grants under this section shall have195.31the following responsibilities:195.32(i) spend the grant money in a manner consistent with their195.33individualized service plan with the local agency;195.34(ii) notify the local agency of any necessary changes in195.35the grant expenditures;195.36(iii) arrange and pay for supports; and196.1(iv) inform the local agency of areas where they have196.2experienced difficulty securing or maintaining supports; and196.3(6) the county shall report client outcomes, services, and196.4costs under this paragraph in a manner prescribed by the196.5commissioner.196.6 Sec. 7. Minnesota Statutes 2002, section 256B.0913, 196.7 subdivision 6, is amended to read: 196.8 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 196.9 The alternative care program is administered by the county 196.10 agency. This agency is the lead agency responsible for the 196.11 local administration of the alternative care program as 196.12 described in this section. However, it may contract with the 196.13 public health nursing service to be the lead agency. The 196.14 commissioner may contract with federally recognized Indian 196.15 tribes with a reservation in Minnesota to serve as the lead 196.16 agency responsible for the local administration of the 196.17 alternative care program as described in the contract. 196.18 (b) Alternative care pilot projects operate according to 196.19 this section and the provisions of Laws 1993, First Special 196.20 Session chapter 1, article 5, section 133, under agreement with 196.21 the commissioner. Each pilot project agreement period shall 196.22 begin no later than the first payment cycle of the state fiscal 196.23 year and continue through the last payment cycle of the state 196.24 fiscal year. 196.25 Sec. 8. Minnesota Statutes 2002, section 256B.0913, 196.26 subdivision 7, is amended to read: 196.27 Subd. 7. [CASE MANAGEMENT.]Providers of case management196.28services for persons receiving services funded by the196.29alternative care program must meet the qualification196.30requirements and standards specified in section 256B.0915,196.31subdivision 1b.The case manager must not approve alternative 196.32 care funding for a client in any setting in which the case 196.33 manager cannot reasonably ensure the client's health and 196.34 safety. The case manager is responsible for the 196.35 cost-effectiveness of the alternative care individual care plan 196.36 and must not approve any care plan in which the cost of services 197.1 funded by alternative care and client contributions exceeds the 197.2 limit specified in section 256B.0915, subdivision 3, paragraph 197.3 (b).The county may allow a case manager employed by the county197.4to delegate certain aspects of the case management activity to197.5another individual employed by the county provided there is197.6oversight of the individual by the case manager. The case197.7manager may not delegate those aspects which require197.8professional judgment including assessments, reassessments, and197.9care plan development.197.10 Sec. 9. Minnesota Statutes 2002, section 256B.0913, 197.11 subdivision 8, is amended to read: 197.12 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 197.13 case manager shall implement the plan of care for each 197.14 alternative care client and ensure that a client's service needs 197.15 and eligibility are reassessed at least every 12 months. The 197.16 plan shall include any services prescribed by the individual's 197.17 attending physician as necessary to allow the individual to 197.18 remain in a community setting. In developing the individual's 197.19 care plan, the case manager should include the use of volunteers 197.20 from families and neighbors, religious organizations, social 197.21 clubs, and civic and service organizations to support the formal 197.22 home care services. The county shall be held harmless for 197.23 damages or injuries sustained through the use of volunteers 197.24 under this subdivision including workers' compensation 197.25 liability. The lead agency shall provide documentation in each 197.26 individual's plan of care and, if requested, to the commissioner 197.27 that the most cost-effective alternatives available have been 197.28 offered to the individual and that the individual was free to 197.29 choose among available qualified providers, both public and 197.30 private, including qualified case management or service 197.31 coordination providers other than those employed by the lead 197.32 agency when the lead agency maintains responsibility for prior 197.33 authorizing services in accordance with statutory and 197.34 administrative requirements. The case manager must give the 197.35 individual a ten-day written notice of any denial, termination, 197.36 or reduction of alternative care services. 198.1 (b) If the county administering alternative care services 198.2 is different than the county of financial responsibility, the 198.3 care plan may be implemented without the approval of the county 198.4 of financial responsibility. 198.5 Sec. 10. Minnesota Statutes 2002, section 256B.0913, 198.6 subdivision 10, is amended to read: 198.7 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 198.8 appropriation for fiscal years 1992 and beyond shall cover only 198.9 alternative care eligible clients. By July 1 of each year, the 198.10 commissioner shall allocate to county agencies the state funds 198.11 available for alternative care for persons eligible under 198.12 subdivision 2. 198.13 (b) The adjusted base for each county is the county's 198.14 current fiscal year base allocation plus any targeted funds 198.15 approved during the current fiscal year. Calculations for 198.16 paragraphs (c) and (d) are to be made as follows: for each 198.17 county, the determination of alternative care program 198.18 expenditures shall be based on payments for services rendered 198.19 from April 1 through March 31 in the base year, to the extent 198.20 that claims have been submitted and paid by June 1 of that year. 198.21 (c) If the alternative care program expenditures as defined 198.22 in paragraph (b) are 95 percent or more of the county's adjusted 198.23 base allocation, the allocation for the next fiscal year is 100 198.24 percent of the adjusted base, plus inflation to the extent that 198.25 inflation is included in the state budget. 198.26 (d) If the alternative care program expenditures as defined 198.27 in paragraph (b) are less than 95 percent of the county's 198.28 adjusted base allocation, the allocation for the next fiscal 198.29 year is the adjusted base allocation less the amount of unspent 198.30 funds below the 95 percent level. 198.31 (e) If the annual legislative appropriation for the 198.32 alternative care program is inadequate to fund the combined 198.33 county allocations for a biennium, the commissioner shall 198.34 distribute to each county the entire annual appropriation as 198.35 that county's percentage of the computed base as calculated in 198.36 paragraphs (c) and (d). 199.1 (f) On agreement between the commissioner and the lead 199.2 agency, the commissioner may have discretion to reallocate 199.3 alternative care base allocations distributed to lead agencies 199.4 in which the base amount exceeds program expenditures. 199.5 Sec. 11. Minnesota Statutes 2002, section 256B.0913, 199.6 subdivision 12, is amended to read: 199.7 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 199.8 all alternative care eligible clients to help pay for the cost 199.9 of participating in the program. The amount of the premium for 199.10 the alternative care client shall be determined as follows: 199.11 (1) when the alternative care client's income less 199.12 recurring and predictable medical expenses isgreater than the199.13recipient's maintenance needs allowance as defined in section199.14256B.0915, subdivision 1d, paragraph (a), butless than 150 199.15 percent of the federal poverty guideline effective on July 1 of 199.16 the state fiscal year in which the premium is being computed, 199.17 and total assets are less than $10,000, the fee is zero; 199.18 (2) when the alternative care client's income less 199.19 recurring and predictable medical expenses is greater than 150 199.20 percent of the federal poverty guideline effective on July 1 of 199.21 the state fiscal year in which the premium is being computed, 199.22 and total assets are less than $10,000, the fee is 25 percent of 199.23 the cost of alternative care services or the difference between 199.24 150 percent of the federal poverty guideline effective on July 1 199.25 of the state fiscal year in which the premium is being computed 199.26 and the client's income less recurring and predictable medical 199.27 expenses, whichever is less; and 199.28 (3) when the alternative care client's total assets are 199.29 greater than $10,000, the fee is 25 percent of the cost of 199.30 alternative care services. 199.31 For married persons, total assets are defined as the total 199.32 marital assets less the estimated community spouse asset 199.33 allowance, under section 256B.059, if applicable. For married 199.34 persons, total income is defined as the client's income less the 199.35 monthly spousal allotment, under section 256B.058. 199.36 All alternative care services except case management shall 200.1 be included in the estimated costs for the purpose of 200.2 determining25 percent ofthecostspremium amount. 200.3 Premiums are due and payable each month alternative care 200.4 services are received unless the actual cost of the services is 200.5 less than the premium, in which case the fee is the lesser 200.6 amount. 200.7 (b) The fee shall be waived by the commissioner when: 200.8 (1) a person who is residing in a nursing facility is 200.9 receiving case management only; 200.10 (2) a person is applying for medical assistance; 200.11 (3) a married couple is requesting an asset assessment 200.12 under the spousal impoverishment provisions; 200.13 (4) a person is found eligible for alternative care, but is 200.14 not yet receiving alternative care services;or200.15 (5) a person's fee under paragraph (a) is less than $25; or 200.16 (6) a person has chosen to participate in a 200.17 consumer-directed service plan for which the cost is no greater 200.18 than the total cost of the person's alternative care service 200.19 plan less the monthly premium amount that would otherwise be 200.20 assessed. 200.21 (c) The county agency must record in the state's receivable 200.22 system the client's assessed premium amount or the reason the 200.23 premium has been waived. The commissioner will bill and collect 200.24 the premium from the client. Money collected must be deposited 200.25 in the general fund and is appropriated to the commissioner for 200.26 the alternative care program. The client must supply the county 200.27 with the client's social security number at the time of 200.28 application. The county shall supply the commissioner with the 200.29 client's social security number and other information the 200.30 commissioner requires to collect the premium from the client. 200.31 The commissioner shall collect unpaid premiums using the Revenue 200.32 Recapture Act in chapter 270A and other methods available to the 200.33 commissioner. The commissioner may require counties to inform 200.34 clients of the collection procedures that may be used by the 200.35 state if a premium is not paid. This paragraph does not apply 200.36 to alternative care pilot projects authorized in Laws 1993, 201.1 First Special Session chapter 1, article 5, section 133, if a 201.2 county operating under the pilot project reports the following 201.3 dollar amounts to the commissioner quarterly: 201.4 (1) total premiums billed to clients; 201.5 (2) total collections of premiums billed; and 201.6 (3) balance of premiums owed by clients. 201.7 If a county does not adhere to these reporting requirements, the 201.8 commissioner may terminate the billing, collecting, and 201.9 remitting portions of the pilot project and require the county 201.10 involved to operate under the procedures set forth in this 201.11 paragraph. 201.12 Sec. 12. Minnesota Statutes 2002, section 256B.0915, 201.13 subdivision 3, is amended to read: 201.14 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND201.15FORECASTING.](a)The number of medical assistance waiver 201.16 recipients that a county may serve must be allocated according 201.17 to the number of medical assistance waiver cases open on July 1 201.18 of each fiscal year. Additional recipients may be served with 201.19 the approval of the commissioner. 201.20(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 201.21 monthly limit for the cost of waivered services to an individual 201.22 elderly waiver client shall be the weighted average monthly 201.23 nursing facility rate of the case mix resident class to which 201.24 the elderly waiver client would be assigned under Minnesota 201.25 Rules, parts 9549.0050 to 9549.0059, less the recipient's 201.26 maintenance needs allowance as described in subdivision 1d, 201.27 paragraph (a), until the first day of the state fiscal year in 201.28 which the resident assessment system as described in section 201.29 256B.437 for nursing home rate determination is implemented. 201.30 Effective on the first day of the state fiscal year in which the 201.31 resident assessment system as described in section 256B.437 for 201.32 nursing home rate determination is implemented and the first day 201.33 of each subsequent state fiscal year, the monthly limit for the 201.34 cost of waivered services to an individual elderly waiver client 201.35 shall be the rate of the case mix resident class to which the 201.36 waiver client would be assigned under Minnesota Rules, parts 202.1 9549.0050 to 9549.0059, in effect on the last day of the 202.2 previous state fiscal year, adjusted by the greater of any 202.3 legislatively adopted home and community-based services 202.4 cost-of-living percentage increase or any legislatively adopted 202.5 statewide percent rate increase for nursing facilities. 202.6(c)(b) If extended medical supplies and equipment or 202.7 environmental modifications are or will be purchased for an 202.8 elderly waiver client, the costs may be prorated for up to 12 202.9 consecutive months beginning with the month of purchase. If the 202.10 monthly cost of a recipient's waivered services exceeds the 202.11 monthly limit established in paragraph(b)(a), the annual cost 202.12 of all waivered services shall be determined. In this event, 202.13 the annual cost of all waivered services shall not exceed 12 202.14 times the monthly limit of waivered services as described in 202.15 paragraph(b)(a). 202.16(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 202.17 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 202.18 nursing facility resident at the time of requesting a 202.19 determination of eligibility for elderly waivered services, a 202.20 monthly conversion limit for the cost of elderly waivered 202.21 services may be requested. The monthly conversion limit for the 202.22 cost of elderly waiver services shall be the resident class 202.23 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 202.24 for that resident in the nursing facility where the resident 202.25 currently resides until July 1 of the state fiscal year in which 202.26 the resident assessment system as described in section 256B.437 202.27 for nursing home rate determination is implemented. Effective 202.28 on July 1 of the state fiscal year in which the resident 202.29 assessment system as described in section 256B.437 for nursing 202.30 home rate determination is implemented, the monthly conversion 202.31 limit for the cost of elderly waiver services shall be the per 202.32 diem nursing facility rate as determined by the resident 202.33 assessment system as described in section 256B.437 for that 202.34 resident in the nursing facility where the resident currently 202.35 resides multiplied by 365 and divided by 12, less the 202.36 recipient's maintenance needs allowance as described in 203.1 subdivision 1d. The initially approved conversion rate may be 203.2 adjusted by the greater of any subsequent legislatively adopted 203.3 home and community-based services cost-of-living percentage 203.4 increase or any subsequent legislatively adopted statewide 203.5 percentage rate increase for nursing facilities. The limit 203.6 under thisclausesubdivision only applies to persons discharged 203.7 from a nursing facility after a minimum 30-day stay and found 203.8 eligible for waivered services on or after July 1, 1997. 203.9 (b) The following costs must be included in determining the 203.10 total monthly costs for the waiver client: 203.11 (1) cost of all waivered services, including extended 203.12 medical supplies and equipment and environmental modifications; 203.13 and 203.14 (2) cost of skilled nursing, home health aide, and personal 203.15 care services reimbursable by medical assistance. 203.16(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 203.17 PROVISIONS.] (a) Medical assistance funding for skilled nursing 203.18 services, private duty nursing, home health aide, and personal 203.19 care services for waiver recipients must be approved by the case 203.20 manager and included in the individual care plan. 203.21(f)(b) A county is not required to contract with a 203.22 provider of supplies and equipment if the monthly cost of the 203.23 supplies and equipment is less than $250. 203.24(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 203.25 care rate shall be considered a difficulty of care payment and 203.26 shall not include room and board. The adult foster care service 203.27 rate shall be negotiated between the county agency and the 203.28 foster care provider. The elderly waiver payment for the foster 203.29 care service in combination with the payment for all other 203.30 elderly waiver services, including case management, must not 203.31 exceed the limit specified in subdivision 3a, paragraph(b)(a). 203.32(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 203.33 for assisted living service shall be a monthly rate negotiated 203.34 and authorized by the county agency based on an individualized 203.35 service plan for each resident and may not cover direct rent or 203.36 food costs. 204.1(1)(b) The individualized monthly negotiated payment for 204.2 assisted living services as described in section 256B.0913, 204.3subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 204.4 residential care services as described in section 256B.0913, 204.5 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 204.6 share, in effect on July 1 of the state fiscal year for which 204.7 the rate limit is being calculated, of the greater of either the 204.8 statewide or any of the geographic groups' weighted average 204.9 monthly nursing facility rate of the case mix resident class to 204.10 which the elderly waiver eligible client would be assigned under 204.11 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 204.12 maintenance needs allowance as described in subdivision 1d, 204.13 paragraph (a), until the July 1 of the state fiscal year in 204.14 which the resident assessment system as described in section 204.15 256B.437 for nursing home rate determination is implemented. 204.16 Effective on July 1 of the state fiscal year in which the 204.17 resident assessment system as described in section 256B.437 for 204.18 nursing home rate determination is implemented and July 1 of 204.19 each subsequent state fiscal year, the individualized monthly 204.20 negotiated payment for the services described in this clause 204.21 shall not exceed the limit described in this clause which was in 204.22 effect on June 30 of the previous state fiscal year and which 204.23 has been adjusted by the greater of any legislatively adopted 204.24 home and community-based services cost-of-living percentage 204.25 increase or any legislatively adopted statewide percent rate 204.26 increase for nursing facilities. 204.27(2)(c) The individualized monthly negotiated payment for 204.28 assisted living services described in section 144A.4605 and 204.29 delivered by a provider licensed by the department of health as 204.30 a class A home care provider or an assisted living home care 204.31 provider and provided in a building that is registered as a 204.32 housing with services establishment under chapter 144D and that 204.33 provides 24-hour supervision in combination with the payment for 204.34 other elderly waiver services, including case management, must 204.35 not exceed the limit specified inparagraph (b)subdivision 3a. 204.36(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 205.1 FORECASTS.] (a) The county shall negotiate individual service 205.2 rates with vendors and may authorize payment for actual costs up 205.3 to the county's current approved rate. Persons or agencies must 205.4 be employed by or under a contract with the county agency or the 205.5 public health nursing agency of the local board of health in 205.6 order to receive funding under the elderly waiver program, 205.7 except as a provider of supplies and equipment when the monthly 205.8 cost of the supplies and equipment is less than $250. 205.9(j)(b) Reimbursement for the medical assistance recipients 205.10 under the approved waiver shall be made from the medical 205.11 assistance account through the invoice processing procedures of 205.12 the department's Medicaid Management Information System (MMIS), 205.13 only with the approval of the client's case manager. The budget 205.14 for the state share of the Medicaid expenditures shall be 205.15 forecasted with the medical assistance budget, and shall be 205.16 consistent with the approved waiver. 205.17(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 205.18 COSTS.] (a) To improve access to community services and 205.19 eliminate payment disparities between the alternative care 205.20 program and the elderly waiver, the commissioner shall establish 205.21 statewide maximum service rate limits and eliminate 205.22 county-specific service rate limits. 205.23(1)(b) Effective July 1, 2001, for service rate limits, 205.24 except those described or defined inparagraphs (g) and205.25(h)subdivisions 3d and 3e, the rate limit for each service 205.26 shall be the greater of the alternative care statewide maximum 205.27 rate or the elderly waiver statewide maximum rate. 205.28(2)(c) Counties may negotiate individual service rates 205.29 with vendors for actual costs up to the statewide maximum 205.30 service rate limit. 205.31 Sec. 13. Minnesota Statutes 2002, section 256B.431, 205.32 subdivision 2r, is amended to read: 205.33 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 205.34 July 1, 1993, the commissioner shall limit payment for leave 205.35 days in a nursing facility to 79 percent of that nursing 205.36 facility's total payment rate for the involved resident. For 206.1 services rendered on or after July 1, 2003, for facilities 206.2 reimbursed under this section or section 256B.434, the 206.3 commissioner shall limit payment for leave days in a nursing 206.4 facility to 60 percent of that nursing facility's total payment 206.5 rate for the involved resident. 206.6 Sec. 14. Minnesota Statutes 2002, section 256B.431, is 206.7 amended by adding a subdivision to read: 206.8 Subd. 2t. [PAYMENT LIMITATION.] For services rendered on 206.9 or after July 1, 2003, for facilities reimbursed under this 206.10 section or section 256B.434, the Medicaid program shall only pay 206.11 a co-payment during a Medicare-covered skilled nursing facility 206.12 stay if the Medicare rate less the resident's co-payment 206.13 responsibility is less than the Medicaid RUG-III case-mix 206.14 payment rate. The amount that shall be paid by the Medicaid 206.15 program is equal to the amount by which the Medicaid RUG-III 206.16 case-mix payment rate exceeds the Medicare rate less the 206.17 co-payment responsibility. Health plans paying for nursing home 206.18 services under section 256B.69, subdivision 6a, may limit 206.19 payments as allowed under this subdivision. 206.20 Sec. 15. Minnesota Statutes 2002, section 256B.431, 206.21 subdivision 32, is amended to read: 206.22 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 206.23 years beginning on or after July 1, 2001, the total payment rate 206.24 for a facility reimbursed under this section, section 256B.434, 206.25 or any other section for the first 90 paid days after admission 206.26 shall be: 206.27 (1) for the first 30 paid days, the rate shall be 120 206.28 percent of the facility's medical assistance rate for each case 206.29 mix class;and206.30 (2) for the next 60 paid days after the first 30 paid days, 206.31 the rate shall be 110 percent of the facility's medical 206.32 assistance rate for each case mix class.; 206.33(b)(3) beginning with the 91st paid day after admission, 206.34 the payment rate shall be the rate otherwise determined under 206.35 this section, section 256B.434, or any other section.; and 206.36(c)(4) payments under thissubdivision appliesparagraph 207.1 apply to admissions occurring on or after July 1, 2001, and 207.2 before July 1, 2003, and to resident days occurring before July 207.3 30, 2003. 207.4 (b) For rate years beginning on or after July 1, 2003, the 207.5 total payment rate for a facility reimbursed under this section, 207.6 section 256B.434, or any other section shall be: 207.7 (1) for the first 30 calendar days after admission, the 207.8 rate shall be 120 percent of the facility's medical assistance 207.9 rate for each RUG class; 207.10 (2) beginning with the 31st calendar day after admission, 207.11 the payment rate shall be the rate otherwise determined under 207.12 this section, section 256B.434, or any other section; and 207.13 (3) payments under this paragraph apply to admissions 207.14 occurring on or after July 1, 2003. 207.15 (c) Effective January 1, 2004, the enhanced rates under 207.16 this subdivision shall not be allowed if a resident has resided 207.17 during the previous 30 calendar days in: 207.18 (1) the same nursing facility; 207.19 (2) a nursing facility owned or operated by a related 207.20 party; or 207.21 (3) a nursing facility or part of a facility that closed. 207.22 Sec. 16. Minnesota Statutes 2002, section 256B.431, is 207.23 amended by adding a subdivision to read: 207.24 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 207.25 YEAR 2004.] Effective June 1, 2003, the commissioner shall 207.26 provide to each nursing home reimbursed under this section or 207.27 section 256B.434, an increase in each case mix payment rate 207.28 equal to the increase in the per-bed surcharge paid under 207.29 section 256.9657, subdivision 1, paragraph (d), divided by 365 207.30 and further divided by .90. The increase shall not be subject 207.31 to any annual percentage increase. The 30-day advance notice 207.32 requirement in section 256B.47, subdivision 2, shall not apply 207.33 to rate increases resulting from this section. The commissioner 207.34 shall not adjust the rate increase under this subdivision unless 207.35 an adjustment under section 256.9657, subdivision 1, paragraph 207.36 (e), is greater than 1.5 percent of the surcharge amount. 208.1 [EFFECTIVE DATE.] This section is effective May 31, 2003. 208.2 Sec. 17. Minnesota Statutes 2002, section 256B.434, 208.3 subdivision 4, is amended to read: 208.4 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 208.5 nursing facilities which have their payment rates determined 208.6 under this section rather than section 256B.431, the 208.7 commissioner shall establish a rate under this subdivision. The 208.8 nursing facility must enter into a written contract with the 208.9 commissioner. 208.10 (b) A nursing facility's case mix payment rate for the 208.11 first rate year of a facility's contract under this section is 208.12 the payment rate the facility would have received under section 208.13 256B.431. 208.14 (c) A nursing facility's case mix payment rates for the 208.15 second and subsequent years of a facility's contract under this 208.16 section are the previous rate year's contract payment rates plus 208.17 an inflation adjustment and, for facilities reimbursed under 208.18 this section or section 256B.431, an adjustment to include the 208.19 cost of any increase in health department licensing fees for the 208.20 facility taking effect on or after July 1, 2001. The index for 208.21 the inflation adjustment must be based on the change in the 208.22 Consumer Price Index-All Items (United States City average) 208.23 (CPI-U) forecasted byData Resources, Inc.the commissioner of 208.24 finance's national economic consultant, as forecasted in the 208.25 fourth quarter of the calendar year preceding the rate year. 208.26 The inflation adjustment must be based on the 12-month period 208.27 from the midpoint of the previous rate year to the midpoint of 208.28 the rate year for which the rate is being determined. For the 208.29 rate years beginning on July 1, 1999, July 1, 2000, July 1, 208.30 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 208.31 paragraph shall apply only to the property-related payment rate, 208.32 except that adjustments to include the cost of any increase in 208.33 health department licensing fees taking effect on or after July 208.34 1, 2001, shall be provided. In determining the amount of the 208.35 property-related payment rate adjustment under this paragraph, 208.36 the commissioner shall determine the proportion of the 209.1 facility's rates that are property-related based on the 209.2 facility's most recent cost report. 209.3 (d) The commissioner shall develop additional 209.4 incentive-based payments of up to five percent above the 209.5 standard contract rate for achieving outcomes specified in each 209.6 contract. The specified facility-specific outcomes must be 209.7 measurable and approved by the commissioner. The commissioner 209.8 may establish, for each contract, various levels of achievement 209.9 within an outcome. After the outcomes have been specified the 209.10 commissioner shall assign various levels of payment associated 209.11 with achieving the outcome. Any incentive-based payment cancels 209.12 if there is a termination of the contract. In establishing the 209.13 specified outcomes and related criteria the commissioner shall 209.14 consider the following state policy objectives: 209.15 (1) improved cost effectiveness and quality of life as 209.16 measured by improved clinical outcomes; 209.17 (2) successful diversion or discharge to community 209.18 alternatives; 209.19 (3) decreased acute care costs; 209.20 (4) improved consumer satisfaction; 209.21 (5) the achievement of quality; or 209.22 (6) any additional outcomes proposed by a nursing facility 209.23 that the commissioner finds desirable. 209.24 Sec. 18. Minnesota Statutes 2002, section 256B.437, 209.25 subdivision 6, is amended to read: 209.26 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 209.27 commissioner of human services shall calculate the amount of the 209.28 planned closure rate adjustment available under subdivision 3, 209.29 paragraph (b), for up to 5,140 beds according to clauses (1) to 209.30 (4): 209.31 (1) the amount available is the net reduction of nursing 209.32 facility beds multiplied by $2,080; 209.33 (2) the total number of beds in the nursing facility or 209.34 facilities receiving the planned closure rate adjustment must be 209.35 identified; 209.36 (3) capacity days are determined by multiplying the number 210.1 determined under clause (2) by 365; and 210.2 (4) the planned closure rate adjustment is the amount 210.3 available in clause (1), divided by capacity days determined 210.4 under clause (3). 210.5 (b) A planned closure rate adjustment under this section is 210.6 effective on the first day of the month following completion of 210.7 closure of the facility designated for closure in the 210.8 application and becomes part of the nursing facility's total 210.9 operating payment rate. 210.10 (c) Applicants may use the planned closure rate adjustment 210.11 to allow for a property payment for a new nursing facility or an 210.12 addition to an existing nursing facility or as an operating 210.13 payment rate adjustment. Applications approved under this 210.14 subdivision are exempt from other requirements for moratorium 210.15 exceptions under section 144A.073, subdivisions 2 and 3. 210.16 (d) Upon the request of a closing facility, the 210.17 commissioner must allow the facility a closure rate adjustment 210.18 as provided under section 144A.161, subdivision 10. 210.19 (e) A facility that has received a planned closure rate 210.20 adjustment may reassign it to another facility that is under the 210.21 same ownership at any time within three years of its effective 210.22 date. The amount of the adjustment shall be computed according 210.23 to paragraph (a). 210.24 (f) If the per bed dollar amount specified in paragraph 210.25 (a), clause (1), is increased, the commissioner shall 210.26 recalculate planned closure rate adjustments for facilities that 210.27 delicense beds under this section on or after July 1, 2001, to 210.28 reflect the increase in the per bed dollar amount. The 210.29 recalculated planned closure rate adjustment shall be effective 210.30 from the date the per bed dollar amount is increased. 210.31 (g) A 26-bed facility that voluntarily delicensed its beds 210.32 in June 2002 for which no closure plan was submitted shall be 210.33 permitted to assign a planned closure rate adjustment, effective 210.34 30 days after final enactment and then delayed in accordance 210.35 with section 144A.161, subdivision 10, to a 22-bed facility 210.36 under common ownership. The commissioner shall not rescind the 211.1 planned closure rate adjustments that were assigned to the five 211.2 nursing facilities with the lowest rates in the development 211.3 region. 211.4 [EFFECTIVE DATE.] This section is effective the day 211.5 following final enactment. 211.6 Sec. 19. Minnesota Statutes 2002, section 256I.02, is 211.7 amended to read: 211.8 256I.02 [PURPOSE.] 211.9 The Group Residential Housing Act establishes a 211.10 comprehensive system of rates and payments for persons who 211.11 reside ina group residencethe community and who meet the 211.12 eligibility criteria under section 256I.04, subdivision 1. 211.13 Sec. 20. Minnesota Statutes 2002, section 256I.04, 211.14 subdivision 3, is amended to read: 211.15 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 211.16 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 211.17 into agreements for new group residential housing beds with 211.18 total rates in excess of the MSA equivalent rate except: (1) 211.19for group residential housing establishments meeting the211.20requirements of subdivision 2a, clause (2) with department211.21approval; (2)for group residential housing establishments 211.22 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 211.23 provided the facility is needed to meet the census reduction 211.24 targets for persons with mental retardation or related 211.25 conditions at regional treatment centers;(3)(2) to ensure 211.26 compliance with the federal Omnibus Budget Reconciliation Act 211.27 alternative disposition plan requirements for inappropriately 211.28 placed persons with mental retardation or related conditions or 211.29 mental illness;(4)(3) up to 80 beds in a single, specialized 211.30 facility located in Hennepin county that will provide housing 211.31 for chronic inebriates who are repetitive users of 211.32 detoxification centers and are refused placement in emergency 211.33 shelters because of their state of intoxication, and planning 211.34 for the specialized facility must have been initiated before 211.35 July 1, 1991, in anticipation of receiving a grant from the 211.36 housing finance agency under section 462A.05, subdivision 20a, 212.1 paragraph (b);(5)(4) notwithstanding the provisions of 212.2 subdivision 2a, for up to 190 supportive housing units in Anoka, 212.3 Dakota, Hennepin, or Ramsey county for homeless adults with a 212.4 mental illness, a history of substance abuse, or human 212.5 immunodeficiency virus or acquired immunodeficiency syndrome. 212.6 For purposes of this section, "homeless adult" means a person 212.7 who is living on the street or in a shelter or discharged from a 212.8 regional treatment center, community hospital, or residential 212.9 treatment program and has no appropriate housing available and 212.10 lacks the resources and support necessary to access appropriate 212.11 housing. At least 70 percent of the supportive housing units 212.12 must serve homeless adults with mental illness, substance abuse 212.13 problems, or human immunodeficiency virus or acquired 212.14 immunodeficiency syndrome who are about to be or, within the 212.15 previous six months, has been discharged from a regional 212.16 treatment center, or a state-contracted psychiatric bed in a 212.17 community hospital, or a residential mental health or chemical 212.18 dependency treatment program. If a person meets the 212.19 requirements of subdivision 1, paragraph (a), and receives a 212.20 federal or state housing subsidy, the group residential housing 212.21 rate for that person is limited to the supplementary rate under 212.22 section 256I.05, subdivision 1a, and is determined by 212.23 subtracting the amount of the person's countable income that 212.24 exceeds the MSA equivalent rate from the group residential 212.25 housing supplementary rate. A resident in a demonstration 212.26 project site who no longer participates in the demonstration 212.27 program shall retain eligibility for a group residential housing 212.28 payment in an amount determined under section 256I.06, 212.29 subdivision 8, using the MSA equivalent rate. Service funding 212.30 under section 256I.05, subdivision 1a, will end June 30, 1997, 212.31 if federal matching funds are available and the services can be 212.32 provided through a managed care entity. If federal matching 212.33 funds are not available, then service funding will continue 212.34 under section 256I.05, subdivision 1a; or (6) for group 212.35 residential housing beds in settings meeting the requirements of 212.36 subdivision 2a, clauses (1) and (3), which are used exclusively 213.1 for recipients receiving home and community-based waiver 213.2 services under sections 256B.0915, 256B.092, subdivision 5, 213.3 256B.093, and 256B.49, and who resided in a nursing facility for 213.4 the six months immediately prior to the month of entry into the 213.5 group residential housing setting. The group residential 213.6 housing rate for these beds must be set so that the monthly 213.7 group residential housing payment for an individual occupying 213.8 the bed when combined with the nonfederal share of services 213.9 delivered under the waiver for that person does not exceed the 213.10 nonfederal share of the monthly medical assistance payment made 213.11 for the person to the nursing facility in which the person 213.12 resided prior to entry into the group residential housing 213.13 establishment. The rate may not exceed the MSA equivalent rate 213.14 plus $426.37 for any case. 213.15 (b) A county agency may enter into a group residential 213.16 housing agreement for beds with rates in excess of the MSA 213.17 equivalent rate in addition to those currently covered under a 213.18 group residential housing agreement if the additional beds are 213.19 only a replacement of beds with rates in excess of the MSA 213.20 equivalent rate which have been made available due to closure of 213.21 a setting, a change of licensure or certification which removes 213.22 the beds from group residential housing payment, or as a result 213.23 of the downsizing of a group residential housing setting. The 213.24 transfer of available beds from one county to another can only 213.25 occur by the agreement of both counties. 213.26 Sec. 21. Minnesota Statutes 2002, section 256I.05, 213.27 subdivision 1, is amended to read: 213.28 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 213.29 rates negotiated by a county agency for a recipient living in 213.30 group residential housing must not exceed the MSA equivalent 213.31 rate specified under section 256I.03, subdivision 5,.with the213.32exception that a county agency may negotiate a supplementary213.33room and board rate that exceeds the MSA equivalent rate for213.34recipients of waiver services under title XIX of the Social213.35Security Act. This exception is subject to the following213.36conditions:214.1(1) the setting is licensed by the commissioner of human214.2services under Minnesota Rules, parts 9555.5050 to 9555.6265;214.3(2) the setting is not the primary residence of the license214.4holder and in which the license holder is not the primary214.5caregiver; and214.6(3) the average supplementary room and board rate in a214.7county for a calendar year may not exceed the average214.8supplementary room and board rate for that county in effect on214.9January 1, 2000. For calendar years beginning on or after214.10January 1, 2002, within the limits of appropriations214.11specifically for this purpose, the commissioner shall increase214.12each county's supplemental room and board rate average on an214.13annual basis by a factor consisting of the percentage change in214.14the Consumer Price Index-All items, United States city average214.15(CPI-U) for that calendar year compared to the preceding214.16calendar year as forecasted by Data Resources, Inc., in the214.17third quarter of the preceding calendar year. If a county has214.18not negotiated supplementary room and board rates for any214.19facilities located in the county as of January 1, 2000, or has214.20an average supplemental room and board rate under $100 per214.21person as of January 1, 2000, it may submit a supplementary room214.22and board rate request with budget information for a facility to214.23the commissioner for approval.214.24The county agency may at any time negotiate a higher or lower214.25room and board rate than the average supplementary room and214.26board rate.214.27(b) Notwithstanding paragraph (a), clause (3), county214.28agencies may negotiate a supplementary room and board rate that214.29exceeds the MSA equivalent rate by up to $426.37 for up to five214.30facilities, serving not more than 20 individuals in total, that214.31were established to replace an intermediate care facility for214.32persons with mental retardation and related conditions located214.33in the city of Roseau that became uninhabitable due to flood214.34damage in June 2002.214.35 [EFFECTIVE DATE.] This section is effective July 1, 2004, 214.36 or upon receipt of federal approval of waiver amendment, 215.1 whichever is later. 215.2 Sec. 22. Minnesota Statutes 2002, section 256I.05, 215.3 subdivision 1a, is amended to read: 215.4 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 215.5 the provisions of section 256I.04, subdivision 3,in addition to215.6the room and board rate specified in subdivision 1,the county 215.7 agency may negotiate a payment not to exceed $426.37 for other 215.8 services necessary to provide room and board provided by the 215.9 group residence if the residence is licensed by or registered by 215.10 the department of health, or licensed by the department of human 215.11 services to provide services in addition to room and board, and 215.12 if the provider of services is not also concurrently receiving 215.13 funding for services for a recipient under a home and 215.14 community-based waiver under title XIX of the Social Security 215.15 Act; or funding from the medical assistance program under 215.16 section 256B.0627, subdivision 4, for personal care services for 215.17 residents in the setting; or residing in a setting which 215.18 receives funding under Minnesota Rules, parts 9535.2000 to 215.19 9535.3000. If funding is available for other necessary services 215.20 through a home and community-based waiver, or personal care 215.21 services under section 256B.0627, subdivision 4, then the GRH 215.22 rate is limited to the rate set in subdivision 1. Unless 215.23 otherwise provided in law, in no case may the supplementary 215.24 service rateplus the supplementary room and board rateexceed 215.25 $426.37. The registration and licensure requirement does not 215.26 apply to establishments which are exempt from state licensure 215.27 because they are located on Indian reservations and for which 215.28 the tribe has prescribed health and safety requirements. 215.29 Service payments under this section may be prohibited under 215.30 rules to prevent the supplanting of federal funds with state 215.31 funds. The commissioner shall pursue the feasibility of 215.32 obtaining the approval of the Secretary of Health and Human 215.33 Services to provide home and community-based waiver services 215.34 under title XIX of the Social Security Act for residents who are 215.35 not eligible for an existing home and community-based waiver due 215.36 to a primary diagnosis of mental illness or chemical dependency 216.1 and shall apply for a waiver if it is determined to be 216.2 cost-effective. 216.3 (b) The commissioner is authorized to make cost-neutral 216.4 transfers from the GRH fund for beds under this section to other 216.5 funding programs administered by the department after 216.6 consultation with the county or counties in which the affected 216.7 beds are located. The commissioner may also make cost-neutral 216.8 transfers from the GRH fund to county human service agencies for 216.9 beds permanently removed from the GRH census under a plan 216.10 submitted by the county agency and approved by the 216.11 commissioner. The commissioner shall report the amount of any 216.12 transfers under this provision annually to the legislature. 216.13 (c) The provisions of paragraph (b) do not apply to a 216.14 facility that has its reimbursement rate established under 216.15 section 256B.431, subdivision 4, paragraph (c). 216.16 Sec. 23. Minnesota Statutes 2002, section 256I.05, 216.17 subdivision 7c, is amended to read: 216.18 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 216.19 authorized to pursue a demonstration project under federal food 216.20 stamp regulation for the purpose of gaining federal 216.21 reimbursement of food and nutritional costs currently paid by 216.22 the state group residential housing program. The commissioner 216.23 shall seek approval no later than January 1, 2004. Any 216.24 reimbursement received is nondedicated revenue to the general 216.25 fund. 216.26 Sec. 24. [REVISOR'S INSTRUCTION.] 216.27 For sections in Minnesota Statutes and Minnesota Rules 216.28 affected by the repealed sections in this article, the revisor 216.29 shall delete internal cross-references where appropriate and 216.30 make changes necessary to correct the punctuation, grammar, or 216.31 structure of the remaining text and preserve its meaning. 216.32 Sec. 25. [REPEALER.] 216.33 Minnesota Statutes 2002, sections 256B.0917; and 256B.437, 216.34 subdivision 2, are repealed effective July 1, 2003. 216.35 ARTICLE 5 216.36 CONTINUING CARE FOR PERSONS WITH DISABILITIES 217.1 Section 1. Minnesota Statutes 2002, section 252.32, 217.2 subdivision 1, is amended to read: 217.3 Subdivision 1. [PROGRAM ESTABLISHED.] In accordance with 217.4 state policy established in section 256F.01 that all children 217.5 are entitled to live in families that offer safe, nurturing, 217.6 permanent relationships, and that public services be directed 217.7 toward preventing the unnecessary separation of children from 217.8 their families, and because many families who have children with 217.9mental retardation or related conditionsdisabilities have 217.10 special needs and expenses that other families do not have, the 217.11 commissioner of human services shall establish a program to 217.12 assist families who havedependentsdependent children with 217.13mental retardation or related conditionsdisabilities living in 217.14 their home. The program shall make support grants available to 217.15 the families. 217.16 Sec. 2. Minnesota Statutes 2002, section 252.32, 217.17 subdivision 1a, is amended to read: 217.18 Subd. 1a. [SUPPORT GRANTS.] (a) Provision of support 217.19 grants must be limited to families who require support and whose 217.20 dependents are under the age of22 and who have mental217.21retardation or who have a related condition21 and who have been 217.22determined by a screening team establishedcertified disabled 217.23 under section256B.092 to be at risk of217.24institutionalization256B.055, subdivision 12, paragraphs (a), 217.25 (b), (c), (d), and (e). Families who are receiving home and 217.26 community-based waivered services for persons with mental 217.27 retardation or related conditions are not eligible for support 217.28 grants. 217.29Families receiving grants who will be receiving home and217.30community-based waiver services for persons with mental217.31retardation or a related condition for their family member217.32within the grant year, and who have ongoing payments for217.33environmental or vehicle modifications which have been approved217.34by the county as a grant expense and would have qualified for217.35payment under this waiver may receive a onetime grant payment217.36from the commissioner to reduce or eliminate the principal of218.1the remaining debt for the modifications, not to exceed the218.2maximum amount allowable for the remaining years of eligibility218.3for a family support grant. The commissioner is authorized to218.4use up to $20,000 annually from the grant appropriation for this218.5purpose. Any amount unexpended at the end of the grant year218.6shall be allocated by the commissioner in accordance with218.7subdivision 3a, paragraph (b), clause (2).Families whose 218.8 annual adjusted gross income is $60,000 or more are not eligible 218.9 for support grants except in cases where extreme hardship is 218.10 demonstrated. Beginning in state fiscal year 1994, the 218.11 commissioner shall adjust the income ceiling annually to reflect 218.12 the projected change in the average value in the United States 218.13 Department of Labor Bureau of Labor Statistics consumer price 218.14 index (all urban) for that year. 218.15 (b) Support grants may be made available as monthly subsidy 218.16 grants and lump sum grants. 218.17 (c) Support grants may be issued in the form of cash, 218.18 voucher, and direct county payment to a vendor. 218.19 (d) Applications for the support grant shall be made by the 218.20 legal guardian to the county social service agency. The 218.21 application shall specify the needs of the families, the form of 218.22 the grant requested by the families, andthatthefamilies have218.23agreed to use the support grant foritems and serviceswithin218.24the designated reimbursable expense categories and218.25recommendations of the countyto be reimbursed. 218.26(e) Families who were receiving subsidies on the date of218.27implementation of the $60,000 income limit in paragraph (a)218.28continue to be eligible for a family support grant until218.29December 31, 1991, if all other eligibility criteria are met.218.30After December 31, 1991, these families are eligible for a grant218.31in the amount of one-half the grant they would otherwise218.32receive, for as long as they remain eligible under other218.33eligibility criteria.218.34 Sec. 3. Minnesota Statutes 2002, section 252.32, 218.35 subdivision 3, is amended to read: 218.36 Subd. 3. [AMOUNT OF SUPPORT GRANT; USE.] Support grant 219.1 amounts shall be determined by the county social service 219.2 agency.Each serviceServices anditemitems purchased with a 219.3 support grant must: 219.4 (1) be over and above the normal costs of caring for the 219.5 dependent if the dependent did not have a disability; 219.6 (2) be directly attributable to the dependent's disabling 219.7 condition; and 219.8 (3) enable the family to delay or prevent the out-of-home 219.9 placement of the dependent. 219.10 The design and delivery of services and items purchased 219.11 under this section must suit the dependent's chronological age 219.12 and be provided in the least restrictive environment possible, 219.13 consistent with the needs identified in the individual service 219.14 plan. 219.15 Items and services purchased with support grants must be 219.16 those for which there are no other public or private funds 219.17 available to the family. Fees assessed to parents for health or 219.18 human services that are funded by federal, state, or county 219.19 dollars are not reimbursable through this program. 219.20 In approving or denying applications, the county shall 219.21 consider the following factors: 219.22 (1) the extent and areas of the functional limitations of 219.23 the disabled child; 219.24 (2) the degree of need in the home environment for 219.25 additional support; and 219.26 (3) the potential effectiveness of the grant to maintain 219.27 and support the person in the family environment. 219.28 The maximum monthly grant amount shall be $250 per eligible 219.29 dependent, or $3,000 per eligible dependent per state fiscal 219.30 year, within the limits of available funds. The county social 219.31 service agency may consider the dependent's supplemental 219.32 security income in determining the amount of the support grant. 219.33The county social service agency may exceed $3,000 per state219.34fiscal year per eligible dependent for emergency circumstances219.35in cases where exceptional resources of the family are required219.36to meet the health, welfare-safety needs of the child.220.1County social service agencies shall continue to provide220.2funds to families receiving state grants on June 30, 1997, if220.3eligibility criteria continue to be met.Any adjustments to 220.4 their monthly grant amount must be based on the needs of the 220.5 family and funding availability. 220.6 Sec. 4. Minnesota Statutes 2002, section 252.32, 220.7 subdivision 3c, is amended to read: 220.8 Subd. 3c. [COUNTY BOARD RESPONSIBILITIES.] County boards 220.9 receiving funds under this section shall: 220.10 (1)determine the needs of families for services in220.11accordance with section 256B.092 or 256E.08 and any rules220.12adopted under those sectionssubmit a plan to the department for 220.13 the management of the family support grant program. The plan 220.14 must include the projected number of families the county will 220.15 serve and policies and procedures for: 220.16 (i) identifying potential families for the program; 220.17 (ii) grant distribution; 220.18 (iii) waiting list procedures; and 220.19 (iv) prioritization of families to receive grants; 220.20 (2) determine the eligibility of all persons proposed for 220.21 program participation; 220.22 (3) approve a plan for items and services to be reimbursed 220.23 and inform families of the county's approval decision; 220.24 (4) issue support grants directly to, or on behalf of, 220.25 eligible families; 220.26 (5) inform recipients of their right to appeal under 220.27 subdivision 3e; 220.28 (6) submit quarterly financial reports under subdivision 3b 220.29 and indicateon the screening documentsthe annual grant level 220.30 for each family, the families denied grants, and the families 220.31 eligible but waiting for funding; and 220.32 (7) coordinate services with other programs offered by the 220.33 county. 220.34 Sec. 5. Minnesota Statutes 2002, section 256.476, 220.35 subdivision 1, is amended to read: 220.36 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 221.1 human services shall establish a consumer support grant program 221.2 for individuals with functional limitations and their families 221.3 who wish to purchase and secure their own supports. The 221.4 commissioner and local agencies shall jointly develop an 221.5 implementation plan which must include a way to resolve the 221.6 issues related to county liability. The program shall: 221.7 (1) make support grantsor exception grants described in221.8subdivision 11available to individuals or families as an 221.9 effective alternative toexisting programs and services, such as221.10 the developmental disability family support program, personal 221.11 care attendant services, home health aide services, and private 221.12 duty nursing services; 221.13 (2) provide consumers more control, flexibility, and 221.14 responsibility over their services and supports; 221.15 (3) promote local program management and decision making; 221.16 and 221.17 (4) encourage the use of informal and typical community 221.18 supports. 221.19 Sec. 6. Minnesota Statutes 2002, section 256.476, 221.20 subdivision 3, is amended to read: 221.21 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 221.22 is eligible to apply for a consumer support grant if the person 221.23 meets all of the following criteria: 221.24 (1) the person is eligible for and has been approved to 221.25 receive services under medical assistance as determined under 221.26 sections 256B.055 and 256B.056 or the person has been approved 221.27 to receive a grant under the developmental disability family 221.28 support program under section 252.32; 221.29 (2) the person is able to direct and purchase the person's 221.30 own care and supports, or the person has a family member, legal 221.31 representative, or other authorized representative who can 221.32 purchase and arrange supports on the person's behalf; 221.33 (3) the person has functional limitations, requires ongoing 221.34 supports to live in the community, and is at risk of or would 221.35 continue institutionalization without such supports; and 221.36 (4) the person will live in a home. For the purpose of 222.1 this section, "home" means the person's own home or home of a 222.2 person's family member. These homes are natural home settings 222.3 and are not licensed by the department of health or human 222.4 services. 222.5 (b) Persons may not concurrently receive a consumer support 222.6 grant if they are: 222.7 (1) receivinghome and community-based services under222.8United States Code, title 42, section 1396h(c);personal care 222.9 attendant and home health aide services, or private duty nursing 222.10 under section 256B.0625; a developmental disability family 222.11 support grant; or alternative care services under section 222.12 256B.0913; or 222.13 (2) residing in an institutional or congregate care setting. 222.14 (c) A person or person's family receiving a consumer 222.15 support grant shall not be charged a fee or premium by a local 222.16 agency for participating in the program. 222.17 (d)The commissioner may limit the participation of222.18recipients of services from federal waiver programs in the222.19consumer support grant program if the participation of these222.20individuals will result in an increase in the cost to the222.21state.Individuals receiving home and community-based waivers 222.22 under United States Code, title 42, section 1396h(c), are not 222.23 eligible for the consumer support grant. 222.24 (e) The commissioner shall establish a budgeted 222.25 appropriation each fiscal year for the consumer support grant 222.26 program. The number of individuals participating in the program 222.27 will be adjusted so the total amount allocated to counties does 222.28 not exceed the amount of the budgeted appropriation. The 222.29 budgeted appropriation will be adjusted annually to accommodate 222.30 changes in demand for the consumer support grants. 222.31 Sec. 7. Minnesota Statutes 2002, section 256.476, 222.32 subdivision 4, is amended to read: 222.33 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 222.34 county board may choose to participate in the consumer support 222.35 grant program. If a county has not chosen to participate by 222.36 July 1, 2002, the commissioner shall contract with another 223.1 county or other entity to provide access to residents of the 223.2 nonparticipating county who choose the consumer support grant 223.3 option. The commissioner shall notify the county board in a 223.4 county that has declined to participate of the commissioner's 223.5 intent to enter into a contract with another county or other 223.6 entity at least 30 days in advance of entering into the 223.7 contract. The local agency shall establish written procedures 223.8 and criteria to determine the amount and use of support grants. 223.9 These procedures must include, at least, the availability of 223.10 respite care, assistance with daily living, and adaptive aids. 223.11 The local agency may establish monthly or annual maximum amounts 223.12 for grants and procedures where exceptional resources may be 223.13 required to meet the health and safety needs of the person on a 223.14 time-limited basis, however, the total amount awarded to each 223.15 individual may not exceed the limits established in subdivision 223.16 11. 223.17 (b) Support grants to a person or a person's family will be 223.18 provided through a monthly subsidy payment and be in the form of 223.19 cash, voucher, or direct county payment to vendor. Support 223.20 grant amounts must be determined by the local agency. Each 223.21 service and item purchased with a support grant must meet all of 223.22 the following criteria: 223.23 (1) it must be over and above the normal cost of caring for 223.24 the person if the person did not have functional limitations; 223.25 (2) it must be directly attributable to the person's 223.26 functional limitations; 223.27 (3) it must enable the person or the person's family to 223.28 delay or prevent out-of-home placement of the person; and 223.29 (4) it must be consistent with the needs identified in the 223.30 serviceplanagreement, when applicable. 223.31 (c) Items and services purchased with support grants must 223.32 be those for which there are no other public or private funds 223.33 available to the person or the person's family. Fees assessed 223.34 to the person or the person's family for health and human 223.35 services are not reimbursable through the grant. 223.36 (d) In approving or denying applications, the local agency 224.1 shall consider the following factors: 224.2 (1) the extent and areas of the person's functional 224.3 limitations; 224.4 (2) the degree of need in the home environment for 224.5 additional support; and 224.6 (3) the potential effectiveness of the grant to maintain 224.7 and support the person in the family environment or the person's 224.8 own home. 224.9 (e) At the time of application to the program or screening 224.10 for other services, the person or the person's family shall be 224.11 provided sufficient information to ensure an informed choice of 224.12 alternatives by the person, the person's legal representative, 224.13 if any, or the person's family. The application shall be made 224.14 to the local agency and shall specify the needs of the person 224.15 and family, the form and amount of grant requested, the items 224.16 and services to be reimbursed, and evidence of eligibility for 224.17 medical assistance. 224.18 (f) Upon approval of an application by the local agency and 224.19 agreement on a support plan for the person or person's family, 224.20 the local agency shall make grants to the person or the person's 224.21 family. The grant shall be in an amount for the direct costs of 224.22 the services or supports outlined in the service agreement. 224.23 (g) Reimbursable costs shall not include costs for 224.24 resources already available, such as special education classes, 224.25 day training and habilitation, case management, other services 224.26 to which the person is entitled, medical costs covered by 224.27 insurance or other health programs, or other resources usually 224.28 available at no cost to the person or the person's family. 224.29 (h) The state of Minnesota, the county boards participating 224.30 in the consumer support grant program, or the agencies acting on 224.31 behalf of the county boards in the implementation and 224.32 administration of the consumer support grant program shall not 224.33 be liable for damages, injuries, or liabilities sustained 224.34 through the purchase of support by the individual, the 224.35 individual's family, or the authorized representative under this 224.36 section with funds received through the consumer support grant 225.1 program. Liabilities include but are not limited to: workers' 225.2 compensation liability, the Federal Insurance Contributions Act 225.3 (FICA), or the Federal Unemployment Tax Act (FUTA). For 225.4 purposes of this section, participating county boards and 225.5 agencies acting on behalf of county boards are exempt from the 225.6 provisions of section 268.04. 225.7 Sec. 8. Minnesota Statutes 2002, section 256.476, 225.8 subdivision 5, is amended to read: 225.9 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 225.10 For the purpose of transferring persons to the consumer support 225.11 grant program fromspecific programs or services, such asthe 225.12 developmental disability family support program and personal 225.13 care assistant services, home health aide services, or private 225.14 duty nursing services, the amount of funds transferred by the 225.15 commissioner between the developmental disability family support 225.16 program account, the medical assistance account, or the consumer 225.17 support grant account shall be based on each county's 225.18 participation in transferring persons to the consumer support 225.19 grant program from those programs and services. 225.20 (b) At the beginning of each fiscal year, county 225.21 allocations for consumer support grants shall be based on: 225.22 (1) the number of persons to whom the county board expects 225.23 to provide consumer supports grants; 225.24 (2) their eligibility for current program and services; 225.25 (3) the amount of nonfederal dollars allowed under 225.26 subdivision 11; and 225.27 (4) projected dates when persons will start receiving 225.28 grants. County allocations shall be adjusted periodically by 225.29 the commissioner based on the actual transfer of persons or 225.30 service openings, and the nonfederal dollars associated with 225.31 those persons or service openings, to the consumer support grant 225.32 program. 225.33 (c) The amount of funds transferred by the commissioner 225.34 from the medical assistance account for an individual may be 225.35 changed if it is determined by the county or its agent that the 225.36 individual's need for support has changed. 226.1 (d) The authority to utilize funds transferred to the 226.2 consumer support grant account for the purposes of implementing 226.3 and administering the consumer support grant program will not be 226.4 limited or constrained by the spending authority provided to the 226.5 program of origination. 226.6 (e) The commissioner may use up to five percent of each 226.7 county's allocation, as adjusted, for payments for 226.8 administrative expenses, to be paid as a proportionate addition 226.9 to reported direct service expenditures. 226.10 (f) The county allocation for each individual or 226.11 individual's family cannot exceed the amount allowed under 226.12 subdivision 11. 226.13 (g) The commissioner may recover, suspend, or withhold 226.14 payments if the county board, local agency, or grantee does not 226.15 comply with the requirements of this section. 226.16 (h) Grant funds unexpended by consumers shall return to the 226.17 state once a year. The annual return of unexpended grant funds 226.18 shall occur in the quarter following the end of the state fiscal 226.19 year. 226.20 Sec. 9. Minnesota Statutes 2002, section 256.476, 226.21 subdivision 11, is amended to read: 226.22 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 226.23 2001.] (a) Effective July 1, 2001, the commissioner shall 226.24 allocate consumer support grant resources to serve additional 226.25 individuals based on a review of Medicaid authorization and 226.26 payment information of persons eligible for a consumer support 226.27 grant from the most recent fiscal year. The commissioner shall 226.28 use the following methodology to calculate maximum allowable 226.29 monthly consumer support grant levels: 226.30 (1) For individuals whose program of origination is medical 226.31 assistance home care under section 256B.0627, the maximum 226.32 allowable monthly grant levels are calculated by: 226.33 (i) determining the nonfederal share of the average service 226.34 authorization for each home care rating; 226.35 (ii) calculating the overall ratio of actual payments to 226.36 service authorizations by program; 227.1 (iii) applying the overall ratio to the average service 227.2 authorization level of each home care rating; 227.3 (iv) adjusting the result for any authorized rate increases 227.4 provided by the legislature; and 227.5 (v) adjusting the result for the average monthly 227.6 utilization per recipient; and. 227.7 (2)for persons with programs of origination other than the227.8program described in clause (1), the maximum grant level for an227.9individual shall not exceed the total of the nonfederal dollars227.10expended on the individual by the program of originationThe 227.11 commissioner may review and evaluate the methodology to reflect 227.12 changes in the home care programs overall ratio of actual 227.13 payments to service authorizations. 227.14 (b) Effective July 1, 2003, persons previously receiving 227.15consumer supportexception grantsprior to July 1, 2001, may227.16continue to receive the grant amount established prior to July227.171, 2001will have their grants calculated using the methodology 227.18 in paragraph (a), clause (1). If a person currently receiving 227.19 an exception grant wishes to have their home care rating 227.20 reevaluated, they may request an assessment as defined in 227.21 section 256B.0627, subdivision 1, paragraph (b). 227.22(c) The commissioner may provide up to 200 exception227.23grants, including grants in use under paragraph (b). Eligible227.24persons shall be provided an exception grant in priority order227.25based upon the date of the commissioner's receipt of the county227.26request. The maximum allowable grant level for an exception227.27grant shall be based upon the nonfederal share of the average227.28service authorization from the most recent fiscal year for each227.29home care rating category. The amount of each exception grant227.30shall be based upon the commissioner's determination of the227.31nonfederal dollars that would have been expended if services had227.32been available for an individual who is unable to obtain the227.33support needed from the program of origination due to the227.34unavailability of qualified service providers at the time or the227.35location where the supports are needed.227.36 Sec. 10. Minnesota Statutes 2002, section 256.9657, is 228.1 amended by adding a subdivision to read: 228.2 Subd. 3b. [ICF/MR LICENSE SURCHARGE.] Effective July 1, 228.3 2003, each nonstate-operated facility as defined under section 228.4 256B.501, subdivision 1, shall pay to the commissioner an annual 228.5 surcharge according to the schedule in subdivision 4, paragraph 228.6 (d). The annual surcharge shall be $1,040 per licensed bed. If 228.7 the number of licensed beds is reduced, the surcharge shall be 228.8 based on the number of remaining licensed beds the second month 228.9 following the receipt of timely notice by the commissioner of 228.10 human services that beds have been delicensed. The facility 228.11 must notify the commissioner of health in writing when beds are 228.12 delicensed. The commissioner of health must notify the 228.13 commissioner of human services within ten working days after 228.14 receiving written notification. If the notification is received 228.15 by the commissioner of human services by the 15th of the month, 228.16 the invoice for the second following month must be reduced to 228.17 recognize the delicensing of beds. The commissioner may reduce, 228.18 and may subsequently restore, the surcharge under this 228.19 subdivision based on the commissioner's determination of a 228.20 permissible surcharge. 228.21 [EFFECTIVE DATE.] This section is effective the day 228.22 following final enactment. 228.23 Sec. 11. Minnesota Statutes 2002, section 256.9657, 228.24 subdivision 4, is amended to read: 228.25 Subd. 4. [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 228.26 commissioner under subdivisions 1 to 3 must be paid in monthly 228.27 installments due on the 15th of the month beginning October 15, 228.28 1992. The monthly payment must be equal to the annual surcharge 228.29 divided by 12. Payments to the commissioner under subdivisions 228.30 2 and 3 for fiscal year 1993 must be based on calendar year 1990 228.31 revenues. Effective July 1 of each year, beginning in 1993, 228.32 payments under subdivisions 2 and 3 must be based on revenues 228.33 earned in the second previous calendar year. 228.34 (b) Effective October 1, 1995, and each October 1 228.35 thereafter, the payments in subdivisions 2 and 3 must be based 228.36 on revenues earned in the previous calendar year. 229.1 (c) If the commissioner of health does not provide by 229.2 August 15 of any year data needed to update the base year for 229.3 the hospital and health maintenance organization surcharges, the 229.4 commissioner of human services may estimate base year revenue 229.5 and use that estimate for the purposes of this section until 229.6 actual data is provided by the commissioner of health. 229.7 (d) Payments to the commissioner under subdivision 3b must 229.8 be paid in monthly installments due on the 15th of the month 229.9 beginning July 15, 2003. The monthly payment must be equal to 229.10 the annual surcharge divided by 12. 229.11 [EFFECTIVE DATE.] This section is effective the day 229.12 following final enactment. 229.13 Sec. 12. Minnesota Statutes 2002, section 256B.0621, 229.14 subdivision 4, is amended to read: 229.15 Subd. 4. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 229.16 QUALIFICATIONS.]The following qualifications and certification229.17standards must be met by providers of relocation targeted case229.18management:229.19(a) The commissioner must certify each provider of229.20relocation targeted case management before enrollment. The229.21certification process shall examine the provider's ability to229.22meet the requirements in this subdivision and other federal and229.23state requirements of this service. A certified relocation229.24targeted case management provider may subcontract with another229.25provider to deliver relocation targeted case management229.26services. Subcontracted providers must demonstrate the ability229.27to provide the services outlined in subdivision 6.229.28(b)(a) A relocation targeted case management provider is 229.29 an enrolled medical assistance provider who is determined by the 229.30 commissioner to have all of the following characteristics: 229.31 (1) the legal authority to provide public welfare under 229.32 sections 393.01, subdivision 7; and 393.07; or a federally 229.33 recognized Indian tribe; 229.34 (2) the demonstrated capacity and experience to provide the 229.35 components of case management to coordinate and link community 229.36 resources needed by the eligible population; 230.1 (3) the administrative capacity and experience to serve the 230.2 target population for whom it will provide services and ensure 230.3 quality of services under state and federal requirements; 230.4 (4) the legal authority to provide complete investigative 230.5 and protective services under section 626.556, subdivision 10; 230.6 and child welfare and foster care services under section 393.07, 230.7 subdivisions 1 and 2; or a federally recognized Indian tribe; 230.8 (5) a financial management system that provides accurate 230.9 documentation of services and costs under state and federal 230.10 requirements; and 230.11 (6) the capacity to document and maintain individual case 230.12 records under state and federal requirements. 230.13 (b) A provider of targeted case management under section 230.14 256B.0625, subdivision 20, may be deemed a certified provider of 230.15 relocation targeted case management. 230.16 (c) A relocation targeted case management provider may 230.17 subcontract with another provider to deliver relocation targeted 230.18 case management services. Subcontracted providers must 230.19 demonstrate the ability to provide the services outlined in 230.20 subdivision 6, and have a procedure in place that notifies the 230.21 recipient and the recipient's legal representative of any 230.22 conflict of interest if the contracted targeted case management 230.23 provider also provides, or will provide, the recipient's 230.24 services and supports. Contracted providers must provide 230.25 information on all conflicts of interest and obtain the 230.26 recipient's informed consent or provide the recipient with 230.27 alternatives. 230.28 Sec. 13. Minnesota Statutes 2002, section 256B.0625, 230.29 subdivision 19c, is amended to read: 230.30 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 230.31 personal care assistant services provided by an individual who 230.32 is qualified to provide the services according to subdivision 230.33 19a and section 256B.0627, where the services are prescribed by 230.34 a physician in accordance with a plan of treatment and are 230.35 supervised by the recipient or a qualified professional. 230.36 "Qualified professional" means a mental health professional as 231.1 defined in section 245.462, subdivision 18, or 245.4871, 231.2 subdivision 27; or a registered nurse as defined in sections 231.3 148.171 to 148.285, or a licensed social worker as defined in 231.4 section 148B.21. As part of the assessment, the county public 231.5 health nurse will assist the recipient or responsible party to 231.6 identify the most appropriate person to provide supervision of 231.7 the personal care assistant. The qualified professional shall 231.8 perform the duties described in Minnesota Rules, part 9505.0335, 231.9 subpart 4. 231.10 Sec. 14. Minnesota Statutes 2002, section 256B.0627, 231.11 subdivision 1, is amended to read: 231.12 Subdivision 1. [DEFINITION.] (a) "Activities of daily 231.13 living" includes eating, toileting, grooming, dressing, bathing, 231.14 transferring, mobility, and positioning. 231.15 (b) "Assessment" means a review and evaluation of a 231.16 recipient's need for home care services conducted in person. 231.17 Assessments for private duty nursing shall be conducted by a 231.18 registered private duty nurse. Assessments for home health 231.19 agency services shall be conducted by a home health agency 231.20 nurse. Assessments for personal care assistant services shall 231.21 be conducted by the county public health nurse or a certified 231.22 public health nurse under contract with the county. A 231.23 face-to-face assessment must include: documentation of health 231.24 status, determination of need, evaluation of service 231.25 effectiveness, identification of appropriate services, service 231.26 plan development or modification, coordination of services, 231.27 referrals and follow-up to appropriate payers and community 231.28 resources, completion of required reports, recommendation of 231.29 service authorization, and consumer education. Once the need 231.30 for personal care assistant services is determined under this 231.31 section, the county public health nurse or certified public 231.32 health nurse under contract with the county is responsible for 231.33 communicating this recommendation to the commissioner and the 231.34 recipient. A face-to-face assessment for personal care 231.35 assistant services is conducted on those recipients who have 231.36 never had a county public health nurse assessment. A 232.1 face-to-face assessment must occur at least annually or when 232.2 there is a significant change in the recipient's condition or 232.3 when there is a change in the need for personal care assistant 232.4 services. A service update may substitute for the annual 232.5 face-to-face assessment when there is not a significant change 232.6 in recipient condition or a change in the need for personal care 232.7 assistant service. A service update or review for temporary 232.8 increase includes a review of initial baseline data, evaluation 232.9 of service effectiveness, redetermination of service need, 232.10 modification of service plan and appropriate referrals, update 232.11 of initial forms, obtaining service authorization, and on going 232.12 consumer education. Assessments for medical assistance home 232.13 care services for mental retardation or related conditions and 232.14 alternative care services for developmentally disabled home and 232.15 community-based waivered recipients may be conducted by the 232.16 county public health nurse to ensure coordination and avoid 232.17 duplication. Assessments must be completed on forms provided by 232.18 the commissioner within 30 days of a request for home care 232.19 services by a recipient or responsible party. 232.20 (c) "Care plan" means a written description of personal 232.21 care assistant services developed by the qualified professional 232.22 or the recipient's physician with the recipient or responsible 232.23 party to be used by the personal care assistant with a copy 232.24 provided to the recipient or responsible party. 232.25 (d) "Complex and regular private duty nursing care" means: 232.26 (1) complex care is private duty nursing provided to 232.27 recipients who are ventilator dependent or for whom a physician 232.28 has certified that were it not for private duty nursing the 232.29 recipient would meet the criteria for inpatient hospital 232.30 intensive care unit (ICU) level of care; and 232.31 (2) regular care is private duty nursing provided to all 232.32 other recipients. 232.33 (e) "Health-related functions" means functions that can be 232.34 delegated or assigned by a licensed health care professional 232.35 under state law to be performed by a personal care attendant. 232.36 (f) "Home care services" means a health service, determined 233.1 by the commissioner as medically necessary, that is ordered by a 233.2 physician and documented in a service plan that is reviewed by 233.3 the physician at least once every 60 days for the provision of 233.4 home health services, or private duty nursing, or at least once 233.5 every 365 days for personal care. Home care services are 233.6 provided to the recipient at the recipient's residence that is a 233.7 place other than a hospital or long-term care facility or as 233.8 specified in section 256B.0625. 233.9 (g) "Instrumental activities of daily living" includes meal 233.10 planning and preparation, managing finances, shopping for food, 233.11 clothing, and other essential items, performing essential 233.12 household chores, communication by telephone and other media, 233.13 and getting around and participating in the community. 233.14 (h) "Medically necessary" has the meaning given in 233.15 Minnesota Rules, parts 9505.0170 to 9505.0475. 233.16 (i) "Personal care assistant" means a person who: 233.17 (1) is at least 18 years old, except for persons 16 to 18 233.18 years of age who participated in a related school-based job 233.19 training program or have completed a certified home health aide 233.20 competency evaluation; 233.21 (2) is able to effectively communicate with the recipient 233.22 and personal care provider organization; 233.23 (3) effective July 1, 1996, has completed one of the 233.24 training requirements as specified in Minnesota Rules, part 233.25 9505.0335, subpart 3, items A to D; 233.26 (4) has the ability to, and provides covered personal care 233.27 assistant services according to the recipient's care plan, 233.28 responds appropriately to recipient needs, and reports changes 233.29 in the recipient's condition to the supervising qualified 233.30 professional or physician; 233.31 (5) is not a consumer of personal care assistant services; 233.32 and 233.33 (6) is subject to criminal background checks and procedures 233.34 specified in section 245A.04. 233.35 (j) "Personal care provider organization" means an 233.36 organization enrolled to provide personal care assistant 234.1 services under the medical assistance program that complies with 234.2 the following: (1) owners who have a five percent interest or 234.3 more, and managerial officials are subject to a background study 234.4 as provided in section 245A.04. This applies to currently 234.5 enrolled personal care provider organizations and those agencies 234.6 seeking enrollment as a personal care provider organization. An 234.7 organization will be barred from enrollment if an owner or 234.8 managerial official of the organization has been convicted of a 234.9 crime specified in section 245A.04, or a comparable crime in 234.10 another jurisdiction, unless the owner or managerial official 234.11 meets the reconsideration criteria specified in section 245A.04; 234.12 (2) the organization must maintain a surety bond and liability 234.13 insurance throughout the duration of enrollment and provides 234.14 proof thereof. The insurer must notify the department of human 234.15 services of the cancellation or lapse of policy; and (3) the 234.16 organization must maintain documentation of services as 234.17 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 234.18 as evidence of compliance with personal care assistant training 234.19 requirements. 234.20 (k) "Responsible party" means an individualresiding with a234.21recipient of personal care assistant serviceswho is capable of 234.22 providing thesupportive caresupport necessary to assist the 234.23 recipient to live in the community, is at least 18 years 234.24 old, actively participates in planning and directing of personal 234.25 care assistant services, and is notathe personal care 234.26 assistant. The responsible party must be accessible to the 234.27 recipient and the personal care assistant when personal care 234.28 services are being provided and monitor the services at least 234.29 weekly according to the plan of care. The responsible party 234.30 must be identified at the time of assessment and listed on the 234.31 recipient's service agreement and care plan. Responsible 234.32 partieswho are parents of minors or guardians of minors or234.33incapacitated personsmay delegate the responsibility to another 234.34 adultduring a temporary absence of at least 24 hours but not234.35more than six months. The person delegated as a responsible234.36party must be able to meet the definition of responsible party,235.1except that the delegated responsible party is required to235.2reside with the recipient only while serving as the responsible235.3partywho is not the personal care assistant. The responsible 235.4 party must assure that the delegate performs the functions of 235.5 the responsible party, is identified at the time of the 235.6 assessment, and is listed on the service agreement and the care 235.7 plan. Foster care license holders may be designated the 235.8 responsible party for residents of the foster care home if case 235.9 management is provided as required in section 256B.0625, 235.10 subdivision 19a. For persons who, as of April 1, 1992, are 235.11 sharing personal care assistant services in order to obtain the 235.12 availability of 24-hour coverage, an employee of the personal 235.13 care provider organization may be designated as the responsible 235.14 party if case management is provided as required in section 235.15 256B.0625, subdivision 19a. 235.16 (l) "Service plan" means a written description of the 235.17 services needed based on the assessment developed by the nurse 235.18 who conducts the assessment together with the recipient or 235.19 responsible party. The service plan shall include a description 235.20 of the covered home care services, frequency and duration of 235.21 services, and expected outcomes and goals. The recipient and 235.22 the provider chosen by the recipient or responsible party must 235.23 be given a copy of the completed service plan within 30 calendar 235.24 days of the request for home care services by the recipient or 235.25 responsible party. 235.26 (m) "Skilled nurse visits" are provided in a recipient's 235.27 residence under a plan of care or service plan that specifies a 235.28 level of care which the nurse is qualified to provide. These 235.29 services are: 235.30 (1) nursing services according to the written plan of care 235.31 or service plan and accepted standards of medical and nursing 235.32 practice in accordance with chapter 148; 235.33 (2) services which due to the recipient's medical condition 235.34 may only be safely and effectively provided by a registered 235.35 nurse or a licensed practical nurse; 235.36 (3) assessments performed only by a registered nurse; and 236.1 (4) teaching and training the recipient, the recipient's 236.2 family, or other caregivers requiring the skills of a registered 236.3 nurse or licensed practical nurse. 236.4 (n) "Telehomecare" means the use of telecommunications 236.5 technology by a home health care professional to deliver home 236.6 health care services, within the professional's scope of 236.7 practice, to a patient located at a site other than the site 236.8 where the practitioner is located. 236.9 Sec. 15. Minnesota Statutes 2002, section 256B.0627, 236.10 subdivision 4, is amended to read: 236.11 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 236.12 personal care assistant services that are eligible for payment 236.13 are services and supports furnished to an individual, as needed, 236.14 to assist in accomplishing activities of daily living; 236.15 instrumental activities of daily living; health-related 236.16 functions through hands-on assistance, supervision, and cuing; 236.17 and redirection and intervention for behavior including 236.18 observation and monitoring. 236.19 (b) Payment for services will be made within the limits 236.20 approved using the prior authorized process established in 236.21 subdivision 5. 236.22 (c) The amount and type of services authorized shall be 236.23 based on an assessment of the recipient's needs in these areas: 236.24 (1) bowel and bladder care; 236.25 (2) skin care to maintain the health of the skin; 236.26 (3) repetitive maintenance range of motion, muscle 236.27 strengthening exercises, and other tasks specific to maintaining 236.28 a recipient's optimal level of function; 236.29 (4) respiratory assistance; 236.30 (5) transfers and ambulation; 236.31 (6) bathing, grooming, and hairwashing necessary for 236.32 personal hygiene; 236.33 (7) turning and positioning; 236.34 (8) assistance with furnishing medication that is 236.35 self-administered; 236.36 (9) application and maintenance of prosthetics and 237.1 orthotics; 237.2 (10) cleaning medical equipment; 237.3 (11) dressing or undressing; 237.4 (12) assistance with eating and meal preparation and 237.5 necessary grocery shopping; 237.6 (13) accompanying a recipient to obtain medical diagnosis 237.7 or treatment; 237.8 (14) assisting, monitoring, or prompting the recipient to 237.9 complete the services in clauses (1) to (13); 237.10 (15) redirection, monitoring, and observation that are 237.11 medically necessary and an integral part of completing the 237.12 personal care assistant services described in clauses (1) to 237.13 (14); 237.14 (16) redirection and intervention for behavior, including 237.15 observation and monitoring; 237.16 (17) interventions for seizure disorders, including 237.17 monitoring and observation if the recipient has had a seizure 237.18 that requires intervention within the past three months; 237.19 (18) tracheostomy suctioning using a clean procedure if the 237.20 procedure is properly delegated by a registered nurse. Before 237.21 this procedure can be delegated to a personal care assistant, a 237.22 registered nurse must determine that the tracheostomy suctioning 237.23 can be accomplished utilizing a clean rather than a sterile 237.24 procedure and must ensure that the personal care assistant has 237.25 been taught the proper procedure; and 237.26 (19) incidental household services that are an integral 237.27 part of a personal care service described in clauses (1) to (18). 237.28 For purposes of this subdivision, monitoring and observation 237.29 means watching for outward visible signs that are likely to 237.30 occur and for which there is a covered personal care service or 237.31 an appropriate personal care intervention. For purposes of this 237.32 subdivision, a clean procedure refers to a procedure that 237.33 reduces the numbers of microorganisms or prevents or reduces the 237.34 transmission of microorganisms from one person or place to 237.35 another. A clean procedure may be used beginning 14 days after 237.36 insertion. 238.1 (d) The personal care assistant services that are not 238.2 eligible for payment are the following: 238.3 (1) services not ordered by the physician; 238.4 (2) assessments by personal care assistant provider 238.5 organizations or by independently enrolled registered nurses; 238.6 (3) services that are not in the service plan; 238.7 (4) services provided by the recipient's spouse, legal 238.8 guardian for an adult or child recipient, or parent of a 238.9 recipient under age 18; 238.10 (5) services provided by a foster care provider of a 238.11 recipient who cannot direct the recipient's own care, unless 238.12 monitored by a county or state case manager under section 238.13 256B.0625, subdivision 19a; 238.14 (6) services provided by the residential or program license 238.15 holder in a residence for more than four persons; 238.16 (7) services that are the responsibility of a residential 238.17 or program license holder under the terms of a service agreement 238.18 and administrative rules; 238.19 (8) sterile procedures; 238.20 (9) injections of fluids into veins, muscles, or skin; 238.21 (10)services provided by parents of adult recipients,238.22adult children, or siblings of the recipient, unless these238.23relatives meet one of the following hardship criteria and the238.24commissioner waives this requirement:238.25(i) the relative resigns from a part-time or full-time job238.26to provide personal care for the recipient;238.27(ii) the relative goes from a full-time to a part-time job238.28with less compensation to provide personal care for the238.29recipient;238.30(iii) the relative takes a leave of absence without pay to238.31provide personal care for the recipient;238.32(iv) the relative incurs substantial expenses by providing238.33personal care for the recipient; or238.34(v) because of labor conditions, special language needs, or238.35intermittent hours of care needed, the relative is needed in238.36order to provide an adequate number of qualified personal care239.1assistants to meet the medical needs of the recipient;239.2(11)homemaker services that are not an integral part of a 239.3 personal care assistant services; 239.4(12)(11) home maintenance, or chore services; 239.5(13)(12) services not specified under paragraph (a); and 239.6(14)(13) services not authorized by the commissioner or 239.7 the commissioner's designee. 239.8 (e) The recipient or responsible party may choose to 239.9 supervise the personal care assistant or to have a qualified 239.10 professional, as defined in section 256B.0625, subdivision 19c, 239.11 provide the supervision. As required under section 256B.0625, 239.12 subdivision 19c, the county public health nurse, as a part of 239.13 the assessment, will assist the recipient or responsible party 239.14 to identify the most appropriate person to provide supervision 239.15 of the personal care assistant. Health-related delegated tasks 239.16 performed by the personal care assistant will be under the 239.17 supervision of a qualified professional or the direction of the 239.18 recipient's physician. If the recipient has a qualified 239.19 professional, Minnesota Rules, part 9505.0335, subpart 4, 239.20 applies. 239.21 Sec. 16. Minnesota Statutes 2002, section 256B.0627, 239.22 subdivision 9, is amended to read: 239.23 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 239.24 (a)The commissioner may allow for the flexible use of personal239.25care assistant hours."Flexible use" means the scheduled use of 239.26 authorized hours of personal care assistant services, which vary 239.27 within the length of the service authorization in order to more 239.28 effectively meet the needs and schedule of the recipient. 239.29 Recipients may use their approved hours flexibly within the 239.30 service authorization period for medically necessary covered 239.31 services specified in the assessment required in subdivision 1. 239.32 The flexible use of authorized hours does not increase the total 239.33 amount of authorized hours available to a recipient as 239.34 determined under subdivision 5. The commissioner shall not 239.35 authorize additional personal care assistant services to 239.36 supplement a service authorization that is exhausted before the 240.1 end date under a flexible service use plan, unless the county 240.2 public health nurse determines a change in condition and a need 240.3 for increased services is established. 240.4 (b)The recipient or responsible party, together with the240.5county public health nurse, shall determine whether flexible use240.6is an appropriate option based on the needs and preferences of240.7the recipient or responsible party, and, if appropriate, must240.8ensure that the allocation of hours covers the ongoing needs of240.9the recipient over the entire service authorization period. As240.10part of the assessment and service planning process, the240.11recipient or responsible party must work with the county public240.12health nurse to develop a written month-to-month plan of the240.13projected use of personal care assistant services that is part240.14of the service plan and ensures that the:240.15(1) health and safety needs of the recipient will be met;240.16(2) total annual authorization will not exceed before the240.17end date; and240.18(3) how actual use of hours will be monitored.240.19(c) If the actual use of personal care assistant service240.20varies significantly from the use projected in the plan, the240.21written plan must be promptly updated by the recipient or240.22responsible party and the county public health nurse.240.23(d)The recipient or responsible party, together with the 240.24 provider, must work to monitor and document the use of 240.25 authorized hours and ensure that a recipient is able to manage 240.26 services effectively throughout the authorized period.The240.27provider must ensure that the month-to-month plan is240.28incorporated into the care plan.Upon request of the recipient 240.29 or responsible party, the provider must furnish regular updates 240.30 to the recipient or responsible party on the amount of personal 240.31 care assistant services used. 240.32(e) The recipient or responsible party may revoke the240.33authorization for flexible use of hours by notifying the240.34provider and county public health nurse in writing.240.35(f) If the requirements in paragraphs (a) to (e) have not240.36substantially been met, the commissioner shall deny, revoke, or241.1suspend the authorization to use authorized hours flexibly. The241.2recipient or responsible party may appeal the commissioner's241.3action according to section 256.045. The denial, revocation, or241.4suspension to use the flexible hours option shall not affect the241.5recipient's authorized level of personal care assistant services241.6as determined under subdivision 5.241.7 Sec. 17. Minnesota Statutes 2002, section 256B.0911, 241.8 subdivision 4d, is amended to read: 241.9 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 241.10 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 241.11 ensure that individuals with disabilities or chronic illness are 241.12 served in the most integrated setting appropriate to their needs 241.13 and have the necessary information to make informed choices 241.14 about home and community-based service options. 241.15 (b) Individuals under 65 years of age who are admitted to a 241.16 nursing facility from a hospital must be screened prior to 241.17 admission as outlined in subdivisions 4a through 4c. 241.18 (c) Individuals under 65 years of age who are admitted to 241.19 nursing facilities with only a telephone screening must receive 241.20 a face-to-face assessment from the long-term care consultation 241.21 team member of the county in which the facility is located or 241.22 from the recipient's county case manager within20 working40 241.23 calendar days of admission. 241.24 (d) Individuals under 65 years of age who are admitted to a 241.25 nursing facility without preadmission screening according to the 241.26 exemption described in subdivision 4b, paragraph (a), clause 241.27 (3), and who remain in the facility longer than 30 days must 241.28 receive a face-to-face assessment within 40 days of admission. 241.29 (e) At the face-to-face assessment, the long-term care 241.30 consultation team member or county case manager must perform the 241.31 activities required under subdivision 3b. 241.32 (f) For individuals under 21 years of age, a screening 241.33 interview which recommends nursing facility admission must be 241.34 face-to-face and approved by the commissioner before the 241.35 individual is admitted to the nursing facility. 241.36 (g) In the event that an individual under 65 years of age 242.1 is admitted to a nursing facility on an emergency basis, the 242.2 county must be notified of the admission on the next working 242.3 day, and a face-to-face assessment as described in paragraph (c) 242.4 must be conducted within20 working days40 calendar days of 242.5 admission. 242.6 (h) At the face-to-face assessment, the long-term care 242.7 consultation team member or the case manager must present 242.8 information about home and community-based options so the 242.9 individual can make informed choices. If the individual chooses 242.10 home and community-based services, the long-term care 242.11 consultation team member or case manager must complete a written 242.12 relocation plan within 20 working days of the visit. The plan 242.13 shall describe the services needed to move out of the facility 242.14 and a time line for the move which is designed to ensure a 242.15 smooth transition to the individual's home and community. 242.16 (i) An individual under 65 years of age residing in a 242.17 nursing facility shall receive a face-to-face assessment at 242.18 least every 12 months to review the person's service choices and 242.19 available alternatives unless the individual indicates, in 242.20 writing, that annual visits are not desired. In this case, the 242.21 individual must receive a face-to-face assessment at least once 242.22 every 36 months for the same purposes. 242.23 (j) Notwithstanding the provisions of subdivision 6, the 242.24 commissioner may pay county agencies directly for face-to-face 242.25 assessments for individuals under 65 years of age who are being 242.26 considered for placement or residing in a nursing facility. 242.27 Sec. 18. Minnesota Statutes 2002, section 256B.0915, is 242.28 amended by adding a subdivision to read: 242.29 Subd. 9. [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 242.30 Notwithstanding contrary provisions of this section, or those in 242.31 other state laws or rules, the commissioner and White Earth 242.32 Reservation may develop a model for tribal management of the 242.33 elderly waiver program and implement this model through a 242.34 contract between the state and White Earth Reservation. The 242.35 model shall include the provision of tribal waiver case 242.36 management, assessment for personal care assistance, and 243.1 administrative requirements otherwise carried out by counties 243.2 but shall not include tribal financial eligibility determination 243.3 for medical assistance. 243.4 Sec. 19. Minnesota Statutes 2002, section 256B.47, 243.5 subdivision 2, is amended to read: 243.6 Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing 243.7 facility rates for private paying residents shall be effective 243.8 unless the nursing facility notifies the resident or person 243.9 responsible for payment of the increase in writing 30 days 243.10 before the increase takes effect. 243.11 A nursing facility may adjust its rates without giving the 243.12 notice required by this subdivision when the purpose of the rate 243.13 adjustment is to reflect anecessarychange in thelevel of care243.14provided to acase-mix classification of the resident. If the 243.15 state fails to set rates as required by section 243.16 256B.431, subdivision 1, the time required for giving notice is 243.17 decreased by the number of days by which the state was late in 243.18 setting the rates. 243.19 (b) If the state does not set rates by the date required in 243.20 section 256B.431, subdivision 1, nursing facilities shall meet 243.21 the requirement for advance notice by informing the resident or 243.22 person responsible for payments, on or before the effective date 243.23 of the increase, that a rate increase will be effective on that 243.24 date. If the exact amount has not yet been determined, the 243.25 nursing facility may raise the rates by the amount anticipated 243.26 to be allowed. Any amounts collected from private pay residents 243.27 in excess of the allowable rate must be repaid to private pay 243.28 residents with interest at the rate used by the commissioner of 243.29 revenue for the late payment of taxes and in effect on the date 243.30 the rate increase is effective. 243.31 Sec. 20. Minnesota Statutes 2002, section 256B.5012, is 243.32 amended by adding a subdivision to read: 243.33 Subd. 5. [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 243.34 periods beginning on or after June 1, 2003, the commissioner 243.35 shall increase the total operating payment rate for each 243.36 facility reimbursed under this section by $3 per day. The 244.1 increase shall not be subject to any annual percentage increase. 244.2 [EFFECTIVE DATE.] This section is effective the day 244.3 following final enactment. 244.4 Sec. 21. Minnesota Statutes 2002, section 256B.5013, is 244.5 amended by adding a subdivision to read: 244.6 Subd. 7. [RATE ADJUSTMENTS FOR SHORT-TERM ADMISSIONS FOR 244.7 CRISIS OR SPECIALIZED MEDICAL CARE.] Beginning July 1, 2003, the 244.8 commissioner may designate up to 25 beds in ICF/MR facilities 244.9 statewide to provide crisis respite or specialized respite care 244.10 for medically fragile individuals. The commissioner shall 244.11 adjust the monthly facility rate to provide payment for 244.12 vacancies in designated respite beds by an amount equal to the 244.13 rate for each recipient residing in a respite bed for up to 15 244.14 days per bed per month. The commissioner may designate respite 244.15 beds in other facilities based on the respite care needs of a 244.16 region or county as provided in section 252.28. Nothing in this 244.17 section shall be construed as limiting payments for short-term 244.18 admissions of eligible recipients to an ICF/MR that is not 244.19 designated for respite care under this subdivision and does not 244.20 receive a temporary rate adjustment. 244.21 Sec. 22. [LICENSING CHANGE.] 244.22 Notwithstanding Minnesota Statutes, sections 245A.11 and 244.23 252.291, the commissioner of human services shall allow an 244.24 existing intermediate care facility for persons with mental 244.25 retardation or related conditions located in Goodhue county 244.26 serving 39 children to be converted to four separately licensed 244.27 or certified cottages serving up to six children each. 244.28 Sec. 23. [REVISOR'S INSTRUCTION.] 244.29 For sections in Minnesota Statutes and Minnesota Rules 244.30 affected by the repealed sections in this article, the revisor 244.31 shall delete internal cross-references where appropriate and 244.32 make changes necessary to correct the punctuation, grammar, or 244.33 structure of the remaining text and preserve its meaning. 244.34 Sec. 24. [REPEALER.] 244.35 (a) Minnesota Statutes 2002, sections 252.32, subdivision 244.36 2; 256B.095; 256B.0951; 256B.0952; 256B.0953; 256B.0954; 245.1 256B.0955; and 256B.5013, subdivision 4, are repealed July 1, 245.2 2003. 245.3 (b) Laws 2001, First Special Session chapter 9, article 13, 245.4 section 24, is repealed July 1, 2003. 245.5 ARTICLE 6 245.6 OCCUPATIONAL LICENSES 245.7 Section 1. Minnesota Statutes 2002, section 116J.70, 245.8 subdivision 2a, is amended to read: 245.9 Subd. 2a. [LICENSE; EXCEPTIONS.] "Business license" or 245.10 "license" does not include the following: 245.11 (1) any occupational license or registration issued by a 245.12 licensing board listed in section 214.01 or any occupational 245.13 registration issued by the commissioner of health pursuant to 245.14 section 214.13; 245.15 (2) any license issued by a county, home rule charter city, 245.16 statutory city, township, or other political subdivision; 245.17 (3) any license required to practice the following 245.18 occupation regulated by the following sections: 245.19 (i) abstracters regulated pursuant to chapter 386; 245.20 (ii) accountants regulated pursuant to chapter 326A; 245.21 (iii) adjusters regulated pursuant to chapter 72B; 245.22 (iv) architects regulated pursuant to chapter 326; 245.23 (v) assessors regulated pursuant to chapter 270; 245.24 (vi) athletic trainers regulated pursuant to chapter 148; 245.25 (vii) attorneys regulated pursuant to chapter 481; 245.26 (viii) auctioneers regulated pursuant to chapter 330; 245.27 (ix) barbers regulated pursuant to chapter 154; 245.28 (x) beauticians regulated pursuant to chapter 155A; 245.29 (xi) boiler operators regulated pursuant to chapter 183; 245.30 (xii) chiropractors regulated pursuant to chapter 148; 245.31 (xiii) collection agencies regulated pursuant to chapter 245.32 332; 245.33 (xiv) cosmetologists regulated pursuant to chapter 155A; 245.34 (xv) dentists, registered dental assistants, and dental 245.35 hygienists regulated pursuant to chapter 150A; 245.36 (xvi) denturists regulated pursuant to chapter 150B; 246.1 (xvii) detectives regulated pursuant to chapter 326; 246.2(xvii)(xviii) electricians regulated pursuant to chapter 246.3 326; 246.4(xviii)(xix) mortuary science practitioners regulated 246.5 pursuant to chapter 149A; 246.6(xix)(xx) engineers regulated pursuant to chapter 326; 246.7(xx)(xxi) insurance brokers and salespersons regulated 246.8 pursuant to chapter 60A; 246.9(xxi)(xxii) certified interior designers regulated 246.10 pursuant to chapter 326; 246.11(xxii)(xxiii) midwives regulated pursuant to chapter 147D; 246.12(xxiii)(xxiv) nursing home administrators regulated 246.13 pursuant to chapter 144A; 246.14(xxiv)(xxv) optometrists regulated pursuant to chapter 246.15 148; 246.16(xxv)(xxvi) osteopathic physicians regulated pursuant to 246.17 chapter 147; 246.18(xxvi)(xxvii) pharmacists regulated pursuant to chapter 246.19 151; 246.20(xxvii)(xxviii) physical therapists regulated pursuant to 246.21 chapter 148; 246.22(xxviii)(xxix) physician assistants regulated pursuant to 246.23 chapter 147A; 246.24(xxix)(xxx) physicians and surgeons regulated pursuant to 246.25 chapter 147; 246.26(xxx)(xxxi) plumbers regulated pursuant to chapter 326; 246.27(xxxi)(xxxii) podiatrists regulated pursuant to chapter 246.28 153; 246.29(xxxii)(xxxiii) practical nurses regulated pursuant to 246.30 chapter 148; 246.31(xxxiii)(xxxiv) professional fund raisers regulated 246.32 pursuant to chapter 309; 246.33(xxxiv)(xxxv) psychologists regulated pursuant to chapter 246.34 148; 246.35(xxxv)(xxxvi) real estate brokers, salespersons, and 246.36 others regulated pursuant to chapters 82 and 83; 247.1(xxxvi)(xxxvii) registered nurses regulated pursuant to 247.2 chapter 148; 247.3(xxxvii)(xxxviii) securities brokers, dealers, agents, and 247.4 investment advisers regulated pursuant to chapter 80A; 247.5(xxxviii)(xxxix) steamfitters regulated pursuant to 247.6 chapter 326; 247.7(xxxix)(xl) teachers and supervisory and support personnel 247.8 regulated pursuant to chapter 125; 247.9(xl)(xli) veterinarians regulated pursuant to chapter 156; 247.10(xli)(xlii) water conditioning contractors and installers 247.11 regulated pursuant to chapter 326; 247.12(xlii)(xliii) water well contractors regulated pursuant to 247.13 chapter 103I; 247.14(xliii)(xliv) water and waste treatment operators 247.15 regulated pursuant to chapter 115; 247.16(xliv)(xlv) motor carriers regulated pursuant to chapter 247.17 221; 247.18(xlv)(xlvi) professional firms regulated under chapter 247.19 319B; 247.20(xlvi)(xlvii) real estate appraisers regulated pursuant to 247.21 chapter 82B; or 247.22(xlvii)(xlviii) residential building contractors, 247.23 residential remodelers, residential roofers, manufactured home 247.24 installers, and specialty contractors regulated pursuant to 247.25 chapter 326; 247.26 (4) any driver's license required pursuant to chapter 171; 247.27 (5) any aircraft license required pursuant to chapter 360; 247.28 (6) any watercraft license required pursuant to chapter 247.29 86B; 247.30 (7) any license, permit, registration, certification, or 247.31 other approval pertaining to a regulatory or management program 247.32 related to the protection, conservation, or use of or 247.33 interference with the resources of land, air, or water, which is 247.34 required to be obtained from a state agency or instrumentality; 247.35 and 247.36 (8) any pollution control rule or standard established by 248.1 the pollution control agency or any health rule or standard 248.2 established by the commissioner of health or any licensing rule 248.3 or standard established by the commissioner of human services. 248.4 Sec. 2. Minnesota Statutes 2002, section 144.335, 248.5 subdivision 1, is amended to read: 248.6 Subdivision 1. [DEFINITIONS.] For the purposes of this 248.7 section, the following terms have the meanings given them: 248.8 (a) "Patient" means a natural person who has received 248.9 health care services from a provider for treatment or 248.10 examination of a medical, psychiatric, or mental condition, the 248.11 surviving spouse and parents of a deceased patient, or a person 248.12 the patient appoints in writing as a representative, including a 248.13 health care agent acting pursuant to chapter 145C, unless the 248.14 authority of the agent has been limited by the principal in the 248.15 principal's health care directive. Except for minors who have 248.16 received health care services pursuant to sections 144.341 to 248.17 144.347, in the case of a minor, patient includes a parent or 248.18 guardian, or a person acting as a parent or guardian in the 248.19 absence of a parent or guardian. 248.20 (b) "Provider" means (1) any person who furnishes health 248.21 care services and is regulated to furnish the services pursuant 248.22 to chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 150A, 248.23 150B, 151, 153, or 153A, or Minnesota Rules, chapter 4666; (2) a 248.24 home care provider licensed under section 144A.46; (3) a health 248.25 care facility licensed pursuant to this chapter or chapter 144A; 248.26 (4) a physician assistant registered under chapter 147A; and (5) 248.27 an unlicensed mental health practitioner regulated pursuant to 248.28 sections 148B.60 to 148B.71. 248.29 (c) "Individually identifiable form" means a form in which 248.30 the patient is or can be identified as the subject of the health 248.31 records. 248.32 Sec. 3. Minnesota Statutes 2002, section 148C.01, is 248.33 amended by adding a subdivision to read: 248.34 Subd. 1a. [ACCREDITING ASSOCIATION.] "Accrediting 248.35 association" means an organization recognized by the 248.36 commissioner that evaluates schools and education programs of 249.1 alcohol and drug counseling or is listed in Nationally 249.2 Recognized Accrediting Agencies and Associations, Criteria and 249.3 Procedures for Listing by the U.S. Secretary of Education and 249.4 Current List (1996), which is incorporated by reference. 249.5 Sec. 4. Minnesota Statutes 2002, section 148C.01, 249.6 subdivision 2, is amended to read: 249.7 Subd. 2. [ALCOHOL AND DRUG COUNSELOR.] "Alcohol and drug 249.8 counselor" or "counselor" means a person who: 249.9 (1) uses, as a representation to the public, any title, 249.10 initials, or description of services incorporating the words 249.11 "alcohol and drug counselor"; 249.12 (2) offers to render professional alcohol and drug 249.13 counseling services relative to the abuse of or the dependency 249.14 on alcohol or other drugs to the general public or groups, 249.15 organizations, corporations, institutions, or government 249.16 agencies for compensation, implying that the person is licensed 249.17 and trained, experienced or expert in alcohol and drug 249.18 counseling; 249.19 (3) holds a valid license issued undersections 148C.01 to249.20148C.11this chapter to engage in the practice of alcohol and 249.21 drug counseling; or 249.22 (4) is an applicant for an alcohol and drug counseling 249.23 license. 249.24 Sec. 5. Minnesota Statutes 2002, section 148C.01, is 249.25 amended by adding a subdivision to read: 249.26 Subd. 2a. [ALCOHOL AND DRUG COUNSELOR ACADEMIC COURSE 249.27 WORK.] "Alcohol and drug counselor academic course work" means 249.28 classroom education, which is directly related to alcohol and 249.29 drug counseling and meets the requirements of section 148C.04, 249.30 subdivision 5a, and is taken through an accredited school or 249.31 educational program. 249.32 Sec. 6. Minnesota Statutes 2002, section 148C.01, is 249.33 amended by adding a subdivision to read: 249.34 Subd. 2b. [ALCOHOL AND DRUG COUNSELOR CONTINUING EDUCATION 249.35 ACTIVITY.] "Alcohol and drug counselor continuing education 249.36 activity" means clock hours that meet the requirements of 250.1 section 148C.075 and Minnesota Rules, part 4747.1100, and are 250.2 obtained by a licensee at educational programs of annual 250.3 conferences, lectures, panel discussions, workshops, seminars, 250.4 symposiums, employer-sponsored inservices, or courses taken 250.5 through accredited schools or education programs, including home 250.6 study courses. A home study course need not be provided by an 250.7 accredited school or education program to meet continuing 250.8 education requirements. 250.9 Sec. 7. Minnesota Statutes 2002, section 148C.01, is 250.10 amended by adding a subdivision to read: 250.11 Subd. 2c. [ALCOHOL AND DRUG COUNSELOR 250.12 TECHNICIAN.] "Alcohol and drug counselor technician" means a 250.13 person not licensed as an alcohol and drug counselor who is 250.14 performing acts authorized under section 148C.045. 250.15 Sec. 8. Minnesota Statutes 2002, section 148C.01, is 250.16 amended by adding a subdivision to read: 250.17 Subd. 2d. [ALCOHOL AND DRUG COUNSELOR TRAINING.] "Alcohol 250.18 and drug counselor training" means clock hours obtained by an 250.19 applicant at educational programs of annual conferences, 250.20 lectures, panel discussions, workshops, seminars, symposiums, 250.21 employer-sponsored inservices, or courses taken through 250.22 accredited schools or education programs, including home study 250.23 courses. Clock hours obtained from accredited schools or 250.24 education programs must be measured under Minnesota Rules, part 250.25 4747.1100, subpart 5. 250.26 Sec. 9. Minnesota Statutes 2002, section 148C.01, is 250.27 amended by adding a subdivision to read: 250.28 Subd. 2f. [CLOCK HOUR.] "Clock hour" means an 250.29 instructional session of 50 consecutive minutes, excluding 250.30 coffee breaks, registration, meals without a speaker, and social 250.31 activities. 250.32 Sec. 10. Minnesota Statutes 2002, section 148C.01, is 250.33 amended by adding a subdivision to read: 250.34 Subd. 2g. [CREDENTIAL.] "Credential" means a license, 250.35 permit, certification, registration, or other evidence of 250.36 qualification or authorization to engage in the practice of an 251.1 occupation. 251.2 Sec. 11. Minnesota Statutes 2002, section 148C.01, is 251.3 amended by adding a subdivision to read: 251.4 Subd. 4a. [LICENSEE.] "Licensee" means a person who holds 251.5 a valid license under this chapter. 251.6 Sec. 12. Minnesota Statutes 2002, section 148C.01, is 251.7 amended by adding a subdivision to read: 251.8 Subd. 11a. [STUDENT.] "Student" means a person enrolled in 251.9 an alcohol and drug counselor education program at an accredited 251.10 school or educational program and earning a minimum of nine 251.11 semester credits per calendar year towards completion of an 251.12 associate's, bachelor's, master's, or doctorate degree 251.13 requirements that include an additional 18 semester credits or 251.14 270 clock hours of alcohol and drug counseling specific course 251.15 work and 440 clock hours of practicum. 251.16 Sec. 13. Minnesota Statutes 2002, section 148C.01, 251.17 subdivision 12, is amended to read: 251.18 Subd. 12. [SUPERVISED ALCOHOL AND DRUGCOUNSELING251.19EXPERIENCECOUNSELOR.]Except during the transition period,251.20 "Supervised alcohol and drugcounseling experiencecounselor" 251.21 meanspractical experience gained bya student,volunteer, or251.22 either before, during, or after the student completes a program 251.23 from an accredited school or educational program of alcohol and 251.24 drug counseling, an intern,andor a person issued a temporary 251.25 permit under section 148C.04, subdivision 4, and who is 251.26 supervised by a person either licensed under this chapter or 251.27 exempt under its provisions; either before, during, or after the251.28student completes a program from an accredited school or251.29educational program of alcohol and drug counseling. 251.30 Sec. 14. Minnesota Statutes 2002, section 148C.01, is 251.31 amended by adding a subdivision to read: 251.32 Subd. 12a. [SUPERVISOR.] "Supervisor" means a licensed 251.33 alcohol and drug counselor licensed under this chapter or other 251.34 licensed professional practicing alcohol and drug counseling 251.35 under section 148C.11 who monitors activities of and accepts 251.36 legal liability for the person practicing under supervision. A 252.1 supervisor shall supervise no more than three trainees 252.2 practicing under section 148C.04, subdivision 6. 252.3 Sec. 15. Minnesota Statutes 2002, section 148C.03, 252.4 subdivision 1, is amended to read: 252.5 Subdivision 1. [GENERAL.] The commissioner shall, after 252.6 consultation with the advisory council or a committee 252.7 established by rule: 252.8 (a) adopt and enforce rules for licensure of alcohol and 252.9 drug counselors, including establishing standards and methods of 252.10 determining whether applicants and licensees are qualified under 252.11 section 148C.04. The rules must provide for examinations and 252.12 establish standards for the regulation of professional conduct. 252.13 The rules must be designed to protect the public; 252.14 (b) develop and, at least twice a year, administer an 252.15 examination to assess applicants' knowledge and skills. The 252.16 commissioner may contract for the administration of an 252.17 examination with an entity designated by the commissioner. The 252.18 examinations must be psychometrically valid and reliable; must 252.19 be written and oral, with the oral examination based on a 252.20 written case presentation; must minimize cultural bias; and must 252.21 be balanced in various theories relative to the practice of 252.22 alcohol and drug counseling; 252.23 (c) issue licenses to individuals qualified under sections 252.24 148C.01 to 148C.11; 252.25 (d) issue copies of the rules for licensure to all 252.26 applicants; 252.27 (e) adopt rules to establish and implement procedures, 252.28 including a standard disciplinary process and rules of 252.29 professional conduct; 252.30 (f) carry out disciplinary actions against licensees; 252.31 (g) establish, with the advice and recommendations of the 252.32 advisory council, written internal operating procedures for 252.33 receiving and investigating complaints and for taking 252.34 disciplinary actions as appropriate; 252.35 (h) educate the public about the existence and content of 252.36 the rules for alcohol and drug counselor licensing to enable 253.1 consumers to file complaints against licensees who may have 253.2 violated the rules; 253.3 (i) evaluate the rules in order to refine and improve the 253.4 methods used to enforce the commissioner's standards; and 253.5 (j)set,collect, and adjustlicense fees for alcohol and 253.6 drug counselorsso that the total fees collected will as closely253.7as possible equal anticipated expenditures during the biennium,253.8as provided in section 16A.1285; fees for initial and renewal253.9application and examinations; late fees for counselors who253.10submit license renewal applications after the renewal deadline;253.11and a surcharge fee. The surcharge fee must include an amount253.12necessary to recover, over a five-year period, the253.13commissioner's direct expenditures for the adoption of the rules253.14providing for the licensure of alcohol and drug counselors. All253.15fees received shall be deposited in the state treasury and253.16credited to the special revenue fund. 253.17 Sec. 16. Minnesota Statutes 2002, section 148C.0351, 253.18 subdivision 1, is amended to read: 253.19 Subdivision 1. [APPLICATION FORMS.] Unless exempted under 253.20 section 148C.11, a person who practices alcohol and drug 253.21 counseling in Minnesota must: 253.22 (1) apply to the commissioner for a license to practice 253.23 alcohol and drug counseling on forms provided by the 253.24 commissioner; 253.25 (2) include with the application a statement that the 253.26 statements in the application are true and correct to the best 253.27 of the applicant's knowledge and belief; 253.28 (3) include with the application a nonrefundable 253.29 application fee specifiedby the commissionerin section 253.30 148C.12; 253.31 (4) include with the application information describing the 253.32 applicant's experience, including the number of years and months 253.33 the applicant has practiced alcohol and drug counseling as 253.34 defined in section 148C.01; 253.35 (5) include with the application the applicant's business 253.36 address and telephone number, or home address and telephone 254.1 number if the applicant conducts business out of the home, and 254.2 if applicable, the name of the applicant's supervisor, manager, 254.3 and employer; 254.4 (6) include with the application a written and signed 254.5 authorization for the commissioner to make inquiries to 254.6 appropriate state regulatory agencies and private credentialing 254.7 organizations in this or any other state where the applicant has 254.8 practiced alcohol and drug counseling; and 254.9 (7) complete the application in sufficient detail for the 254.10 commissioner to determine whether the applicant meets the 254.11 requirements for filing. The commissioner may ask the applicant 254.12 to provide additional information necessary to clarify 254.13 incomplete or ambiguous information submitted in the application. 254.14 Sec. 17. Minnesota Statutes 2002, section 148C.0351, is 254.15 amended by adding a subdivision to read: 254.16 Subd. 4. [INITIAL LICENSE; TERM.] (a) An initial license 254.17 is effective on the date the commissioner indicates on the 254.18 license certificate, with the license number, sent to the 254.19 applicant upon approval of the application. 254.20 (b) An initial license is valid for a period beginning with 254.21 the effective date in paragraph (a) and ending on the date 254.22 specified by the commissioner on the license certificate placing 254.23 the applicant in an existing two-year renewal cycle, as 254.24 established under section 148C.05, subdivision 1. 254.25 Sec. 18. [148C.0355] [COMMISSIONER ACTION ON APPLICATIONS 254.26 FOR LICENSURE.] 254.27 The commissioner shall act on each application for 254.28 licensure within 90 days from the date the completed application 254.29 and all required information is received by the commissioner. 254.30 The commissioner shall determine if the applicant meets the 254.31 requirements for licensure and whether there are grounds for 254.32 denial of licensure under this chapter. If the commissioner 254.33 denies an application on grounds other than the applicant's 254.34 failure of an examination, the commissioner shall: 254.35 (1) notify the applicant, in writing, of the denial and the 254.36 reason for the denial and provide the applicant 30 days from the 255.1 date of the letter informing the applicant of the denial in 255.2 which the applicant may provide additional information to 255.3 address the reasons for the denial. If the applicant does not 255.4 respond in writing to the commissioner within the 30-day period, 255.5 the denial is final. If the commissioner receives additional 255.6 information, the commissioner shall review it and make a final 255.7 determination thereafter; 255.8 (2) notify the applicant that an application submitted 255.9 following denial is a new application and must be accompanied by 255.10 the appropriate fee as specified in section 148C.12; and 255.11 (3) notify the applicant of the right to request a hearing 255.12 under chapter 14. 255.13 Sec. 19. Minnesota Statutes 2002, section 148C.04, is 255.14 amended to read: 255.15 148C.04 [REQUIREMENTS FOR LICENSURE.] 255.16 Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner 255.17 shall issue licenses to the individuals qualified undersections255.18148C.01 to 148C.11this chapter to practice alcohol and drug 255.19 counseling. 255.20 Subd. 2. [FEE.] Each applicant shall pay a nonrefundable 255.21 feeset by the commissioner pursuant to section 148C.03as 255.22 specified in section 148C.12. Fees paid to the commissioner 255.23 shall be deposited in the special revenue fund. 255.24 Subd. 3. [LICENSINGREQUIREMENTS FORTHE FIRST FIVE255.25YEARSLICENSURE BEFORE JULY 1, 2008.]For five years after the255.26effective date of the rules authorized in section 148C.03,255.27theAn applicant, unless qualified under section 148C.06 during255.28the 25-month period authorized therein, under section 148C.07,255.29or under subdivision 4,for a license must furnish evidence 255.30 satisfactory to the commissioner that the applicant has met all 255.31 the requirements in clauses (1) to (3). The applicant must have: 255.32 (1) received an associate degree, or an equivalent number 255.33 of credit hours, and a certificate in alcohol and drug 255.34 counseling, including 18 semester credits or 270 clock hours of 255.35alcohol and drug counseling classroom educationacademic course 255.36 work in accordance with subdivision 5a, paragraph (a), from an 256.1 accredited school or educational program and 880 clock hours of 256.2 supervised alcohol and drug counseling practicum; 256.3 (2) completed a written case presentation and 256.4 satisfactorily passed an oral examination established by the 256.5 commissioner that demonstrates competence in the core functions; 256.6 and 256.7 (3) satisfactorily passed a written examination as 256.8 established by the commissioner. 256.9 Subd. 4. [LICENSINGREQUIREMENTSAFTER FIVE YEARSFOR 256.10 LICENSURE AFTER JULY 1, 2008.]Beginning five years after the256.11effective date of the rules authorized in section 148C.03,256.12subdivision 1 ,An applicant forlicensurea license must submit 256.13 evidence to the commissioner that the applicant has met one of 256.14 the following requirements: 256.15 (1) the applicant must have: 256.16 (i) received a bachelor's degree from an accredited school 256.17 or educational program, including48018 semester credits or 270 256.18 clock hours ofalcohol and drug counseling educationacademic 256.19 course work in accordance with subdivision 5a, paragraph (a), 256.20 from an accredited school or educational program and 880 clock 256.21 hours of supervised alcohol and drug counseling practicum; 256.22 (ii) completed a written case presentation and 256.23 satisfactorily passed an oral examination established by the 256.24 commissioner that demonstrates competence in the core functions; 256.25 and 256.26 (iii) satisfactorily passed a written examination as 256.27 established by the commissioner; or 256.28 (2) the applicant must meet the requirements of section 256.29 148C.07. 256.30 Subd. 5a. [ACADEMIC COURSE WORK.] (a) Minimum academic 256.31 course work requirements for licensure as referred to under 256.32 subdivision 3, clause (1), and subdivision 4, clause (1), item 256.33 (i), must be in the following areas: 256.34 (1) overview of alcohol and drug counseling focusing on the 256.35 transdisciplinary foundations of alcohol and drug counseling and 256.36 providing an understanding of theories of chemical dependency, 257.1 the continuum of care, and the process of change; 257.2 (2) pharmacology of substance abuse disorders and the 257.3 dynamics of addiction; 257.4 (3) screening, intake, assessment, and treatment planning; 257.5 (4) counseling theory and practice, crisis intervention, 257.6 orientation, and client education; 257.7 (5) case management, consultation, referral, treatment 257.8 planning, reporting, recordkeeping, and professional and ethical 257.9 responsibilities; and 257.10 (6) multicultural aspects of chemical dependency to include 257.11 awareness of learning outcomes described in Minnesota Rules, 257.12 part 4747.1100, subpart 2, and the ability to know when 257.13 consultation is needed. 257.14 (b) Advanced academic course work includes, at a minimum, 257.15 the course work required in paragraph (a) and additional course 257.16 work in the following areas: 257.17 (1) advanced study in the areas listed in paragraph (a); 257.18 (2) chemical dependency and the family; 257.19 (3) treating substance abuse disorders in culturally 257.20 diverse and identified populations; 257.21 (4) dual diagnoses/co-occurring disorders with substance 257.22 abuse disorders; and 257.23 (5) ethics and chemical dependency. 257.24 Subd. 6. [TEMPORARYPRACTICEPERMIT REQUIREMENTS.] (a)A257.25person may temporarilyThe commissioner shall issue a temporary 257.26 permit to practice alcohol and drug counseling prior to being 257.27 licensed under this chapter if the person: 257.28 (1) either: 257.29 (i)meets the associate degree education and practicum257.30requirements of subdivision 3, clause (1);257.31(ii) meets the bachelor's degree education and practicum257.32requirements of subdivision 4, clause (1), item (i); or257.33(iii)submits verification of a current and unrestricted 257.34 credential for the practice of alcohol and drug counseling from 257.35 a national certification body or a certification or licensing 257.36 body from another state, United States territory, or federally 258.1 recognized tribal authority; 258.2 (ii) submits verification of the completion of at least 64 258.3 semester credits, including 270 clock hours or 18 semester 258.4 credits of formal classroom education in alcohol and drug 258.5 counseling and at least 440 clock hours of alcohol and drug 258.6 counseling practicum from an accredited school or educational 258.7 program; or 258.8 (iii) meets the requirements of section 148C.11, 258.9 subdivision 6, clauses (1), (2), and (5); 258.10 (2)requestsapplies, in writing,temporary practice status258.11with the commissioneron an application formaccording to258.12section 148C.0351provided by the commissioner, which includes 258.13 the nonrefundablelicensetemporary permit fee as specified in 258.14 section 148C.12 and an affirmation by the person's supervisor, 258.15 as defined in paragraph(b)(c), clause (1),andwhich is signed 258.16 and dated by the person and the person's supervisor; and 258.17 (3) has not been disqualified to practice temporarily on 258.18 the basis of a background investigation under section 148C.09, 258.19 subdivision 1a; and. 258.20(4) has been notified(b) The commissioner must notify the 258.21 person in writing within 90 days from the date the completed 258.22 application and all required information is received by the 258.23 commissionerthatwhether the person is qualified to practice 258.24 under this subdivision. 258.25(b)(c) A person practicing under this subdivision: 258.26 (1) may practiceonly in a program licensed by the258.27department of human services andunder tribal jurisdiction or 258.28 under the direct, on-sitesupervision of a person who is 258.29 licensed under this chapterand employed in that licensed258.30program; 258.31 (2) is subject to the rules of professional conduct set by 258.32 rule; and 258.33 (3) is not subject to the continuing education requirements 258.34 of section148C.05148C.075. 258.35 (c) A person practicing under this subdivisionmay notmust 258.36 usewith the public anythe title or description stating or 259.1 implying that the person islicensed to engagea trainee engaged 259.2 in the practice of alcohol and drug counseling. 259.3 (d)The temporary status ofA personapplying for temporary259.4practicepracticing under this subdivisionexpires on the date259.5the commissioner grants or denies licensingmust annually submit 259.6 a renewal application on forms provided by the commissioner with 259.7 the renewal fee required in section 148C.12, subdivision 3, and 259.8 the commissioner may renew the temporary permit if the trainee 259.9 meets the requirements of this subdivision. A trainee may renew 259.10 a practice permit no more than five times. 259.11 (e) A temporary permit expires if not renewed, upon a 259.12 change of employment of the trainee or upon a change in 259.13 supervision, or upon the granting or denial by the commissioner 259.14 of a license. 259.15 Subd. 7. [EFFECT AND SUSPENSION OF TEMPORARY PRACTICE.] 259.16 Approval of a person's application for temporary practice 259.17 creates no rights to or expectation of approval from the 259.18 commissioner for licensure as an alcohol and drug counselor. 259.19 The commissioner may suspend or restrict a person's temporary 259.20 practice status according to section 148C.09. 259.21 [EFFECTIVE DATE.] Subdivisions 1, 2, 3, 4, and 5 are 259.22 effective January 28, 2003. Subdivision 6 is effective July 1, 259.23 2003. 259.24 Sec. 20. [148C.045] [ALCOHOL AND DRUG COUNSELOR 259.25 TECHNICIAN.] 259.26 An alcohol and drug counselor technician may perform the 259.27 services described in section 148C.01, subdivision 9, paragraphs 259.28 (1), (2), and (3), while under the direct supervision of a 259.29 licensed alcohol and drug counselor. 259.30 Sec. 21. Minnesota Statutes 2002, section 148C.05, 259.31 subdivision 1, is amended to read: 259.32 Subdivision 1. [BIENNIAL RENEWALREQUIREMENTS.]To renew a259.33license, an applicant must:259.34(1) complete a renewal application every two years on a259.35form provided by the commissioner and submit the biennial259.36renewal fee by the deadline; and260.1(2) submit additional information if requested by the260.2commissioner to clarify information presented in the renewal260.3application. This information must be submitted within 30 days260.4of the commissioner's request.A license must be renewed every 260.5 two years. 260.6 Sec. 22. Minnesota Statutes 2002, section 148C.05, is 260.7 amended by adding a subdivision to read: 260.8 Subd. 1a. [RENEWAL REQUIREMENTS.] To renew a license, an 260.9 applicant must submit to the commissioner: 260.10 (1) a completed and signed application for license renewal, 260.11 including a signed consent authorizing the commissioner to 260.12 obtain information about the applicant from third parties, 260.13 including, but not limited to, employers, former employers, and 260.14 law enforcement agencies; 260.15 (2) the renewal fee required under section 148C.12; and 260.16 (3) additional information as requested by the commissioner 260.17 to clarify information presented in the renewal application. 260.18 The licensee must submit information within 30 days of the date 260.19 of the commissioner's request. 260.20 Sec. 23. Minnesota Statutes 2002, section 148C.05, is 260.21 amended by adding a subdivision to read: 260.22 Subd. 5. [LICENSE RENEWAL NOTICE.] At least 60 calendar 260.23 days before the renewal deadline date in subdivision 6, the 260.24 commissioner shall mail a renewal notice to the licensee's last 260.25 known address on file with the commissioner. The notice must 260.26 include an application for license renewal, the renewal 260.27 deadline, and notice of fees required for renewal. The 260.28 licensee's failure to receive notice does not relieve the 260.29 licensee of the obligation to meet the renewal deadline and 260.30 other requirements for license renewal. 260.31 Sec. 24. Minnesota Statutes 2002, section 148C.05, is 260.32 amended by adding a subdivision to read: 260.33 Subd. 6. [RENEWAL DEADLINE AND LAPSE OF LICENSURE.] (a) 260.34 Licensees must comply with paragraphs (b) to (d). 260.35 (b) Each license certificate must state an expiration 260.36 date. An application for license renewal must be received by 261.1 the commissioner or postmarked at least 30 calendar days before 261.2 the expiration date. If the postmark is illegible, the 261.3 application must be considered timely if received at least 21 261.4 calendar days before the expiration date. 261.5 (c) An application for license renewal not received within 261.6 the time required under paragraph (b) must be accompanied by a 261.7 late fee in addition to the renewal fee required in section 261.8 148C.12. 261.9 (d) A licensee's license lapses if the licensee fails to 261.10 submit to the commissioner a license renewal application by the 261.11 licensure expiration date. A licensee shall not engage in the 261.12 practice of alcohol and drug counseling while the license is 261.13 lapsed. A licensee whose license has lapsed may renew the 261.14 license by complying with section 148C.06. 261.15 Sec. 25. [148C.055] [INACTIVE OR LAPSED LICENSE.] 261.16 Subdivision 1. [INACTIVE LICENSE STATUS.] Unless a 261.17 complaint is pending against the licensee, a licensee whose 261.18 license is in good standing may request, in writing, that the 261.19 license be placed on the inactive list. If a complaint is 261.20 pending against a licensee, a license may not be placed on the 261.21 inactive list until action relating to the complaint is 261.22 concluded. The commissioner must receive the request for 261.23 inactive status before expiration of the license. A request for 261.24 inactive status received after the license expiration date must 261.25 be denied. A licensee may renew a license that is inactive 261.26 under this subdivision by meeting the renewal requirements of 261.27 section 148C.06, subdivision 2, except that payment of a late 261.28 renewal fee is not required. A licensee must not practice 261.29 alcohol and drug counseling while the license is inactive. 261.30 Subd. 2. [RENEWAL OF INACTIVE LICENSE.] A licensee whose 261.31 license is inactive shall renew the inactive status by the 261.32 inactive status expiration date determined by the commissioner 261.33 or the license will lapse. An application for renewal of 261.34 inactive status must include evidence satisfactory to the 261.35 commissioner that the licensee has completed 40 clock hours of 261.36 continuing professional education required in section 148C.075, 262.1 and be received by the commissioner at least 30 calendar days 262.2 before the expiration date. If the postmark is illegible, the 262.3 application must be considered timely if received at least 21 262.4 calendar days before the expiration date. Late renewal of 262.5 inactive status must be accompanied by a late fee as required in 262.6 section 148C.12. 262.7 Subd. 3. [RENEWAL OF LAPSED LICENSE.] An individual whose 262.8 license has lapsed for less than two years may renew the license 262.9 by submitting: 262.10 (1) a completed and signed license renewal application; 262.11 (2) the inactive license renewal fee or the renewal fee and 262.12 the late fee as required under section 148C.12; and 262.13 (3) proof of having met the continuing education 262.14 requirements in section 148C.075 since the individual's initial 262.15 licensure or last license renewal. The license issued is then 262.16 effective for the remainder of the next two-year license cycle. 262.17 Subd. 4. [LICENSE RENEWAL FOR TWO YEARS OR MORE AFTER 262.18 LICENSE EXPIRATION DATE.] An individual who submitted a license 262.19 renewal two years or more after the license expiration date must 262.20 submit the following: 262.21 (1) a completed and signed application for licensure, as 262.22 required by section 148C.0351; 262.23 (2) the initial license fee as required in section 148C.12; 262.24 and 262.25 (3) verified documentation of having achieved a passing 262.26 score within the past year on an examination required by the 262.27 commissioner. 262.28 Sec. 26. Minnesota Statutes 2002, section 148C.07, is 262.29 amended to read: 262.30 148C.07 [RECIPROCITY.] 262.31The commissioner shall issue an appropriate license to(a) 262.32 An individual who holds a current license orother credential to262.33engage in alcohol and drug counselingnational certification as 262.34 an alcohol and drug counselor from another jurisdictionif the262.35commissioner finds that the requirements for that credential are262.36substantially similar to the requirements in sections 148C.01 to263.1148C.11must file with the commissioner a completed application 263.2 for licensure by reciprocity containing the information required 263.3 under this section. 263.4 (b) The applicant must request the credentialing authority 263.5 of the jurisdiction in which the credential is held to send 263.6 directly to the commissioner a statement that the credential is 263.7 current and in good standing, the applicant's qualifications 263.8 that entitled the applicant to the credential, and a copy of the 263.9 jurisdiction's credentialing laws and rules that were in effect 263.10 at the time the applicant obtained the credential. 263.11 (c) The commissioner shall issue a license if the 263.12 commissioner finds that the requirements, which the applicant 263.13 had to meet to obtain the credential from the other jurisdiction 263.14 were substantially similar to the current requirements for 263.15 licensure in this chapter, and the applicant is not otherwise 263.16 disqualified under section 148C.09. 263.17 Sec. 27. [148C.075] [CONTINUING EDUCATION REQUIREMENTS.] 263.18 Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner 263.19 shall establish a two-year continuing education reporting 263.20 schedule requiring licensees to report completion of the 263.21 requirements of this section. Licensees must document 263.22 completion of a minimum of 40 clock hours of continuing 263.23 education activities each reporting period. A licensee may be 263.24 given credit only for activities that directly relate to the 263.25 practice of alcohol and drug counseling, the core functions, or 263.26 the rules of professional conduct in Minnesota Rules, part 263.27 4747.1400. The continuing education reporting form must require 263.28 reporting of the following information: 263.29 (1) the continuing education activity title; 263.30 (2) a brief description of the continuing education 263.31 activity; 263.32 (3) the sponsor, presenter, or author; 263.33 (4) the location and attendance dates; 263.34 (5) the number of clock hours; and 263.35 (6) a statement that the information is true and correct to 263.36 the best knowledge of the licensee. 264.1 Only continuing education obtained during the previous 264.2 two-year reporting period may be considered at the time of 264.3 reporting. Clock hours must be earned and reported in 264.4 increments of one-half clock hour with a minimum of one clock 264.5 hour for each continuing education activity. 264.6 Subd. 2. [CONTINUING EDUCATION REQUIREMENTS FOR LICENSEE'S 264.7 FIRST FOUR YEARS.] A licensee must, as part of meeting the clock 264.8 hour requirement of this section, obtain and document 18 hours 264.9 of cultural diversity training within the first four years after 264.10 the licensee's initial license effective date according to the 264.11 commissioner's reporting schedule. 264.12 Subd. 3. [CONTINUING EDUCATION REQUIREMENTS AFTER 264.13 LICENSEE'S INITIAL FOUR YEARS.] Beginning four years following a 264.14 licensee's initial license effective date and according to the 264.15 board's reporting schedule, a licensee must document completion 264.16 of a minimum of six clock hours each reporting period of 264.17 cultural diversity training. Licensees must also document 264.18 completion of six clock hours in courses directly related to the 264.19 rules of professional conduct in Minnesota Rules, part 4747.1400. 264.20 Subd. 4. [STANDARDS FOR APPROVAL.] In order to obtain 264.21 clock hour credit for a continuing education activity, the 264.22 activity must: 264.23 (1) constitute an organized program of learning; 264.24 (2) reasonably be expected to advance the knowledge and 264.25 skills of the alcohol and drug counselor; 264.26 (3) pertain to subjects that directly relate to the 264.27 practice of alcohol and drug counseling and the core functions 264.28 of an alcohol and drug counselor, or the rules of professional 264.29 conduct in Minnesota Rules, part 4747.1400; 264.30 (4) be conducted by individuals who have education, 264.31 training, and experience and are knowledgeable about the subject 264.32 matter; and 264.33 (5) be presented by a sponsor who has a system to verify 264.34 participation and maintains attendance records for three years, 264.35 unless the sponsor provides dated evidence to each participant 264.36 with the number of clock hours awarded. 265.1 Sec. 28. Minnesota Statutes 2002, section 148C.10, 265.2 subdivision 1, is amended to read: 265.3 Subdivision 1. [PRACTICE.]After the commissioner adopts265.4rules,Noindividualperson, other than those individuals 265.5 exempted under section 148C.11, or 148C.045, shall engage in 265.6 alcohol and drug counselingpractice unless that individual265.7holds a valid licensewithout first being licensed under this 265.8 chapter as an alcohol and drug counselor. For purposes of this 265.9 chapter, an individual engages in the practice of alcohol and 265.10 drug counseling if the individual performs or offers to perform 265.11 alcohol and drug counseling services as defined in section 265.12 148C.01, subdivision 10, or if the individual is held out as 265.13 able to perform those services. 265.14 Sec. 29. Minnesota Statutes 2002, section 148C.10, 265.15 subdivision 2, is amended to read: 265.16 Subd. 2. [USE OF TITLES.]After the commissioner adopts265.17rules,Noindividualperson shall present themselves or any 265.18 other individual to the public by any title incorporating the 265.19 words "licensed alcohol and drug counselor" or otherwise hold 265.20 themselves out to the public by any title or description stating 265.21 or implying that they are licensed or otherwise qualified to 265.22 practice alcohol and drug counseling unless that individual 265.23 holds a valid license.City, county, and state agency alcohol265.24and drug counselors who are not licensed under sections 148C.01265.25to 148C.11 may use the title "city agency alcohol and drug265.26counselor," "county agency alcohol and drug counselor," or265.27"state agency alcohol and drug counselor." Hospital alcohol and265.28drug counselors who are not licensed under sections 148C.01 to265.29148C.11 may use the title "hospital alcohol and drug counselor"265.30while acting within the scope of their employmentPersons issued 265.31 a temporary permit must use titles consistent with section 265.32 148C.04, subdivision 6, paragraph (c). 265.33 Sec. 30. Minnesota Statutes 2002, section 148C.11, is 265.34 amended to read: 265.35 148C.11 [EXCEPTIONS TO LICENSE REQUIREMENT.] 265.36 Subdivision 1. [OTHER PROFESSIONALS.] (a) Nothing in 266.1sections 148C.01 to 148C.10 shall preventthis chapter prevents 266.2 members of other professions or occupations from performing 266.3 functions for which they are qualified or licensed. This 266.4 exception includes, but is not limited to, licensed physicians, 266.5 registered nurses, licensed practical nurses, licensed 266.6 psychological practitioners, members of the clergy, American 266.7 Indian medicine men and women, licensed attorneys, probation 266.8 officers, licensed marriage and family therapists, licensed 266.9 social workers, licensed professional counselors, licensed 266.10 school counselors, and registered occupational therapists or 266.11 occupational therapy assistants. 266.12 (b) Nothing in this chapter prohibits technicians and 266.13 resident managers in programs licensed by the department of 266.14 human services from discharging their duties as provided in 266.15 Minnesota Rules, chapter 9530. 266.16 (c) Any person who is exempt under this section but who 266.17 elects to obtain a license under this chapter is subject to this 266.18 chapter to the same extent as other licensees. 266.19 (d) These persons must not, however, use a title 266.20 incorporating the words "alcohol and drug counselor" or 266.21 "licensed alcohol and drug counselor" or otherwise hold 266.22 themselves out to the public by any title or description stating 266.23 or implying that they are engaged in the practice of alcohol and 266.24 drug counseling, or that they are licensed to engage in the 266.25 practice of alcohol and drug counseling. Persons engaged in the 266.26 practice of alcohol and drug counseling are not exempt from the 266.27 commissioner's jurisdiction solely by the use of one of the 266.28 above titles. 266.29 Subd. 2. [STUDENTS.] Nothing in sections 148C.01 to 266.30 148C.10 shall prevent students enrolled in an accredited school 266.31 of alcohol and drug counseling from engaging in the practice of 266.32 alcohol and drug counseling while under qualified supervision in 266.33 an accredited school of alcohol and drug counseling. 266.34 Subd. 3. [FEDERALLY RECOGNIZED TRIBES; ETHNIC MINORITIES.] 266.35 (a) Alcohol and drug counselorslicensed to practicepracticing 266.36 alcohol and drug counseling according to standards established 267.1 by federally recognized tribes, while practicing under tribal 267.2 jurisdiction, are exempt from the requirements of this chapter. 267.3 In practicing alcohol and drug counseling under tribal 267.4 jurisdiction, individualslicensedpracticing under that 267.5 authority shall be afforded the same rights, responsibilities, 267.6 and recognition as persons licensed pursuant to this chapter. 267.7 (b) The commissioner shall develop special licensing 267.8 criteria for issuance of a license to alcohol and drug 267.9 counselors who: (1) practice alcohol and drug counseling with a 267.10 member of an ethnic minority population or with a person with a 267.11 disability as defined by rule; or (2) are employed by agencies 267.12 whose primary agency service focus addresses ethnic minority 267.13 populations or persons with a disability as defined by rule. 267.14 These licensing criteria may differ from the licensing 267.15criteriarequirements specified in section 148C.04. To develop, 267.16 implement, and evaluate the effect of these criteria, the 267.17 commissioner shall establish a committee comprised of, but not 267.18 limited to, representatives from the Minnesota commission 267.19 serving deaf and hard-of-hearing people, the council on affairs 267.20 of Chicano/Latino people, the council on Asian-Pacific 267.21 Minnesotans, the council on Black Minnesotans, the council on 267.22 disability, and the Indian affairs council. The committee does 267.23 not expire. 267.24 (c) The commissioner shall issue a license to an applicant 267.25 who (1) is an alcohol and drug counselor who is exempt under 267.26 paragraph (a) from the requirements of this chapter; (2) has at 267.27 least 2,000 hours of alcohol and drug counselor experience as 267.28 defined by the core functions; and (3) meets the licensing 267.29 requirements that are in effect on the date of application under 267.30 section 148C.04, subdivision 3 or 4, except the written case 267.31 presentation and oral examination component under section 267.32 148C.04, subdivision 3, clause (2), or 4, clause (1), item 267.33 (ii). When applying for a license under this paragraph, an 267.34 applicant must follow the procedures for admission to licensure 267.35 specified under section 148C.0351. A person who receives a 267.36 license under this paragraph must complete the written case 268.1 presentation and satisfactorily pass the oral examination 268.2 component under section 148C.04, subdivision 3, clause (2), or 268.3 4, clause (1), item (ii), at the earliest available opportunity 268.4 after the commissioner begins administering oral examinations. 268.5 The commissioner may suspend or restrict a person's license 268.6 according to section 148C.09 if the person fails to complete the 268.7 written case presentation and satisfactorily pass the oral 268.8 examination. This paragraph expires July 1, 2004. 268.9 Subd. 4. [HOSPITAL ALCOHOL AND DRUG COUNSELORS.]The268.10licensing of hospital alcohol and drug counselors shall be268.11voluntary, while the counselor is employed by the hospital.268.12 Effective January 1, 2006, hospitals employing alcohol and drug 268.13 counselors shallnotbe required to employ licensed alcohol and 268.14 drug counselors, nor shall they require their alcohol and drug268.15counselors to be licensed, however, nothing in this chapter will268.16prohibit hospitals from requiring their counselors to be268.17eligible for licensure. An alcohol or drug counselor employed 268.18 by a hospital must be licensed as an alcohol and drug counselor 268.19 in accordance with this chapter. 268.20 Subd. 5. [CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG 268.21 COUNSELORS.]The licensing of city, county, and state agency268.22alcohol and drug counselors shall be voluntary, while the268.23counselor is employed by the city, county, or state agency.268.24 Effective January 1, 2006, city, county, and state agencies 268.25 employing alcohol and drug counselors shallnotbe required to 268.26 employ licensed alcohol and drug counselors, nor shall they268.27require their drug and alcohol counselors to be licensed. An 268.28 alcohol and drug counselor employed by a city, county, or state 268.29 agency must be licensed as an alcohol and drug counselor in 268.30 accordance with this chapter. 268.31 Subd. 6. [TRANSITION PERIOD FOR HOSPITAL AND CITY, COUNTY, 268.32 AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] For the period 268.33 between July 1, 2003, and January 1, 2006, the commissioner 268.34 shall grant a license to an individual who is employed as an 268.35 alcohol and drug counselor at a Minnesota hospital or a city, 268.36 county, or state agency in Minnesota if the individual: 269.1 (1) was employed as an alcohol and drug counselor at a 269.2 hospital or a city, county, or state agency before August 1, 269.3 2002; 269.4 (2) has 8,000 hours of alcohol and drug counselor work 269.5 experience; 269.6 (3) has completed a written case presentation and 269.7 satisfactorily passed an oral examination established by the 269.8 commissioner; 269.9 (4) has satisfactorily passed a written examination as 269.10 established by the commissioner; and 269.11 (5) meets the requirements in section 148C.0351. 269.12 Sec. 31. [148C.12] [FEES.] 269.13 Subdivision 1. [APPLICATION FEE.] The application fee is 269.14 $295. 269.15 Subd. 2. [BIENNIAL RENEWAL FEE.] The license renewal fee 269.16 is $295. If the commissioner changes the renewal schedule and 269.17 the expiration date is less than two years, the fee must be 269.18 prorated. 269.19 Subd. 3. [TEMPORARY PERMIT FEE.] The initial fee for 269.20 applicants under section 148C.04, subdivision 6, paragraph (a), 269.21 is $100. The fee for annual renewal of a temporary permit is 269.22 $100. 269.23 Subd. 4. [EXAMINATION FEE.] The examination fee for the 269.24 written examination is $95 and for the oral examination is $200. 269.25 Subd. 5. [INACTIVE RENEWAL FEE.] The inactive renewal fee 269.26 is $150. 269.27 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 269.28 biennial renewal fee, the inactive renewal fee, or the annual 269.29 fee for renewal of temporary practice status. 269.30 Subd. 7. [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The 269.31 fee for renewal of a license that has expired for less than two 269.32 years is the total of the biennial renewal fee, the late fee, 269.33 and a fee of $100 for review and approval of the continuing 269.34 education report. 269.35 Subd. 8. [FEE FOR LICENSE VERIFICATIONS.] The fee for 269.36 license verification to institutions and other jurisdictions is 270.1 $25. 270.2 Subd. 9. [SURCHARGE FEE.] Notwithstanding section 270.3 16A.1285, subdivision 2, a surcharge of $99 shall be paid at the 270.4 time of initial application for or renewal of an alcohol and 270.5 drug counselor license until June 30, 2013. 270.6 Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable. 270.7 Sec. 32. Minnesota Statutes 2002, section 150A.05, 270.8 subdivision 2, is amended to read: 270.9 Subd. 2. [EXEMPTIONS AND EXCEPTIONS OF CERTAIN PRACTICES 270.10 AND OPERATIONS.] Sections 150A.01 to 150A.12 do not apply to: 270.11 (1) the practice of dentistry or dental hygiene in any 270.12 branch of the armed services of the United States, the United 270.13 States Public Health Service, or the United States Veterans 270.14 Administration; 270.15 (2) the practice of dentistry, dental hygiene, or dental 270.16 assisting by undergraduate dental students, dental hygiene 270.17 students, and dental assisting students of the University of 270.18 Minnesota, schools of dental hygiene, or schools of dental 270.19 assisting approved by the board, when acting under the direction 270.20 and supervision of a licensed dentist or a licensed dental 270.21 hygienist acting as an instructor; 270.22 (3) the practice of dentistry by licensed dentists of other 270.23 states or countries while appearing as clinicians under the 270.24 auspices of a duly approved dental school or college, or a 270.25 reputable dental society, or a reputable dental study club 270.26 composed of dentists; 270.27 (4) the actions of persons while they are taking 270.28 examinations for licensure or registration administered or 270.29 approved by the board pursuant to sections 150A.03, subdivision 270.30 1, and 150A.06, subdivisions 1, 2, and 2a; 270.31 (5) the practice of dentistry by dentists and dental 270.32 hygienists licensed by other states during their functioning as 270.33 examiners responsible for conducting licensure or registration 270.34 examinations administered by regional and national testing 270.35 agencies with whom the board is authorized to affiliate and 270.36 participate under section 150A.03, subdivision 1, and the 271.1 practice of dentistry by the regional and national testing 271.2 agencies during their administering examinations pursuant to 271.3 section 150A.03, subdivision 1; 271.4 (6) the use of X-rays or other diagnostic imaging 271.5 modalities for making radiographs or other similar records in a 271.6 hospital under the supervision of a physician or dentist or by a 271.7 person who is credentialed to use diagnostic imaging modalities 271.8 or X-ray machines for dental treatment, roentgenograms, or 271.9 dental diagnostic purposes by a credentialing agency other than 271.10 the board of dentistry;or271.11 (7) the service, other than service performed directly upon 271.12 the person of a patient, of constructing, altering, repairing, 271.13 or duplicating any denture, partial denture, crown, bridge, 271.14 splint, orthodontic, prosthetic, or other dental appliance, when 271.15 performed according to a written work order from a licensed 271.16 dentist in accordance with section 150A.10, subdivision 3; or 271.17 (8) services that are included within the practice of 271.18 denturism, as defined in section 150B.01, and that are provided 271.19 by denturists licensed under chapter 150B. 271.20 Sec. 33. [150B.01] [DEFINITIONS.] 271.21 Subdivision 1. [APPLICATION.] The definitions in this 271.22 section apply to this chapter. 271.23 Subd. 2. [ADVISORY COUNCIL.] "Advisory council" means the 271.24 denture technology advisory council. 271.25 Subd. 3. [BOARD.] "Board" means the board of dentistry. 271.26 Subd. 4. [DENTURE.] "Denture" means a removable full or 271.27 partial upper or lower dental appliance to be worn in the mouth 271.28 to replace missing natural teeth. 271.29 Subd. 5. [DENTURIST.] "Denturist" means a person who 271.30 engages in the practice of denturism and is licensed under this 271.31 chapter. 271.32 Subd. 6. [PRACTICE OF DENTURISM.] "Practice of denturism" 271.33 means: 271.34 (1) making, placing, constructing, altering, reproducing, 271.35 or repairing a denture; and 271.36 (2) taking impressions and furnishing or supplying a 272.1 denture directly to a person, or advising the use of the 272.2 denture, and maintaining a facility for these purposes. 272.3 Sec. 34. [150B.02] [PRACTICE OF DENTURISM PERMITTED.] 272.4 A licensed denturist may engage in the practice of 272.5 denturism only on patients at facilities that serve individuals 272.6 who are uninsured or who are Minnesota health care public 272.7 program recipients, including a hospital; nursing home; home 272.8 health agency; housing with services; group home serving the 272.9 elderly or disabled; state-operated facility licensed by the 272.10 commissioner of human services or the commissioner of 272.11 corrections; federal, state, or local public health facility; or 272.12 nonprofit organization. 272.13 Sec. 35. [150B.03] [LICENSURE; PROTECTED TITLES AND 272.14 RESTRICTIONS ON USE.] 272.15 Subdivision 1. [LICENSURE REQUIRED.] No person may engage 272.16 in the practice of denturism unless the person is licensed as a 272.17 denturist under this chapter. 272.18 Subd. 2. [PROTECTED TITLES.] No person may hold himself or 272.19 herself out to the public as a denturist, use the title 272.20 "licensed denturist" or "denturist," or use any other titles, 272.21 words, letters, abbreviations, or insignia indicating or 272.22 implying that the person is licensed under this chapter or 272.23 eligible for licensure under this chapter, unless the person has 272.24 been licensed as a denturist under this chapter. 272.25 Subd. 3. [PENALTY.] A person who violates any provision of 272.26 this section is guilty of a misdemeanor. 272.27 Sec. 36. [150B.04] [EXCLUSIONS FROM CHAPTER.] 272.28 Nothing in this chapter prohibits or restricts: 272.29 (1) the practice of a health-related occupation by a person 272.30 who is licensed, registered, or certified in Minnesota and who 272.31 is practicing within the scope of practice of that occupation; 272.32 (2) the practice of denturism by a person employed in the 272.33 service of the federal government while performing duties 272.34 incident to that employment; 272.35 (3) the practice of denturism by a student enrolled in a 272.36 school approved by the board, if the denturism services provided 273.1 by a student are provided according to a course of instruction 273.2 or an assignment from an instructor, and under the supervision 273.3 of an instructor; or 273.4 (4) work performed by dental laboratories and dental 273.5 technicians under the written prescription of a dentist. 273.6 Sec. 37. [150B.05] [EXAMINATION AND REFERRAL 273.7 REQUIREMENTS.] 273.8 Before making and fitting a denture, a denturist must 273.9 receive from the patient a certificate of oral health from a 273.10 licensed dentist or physician certifying that a denture will 273.11 pose no threat to the patient's health. The certificate must be 273.12 dated within 60 days from the date the services are performed by 273.13 the denturist. Nothing in this section shall be construed to 273.14 require a certificate of oral health before a denturist can 273.15 perform services to alter or repair a denture or advise on the 273.16 use of a denture. 273.17 Sec. 38. [150B.06] [DUTIES OF BOARD.] 273.18 To regulate denturists, the board shall exercise the 273.19 following powers and duties: 273.20 (1) establish qualifications for persons applying for 273.21 licensure; 273.22 (2) prescribe, administer, and determine the requirements 273.23 for examinations and establish what constitutes a passing grade 273.24 for licensure; 273.25 (3) adopt rules necessary to implement this chapter; 273.26 (4) evaluate schools, and designate those schools from 273.27 which graduation will be accepted as proof of an applicant's 273.28 completion of the course work requirements for licensure; 273.29 (5) discipline applicants and persons licensed under this 273.30 chapter who violate a ground for disciplinary action; 273.31 (6) issue licenses for the practice of denturism; 273.32 (7) administer oaths and subpoena witnesses to carry out 273.33 the activities authorized under this chapter; 273.34 (8) establish forms and procedures necessary to implement 273.35 this chapter; and 273.36 (9) hire staff as needed to implement this chapter and act 274.1 on behalf of the board and the advisory council. 274.2 Sec. 39. [150B.07] [DENTURE TECHNOLOGY ADVISORY COUNCIL.] 274.3 Subdivision 1. [ESTABLISHMENT; MEMBERSHIP.] (a) The board 274.4 shall appoint seven persons to a denture technology advisory 274.5 council. The advisory council shall consist of: 274.6 (1) four persons who are licensed denturists under this 274.7 chapter. The initial appointees need not be licensed denturists 274.8 but must have at least five years of experience in the practice 274.9 of denturism or in a related field; 274.10 (2) two persons who are public members, as defined in 274.11 section 214.02, and who are not affiliated with any health care 274.12 occupation or facility. At least one of the public members must 274.13 be over 65 years of age and must represent senior citizens; and 274.14 (3) one person who is a dentist serving on the board of 274.15 dentistry. 274.16 (b) No person may serve more than two consecutive terms on 274.17 the advisory council. 274.18 Subd. 2. [ORGANIZATION.] The advisory council shall be 274.19 organized and administered under section 15.059. 274.20 Subd. 3. [DUTIES.] At the board's request, the advisory 274.21 council shall: 274.22 (1) advise the board regarding licensure qualifications for 274.23 denturists; 274.24 (2) advise the board regarding requirements for 274.25 examinations, what constitutes a passing grade on an 274.26 examination, and prescribing and administering examinations; 274.27 (3) advise the board regarding rules that are necessary to 274.28 implement this chapter; 274.29 (4) review reports of investigations related to individuals 274.30 and make recommendations to the board as to whether licensure 274.31 should be denied or disciplinary action should be taken; and 274.32 (5) perform other duties for advisory councils authorized 274.33 by chapter 214, as directed by the board. 274.34 Sec. 40. [150B.08] [LICENSURE FEES.] 274.35 Subdivision 1. [FEES.] The following denturist license 274.36 fees shall be paid to the board: 275.1 (1) licensure fee, $905; 275.2 (2) license renewal fee, $905; 275.3 (3) inactive license fee, $905; and 275.4 (4) inactive license renewal fee, $905. 275.5 Subd. 2. [SURCHARGE FEE.] Notwithstanding section 275.6 16A.1285, subdivision 2, a surcharge of $1,644 shall be paid at 275.7 the time of initial application for or renewal of a denturist 275.8 license until June 30, 2008. 275.9 Subd. 3. [NONREFUNDABLE; WHERE DEPOSITED.] All fees 275.10 collected are nonrefundable and must be deposited in the state 275.11 government special revenue fund. 275.12 Sec. 41. [150B.09] [REQUIREMENTS FOR LICENSURE.] 275.13 Subdivision 1. [GENERAL REQUIREMENTS FOR LICENSURE.] The 275.14 board shall issue a license to practice denturism to an 275.15 applicant who: 275.16 (1) submits a completed application to the board on a form 275.17 provided by the board; 275.18 (2) submits the fees required under section 150B.08; 275.19 (3) documents successful completion of formal training 275.20 lasting at least two years with a major course of study in the 275.21 practice of denturism, at a school approved by the board. The 275.22 formal training must include special training in oral pathology, 275.23 infection control, medical emergencies, and clinical experience 275.24 specified by the board; and 275.25 (4) passes a written examination and practical examination 275.26 approved by the board. 275.27 Subd. 2. [LICENSURE BY RECIPROCITY.] The board shall issue 275.28 a license by reciprocity to practice denturism to an applicant 275.29 who is currently licensed or registered to practice denturism in 275.30 another state that the board determines has substantially 275.31 equivalent licensure or registration standards to those in this 275.32 state, and who: 275.33 (1) submits a completed application to the board on a form 275.34 provided by the board; 275.35 (2) submits the fees required under section 150B.08; 275.36 (3) provides proof of having successfully passed a written 276.1 examination and practical examination for denturism in the state 276.2 where the applicant is licensed or registered, if the board 276.3 determines that the examinations are substantially equivalent to 276.4 those in this state; and 276.5 (4) submits an affidavit from the agency that licenses or 276.6 registers denturists in the state where the applicant is 276.7 licensed or registered, attesting to the fact that the applicant 276.8 is currently licensed or registered in that state. 276.9 Subd. 3. [LICENSURE BY EQUIVALENCY DURING TRANSITION 276.10 PERIOD.] Between July 1, 2003, and June 30, 2005, the board 276.11 shall issue a license by equivalency to an applicant who: 276.12 (1) submits a completed application to the board on a form 276.13 provided by the board; 276.14 (2) submits the fees required under section 150B.08; 276.15 (3) submits either: 276.16 (i) three affidavits from persons other than family members 276.17 attesting that the applicant has been employed in the practice 276.18 of denturism for at least five years, or submits documentation 276.19 of at least 4,000 hours of practical experience in the practice 276.20 of denturism; or 276.21 (ii) documentation of successful completion of a training 276.22 course approved by the board, or successful completion of an 276.23 equivalent course approved by the board; and 276.24 (4) passes a written examination and practical examination 276.25 approved by the board. 276.26 Subd. 4. [CONTENT OF LICENSE.] A license must list all 276.27 addresses where the licensed denturist will engage in the 276.28 practice of denturism. 276.29 Subd. 5. [LICENSE RENEWAL.] The board shall establish by 276.30 rule the requirements for license renewal. The requirements for 276.31 license renewal shall not be more stringent than the 276.32 requirements for licensure established in this chapter. 276.33 Sec. 42. [150B.10] [LICENSURE EXAMINATION.] 276.34 Subdivision 1. [EXAMINATION ADMINISTRATION.] The board 276.35 shall prescribe and administer the written and practical 276.36 examinations for licensure under this chapter. The board may 277.1 hire denturists licensed under this chapter to prepare, 277.2 administer, and grade the examinations, or may contract with 277.3 regional examiners to prepare, administer, and grade the 277.4 examinations. 277.5 Subd. 2. [REQUIREMENTS FOR EXAMINATIONS.] The examinations 277.6 must determine the qualifications, fitness, and ability of the 277.7 applicant to practice denturism. The examinations must include 277.8 a written examination and a practical examination involving a 277.9 demonstration of skills. The written examination must cover the 277.10 following subjects: head and oral anatomy and physiology, oral 277.11 pathology, partial denture construction and design, 277.12 microbiology, clinical dental technology, dental laboratory 277.13 technology, clinical jurisprudence, asepsis, medical 277.14 emergencies, and cardiopulmonary resuscitation. Examinations 277.15 must be held at least annually. The first examination must be 277.16 administered no later than December 31, 2003. 277.17 Subd. 3. [FAILURE OF WRITTEN OR PRACTICAL 277.18 EXAMINATION.] Upon payment of an appropriate fee, an applicant 277.19 who fails either the written or practical examination may take 277.20 again the portion of the examination that the applicant failed. 277.21 Sec. 43. [150B.11] [INACTIVE LICENSE.] 277.22 Subdivision 1. [GENERAL.] Licensed denturists may place 277.23 their license on inactive status. A person whose license is on 277.24 inactive status shall not engage in the practice of denturism in 277.25 this state without first reactivating the license. An inactive 277.26 license must be renewed according to a schedule established by 277.27 the board. Failure to renew an inactive license shall result in 277.28 cancellation of the inactive license. 277.29 Subd. 2. [CHANGE TO ACTIVE STATUS.] The board shall by 277.30 rule establish requirements under which a person whose license 277.31 is on inactive status may change the license to active status. 277.32 Subd. 3. [DISCIPLINARY ACTION.] If a disciplinary 277.33 proceeding has been initiated to suspend or revoke a person's 277.34 inactive license, the license shall remain inactive until the 277.35 proceedings are completed. 277.36 Sec. 44. [150B.12] [GROUNDS FOR DISCIPLINARY ACTION; 278.1 DISCIPLINARY ACTIONS; SUSPENSION.] 278.2 Subdivision 1. [GROUNDS FOR DENIAL OF LICENSURE OR 278.3 DISCIPLINE.] The board may refuse to grant a license, may 278.4 approve licensure with conditions, or may discipline a denturist 278.5 licensed under this chapter using any disciplinary actions 278.6 listed in subdivision 2 on proof that the individual has: 278.7 (1) intentionally submitted false or misleading information 278.8 to the board or the advisory council; 278.9 (2) failed, within 30 days, to provide information in 278.10 response to a written request by the board or advisory council; 278.11 (3) engaged in the practice of denturism in an incompetent 278.12 manner or in a manner that falls below the community standard of 278.13 care; 278.14 (4) violated any provision of this chapter; 278.15 (5) failed to perform the practice of denturism with 278.16 reasonable judgment, skill, or safety due to the use of alcohol 278.17 or drugs, or due to other physical or mental impairment; 278.18 (6) been convicted of violating any state or federal law, 278.19 rule, or regulation which directly relates to the practice of 278.20 denturism; 278.21 (7) aided or abetted another person in violating any 278.22 provision of this chapter; 278.23 (8) been disciplined for conduct in the practice of an 278.24 occupation by the state of Minnesota, another jurisdiction, or a 278.25 national professional association, if any of the grounds for 278.26 discipline are the same or substantially equivalent to those in 278.27 this chapter; 278.28 (9) not cooperated with the board or advisory council in an 278.29 investigation of allegations of a ground for disciplinary 278.30 action; 278.31 (10) advertised in a manner that is false or misleading; 278.32 (11) engaged in dishonest, unethical, or unprofessional 278.33 conduct in connection with the practice of denturism that is 278.34 likely to deceive, defraud, or harm the public; 278.35 (12) demonstrated a willful or careless disregard for the 278.36 health, welfare, or safety of a patient; 279.1 (13) performed medical diagnosis, practiced dentistry, or 279.2 provided treatment, other than the practice of denturism, 279.3 without being licensed to do so under the laws of this state; 279.4 (14) paid or promised to pay a commission or part of a fee 279.5 to any person who contacts the denturist for consultation or 279.6 sends patients to the denturist for treatment; 279.7 (15) engaged in an incentive payment arrangement, other 279.8 than that prohibited by clause (14), that promotes 279.9 overutilization of the practice of denturism, whereby the 279.10 referring person or person who controls the availability of 279.11 denturist services to a patient profits unreasonably as a result 279.12 of patient treatment; 279.13 (16) engaged in abusive or fraudulent billing practices, 279.14 including violations of federal Medicare and Medicaid laws, Food 279.15 and Drug Administration regulations, or state medical assistance 279.16 laws; 279.17 (17) obtained money, property, or services from a patient 279.18 through the use of undue influence, high-pressure sales tactics, 279.19 harassment, duress, deception, or fraud; 279.20 (18) performed services for a patient who had no 279.21 possibility of benefiting from the services; 279.22 (19) failed to refer a patient to a dentist or physician 279.23 for examination or services as required under section 150B.05, 279.24 or otherwise violated section 150B.05; 279.25 (20) engaged in conduct with a patient that is sexual or 279.26 may reasonably be interpreted by the patient as sexual, or in 279.27 any verbal behavior that is seductive or sexually demeaning to a 279.28 patient; 279.29 (21) violated a federal or state court order, including a 279.30 conciliation court judgment, or a disciplinary order issued by 279.31 the board, related to the person's practice of denturism; or 279.32 (22) any other just cause related to the practice of 279.33 denturism. 279.34 Subd. 2. [FORMS OF DISCIPLINARY ACTION.] When the board 279.35 finds that an applicant or a licensed denturist has engaged in a 279.36 ground for disciplinary action under this chapter, the board may 280.1 take one or more of the following actions: 280.2 (1) refuse to grant a license; 280.3 (2) revoke the license; 280.4 (3) suspend the license; 280.5 (4) impose limitations or conditions on the license; 280.6 (5) impose a civil penalty not exceeding $10,000 for each 280.7 separate violation, the amount of the civil penalty to be fixed 280.8 so as to deprive the denturist of any economic advantage gained 280.9 by the violation charged or to reimburse the board for all costs 280.10 of the investigation and proceeding; including, but not limited 280.11 to, the amount paid by the board for services from the office of 280.12 administrative hearings, attorney fees, court reports, 280.13 witnesses, reproduction of records, advisory council members' 280.14 per diem compensation, staff time, and expense incurred by 280.15 advisory council members and department staff; 280.16 (6) order the denturist to provide uncompensated 280.17 professional service under supervision at a designated clinic or 280.18 other health care institution; 280.19 (7) censure or reprimand the denturist; or 280.20 (8) any other action justified by the case. 280.21 Subd. 3. [DISCOVERY; SUBPOENAS.] In all matters relating 280.22 to the board's investigation and enforcement activities related 280.23 to denturists, the board may issue subpoenas and compel the 280.24 attendance of witnesses and the production of all necessary 280.25 papers, books, records, documents, and other evidentiary 280.26 materials. Any person failing or refusing to appear or testify 280.27 regarding any matter about which the person may be lawfully 280.28 questioned or failing to produce any papers, books, records, 280.29 documents, or other evidentiary materials in the matter to be 280.30 heard, after having been required by order of the board or by a 280.31 subpoena of the board to do so may, upon application by the 280.32 board to the district court in any district, be ordered to 280.33 comply with the order or subpoena. The board may administer 280.34 oaths to witnesses or take their affirmation. Depositions may 280.35 be taken within or outside the state in the manner provided by 280.36 law for the taking of depositions in civil actions. A subpoena 281.1 or other process or paper may be served upon a person it names 281.2 anywhere within the state by any officer authorized to serve 281.3 subpoenas or other process in civil actions in the same manner 281.4 as prescribed by law for service of process issued out of the 281.5 district court of this state. 281.6 Subd. 4. [TEMPORARY SUSPENSION.] In addition to any other 281.7 remedy provided by law, the board may, without a hearing, 281.8 temporarily suspend the right of a denturist to practice if the 281.9 board finds that the denturist has violated a statute or rule 281.10 that the board has authority to enforce and that continued 281.11 practice by the denturist would create a serious risk of harm to 281.12 others. The suspension takes effect upon service of a written 281.13 order on the denturist specifying the statute or rule violated. 281.14 The order remains in effect until the board issues a final order 281.15 in the matter after a hearing or upon agreement between the 281.16 board and the denturist. Service of the order is effective if 281.17 the order is served on the denturist or the denturist's attorney 281.18 either personally or by first class mail. Within ten days of 281.19 service of the order, the board shall hold a hearing on the sole 281.20 issue of whether there is a reasonable basis to continue, 281.21 modify, or lift the suspension. Evidence presented by the board 281.22 or denturist must be by affidavit only. The denturist or the 281.23 denturist's attorney of record may appear for oral argument. 281.24 Within five working days after the hearing, the board shall 281.25 issue an order and, if the suspension is continued, schedule a 281.26 contested case hearing within 45 days after issuance of the 281.27 order. The administrative law judge shall issue a report within 281.28 30 days after closing of the contested case hearing record. The 281.29 board shall issue a final order within 30 days after receipt of 281.30 that report, the hearing record, and any exceptions to the 281.31 report filed by the parties. 281.32 Subd. 5. [AUTOMATIC SUSPENSION.] A denturist's right to 281.33 practice is automatically suspended if (1) a guardian is 281.34 appointed for a denturist, by order of a district court under 281.35 sections 525.54 to 525.61, or (2) the denturist is committed by 281.36 order of a district court under chapter 253B. The right to 282.1 practice remains suspended until the denturist is restored to 282.2 capacity by a court and, upon petition by the denturist, the 282.3 suspension is terminated by the board after a hearing or upon 282.4 agreement between the board and the denturist. 282.5 Sec. 45. [150B.13] [ADDITIONAL REMEDIES.] 282.6 Subdivision 1. [CEASE AND DESIST.] (a) The board may issue 282.7 a cease and desist order to stop a person from violating or 282.8 threatening to violate a statute, rule, or order which the board 282.9 has issued or has authority to enforce. The cease and desist 282.10 order must state the reason for its issuance and give notice of 282.11 the person's right to request a hearing under sections 14.57 to 282.12 14.62. If, within 15 days of service of the order, the subject 282.13 of the order fails to request a hearing in writing, the order is 282.14 the final order of the board and is not reviewable by a court or 282.15 agency. 282.16 (b) A hearing must be initiated by the board not later than 282.17 30 days from the date of the board's receipt of a written 282.18 hearing request. Within 30 days of receipt of the 282.19 administrative law judge's report, and any written agreement or 282.20 exceptions filed by the parties, the board shall issue a final 282.21 order modifying, vacating, or making permanent the cease and 282.22 desist order as the facts require. The final order remains in 282.23 effect until modified or vacated by the board. 282.24 (c) When a request for a stay of a cease and desist order 282.25 accompanies a timely hearing request, the board may, in the 282.26 board's discretion, grant the stay. If the board does not grant 282.27 a requested stay, the board shall refer the request to the 282.28 office of administrative hearings within three working days of 282.29 receipt of the request. Within ten days after receiving the 282.30 request from the board, an administrative law judge shall issue 282.31 a recommendation to grant or deny the stay. The board shall 282.32 grant or deny the stay within five working days of receiving the 282.33 administrative law judge's recommendation. 282.34 (d) In the event of noncompliance with a cease and desist 282.35 order, the board may institute a proceeding in district court to 282.36 obtain injunctive relief or other appropriate relief, including 283.1 a civil penalty payable to the board not exceeding $10,000 for 283.2 each separate violation. 283.3 Subd. 2. [INJUNCTIVE RELIEF.] In addition to any other 283.4 remedy provided by law, including the issuance of a cease and 283.5 desist order under subdivision 1, the board may in the board's 283.6 own name bring an action in district court for injunctive relief 283.7 to restrain a denturist from a violation or threatened violation 283.8 of any statute, rule, or order which the board has authority to 283.9 administer, enforce, or issue. 283.10 Subd. 3. [ADDITIONAL POWERS.] The issuance of a cease and 283.11 desist order or injunctive relief granted under this section 283.12 does not relieve a denturist from criminal prosecution by a 283.13 competent authority or from disciplinary action by the board. 283.14 Sec. 46. [150B.14] [REPORTING OBLIGATIONS.] 283.15 Subdivision 1. [PERMISSION TO REPORT.] A person who has 283.16 knowledge of any conduct constituting grounds for disciplinary 283.17 action relating to the practice of denturism under this chapter 283.18 may report the violation to the board. 283.19 Subd. 2. [INSTITUTIONS.] A state agency, political 283.20 subdivision, agency of a local unit of government, private 283.21 agency, hospital, clinic, prepaid medical plan, or other health 283.22 care institution or organization located in this state shall 283.23 report to the board any action taken by the agency, institution, 283.24 or organization or any of its administrators or medical or other 283.25 committees to revoke, suspend, restrict, or condition a 283.26 denturist's privilege to practice or treat patients or clients 283.27 in the institution, or as part of the organization, any denial 283.28 of privileges, or any other disciplinary action for conduct that 283.29 might constitute grounds for disciplinary action by the board 283.30 under this chapter. The institution, organization, or 283.31 governmental entity shall also report the resignation of any 283.32 denturists before the conclusion of any disciplinary action 283.33 proceeding for conduct that might constitute grounds for 283.34 disciplinary action under this chapter, or before the 283.35 commencement of formal charges but after the denturist had 283.36 knowledge that formal charges were contemplated or were being 284.1 prepared. 284.2 Subd. 3. [PROFESSIONAL SOCIETIES.] A state or local 284.3 professional society for denturists shall report to the board 284.4 any termination, revocation, or suspension of membership or any 284.5 other disciplinary action taken against a denturist. If the 284.6 society has received a complaint that might be grounds for 284.7 discipline under this chapter against a member on which it has 284.8 not taken any disciplinary action, the society shall report the 284.9 complaint and the reason why it has not taken action on it or 284.10 shall direct the complainant to the board. 284.11 Subd. 4. [LICENSED PROFESSIONALS.] A licensed health 284.12 professional shall report to the board personal knowledge of any 284.13 conduct that the licensed health professional reasonably 284.14 believes constitutes grounds for disciplinary action under this 284.15 chapter by a denturist, including conduct indicating that the 284.16 denturist may be medically incompetent, or may be medically or 284.17 physically unable to engage safely in the provision of 284.18 services. If the information was obtained in the course of a 284.19 client relationship, the client is a denturist, and the treating 284.20 individual successfully counsels the denturist to limit or 284.21 withdraw from practice to the extent required by the impairment, 284.22 the board may deem this limitation of or withdrawal from 284.23 practice to be sufficient disciplinary action. 284.24 Subd. 5. [INSURERS.] (a) Each insurer authorized to sell 284.25 insurance described in section 60A.06, subdivision 1, clause 284.26 (13), and providing professional liability insurance to 284.27 denturists or the medical joint underwriting association under 284.28 chapter 62F, shall submit to the board quarterly reports 284.29 concerning the denturists against whom malpractice settlements 284.30 and awards have been made. The report must contain at least the 284.31 following information: 284.32 (1) the total number of malpractice settlements or awards 284.33 made; 284.34 (2) the date the malpractice settlements or awards were 284.35 made; 284.36 (3) the allegations contained in the claim or complaint 285.1 leading to the settlements or awards made; 285.2 (4) the dollar amount of each settlement or award; 285.3 (5) the address of the practice of the denturist against 285.4 whom an award was made or with whom a settlement was made; and 285.5 (6) the name of the denturist against whom an award was 285.6 made or with whom a settlement was made. 285.7 (b) The insurance company shall, in addition to the above 285.8 information, submit to the board any information, records, and 285.9 files, including clients' charts and records, it possesses that 285.10 tend to substantiate a charge that a denturist may have engaged 285.11 in conduct violating this chapter. 285.12 Subd. 6. [SELF REPORTING.] A denturist shall report to the 285.13 board any personal action that would require that a report be 285.14 filed with the board by any person, health care facility, 285.15 business, or organization under subdivisions 2 to 5. The 285.16 denturist shall also report the revocation, suspension, 285.17 restriction, limitation, or other disciplinary action in this 285.18 state and report the filing of charges regarding the denturist's 285.19 license or right of practice in another state or jurisdiction. 285.20 Subd. 7. [DEADLINES; FORMS.] Reports required by 285.21 subdivisions 2 to 6 must be submitted no later than 30 days 285.22 after the reporter learns of the occurrence of the reportable 285.23 event or transaction. The board may provide forms for the 285.24 submission of the reports required by this section, may require 285.25 that reports be submitted on the forms provided, and may adopt 285.26 rules necessary to assure prompt and accurate reporting. 285.27 Sec. 47. [150B.15] [INVESTIGATIONS; PROFESSIONAL 285.28 COOPERATION; EXCHANGING INFORMATION.] 285.29 Subdivision 1. [COOPERATION.] A denturist who is the 285.30 subject of an investigation, or who is questioned in connection 285.31 with an investigation, by or on behalf of the board, shall 285.32 cooperate fully with the investigation. Cooperation includes 285.33 responding fully to any question raised by or on behalf of the 285.34 board relating to the subject of the investigation whether tape 285.35 recorded or not. Challenges to requests of the board may be 285.36 brought before the appropriate agency or court. 286.1 Subd. 2. [EXCHANGING INFORMATION.] (a) The board shall 286.2 establish internal operating procedures for: 286.3 (1) exchanging information with state boards; agencies, 286.4 including the office of ombudsman for mental health and mental 286.5 retardation; health-related and law enforcement facilities; 286.6 departments responsible for licensing health-related 286.7 occupations, facilities, and programs; and law enforcement 286.8 personnel in this and other states; and 286.9 (2) coordinating investigations involving matters within 286.10 the jurisdiction of more than one regulatory agency. 286.11 (b) The procedures for exchanging information must provide 286.12 for forwarding to an entity described in paragraph (a), clause 286.13 (1), any information or evidence, including the results of 286.14 investigations, that is relevant to matters within the 286.15 regulatory jurisdiction of that entity. The data have the same 286.16 classification in the possession of the agency receiving the 286.17 data as they have in the possession of the agency providing the 286.18 data. 286.19 (c) The board shall establish procedures for exchanging 286.20 information with other states regarding disciplinary action 286.21 against denturists. 286.22 (d) The board shall forward to another governmental agency 286.23 any complaints received by the board that do not relate to the 286.24 board's jurisdiction but that relate to matters within the 286.25 jurisdiction of the other governmental agency. The agency to 286.26 which a complaint is forwarded shall advise the board of the 286.27 disposition of the complaint. A complaint or other information 286.28 received by another governmental agency relating to a statute or 286.29 rule that the board is empowered to enforce must be forwarded to 286.30 the board to be processed according to this section. 286.31 (e) The board shall furnish to a person who made a 286.32 complaint regarding a denturist a description of the actions of 286.33 the board relating to the complaint. 286.34 Sec. 48. Minnesota Statutes 2002, section 319B.40, is 286.35 amended to read: 286.36 319B.40 [PROFESSIONAL HEALTH SERVICES.] 287.1 (a) Individuals who furnish professional services pursuant 287.2 to a license, registration, or certificate issued by the state 287.3 of Minnesota to practice medicine pursuant to sections 147.01 to 287.4 147.22, as a physician assistant pursuant to sections 147A.01 to 287.5 147A.27, chiropractic pursuant to sections 148.01 to 148.106, 287.6 registered nursing pursuant to sections 148.171 to 148.285, 287.7 optometry pursuant to sections 148.52 to 148.62, psychology 287.8 pursuant to sections 148.88 to 148.98, social work pursuant to 287.9 sections 148B.18 to 148B.289, dentistry pursuant to sections 287.10 150A.01 to 150A.12, pharmacy pursuant to sections 151.01 to 287.11 151.40, or podiatric medicine pursuant to sections 153.01 to 287.12 153.26 are specifically authorized to practice any of these 287.13 categories of services in combination if the individuals are 287.14 organized under this chapter. 287.15 (b) Denturists licensed pursuant to chapter 150B are 287.16 authorized to provide professional services in combination with 287.17 dentists licensed pursuant to sections 150A.01 to 150A.12 if the 287.18 individuals providing the services are organized under this 287.19 chapter and if the combination does not impede the independent 287.20 professional judgment of either party. 287.21 (c) This authorization does not authorize an individual to 287.22 practice any profession, or furnish a professional service, for 287.23 which the individual is not licensed, registered, or certified, 287.24 but otherwise applies regardless of any contrary provision of a 287.25 licensing statute or rules adopted pursuant to that statute, 287.26 related to practicing and organizing in combination with other 287.27 health services professionals. 287.28 Sec. 49. [EVALUATION OF LICENSED DENTURISTS.] 287.29 The dental access advisory committee established under 287.30 Minnesota Statutes, section 256B.55, shall evaluate the use of 287.31 denturists in the public assistance health care programs. The 287.32 evaluation shall include the quality of services provided by 287.33 licensed denturists, the cost effectiveness of using licensed 287.34 denturists, and the overall effect on dental access. Based on 287.35 the evaluation, the advisory committee shall include in the 287.36 report required to be submitted to the legislature on February 288.1 1, 2006, recommendations on repealing Minnesota Statutes, 288.2 section 150B.02, and on the requirement specified in Minnesota 288.3 Statutes, section 150B.05, that a patient present a denturist 288.4 with a certificate of oral health from a licensed dentist or 288.5 physician before receiving certain services from the denturist. 288.6 Sec. 50. [REPEALER.] 288.7 (a) Minnesota Statutes 2002, sections 148C.0351, 288.8 subdivision 2; 148C.05, subdivisions 2, 3, and 4; 148C.06; and 288.9 148C.10, subdivision 1a, are repealed. 288.10 (b) Minnesota Rules, parts 4747.0030, subparts 25, 28, and 288.11 30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A, 288.12 B, and D; 4747.0070, subparts 4 and 5; 4747.0080; 4747.0090; 288.13 4747.0100; 4747.0300; 4747.0400, subparts 2 and 3; 4747.0500; 288.14 4747.0600; 4747.1000; 4747.1100, subpart 3; and 4747.1600, are 288.15 repealed. 288.16 ARTICLE 7 288.17 CHILDREN'S SERVICES 288.18 Section 1. Minnesota Statutes 2002, section 124D.23, 288.19 subdivision 1, is amended to read: 288.20 Subdivision 1. [ESTABLISHMENT.] (a) In order to qualify as 288.21 a family services collaborative, a minimum of one school 288.22 district, one county, one public health entity, one community 288.23 action agency as defined in section 119A.375, and one Head Start 288.24 grantee if the community action agency is not the designated 288.25 federal grantee for the Head Start program must agree in writing 288.26 to provide coordinated family services and commit resources to 288.27 an integrated fund. Collaboratives are expected to have broad 288.28 community representation, which may include other local 288.29 providers, including additional school districts, counties, and 288.30 public health entities, other municipalities, public libraries, 288.31 existing culturally specific community organizations, tribal 288.32 entities, local health organizations, private and nonprofit 288.33 service providers, child care providers, local foundations, 288.34 community-based service groups, businesses, local transit 288.35 authorities or other transportation providers, community action 288.36 agencies under section 119A.375, senior citizen volunteer 289.1 organizations, parent organizations, parents, and sectarian 289.2 organizations that provide nonsectarian services. 289.3 (b) Members of the governing bodies of political 289.4 subdivisions involved in the establishment of a family services 289.5 collaborative shall select representatives of the 289.6 nongovernmental entities listed in paragraph (a) to serve on the 289.7 governing board of a collaborative. The governing body members 289.8 of the political subdivisions shall select one or more 289.9 representatives of the nongovernmental entities within the 289.10 family service collaborative. 289.11 (c) Two or more family services collaboratives or 289.12 children's mental health collaboratives may consolidate 289.13 decision-making, pool resources, and collectively act on behalf 289.14 of the individual collaboratives, based on a written agreement 289.15 among the participating collaboratives. 289.16 Sec. 2. Minnesota Statutes 2002, section 144.551, 289.17 subdivision 1, is amended to read: 289.18 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 289.19 (a) The following construction or modification may not be 289.20 commenced: 289.21 (1) any erection, building, alteration, reconstruction, 289.22 modernization, improvement, extension, lease, or other 289.23 acquisition by or on behalf of a hospital that increases the bed 289.24 capacity of a hospital, relocates hospital beds from one 289.25 physical facility, complex, or site to another, or otherwise 289.26 results in an increase or redistribution of hospital beds within 289.27 the state; and 289.28 (2) the establishment of a new hospital. 289.29 (b) This section does not apply to: 289.30 (1) construction or relocation within a county by a 289.31 hospital, clinic, or other health care facility that is a 289.32 national referral center engaged in substantial programs of 289.33 patient care, medical research, and medical education meeting 289.34 state and national needs that receives more than 40 percent of 289.35 its patients from outside the state of Minnesota; 289.36 (2) a project for construction or modification for which a 290.1 health care facility held an approved certificate of need on May 290.2 1, 1984, regardless of the date of expiration of the 290.3 certificate; 290.4 (3) a project for which a certificate of need was denied 290.5 before July 1, 1990, if a timely appeal results in an order 290.6 reversing the denial; 290.7 (4) a project exempted from certificate of need 290.8 requirements by Laws 1981, chapter 200, section 2; 290.9 (5) a project involving consolidation of pediatric 290.10 specialty hospital services within the Minneapolis-St. Paul 290.11 metropolitan area that would not result in a net increase in the 290.12 number of pediatric specialty hospital beds among the hospitals 290.13 being consolidated; 290.14 (6) a project involving the temporary relocation of 290.15 pediatric-orthopedic hospital beds to an existing licensed 290.16 hospital that will allow for the reconstruction of a new 290.17 philanthropic, pediatric-orthopedic hospital on an existing site 290.18 and that will not result in a net increase in the number of 290.19 hospital beds. Upon completion of the reconstruction, the 290.20 licenses of both hospitals must be reinstated at the capacity 290.21 that existed on each site before the relocation; 290.22 (7) the relocation or redistribution of hospital beds 290.23 within a hospital building or identifiable complex of buildings 290.24 provided the relocation or redistribution does not result in: 290.25 (i) an increase in the overall bed capacity at that site; (ii) 290.26 relocation of hospital beds from one physical site or complex to 290.27 another; or (iii) redistribution of hospital beds within the 290.28 state or a region of the state; 290.29 (8) relocation or redistribution of hospital beds within a 290.30 hospital corporate system that involves the transfer of beds 290.31 from a closed facility site or complex to an existing site or 290.32 complex provided that: (i) no more than 50 percent of the 290.33 capacity of the closed facility is transferred; (ii) the 290.34 capacity of the site or complex to which the beds are 290.35 transferred does not increase by more than 50 percent; (iii) the 290.36 beds are not transferred outside of a federal health systems 291.1 agency boundary in place on July 1, 1983; and (iv) the 291.2 relocation or redistribution does not involve the construction 291.3 of a new hospital building; 291.4 (9) a construction project involving up to 35 new beds in a 291.5 psychiatric hospital in Rice county that primarily serves 291.6 adolescents and that receives more than 70 percent of its 291.7 patients from outside the state of Minnesota; 291.8 (10) a project to replace a hospital or hospitals with a 291.9 combined licensed capacity of 130 beds or less if: (i) the new 291.10 hospital site is located within five miles of the current site; 291.11 and (ii) the total licensed capacity of the replacement 291.12 hospital, either at the time of construction of the initial 291.13 building or as the result of future expansion, will not exceed 291.14 70 licensed hospital beds, or the combined licensed capacity of 291.15 the hospitals, whichever is less; 291.16 (11) the relocation of licensed hospital beds from an 291.17 existing state facility operated by the commissioner of human 291.18 services to a new or existing facility, building, or complex 291.19 operated by the commissioner of human services; from one 291.20 regional treatment center site to another; or from one building 291.21 or site to a new or existing building or site on the same 291.22 campus; 291.23 (12) the construction or relocation of hospital beds 291.24 operated by a hospital having a statutory obligation to provide 291.25 hospital and medical services for the indigent that does not 291.26 result in a net increase in the number of hospital beds; 291.27 (13) a construction project involving the addition of up to 291.28 31 new beds in an existing nonfederal hospital in Beltrami 291.29 county;or291.30 (14) a construction project involving the addition of up to 291.31 eight new beds in an existing nonfederal hospital in Otter Tail 291.32 county with 100 licensed acute care beds; or 291.33 (15) a project for the construction or relocation of up to 291.34 20 hospital beds for the operation of up to two psychiatric 291.35 facilities or units for children provided that the operation of 291.36 the facilities or units have received the approval of the 292.1 commissioner of human services. 292.2 Sec. 3. Minnesota Statutes 2002, section 245.4874, is 292.3 amended to read: 292.4 245.4874 [DUTIES OF COUNTY BOARD.] 292.5 The county board in each county shall use its share of 292.6 mental health and Community Social Services Act funds allocated 292.7 by the commissioner according to a biennial children's mental 292.8 health component of the community social services plan required 292.9 under section 245.4888, and approved by the commissioner. The 292.10 county board must: 292.11 (1) develop a system of affordable and locally available 292.12 children's mental health services according to sections 245.487 292.13 to 245.4888; 292.14 (2) establish a mechanism providing for interagency 292.15 coordination as specified in section 245.4875, subdivision 6; 292.16 (3) develop a biennial children's mental health component 292.17 of the community social services plan required under section 292.18 256E.09 which considers the assessment of unmet needs in the 292.19 county as reported by the local children's mental health 292.20 advisory council under section 245.4875, subdivision 5, 292.21 paragraph (b), clause (3). The county shall provide, upon 292.22 request of the local children's mental health advisory council, 292.23 readily available data to assist in the determination of unmet 292.24 needs; 292.25 (4) assure that parents and providers in the county receive 292.26 information about how to gain access to services provided 292.27 according to sections 245.487 to 245.4888; 292.28 (5) coordinate the delivery of children's mental health 292.29 services with services provided by social services, education, 292.30 corrections, health, and vocational agencies to improve the 292.31 availability of mental health services to children and the 292.32 cost-effectiveness of their delivery; 292.33 (6) assure that mental health services delivered according 292.34 to sections 245.487 to 245.4888 are delivered expeditiously and 292.35 are appropriate to the child's diagnostic assessment and 292.36 individual treatment plan; 293.1 (7) provide the community with information about predictors 293.2 and symptoms of emotional disturbances and how to access 293.3 children's mental health services according to sections 245.4877 293.4 and 245.4878; 293.5 (8) provide for case management services to each child with 293.6 severe emotional disturbance according to sections 245.486; 293.7 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 293.8 and 5; 293.9 (9) provide for screening of each child under section 293.10 245.4885 upon admission to a residential treatment facility, 293.11 acute care hospital inpatient treatment, or informal admission 293.12 to a regional treatment center; 293.13 (10) prudently administer grants and purchase-of-service 293.14 contracts that the county board determines are necessary to 293.15 fulfill its responsibilities under sections 245.487 to 245.4888; 293.16 (11) assure that mental health professionals, mental health 293.17 practitioners, and case managers employed by or under contract 293.18 to the county to provide mental health services are qualified 293.19 under section 245.4871; 293.20 (12) assure that children's mental health services are 293.21 coordinated with adult mental health services specified in 293.22 sections 245.461 to 245.486 so that a continuum of mental health 293.23 services is available to serve persons with mental illness, 293.24 regardless of the person's age;and293.25 (13) assure that culturally informed mental health 293.26 consultants are used as necessary to assist the county board in 293.27 assessing and providing appropriate treatment for children of 293.28 cultural or racial minority heritage; and 293.29 (14) arrange for or provide a children's mental health 293.30 screening to a child receiving child protective services or a 293.31 child in out-of-home placement, a child for whom parental rights 293.32 have been terminated, a child alleged or found to be delinquent, 293.33 and a child found to have committed a juvenile petty offense for 293.34 the third or subsequent time, unless a screening has been 293.35 performed within the previous 180 days, or the child is 293.36 currently under the care of a mental health professional. The 294.1 screening shall be conducted with a screening instrument 294.2 approved by the commissioner of human services and shall be 294.3 conducted by a mental health practitioner as defined in section 294.4 245.4871, subdivision 26, or a probation officer or local social 294.5 services agency staff person who is trained in the use of the 294.6 screening instrument. If the screen indicates a need for 294.7 assessment, the child's family, or if the family lacks mental 294.8 health insurance, the local social services agency, in 294.9 consultation with the child's family, shall have conducted a 294.10 diagnostic assessment, including a functional assessment, as 294.11 defined in section 245.4871. 294.12 [EFFECTIVE DATE.] This section is effective July 1, 2004. 294.13 Sec. 4. Minnesota Statutes 2002, section 245.493, 294.14 subdivision 1a, is amended to read: 294.15 Subd. 1a. [DUTIES OF CERTAIN COORDINATING BODIES.] (a) By 294.16 mutual agreement of the collaborative and a coordinating body 294.17 listed in this subdivision, a children's mental health 294.18 collaborative or a collaborative established by the merger of a 294.19 children's mental health collaborative and a family services 294.20 collaborative under section 124D.23, may assume the duties of a 294.21 community transition interagency committee established under 294.22 section 125A.22; an interagency early intervention committee 294.23 established under section 125A.30; a local advisory council 294.24 established under section 245.4875, subdivision 5; or a local 294.25 coordinating council established under section 245.4875, 294.26 subdivision 6. 294.27 (b) Two or more family services collaboratives or 294.28 children's mental health collaboratives may consolidate 294.29 decision-making, pool resources, and collectively act on behalf 294.30 of the individual collaboratives, based on a written agreement 294.31 among the participating collaboratives. 294.32 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 294.33 amended by adding a subdivision to read: 294.34 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 294.35 SERVICES.] Medical assistance covers children's mental health 294.36 crisis response services according to section 256B.0944. 295.1 [EFFECTIVE DATE.] This section is effective July 1, 2004. 295.2 Sec. 6. Minnesota Statutes 2002, section 256B.0625, is 295.3 amended by adding a subdivision to read: 295.4 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 295.5 Medical assistance covers children's therapeutic services and 295.6 supports according to section 256B.0943. 295.7 [EFFECTIVE DATE.] This section is effective July 1, 2004. 295.8 Sec. 7. Minnesota Statutes 2002, section 256B.0625, is 295.9 amended by adding a subdivision to read: 295.10 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 295.11 YEARS OF AGE.] Medical assistance covers subacute psychiatric 295.12 care for person under 21 years of age when: 295.13 (1) the services meet the requirements of Code of Federal 295.14 Regulations, title 42, section 440.160; 295.15 (2) the facility is accredited as a psychiatric treatment 295.16 facility by the joint commission on accreditation of healthcare 295.17 organizations, the commission on accreditation of rehabilitation 295.18 facilities, or the council on accreditation; and 295.19 (3) the facility is licensed by the commissioner of health 295.20 under section 144.50. 295.21 Sec. 8. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 295.22 SUPPORTS.] 295.23 Subdivision 1. [DEFINITIONS.] For purposes of this 295.24 section, the following terms have the meanings given them. 295.25 (a) "Children's therapeutic services and supports" means 295.26 the flexible package of mental health services for children who 295.27 require varying therapeutic and rehabilitative levels of 295.28 intervention. The services are time-limited interventions that 295.29 are delivered using various treatment modalities and 295.30 combinations of services designed to reach treatment outcomes 295.31 identified in the individual treatment plan. 295.32 (b) "Clinical supervision" means the overall responsibility 295.33 of the mental health professional for the control and direction 295.34 of individualized treatment planning, service delivery, and 295.35 treatment review for each client. A mental health professional 295.36 who is an enrolled Minnesota health care program provider 296.1 accepts full professional responsibility for a supervisee's 296.2 actions and decisions, instructs the supervisee in the 296.3 supervisee's work, and oversees or directs the supervisee's work. 296.4 (c) "County board" means the county board of commissioners 296.5 or board established under sections 402.01 to 402.10 or 471.59. 296.6 (d) "Crisis assistance" has the meaning given in section 296.7 245.4871, subdivision 9a. 296.8 (e) "Culturally competent provider" means a provider who 296.9 understands and can utilize to a client's benefit the client's 296.10 culture when providing services to the client. A provider may 296.11 be culturally competent because the provider is of the same 296.12 cultural or ethnic group as the client or the provider has 296.13 developed the knowledge and skills through training and 296.14 experience to provide services to culturally diverse clients. 296.15 (f) "Day treatment program" for children means a site-based 296.16 structured program consisting of group psychotherapy for more 296.17 than three individuals and other intensive therapeutic services 296.18 provided by a multidisciplinary team, under the clinical 296.19 supervision of a mental health professional. 296.20 (g) "Diagnostic assessment" has the meaning given in 296.21 section 245.4871, subdivision 11. 296.22 (h) "Direct service time" means the time that a mental 296.23 health professional, mental health practitioner, or mental 296.24 health behavioral aide spends face-to-face with a client and the 296.25 client's family. Direct service time includes time in which the 296.26 provider obtains a client's history or provides service 296.27 components of children's therapeutic services and supports. 296.28 Direct service time does not include time doing work before and 296.29 after providing direct services, including scheduling, 296.30 maintaining clinical records, consulting with others about the 296.31 client's mental health status, preparing reports, receiving 296.32 clinical supervision directly related to the client's 296.33 psychotherapy session, and revising the client's individual 296.34 treatment plan. 296.35 (i) "Direction of mental health behavioral aide" means the 296.36 activities of a mental health professional or mental health 297.1 practitioner in guiding the mental health behavioral aide in 297.2 providing services to a client. The direction of a mental 297.3 health behavioral aide must be based on the client's 297.4 individualized treatment plan and meet the requirements in 297.5 subdivision 6, paragraph (b), clause (5). 297.6 (j) "Emotional disturbance" has the meaning given in 297.7 section 245.4871, subdivision 15. For persons at least age 18 297.8 but under age 21, mental illness has the meaning given in 297.9 section 245.462, subdivision 20, paragraph (a). 297.10 (k) "Individual behavioral plan" means a plan of 297.11 intervention, treatment, and services for a child written by a 297.12 mental health professional or mental health practitioner, under 297.13 the clinical supervision of a mental health professional, to 297.14 guide the work of the mental health behavioral aide. 297.15 (l) "Individual treatment plan" has the meaning given in 297.16 section 245.4871, subdivision 21. 297.17 (m) "Mental health professional" means an individual as 297.18 defined in section 245.4871, subdivision 27, clauses (1) to (5), 297.19 or tribal vendor as defined in section 256B.02, subdivision 7, 297.20 paragraph (b). 297.21 (n) "Preschool program" means a day program licensed under 297.22 Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 297.23 children's therapeutic services and supports provider to provide 297.24 a structured treatment program to a child who is at least 33 297.25 months old but who has not yet attended the first day of 297.26 kindergarten. 297.27 (o) "Skills training" means individual, family, or group 297.28 training designed to improve the basic functioning of the child 297.29 with emotional disturbance and the child's family in the 297.30 activities of daily living and community living, and to improve 297.31 the social functioning of the child and the child's family in 297.32 areas important to the child's maintaining or reestablishing 297.33 residency in the community. Individual, family, and group 297.34 skills training must: 297.35 (1) consist of activities designed to promote skill 297.36 development of the child and the child's family in the use of 298.1 age-appropriate daily living skills, interpersonal and family 298.2 relationships, and leisure and recreational services; 298.3 (2) consist of activities that will assist the family's 298.4 understanding of normal child development and to use parenting 298.5 skills that will help the child with emotional disturbance 298.6 achieve the goals outlined in the child's individual treatment 298.7 plan; and 298.8 (3) promote family preservation and unification, promote 298.9 the family's integration with the community, and reduce the use 298.10 of unnecessary out-of-home placement or institutionalization of 298.11 children with emotional disturbance. 298.12 Subd. 2. [COVERED SERVICE COMPONENTS OF CHILDREN'S 298.13 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 298.14 approval, medical assistance covers medically necessary 298.15 children's therapeutic services and supports as defined in this 298.16 section that an eligible provider entity under subdivisions 4 298.17 and 5 provides to a client eligible under subdivision 3. 298.18 (b) The service components of children's therapeutic 298.19 services and supports are: 298.20 (1) individual, family, and group psychotherapy; 298.21 (2) individual, family, or group skills training provide by 298.22 a mental health professional or mental health practitioner; 298.23 (3) crisis assistance; 298.24 (4) mental health behavioral aide services; and 298.25 (5) direction of a mental health behavioral aide. 298.26 (c) Service components may be combined to constitute 298.27 therapeutic programs, including day treatment programs and 298.28 preschool programs. Although day treatment and preschool 298.29 programs have specific client and provider eligibility 298.30 requirements, medical assistance only pays for the service 298.31 components listed in paragraph (b). 298.32 Subd. 3. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 298.33 eligibility to receive children's therapeutic services and 298.34 supports under this section shall be determined based on a 298.35 diagnostic assessment by a mental health professional that is 298.36 performed within 180 days of the initial start of service. The 299.1 diagnostic assessment must: 299.2 (1) include current diagnoses on all five axes of the 299.3 client's current mental health status; 299.4 (2) determine whether a child under age 18 has a diagnosis 299.5 of emotional disturbance or, if the person is between the ages 299.6 of 18 and 21, whether the person has a mental illness; 299.7 (3) document children's therapeutic services and supports 299.8 as medically necessary to address an identified disability, 299.9 functional impairment, and the individual client's needs and 299.10 goals; 299.11 (4) be used in the development of the individualized 299.12 treatment plan; and 299.13 (5) be completed annually until age 18. For individuals 299.14 between age 18 and 21, unless a client's mental health condition 299.15 has changed markedly since the client's most recent diagnostic 299.16 assessment, annual updating is necessary. For the purpose of 299.17 this section, "updating" means a written summary, including 299.18 current diagnoses on all five axes, by a mental health 299.19 professional of the client's current mental health status and 299.20 service needs. 299.21 Subd. 4. [PROVIDER ENTITY CERTIFICATION.] (a) Effective 299.22 July 1, 2003, the commissioner shall establish an initial 299.23 provider entity application and certification process and 299.24 recertification process to determine whether a provider entity 299.25 has an administrative and clinical infrastructure that meets the 299.26 requirements in subdivisions 5 and 6. The commissioner shall 299.27 recertify a provider entity at least every three years. The 299.28 commissioner shall establish a process for decertification of a 299.29 provider entity that no longer meets the requirements in this 299.30 section. The county, tribe, and the commissioner shall be 299.31 mutually responsible and accountable for the county's, tribe's, 299.32 and state's part of the certification, recertification, and 299.33 decertification processes. 299.34 (b) For purposes of this section, a provider entity must be: 299.35 (1) an Indian health services facility or a facility owned 299.36 and operated by a tribe or tribal organization operating as a 300.1 638 facility under Public Law 93-368 certified by the state; 300.2 (2) a county-operated entity certified by the state; or 300.3 (3) a noncounty entity recommended for certification by the 300.4 provider's host county and certified by the state. 300.5 Subd. 5. [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 300.6 REQUIREMENTS.] (a) To be an eligible provider entity under this 300.7 section, a provider entity must have an administrative 300.8 infrastructure that establishes authority and accountability for 300.9 decision making and oversight of functions, including finance, 300.10 personnel, system management, clinical practice, and performance 300.11 measurement. The provider must have written policies and 300.12 procedures that it reviews and updates every three years and 300.13 distributes to staff initially and upon each subsequent update. 300.14 (b) The administrative infrastructure written policies and 300.15 procedures must include: 300.16 (1) personnel procedures, including a process for: (i) 300.17 recruiting, hiring, training, and retention of culturally and 300.18 linguistically competent providers; (ii) conducting a criminal 300.19 background check on all direct service providers and volunteers; 300.20 (iii) investigating, reporting, and acting on violations of 300.21 ethical conduct standards; (iv) investigating, reporting, and 300.22 acting on violations of data privacy policies that are compliant 300.23 with federal and state laws; (v) utilizing volunteers, including 300.24 screening applicants, training and supervising volunteers, and 300.25 providing liability coverage for volunteers; and (vi) 300.26 documenting that a mental health professional, mental health 300.27 practitioner, or mental health behavioral aide meets the 300.28 applicable provider qualification criteria, training criteria 300.29 under subdivision 8, and clinical supervision or direction of a 300.30 mental health behavioral aide requirements under subdivision 6; 300.31 (2) fiscal procedures, including internal fiscal control 300.32 practices and a process for collecting revenue that is compliant 300.33 with federal and state laws; 300.34 (3) if a client is receiving services from a case manager 300.35 or other provider entity, a service coordination process that 300.36 ensures services are provided in the most appropriate manner to 301.1 achieve maximum benefit to the client. The provider entity must 301.2 ensure coordination and nonduplication of services consistent 301.3 with county board coordination procedures established under 301.4 section 245.4881, subdivision 5; 301.5 (4) a performance measurement system, including monitoring 301.6 to determine cultural appropriateness of services identified in 301.7 the individual treatment plan, as determined by the client's 301.8 culture, beliefs, values, and language, and family-driven 301.9 services; and 301.10 (5) a process to establish and maintain individual client 301.11 records. The client's records must include: (i) the client's 301.12 personal information; (ii) forms applicable to data privacy; 301.13 (iii) the client's diagnostic assessment, updates, tests, 301.14 individual treatment plan, and individual behavior plan, if 301.15 necessary; (iv) documentation of service delivery as specified 301.16 under subdivision 6; (v) telephone contacts; (vi) discharge 301.17 plan; and (vii) if applicable, insurance information. 301.18 Subd. 6. [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 301.19 REQUIREMENTS.] (a) To be an eligible provider entity under this 301.20 section, a provider entity must have a clinical infrastructure 301.21 that utilizes diagnostic assessment, an individualized treatment 301.22 plan, service delivery, and individual treatment plan review 301.23 that are culturally competent, child-centered, and family-driven 301.24 to achieve maximum benefit for the client. The provider entity 301.25 must review and update the clinical policies and procedures 301.26 every three years and must distribute the policies and 301.27 procedures to staff initially and upon each subsequent update. 301.28 (b) The clinical infrastructure written policies and 301.29 procedures must include policies and procedures for: 301.30 (1) providing or obtaining a client's diagnostic assessment 301.31 that identifies acute and chronic clinical disorders, 301.32 co-occurring medical conditions, sources of psychological and 301.33 environmental problems, and a functional assessment. The 301.34 functional assessment must clearly summarize the client's 301.35 individual strengths and needs; 301.36 (2) developing an individual treatment plan that is: (i) 302.1 based on the information in the client's diagnostic assessment; 302.2 (ii) developed no later than the end of the first psychotherapy 302.3 session after the completion of the client's diagnostic 302.4 assessment by the mental health professional who provides the 302.5 client's psychotherapy; (iii) developed through a 302.6 child-centered, family-driven planning process that identifies 302.7 service needs and individualized, planned, and culturally 302.8 appropriate interventions that contain specific treatment goals 302.9 and objectives for the client and the client's family or foster 302.10 family; (iv) reviewed at least once every 90 days and revised, 302.11 if necessary; and (v) signed by the client or, if appropriate, 302.12 by the client's parent or other person authorized by statute to 302.13 consent to mental health services for the client; 302.14 (3) developing an individual behavior plan that documents 302.15 services to be provided by the mental health behavioral aide. 302.16 The individual behavior plan must include: (i) detailed 302.17 instructions on the service to be provided; (ii) time allocated 302.18 to each service; (iii) methods of documenting the child's 302.19 behavior; (iv) methods of monitoring the child's progress in 302.20 reaching objectives; and (v) goals to increase or decrease 302.21 targeted behavior as identified in the individual treatment 302.22 plan; 302.23 (4) clinical supervision of the mental health practitioner 302.24 and mental health behavioral aide. A mental health professional 302.25 must document the clinical supervision the professional provides 302.26 by cosigning individual treatment plans and making entries in 302.27 the client's record on supervisory activities. Clinical 302.28 supervision does not include the authority to make or terminate 302.29 court-ordered placements of the child. A clinical supervisor 302.30 must be available for urgent consultation as required by the 302.31 individual client's needs or the situation. Clinical 302.32 supervision may occur individually or in a small group to 302.33 discuss treatment and review progress toward goals. The focus 302.34 of clinical supervision must be the client's treatment needs and 302.35 progress and the mental health practitioner's or behavioral 302.36 aide's ability to provide services; 303.1 (5) providing direction to a mental health behavioral 303.2 aide. For entities that employ mental health behavioral aides, 303.3 the clinical supervisor must be employed by the provider entity 303.4 to ensure necessary and appropriate oversight for the client's 303.5 treatment and continuity of care. The mental health 303.6 professional or mental health practitioner giving direction must 303.7 begin with the goals on the individualized treatment plan, and 303.8 instruct the mental health behavioral aide on how to construct 303.9 therapeutic activities and interventions that will lead to goal 303.10 attainment. The professional or practitioner giving direction 303.11 must also instruct the mental health behavioral aide about the 303.12 client's diagnosis, functional status, and other characteristics 303.13 that are likely to affect service delivery. Direction must also 303.14 include determining that the mental health behavioral aide has 303.15 the skills to interact with the client and the client's family 303.16 in ways that convey personal and cultural respect and that the 303.17 aide actively solicits information relevant to treatment from 303.18 the family. The aide must be able to clearly explain the 303.19 activities the aide is doing with the client and the activities' 303.20 relationship to treatment goals. Direction is more didactic 303.21 than is supervision and requires the professional or 303.22 practitioner providing it to continuously evaluate the mental 303.23 health behavioral aide's ability to carry out the activities of 303.24 the individualized treatment plan and the individualized 303.25 behavior plan. When providing direction, the professional or 303.26 practitioner must: (i) review progress notes prepared by the 303.27 mental health behavioral aide for accuracy and consistency with 303.28 diagnostic assessment, treatment plan, and behavior goals and 303.29 the professional or practitioner must approve and sign the 303.30 progress notes; (ii) identify changes in treatment strategies, 303.31 revise the individual behavior plan, and communicate treatment 303.32 instructions and methodologies as appropriate to ensure that 303.33 treatment is implemented correctly; (iii) demonstrate 303.34 family-friendly behaviors that support healthy collaboration 303.35 among the child, the child's family, and providers as treatment 303.36 is planned and implemented; (iv) ensure that the mental health 304.1 behavioral aide is able to effectively communicate with the 304.2 child, the child's family, and the provider; and (v) record the 304.3 results of any evaluation and corrective actions taken to modify 304.4 the work of the mental health behavioral aide; 304.5 (6) providing service delivery that implements the 304.6 individual treatment plan and meets the requirements under 304.7 subdivision 9; and 304.8 (7) individual treatment plan review. The review must 304.9 determine the extent to which the services have met the goals 304.10 and objectives in the previous treatment plan. The review must 304.11 assess the client's progress and ensure that services and 304.12 treatment goals continue to be necessary and appropriate to the 304.13 client and the client's family or foster family. Revision of 304.14 the individual treatment plan does not require a new diagnostic 304.15 assessment unless the client's mental health status has changed 304.16 markedly. The updated treatment plan must be signed by the 304.17 client, if appropriate, and by the client's parent or other 304.18 person authorized by statute to give consent to the mental 304.19 health services for the child. 304.20 Subd. 7. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 304.21 PROVIDERS.] (a) An individual or team provider working within 304.22 the scope of the provider's practice or qualifications may 304.23 provide service components of children's therapeutic services 304.24 and supports that are identified as medically necessary in a 304.25 client's individual treatment plan. 304.26 (b) An individual provider and multidisciplinary team 304.27 include: 304.28 (1) a mental health professional as defined in subdivision 304.29 1, paragraph (m); 304.30 (2) a mental health practitioner as defined in section 304.31 245.4871, subdivision 26. The mental health practitioner must 304.32 work under the clinical supervision of a mental health 304.33 professional; 304.34 (3) a mental health behavioral aide working under the 304.35 direction of a mental health professional to implement the 304.36 rehabilitative mental health services identified in the client's 305.1 individual treatment plan. A level I mental health behavioral 305.2 aide must: (i) be at least 18 years old; (ii) have a high 305.3 school diploma or general equivalency diploma (GED) or two years 305.4 of experience as a primary caregiver to a child with severe 305.5 emotional disturbance within the previous ten years; and (iii) 305.6 meet preservices and continuing education requirements under 305.7 subdivision 8. A level II mental health behavioral aide must: 305.8 (i) be at least 18 years old; (ii) have an associate or 305.9 bachelor's degree or 4,000 hours of experience in delivering 305.10 clinical services in the treatment of mental illness concerning 305.11 children or adolescents; and (iii) meet preservice and 305.12 continuing education requirements in subdivision 8; 305.13 (4) a preschool program multidisciplinary team that 305.14 includes at least one mental health professional and one or more 305.15 of the following individuals under the clinical supervision of a 305.16 mental health professional: (i) a mental health practitioner; 305.17 or (ii) a program person, including a teacher, assistant 305.18 teacher, or aide, who meets the qualifications and training 305.19 standards of a level I mental health behavioral aide; or 305.20 (5) a day treatment multidisciplinary team that includes at 305.21 least one mental health professional and one mental health 305.22 practitioner. 305.23 Subd. 8. [REQUIRED PRESERVICE AND CONTINUING 305.24 EDUCATION.] (a) A provider entity shall establish a plan to 305.25 provide preservice and continuing education for staff. The plan 305.26 must clearly describe the type of training necessary to maintain 305.27 current skills and obtain new skills, and that relates to the 305.28 provider entity's goals and objectives for services offered. 305.29 (b) A provider that employs a mental health behavioral aide 305.30 under this section must require the mental health behavioral 305.31 aide to complete 30 hours of preservice training. The 305.32 preservice training must include topics specified in Minnesota 305.33 Rules, part 9535.4068, subparts 1 and 2, and parent team 305.34 training. The preservice training must include 15 hours of 305.35 in-person training of a mental health behavioral aide in mental 305.36 health services delivery and eight hours of parent team 306.1 training. Components of parent team training include: 306.2 (1) partnering with parents; 306.3 (2) fundamentals of family support; 306.4 (3) fundamentals of policy and decision making; 306.5 (4) defining equal partnership; 306.6 (5) complexities of the parent and service provider 306.7 partnership in multiple service delivery systems due to system 306.8 strengths and weaknesses; 306.9 (6) sibling impacts; 306.10 (7) support networks; and 306.11 (8) community resources. 306.12 (c) A provider entity that employs a mental health 306.13 practitioner and a mental health behavioral aide to provide 306.14 children's therapeutic services and supports under this section 306.15 must require the mental health practitioner and mental health 306.16 behavioral aide to complete 20 hours of continuing education 306.17 every two calendar years. The continuing education must be 306.18 related to serving the needs of a child with emotional 306.19 disturbance in the child's home environment and the child's 306.20 family. The topics covered in orientation and training must 306.21 conform to Minnesota Rules, part 9535.4068. 306.22 (d) The provider entity must document the mental health 306.23 practitioner's or mental health behavioral aide's annual 306.24 completion of the required continuing education. The 306.25 documentation must include the date, subject, and number of 306.26 hours of the continuing education, and attendance records, as 306.27 verified by the staff member's signature, job title, and the 306.28 instructor's name. The provider entity must keep documentation 306.29 for each employee, including records of attendance at 306.30 professional workshops and conferences, at a central location 306.31 and in the employee's personnel file. 306.32 Subd. 9. [SERVICE DELIVERY CRITERIA.] (a) In delivering 306.33 services under this section, a certified provider entity must 306.34 ensure that: 306.35 (1) each individual provider's caseload size permits the 306.36 provider to deliver services to both clients with severe, 307.1 complex needs and clients with less intensive needs. The 307.2 provider's caseload size should reasonably enable the provider 307.3 to play an active role in service planning, monitoring, and 307.4 delivering services to meet the client's and client's family's 307.5 needs, as specified in each client's individual treatment plan; 307.6 (2) site-based programs, including day treatment and 307.7 preschool programs, provide staffing and facilities to ensure 307.8 the client's health, safety, and protection of rights, and that 307.9 the programs are able to implement each client's individual 307.10 treatment plan; 307.11 (3) a day treatment program is provided to a group of 307.12 clients by a multidisciplinary staff under the clinical 307.13 supervision of a mental health professional. The day treatment 307.14 program must be provided in and by: (i) an outpatient hospital 307.15 accredited by the joint commission on accreditation of health 307.16 organizations and licensed under sections 144.50 to 144.55; (ii) 307.17 a community mental health center under section 245.62; and (iii) 307.18 an entity that is under contract with the county board to 307.19 operate a program that meets the requirements of sections 307.20 245.4712, subdivision 2, and 245.4884, subdivision 2, and 307.21 Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 307.22 program must stabilize the client's mental health status while 307.23 developing and improving the client's independent living and 307.24 socialization skills. The goal of the day treatment program 307.25 must be to reduce or relieve the effects of mental illness and 307.26 provide training to enable the client to live in the community. 307.27 The program must be available at least one day a week for a 307.28 minimum three-hour time block. The three-hour time block must 307.29 include at least one hour, but no more than two hours, of 307.30 individual or group psychotherapy. The remainder of the 307.31 three-hour time block may include recreation therapy, 307.32 socialization therapy, or independent living skills therapy, but 307.33 only if the therapies are included in the client's individual 307.34 treatment plan. Day treatment programs are not part of 307.35 inpatient or residential treatment services; and 307.36 (4) a preschool program is a structured treatment program 308.1 offered to a child who is at least 33 months old, but who has 308.2 not yet reached the first day of kindergarten, by a preschool 308.3 multidisciplinary team in a day program licensed under Minnesota 308.4 Rules, parts 9503.0005 to 9503.0175. The program must be 308.5 available at least one day a week for a minimum two-hour time 308.6 block. The structured treatment program may include individual 308.7 or group psychotherapy and recreation therapy, socialization 308.8 therapy, or independent living skills therapy, if included in 308.9 the client's individual treatment plan. 308.10 (b) A provider entity must delivery the service components 308.11 of children's therapeutic services and supports in compliance 308.12 with the following requirements: 308.13 (1) individual, family, and group psychotherapy must be 308.14 delivered as specified in Minnesota Rules, parts 9505.0523; 308.15 (2) individual, family, or group skills training must be 308.16 provided by a mental health professional or a mental health 308.17 practitioner who has a consulting relationship with a mental 308.18 health professional who accepts full professional responsibility 308.19 for the training; 308.20 (3) crisis assistance must be an intense, time-limited, and 308.21 designed to resolve or stabilize crisis through arrangements for 308.22 direct intervention and support services to the child and the 308.23 child's family. Crisis assistance must utilize resources 308.24 designed to address abrupt or substantial changes in the 308.25 functioning of the child or the child's family as evidenced by a 308.26 sudden change in behavior with negative consequences for well 308.27 being, a loss of usual coping mechanisms, or the presentation of 308.28 danger to self or others; 308.29 (4) medically necessary services that are provided by a 308.30 mental health behavioral aide must be designed to improve the 308.31 functioning of the child and support the family in activities of 308.32 daily and community living. A mental health behavioral aide 308.33 must document the delivery of services in written progress 308.34 notes. The mental health behavioral aide must implement goals 308.35 in the treatment plan for the child's emotional disturbance that 308.36 allow the child to acquire developmentally and therapeutically 309.1 appropriate daily living skills, social skills, and leisure and 309.2 recreational skills through targeted activities. These 309.3 activities may include: 309.4 (i) assisting a child as needed with skills development in 309.5 dressing, eating, and toileting; 309.6 (ii) assisting, monitoring, and guiding the child to 309.7 complete tasks, including facilitating the child's participation 309.8 in medical appointments; 309.9 (iii) observing the child and intervening to redirect the 309.10 child's inappropriate behavior; 309.11 (iv) assisting the child in using age-appropriate 309.12 self-management skills as related to the child's emotional 309.13 disorder or mental illness, including problem solving, decision 309.14 making, communication, conflict resolution, anger management, 309.15 social skills, and recreational skills; 309.16 (v) implementing deescalation techniques as recommended by 309.17 the mental health professional; 309.18 (vi) implementing any other mental health service that the 309.19 mental health professional has approved as being within the 309.20 scope of the behavioral aide's duties; or 309.21 (vii) assisting the parents to develop and use parenting 309.22 skills that help the child achieve the goals outlined in the 309.23 child's individual treatment plan or individual behavioral 309.24 plan. Parenting skills must be directed exclusively to the 309.25 child's treatment; and 309.26 (5) direction of a mental health behavioral aide must 309.27 include the following: 309.28 (i) a total of one hour of on-site observation by a mental 309.29 health professional during the first 12 hours of service 309.30 provided to a child; 309.31 (ii) ongoing on-site observation by a mental health 309.32 professional or mental health practitioner for at least a total 309.33 of one hour during every 40 hours of service provided to a 309.34 child; and 309.35 (iii) immediate accessibility of the mental health 309.36 professional or mental health practitioner to the mental health 310.1 behavioral aide during service provision. 310.2 Subd. 10. [SERVICE AUTHORIZATION.] The commissioner shall 310.3 publish in the State Register a list of health services that 310.4 require prior authorization, as well as the criteria and 310.5 standards used to select health services on the list. The list 310.6 and the criteria and standards used to formulate the list are 310.7 not subject to the requirements of sections 14.001 to 14.69. 310.8 The commissioner's decision on whether prior authorization is 310.9 required for a health service is not subject to administrative 310.10 appeal. 310.11 Subd. 11. [DOCUMENTATION AND BILLING.] (a) A provider 310.12 entity must document the services it provides under this 310.13 section. The provider entity must ensure that the entity's 310.14 documentation standards meet the requirements of federal and 310.15 state laws. Services billed under this section that are not 310.16 documented according to this subdivision shall be subject to 310.17 monetary recovery by the commissioner. 310.18 (b) An individual mental health provider must promptly 310.19 document the following in a client's record after providing 310.20 services to the client: 310.21 (1) each occurrence of the client's mental health service, 310.22 including the date, type, length, and scope of the service; 310.23 (2) the name of the person who gave the service; 310.24 (3) contact made with other persons interested in the 310.25 client, including representatives of the courts, corrections 310.26 systems, or schools. The provider must document the name and 310.27 date of each contact; 310.28 (4) any contact made with the client's other mental health 310.29 providers, case manager, family members, primary caregiver, 310.30 legal representative, or the reason the provider did not contact 310.31 the client's family members, primary caregiver, or legal 310.32 representative, if applicable; and 310.33 (5) required clinical supervision, as appropriate. 310.34 Subd. 12. [EXCLUDED SERVICES.] The following services are 310.35 not eligible for medical assistance payment as children's 310.36 therapeutic services and supports: 311.1 (1) service components of children's therapeutic services 311.2 and supports simultaneously provided by more than one provider 311.3 entity unless prior authorization is obtained; 311.4 (2) children's therapeutic services and supports provided 311.5 in violation of medical assistance policy in Minnesota Rules, 311.6 part 9505.0220; 311.7 (3) mental health behavioral aide services provided by a 311.8 personal care assistant who is not qualified as a mental health 311.9 behavioral aide and employed by a certified children's 311.10 therapeutic services and supports provider entity; 311.11 (4) services that are the responsibility of a residential 311.12 or program license holder, including foster care providers under 311.13 the terms of a service agreement or administrative rules 311.14 governing licensure; 311.15 (5) up to 15 hours of children's therapeutic services and 311.16 supports provided within a six-month period to a child with 311.17 severe emotional disturbance who is residing in a hospital, a 311.18 group home as defined in Minnesota Rules, part 9560.0520, 311.19 subpart 4, a residential treatment facility licensed under 311.20 Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 311.21 treatment center, or other institutional group setting or who is 311.22 participating in a program of partial hospitalization are 311.23 eligible for medical assistance payment if part of the discharge 311.24 plan; and 311.25 (6) adjunctive activities that may be offered by a provider 311.26 entity but are not otherwise covered by medical assistance, 311.27 including: 311.28 (i) a service that is primarily recreation oriented or that 311.29 is provided in a setting that is not medically supervised. This 311.30 includes sports activities, exercise groups, activities such as 311.31 craft hours, leisure time, social hours, meal or snack time, 311.32 trips to community activities, and tours; 311.33 (ii) a social or educational service that does not have or 311.34 cannot reasonably be expected to have a therapeutic outcome 311.35 related to the client's emotional disturbance; 311.36 (iii) consultation with other providers or service agency 312.1 staff about the care or progress of a client; 312.2 (iv) prevention or education programs provided to the 312.3 community; and 312.4 (v) treatment for clients with primary diagnoses of alcohol 312.5 or other drug abuse. 312.6 [EFFECTIVE DATE.] Unless otherwise specified, this section 312.7 is effective July 1, 2004. 312.8 Sec. 9. [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 312.9 HEALTH CRISIS RESPONSE SERVICES.] 312.10 Subdivision 1. [DEFINITIONS.] For purposes of this 312.11 section, the following terms have the meanings given them. 312.12 (a) "Mental health crisis" means a child's behavioral, 312.13 emotional, or psychiatric situation that, but for the provision 312.14 of crisis response services to the child, would likely result in 312.15 significantly reduced levels of functioning in primary 312.16 activities of daily living, an emergency situation, or the 312.17 child's placement in a more restrictive setting, including, but 312.18 not limited to, inpatient hospitalization. 312.19 (b) "Mental health emergency" means a child's behavioral, 312.20 emotional, or psychiatric situation that causes an immediate 312.21 need for mental health services and is consistent with section 312.22 62Q.55. A physician, mental health professional, or crisis 312.23 mental health practitioner determines a mental health crisis or 312.24 emergency for medical assistance reimbursement with input from 312.25 the client and the client's family, if possible. 312.26 (c) "Mental health crisis assessment" means an immediate 312.27 face-to-face assessment by a physician, mental health 312.28 professional, or mental health practitioner under the clinical 312.29 supervision of a mental health professional, following a 312.30 screening that suggests the child may be experiencing a mental 312.31 health crisis or mental health emergency situation. 312.32 (d) "Mental health mobile crisis intervention services" 312.33 means face-to-face, short-term intensive mental health services 312.34 initiated during a mental health crisis or mental health 312.35 emergency. Mental health mobile crisis services must help the 312.36 recipient cope with immediate stressors, identify and utilize 313.1 available resources and strengths, and begin to return to the 313.2 recipient's baseline level of functioning. Mental health mobile 313.3 services must be provided on-site by a mobile crisis 313.4 intervention team outside of an emergency room, urgent care, or 313.5 an inpatient hospital setting. 313.6 (e) "Mental health crisis stabilization services" means 313.7 individualized mental health services provided to a recipient 313.8 following crisis intervention services that are designed to 313.9 restore the recipient to the recipient's prior functional 313.10 level. The individual treatment plan recommending mental health 313.11 crisis stabilization must be completed by the intervention team 313.12 or by staff after an inpatient or urgent care visit. Mental 313.13 health crisis stabilization services may be provided in the 313.14 recipient's home, the home of a family member or friend of the 313.15 recipient, another community setting, or a short-term 313.16 supervised, licensed residential program if the service is not 313.17 included in the facility's cost pool or per diem. Mental health 313.18 crisis stabilization is not reimbursable when provided as part 313.19 of a partial hospitalization or day treatment program. 313.20 Subd. 2. [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 313.21 covers medically necessary children's mental health crisis 313.22 response services, subject to federal approval, if provided to 313.23 an eligible recipient under subdivision 3, by a qualified 313.24 provider entity under subdivision 4 or a qualified individual 313.25 provider working within the provider's scope of practice, and 313.26 identified in the recipient's individual crisis treatment plan 313.27 under subdivision 8. 313.28 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 313.29 individual who: 313.30 (1) is eligible for medical assistance; 313.31 (2) is under age 18 or between the ages of 18 and 21; 313.32 (3) is screened as possibly experiencing a mental health 313.33 crisis or mental health emergency where a mental health crisis 313.34 assessment is needed; 313.35 (4) is assessed as experiencing a mental health crisis or 313.36 mental health emergency, and mental health mobile crisis 314.1 intervention or mental health crisis stabilization services are 314.2 determined to be medically necessary; and 314.3 (5) meets the criteria for emotional disturbance or mental 314.4 illness. 314.5 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A crisis 314.6 intervention and crisis stabilization provider entity must meet 314.7 the administrative and clinical standards specified in section 314.8 256B.0943, subdivisions 5 and 6, meet the standards listed in 314.9 paragraph (b), and be: 314.10 (1) an Indian health service facility or facility owned and 314.11 operated by a tribe or a tribal organization operating under 314.12 Public Law 93-638 as a 638 facility; 314.13 (2) a county board-operated entity; or 314.14 (3) a provider entity that is under contract with the 314.15 county board in the county where the potential crisis or 314.16 emergency is occurring. 314.17 (b) The children's mental health crisis response services 314.18 provider entity must: 314.19 (1) ensure that mental health crisis assessment and mobile 314.20 crisis intervention services are available 24 hours a day, seven 314.21 days a week; 314.22 (2) directly provide the services or, if services are 314.23 subcontracted, the provider entity must maintain clinical 314.24 responsibility for services and billing; 314.25 (3) ensure that crisis intervention services are provided 314.26 in a manner consistent with sections 245.487 to 245.4888; and 314.27 (4) develop and maintain written policies and procedures 314.28 regarding service provision that include safety of staff and 314.29 recipients in high-risk situations. 314.30 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 314.31 QUALIFICATIONS.] (a) To provide children's mental health mobile 314.32 crisis intervention services, a mobile crisis intervention team 314.33 must include: 314.34 (1) at least two mental health professionals as defined in 314.35 section 256B.0943, subdivision 1, paragraph (m); or 314.36 (2) a combination of at least one mental health 315.1 professional and one mental health practitioner as defined in 315.2 section 245.4871, subdivision 26, with the required mental 315.3 health crisis training and under the clinical supervision of a 315.4 mental health professional on the team. 315.5 (b) The team must have at least two people with at least 315.6 one member providing on-site crisis intervention services when 315.7 needed. Team members must be experienced in mental health 315.8 assessment, crisis intervention techniques, and clinical 315.9 decision making under emergency conditions and have knowledge of 315.10 local services and resources. The team must recommend and 315.11 coordinate the team's services with appropriate local resources, 315.12 including as the county social services agency, mental health 315.13 service providers, and local law enforcement, if necessary. 315.14 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 315.15 INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 315.16 crisis intervention services, a screening of the potential 315.17 crisis situation must be conducted. The screening may use the 315.18 resources of crisis assistance and emergency services as defined 315.19 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 315.20 1 and 2. The screening must gather information, determine 315.21 whether a crisis situation exists, identify the parties 315.22 involved, and determine an appropriate response. 315.23 (b) If a crisis exists, a crisis assessment must be 315.24 completed. A crisis assessment must evaluate any immediate 315.25 needs for which emergency services are needed and, as time 315.26 permits, the recipient's current life situation, sources of 315.27 stress, mental health problems and symptoms, strengths, cultural 315.28 considerations, support network, vulnerabilities, and current 315.29 functioning. 315.30 (c) If the crisis assessment determines mobile crisis 315.31 intervention services are needed, the intervention services must 315.32 be provided promptly. As the opportunity presents itself during 315.33 the intervention, at least two members of the mobile crisis 315.34 intervention team must confer directly or by telephone about the 315.35 assessment, treatment plan, and actions taken and needed. At 315.36 least one of the team members must be on site providing crisis 316.1 intervention services. If providing on-site crisis intervention 316.2 services, a mental health practitioner must seek clinical 316.3 supervision as required under subdivision 9. 316.4 (d) The mobile crisis intervention team must develop an 316.5 initial, brief crisis treatment plan as soon as appropriate but 316.6 no later than 24 hours after the initial face-to-face 316.7 intervention. The plan must address the needs and problems 316.8 noted in the crisis assessment and include measurable short-term 316.9 goals, cultural considerations, and frequency and type of 316.10 services to be provided to achieve the goals and reduce or 316.11 eliminate the crisis. The crisis treatment plan must be updated 316.12 as needed to reflect current goals and services. The team must 316.13 involve the client and the client's family in developing and 316.14 implementing the plan. 316.15 (e) The team must document in progress notes which 316.16 short-term goals have been met and when no further crisis 316.17 intervention services are required. 316.18 (f) If the client's crisis is stabilized, but the client 316.19 needs a referral for mental health crisis stabilization services 316.20 or to other services, the team must provide a referral to these 316.21 services. If the recipient has a case manager, planning for 316.22 other services must be coordinated with the case manager. 316.23 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 316.24 stabilization services must be provided by a mental health 316.25 professional or a mental health practitioner who works under the 316.26 clinical supervision of a mental health professional and for a 316.27 crisis stabilization services provider entity, and must meet the 316.28 following standards: 316.29 (1) a crisis stabilization treatment plan must be developed 316.30 which meets the criteria in subdivision 8; 316.31 (2) services must be delivered according to the treatment 316.32 plan and include face-to-face contact with the recipient by 316.33 qualified staff for further assessment, help with referrals, 316.34 updating the crisis stabilization treatment plan, supportive 316.35 counseling, skills training, and collaboration with other 316.36 service providers in the community; and 317.1 (3) mental health practitioners must have completed at 317.2 least 30 hours of training in crisis intervention and 317.3 stabilization during the past two years. 317.4 Subd. 8. [TREATMENT PLAN.] (a)The individual crisis 317.5 stabilization treatment plan must include, at a minimum: 317.6 (1) a list of problems identified in the assessment; 317.7 (2) a list of the recipient's strengths and resources; 317.8 (3) concrete, measurable short-term goals and tasks to be 317.9 achieved, including time frames for achievement of the goals; 317.10 (4) specific objectives directed toward the achievement of 317.11 each goal; 317.12 (5) documentation of the participants involved in the 317.13 service planning; 317.14 (6) planned frequency and type of services initiated; 317.15 (7) a crisis response action plan if a crisis should occur; 317.16 and 317.17 (8) clear progress notes on the outcome of goals. 317.18 (b) The client, if clinically appropriate, must be a 317.19 participant in the development of the crisis stabilization 317.20 treatment plan. The client or the client's legal guardian must 317.21 sign the service plan or documentation must be provided why this 317.22 was not possible. A copy of the plan must be given to the 317.23 client and the client's legal guardian. The plan should include 317.24 services arranged, including specific providers where applicable. 317.25 (c) A treatment plan must be developed by a mental health 317.26 professional or mental health practitioner under the clinical 317.27 supervision of a mental health professional. A written plan 317.28 must be completed within 24 hours of beginning services with the 317.29 client. 317.30 Subd. 9. [SUPERVISION.] (a) A mental health practitioner 317.31 may provide crisis assessment and mobile crisis intervention 317.32 services if the following clinical supervision requirements are 317.33 met: 317.34 (1) the mental health provider entity must accept full 317.35 responsibility for the services provided; 317.36 (2) the mental health professional of the provider entity, 318.1 who is an employee or under contract with the provider entity, 318.2 must be immediately available by telephone or in person for 318.3 clinical supervision; 318.4 (3) the mental health professional is consulted, in person 318.5 or by telephone, during the first three hours when a mental 318.6 health practitioner provides on-site service; and 318.7 (4) the mental health professional must review and approve 318.8 the tentative crisis assessment and crisis treatment plan, 318.9 document the consultation, and sign the crisis assessment and 318.10 treatment plan within the next business day. 318.11 (b) If the mobile crisis intervention services continue 318.12 into a second calendar day, a mental health professional must 318.13 contact the client face-to-face on the second day to provide 318.14 services and update the crisis treatment plan. The on-site 318.15 observation must be documented in the client's record and signed 318.16 by the mental health professional. 318.17 Subd. 10. [CLIENT RECORD.] The provider must maintain a 318.18 file for each client that complies with the requirements under 318.19 section 256B.0943, subdivision 11, and contains the following 318.20 information: 318.21 (1) individual crisis treatment plans signed by the 318.22 recipient, mental health professional, and mental health 318.23 practitioner who developed the crisis treatment plan, or if the 318.24 recipient refused to sign the plan, the date and reason stated 318.25 by the recipient for not signing the plan; 318.26 (2) signed release of information forms; 318.27 (3) recipient health information and current medications; 318.28 (4) emergency contacts for the recipient; 318.29 (5) case records that document the date of service, place 318.30 of service delivery, signature of the person providing the 318.31 service, and the nature, extent, and units of service. Direct 318.32 or telephone contact with the recipient's family or others 318.33 should be documented; 318.34 (6) required clinical supervision by mental health 318.35 professionals; 318.36 (7) summary of the recipient's case reviews by staff; and 319.1 (8) any written information by the recipient that the 319.2 recipient wants in the file. 319.3 Subd. 11. [EXCLUDED SERVICES.] The following services are 319.4 excluded from reimbursement under this section: 319.5 (1) room and board services; 319.6 (2) services delivered to a recipient while admitted to an 319.7 inpatient hospital; 319.8 (3) transportation services under children's mental health 319.9 crisis response service; 319.10 (4) services provided and billed by a provider who is not 319.11 enrolled under medical assistance to provide children's mental 319.12 health crisis response services; 319.13 (5) crisis response services provided by a residential 319.14 treatment center to clients in their facility; 319.15 (6) services performed by volunteers; 319.16 (7) direct billing of time spent "on call" when not 319.17 delivering services to a recipient; 319.18 (8) provider service time included in case management 319.19 reimbursement; 319.20 (9) outreach services to potential recipients; and 319.21 (10) a mental health service that is not medically 319.22 necessary. 319.23 [EFFECTIVE DATE.] This section is effective July 1, 2004. 319.24 Sec. 10. Minnesota Statutes 2002, section 256B.0945, 319.25 subdivision 2, is amended to read: 319.26 Subd. 2. [COVERED SERVICES.] All services must be included 319.27 in a child's individualized treatment or multiagency plan of 319.28 care as defined in chapter 245. 319.29(a) For facilities that are institutions for mental319.30diseases according to statute and regulation or are not319.31institutions for mental diseases but are approved by the319.32commissioner to provide services under this paragraph, medical319.33assistance covers the full contract rate, including room and319.34board if the services meet the requirements of Code of Federal319.35Regulations, title 42, section 440.160.319.36(b)For facilities that are not institutions for mental 320.1 diseases according to federal statute and regulationand are not320.2providing services under paragraph (a), medical assistance 320.3 covers mental health related services that are required to be 320.4 provided by a residential facility under section 245.4882 and 320.5 administrative rules promulgated thereunder, except for room and 320.6 board. 320.7 Sec. 11. Minnesota Statutes 2002, section 256B.0945, 320.8 subdivision 4, is amended to read: 320.9 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 320.10 256B.19 and 256B.041, payments to counties for residential 320.11 services provided by a residential facility shall only be made 320.12 of federal earnings for services provided under this section, 320.13 and the nonfederal share of costs for services provided under 320.14 this section shall be paid by the county from sources other than 320.15 federal funds or funds used to match other federal funds. 320.16Payment to counties for services provided according to320.17subdivision 2, paragraph (a), shall be the federal share of the320.18contract rate.Payment to counties for services provided 320.19 according tosubdivision 2, paragraph (b),this section shall be 320.20 a proportion of the per day contract rate that relates to 320.21 rehabilitative mental health services and shall not include 320.22 payment for costs or services that are billed to the IV-E 320.23 program as room and board. 320.24 (b) The commissioner shall set aside a portion not to 320.25 exceed five percent of the federal funds earned under this 320.26 section to cover the state costs of administering this section. 320.27 Any unexpended funds from the set-aside shall be distributed to 320.28 the counties in proportion to their earnings under this section. 320.29 Sec. 12. Minnesota Statutes 2002, section 259.67, 320.30 subdivision 4, is amended to read: 320.31 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 320.32 shall use the AFDC requirements as specified in federal law as 320.33 of July 16, 1996, when determining the child's eligibility for 320.34 adoption assistance under title IV-E of the Social Security 320.35 Act. If the child does not qualify, the placing agency shall 320.36 certify a child as eligible for state funded adoption assistance 321.1 only if the following criteria are met: 321.2 (1) Due to the child's characteristics or circumstances it 321.3 would be difficult to provide the child an adoptive home without 321.4 adoption assistance. 321.5 (2)(i) A placement agency has made reasonable efforts to 321.6 place the child for adoption without adoption assistance, but 321.7 has been unsuccessful; or 321.8 (ii) the child's licensed foster parents desire to adopt 321.9 the child and it is determined by the placing agency that the 321.10 adoption is in the best interest of the child. 321.11 (3) The child has been a ward of the commissioneror, a 321.12 Minnesota-licensed child-placing agency, or a tribal social 321.13 service agency of Minnesota recognized by the Secretary of the 321.14 Interior. 321.15 (b) For purposes of this subdivision, the characteristics 321.16 or circumstances that may be considered in determining whether a 321.17 child is a child with special needs under United States Code, 321.18 title 42, chapter 7, subchapter IV, part E, or meets the 321.19 requirements of paragraph (a), clause (1), are the following: 321.20 (1) The child is a member of a sibling group to be placed 321.21 as one unit in which at least one sibling is older than 15 321.22 months of age or is described in clause (2) or (3). 321.23 (2) The child has documented physical, mental, emotional, 321.24 or behavioral disabilities. 321.25 (3) The child has a high risk of developing physical, 321.26 mental, emotional, or behavioral disabilities. 321.27 (4) The child is adopted according to tribal law without a 321.28 termination of parental rights or relinquishment, provided that 321.29 the tribe has documented the valid reason why the child cannot 321.30 or should not be returned to the home of the child's parent. 321.31 (c) When a child's eligibility for adoption assistance is 321.32 based upon the high risk of developing physical, mental, 321.33 emotional, or behavioral disabilities, payments shall not be 321.34 made under the adoption assistance agreement unless and until 321.35 the potential disability manifests itself as documented by an 321.36 appropriate health care professional. 322.1 Sec. 13. Minnesota Statutes 2002, section 260B.157, 322.2 subdivision 1, is amended to read: 322.3 Subdivision 1. [INVESTIGATION.] Upon request of the court 322.4 the local social services agency or probation officer shall 322.5 investigate the personal and family history and environment of 322.6 any minor coming within the jurisdiction of the court under 322.7 section 260B.101 and shall report its findings to the court. 322.8 The court may order any minor coming within its jurisdiction to 322.9 be examined by a duly qualified physician, psychiatrist, or 322.10 psychologist appointed by the court. 322.11 The court shall have a chemical use assessment conducted 322.12 when a child is (1) found to be delinquent for violating a 322.13 provision of chapter 152, or for committing a felony-level 322.14 violation of a provision of chapter 609 if the probation officer 322.15 determines that alcohol or drug use was a contributing factor in 322.16 the commission of the offense, or (2) alleged to be delinquent 322.17 for violating a provision of chapter 152, if the child is being 322.18 held in custody under a detention order. The assessor's 322.19 qualifications and the assessment criteria shall comply with 322.20 Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 322.21 chapter 254B are to be used to pay for the recommended 322.22 treatment, the assessment and placement must comply with all 322.23 provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 322.24 9530.7000 to 9530.7030. The commissioner of human services 322.25 shall reimburse the court for the cost of the chemical use 322.26 assessment, up to a maximum of $100. 322.27 The court shall have a children's mental health screening 322.28 conducted when a child is alleged to be delinquent or is found 322.29 to be delinquent. The screening shall be conducted with a 322.30 screening instrument approved by the commissioner of human 322.31 services and shall be conducted by a mental health practitioner 322.32 as defined in section 245.4871, subdivision 26, or a probation 322.33 officer who is trained in the use of the screening instrument. 322.34 If the screening indicates a need for assessment, the local 322.35 social services agency, in consultation with the child's family, 322.36 shall have a diagnostic assessment conducted, including a 323.1 functional assessment, as defined in section 245.4871. 323.2 With the consent of the commissioner of corrections and 323.3 agreement of the county to pay the costs thereof, the court may, 323.4 by order, place a minor coming within its jurisdiction in an 323.5 institution maintained by the commissioner for the detention, 323.6 diagnosis, custody and treatment of persons adjudicated to be 323.7 delinquent, in order that the condition of the minor be given 323.8 due consideration in the disposition of the case. Any funds 323.9 received under the provisions of this subdivision shall not 323.10 cancel until the end of the fiscal year immediately following 323.11 the fiscal year in which the funds were received. The funds are 323.12 available for use by the commissioner of corrections during that 323.13 period and are hereby appropriated annually to the commissioner 323.14 of corrections as reimbursement of the costs of providing these 323.15 services to the juvenile courts. 323.16 [EFFECTIVE DATE.] This section is effective July 1, 2004. 323.17 Sec. 14. Minnesota Statutes 2002, section 260B.176, 323.18 subdivision 2, is amended to read: 323.19 Subd. 2. [REASONS FOR DETENTION.] (a) If the child is not 323.20 released as provided in subdivision 1, the person taking the 323.21 child into custody shall notify the court as soon as possible of 323.22 the detention of the child and the reasons for detention. 323.23 (b) No child may be detained in a juvenile secure detention 323.24 facility or shelter care facility longer than 36 hours, 323.25 excluding Saturdays, Sundays, and holidays, after being taken 323.26 into custody for a delinquent act as defined in section 323.27 260B.007, subdivision 6, unless a petition has been filed and 323.28 the judge or referee determines pursuant to section 260B.178 323.29 that the child shall remain in detention. 323.30 (c) No child may be detained in an adult jail or municipal 323.31 lockup longer than 24 hours, excluding Saturdays, Sundays, and 323.32 holidays, or longer than six hours in an adult jail or municipal 323.33 lockup in a standard metropolitan statistical area, after being 323.34 taken into custody for a delinquent act as defined in section 323.35 260B.007, subdivision 6, unless: 323.36 (1) a petition has been filed under section 260B.141; and 324.1 (2) a judge or referee has determined under section 324.2 260B.178 that the child shall remain in detention. 324.3 After August 1, 1991, no child described in this paragraph 324.4 may be detained in an adult jail or municipal lockup longer than 324.5 24 hours, excluding Saturdays, Sundays, and holidays, or longer 324.6 than six hours in an adult jail or municipal lockup in a 324.7 standard metropolitan statistical area, unless the requirements 324.8 of this paragraph have been met and, in addition, a motion to 324.9 refer the child for adult prosecution has been made under 324.10 section 260B.125. Notwithstanding this paragraph, continued 324.11 detention of a child in an adult detention facility outside of a 324.12 standard metropolitan statistical area county is permissible if: 324.13 (i) the facility in which the child is detained is located 324.14 where conditions of distance to be traveled or other ground 324.15 transportation do not allow for court appearances within 24 324.16 hours. A delay not to exceed 48 hours may be made under this 324.17 clause; or 324.18 (ii) the facility is located where conditions of safety 324.19 exist. Time for an appearance may be delayed until 24 hours 324.20 after the time that conditions allow for reasonably safe 324.21 travel. "Conditions of safety" include adverse life-threatening 324.22 weather conditions that do not allow for reasonably safe travel. 324.23 The continued detention of a child under clause (i) or (ii) 324.24 must be reported to the commissioner of corrections. 324.25 (d) If a child described in paragraph (c) is to be detained 324.26 in a jail beyond 24 hours, excluding Saturdays, Sundays, and 324.27 holidays, the judge or referee, in accordance with rules and 324.28 procedures established by the commissioner of corrections, shall 324.29 notify the commissioner of the place of the detention and the 324.30 reasons therefor. The commissioner shall thereupon assist the 324.31 court in the relocation of the child in an appropriate juvenile 324.32 secure detention facility or approved jail within the county or 324.33 elsewhere in the state, or in determining suitable 324.34 alternatives. The commissioner shall direct that a child 324.35 detained in a jail be detained after eight days from and 324.36 including the date of the original detention order in an 325.1 approved juvenile secure detention facility with the approval of 325.2 the administrative authority of the facility. If the court 325.3 refers the matter to the prosecuting authority pursuant to 325.4 section 260B.125, notice to the commissioner shall not be 325.5 required. 325.6 (e) When a child is detained for an alleged delinquent act 325.7 in a state licensed juvenile facility or program, or when a 325.8 child is detained in an adult jail or municipal lockup as 325.9 provided in paragraph (c), the supervisor of the facility shall, 325.10 if the child's parent or legal guardian consents, have a 325.11 children's mental health screening conducted with a screening 325.12 instrument approved by the commissioner of human services, 325.13 unless a screening has been performed within the previous 180 325.14 days or the child is currently under the care of a mental health 325.15 professional. The screening shall be conducted by a mental 325.16 health practitioner as defined in section 245.4871, subdivision 325.17 26, or a probation officer who is trained in the use of the 325.18 screening instrument. The screening shall be conducted after 325.19 the initial detention hearing has been held and the court has 325.20 ordered the child continued in detention. The results of the 325.21 screening may only be presented to the court at the 325.22 dispositional phase of the court proceedings on the matter 325.23 unless the parent or legal guardian consents to presentation at 325.24 a different time. If the screening indicates a need for 325.25 assessment, the local social services agency or probation 325.26 officer, with the approval of the child's parent or legal 325.27 guardian, shall have a diagnostic assessment conducted, 325.28 including a functional assessment, as defined in section 325.29 245.4871. 325.30 [EFFECTIVE DATE.] This section is effective July 1, 2004. 325.31 Sec. 15. Minnesota Statutes 2002, section 260B.178, 325.32 subdivision 1, is amended to read: 325.33 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) The 325.34 court shall hold a detention hearing: 325.35 (1) within 36 hours of the time the child was taken into 325.36 custody, excluding Saturdays, Sundays, and holidays, if the 326.1 child is being held at a juvenile secure detention facility or 326.2 shelter care facility; or 326.3 (2) within 24 hours of the time the child was taken into 326.4 custody, excluding Saturdays, Sundays, and holidays, if the 326.5 child is being held at an adult jail or municipal lockup. 326.6 (b) Unless there is reason to believe that the child would 326.7 endanger self or others, not return for a court hearing, run 326.8 away from the child's parent, guardian, or custodian or 326.9 otherwise not remain in the care or control of the person to 326.10 whose lawful custody the child is released, or that the child's 326.11 health or welfare would be immediately endangered, the child 326.12 shall be released to the custody of a parent, guardian, 326.13 custodian, or other suitable person, subject to reasonable 326.14 conditions of release including, but not limited to, a 326.15 requirement that the child undergo a chemical use assessment as 326.16 provided in section 260B.157, subdivision 1, and a children's 326.17 mental health screening as provided in section 260B.176, 326.18 subdivision 2, paragraph (e). In determining whether the 326.19 child's health or welfare would be immediately endangered, the 326.20 court shall consider whether the child would reside with a 326.21 perpetrator of domestic child abuse. 326.22 [EFFECTIVE DATE.] This section is effective July 1, 2004. 326.23 Sec. 16. Minnesota Statutes 2002, section 260B.193, 326.24 subdivision 2, is amended to read: 326.25 Subd. 2. [CONSIDERATION OF REPORTS.] Before making a 326.26 disposition in a case, or appointing a guardian for a child, the 326.27 court may consider any report or recommendation made by the 326.28 local social services agency, probation officer, licensed 326.29 child-placing agency, foster parent, guardian ad litem, tribal 326.30 representative, or other authorized advocate for the child or 326.31 child's family, a school district concerning the effect on 326.32 student transportation of placing a child in a school district 326.33 in which the child is not a resident, or any other information 326.34 deemed material by the court. In addition, the court may 326.35 consider the results of the children's mental health screening 326.36 provided in section 260B.157, subdivision 1. 327.1 [EFFECTIVE DATE.] This section is effective July 1, 2004. 327.2 Sec. 17. Minnesota Statutes 2002, section 260B.235, 327.3 subdivision 6, is amended to read: 327.4 Subd. 6. [ALTERNATIVE DISPOSITION.] In addition to 327.5 dispositional alternatives authorized by subdivision34, in the 327.6 case of a third or subsequent finding by the court pursuant to 327.7 an admission in court or after trial that a child has committed 327.8 a juvenile alcohol or controlled substance offense, the juvenile 327.9 court shall order a chemical dependency evaluation of the child 327.10 and if warranted by the evaluation, the court may order 327.11 participation by the child in an inpatient or outpatient 327.12 chemical dependency treatment program, or any other treatment 327.13 deemed appropriate by the court. In the case of a third or 327.14 subsequent finding that a child has committed any juvenile petty 327.15 offense, the court shall order a children's mental health 327.16 screening be conducted as provided in section 260B.157, 327.17 subdivision 1, and if indicated by the screening, to undergo a 327.18 diagnostic assessment, including a functional assessment, as 327.19 defined in section 245.4871. 327.20 [EFFECTIVE DATE.] This section is effective July 1, 2004. 327.21 Sec. 18. [MEDICAL ASSISTANCE FOR MENTAL HEALTH SERVICES 327.22 PROVIDED IN OUT-OF-HOME PLACEMENT SETTINGS.] 327.23 The commissioner of human services shall develop a plan in 327.24 conjunction with the commissioner of corrections and 327.25 representatives from counties, provider groups, and other 327.26 stakeholders, to secure medical assistance funding for mental 327.27 health-related services provided in out-of-home placement 327.28 settings, including treatment foster care, group homes, and 327.29 residential programs licensed under Minnesota Statutes, chapters 327.30 241 and 245A. The plan must include proposed legislation, 327.31 fiscal implications, and other pertinent information. 327.32 Treatment foster care services must be provided by a child 327.33 placing agency licensed under Minnesota Rules, parts 9543.0010 327.34 to 9543.0150 or 9545.0755 to 9545.0845. 327.35 The commissioner shall report to the legislature by January 327.36 15, 2004. 328.1 Sec. 19. [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 328.2 AND SUPPORTS.] 328.3 Beginning July 1, 2003, the commissioner shall use the 328.4 provider certification process under Minnesota Statutes, section 328.5 256B.0943, instead of the provider certification process 328.6 required in Minnesota Rules, parts 9505.0324; 9505.0326; and 328.7 9505.0327. 328.8 Sec. 20. [REVISOR'S INSTRUCTION.] 328.9 For sections in Minnesota Statutes and Minnesota Rules 328.10 affected by the repealed sections in this article, the revisor 328.11 shall delete internal cross-references where appropriate and 328.12 make changes necessary to correct the punctuation, grammar, or 328.13 structure of the remaining text and preserve its meaning. 328.14 Sec. 21. [REPEALER.] 328.15 (a) Minnesota Statutes 2002, sections 256B.0945, 328.16 subdivision 10, is repealed. 328.17 (b) Minnesota Statutes 2002, section 256B.0625, 328.18 subdivisions 35 and 36, are repealed effective July 1, 2004. 328.19 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 328.20 9505.0327, are repealed effective July 1, 2004. 328.21 ARTICLE 8 328.22 PROHIBITED TRANSFERS; LIENS; ESTATE CLAIMS 328.23 Section 1. Minnesota Statutes 2002, section 256B.0595, 328.24 subdivision 1, is amended to read: 328.25 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 328.26 of assets made on or before August 10, 1993, if a person or the 328.27 person's spouse has given away, sold, or disposed of, for less 328.28 than fair market value, any asset or interest therein, except 328.29 assets other than the homestead that are excluded under the 328.30 supplemental security program, within 30 months before or any 328.31 time after the date of institutionalization if the person has 328.32 been determined eligible for medical assistance, or within 30 328.33 months before or any time after the date of the first approved 328.34 application for medical assistance if the person has not yet 328.35 been determined eligible for medical assistance, the person is 328.36 ineligible for long-term care services for the period of time 329.1 determined under subdivision 2. 329.2 (b) Effective for transfers made after August 10, 1993, a 329.3 person, a person's spouse, or any person, court, or 329.4 administrative body with legal authority to act in place of, on 329.5 behalf of, at the direction of, or upon the request of the 329.6 person or person's spouse, may not give away, sell, or dispose 329.7 of, for less than fair market value, any asset or interest 329.8 therein, except assets other than the homestead that are 329.9 excluded under the supplemental security income program, for the 329.10 purpose of establishing or maintaining medical assistance 329.11 eligibility. This applies to all transfers, including those 329.12 made by a community spouse after the month in which the 329.13 institutionalized spouse is determined eligible for medical 329.14 assistance. For purposes of determining eligibility for 329.15 long-term care services, any transfer of such assets within 36 329.16 months before or any time after an institutionalized person 329.17 applies for medical assistance, or 36 months before or any time 329.18 after a medical assistance recipient becomes institutionalized, 329.19 for less than fair market value may be considered. Any such 329.20 transfer is presumed to have been made for the purpose of 329.21 establishing or maintaining medical assistance eligibility and 329.22 the person is ineligible for long-term care services for the 329.23 period of time determined under subdivision 2, unless the person 329.24 furnishes convincing evidence to establish that the transaction 329.25 was exclusively for another purpose, or unless the transfer is 329.26 permitted under subdivision 3 or 4. Notwithstanding the 329.27 provisions of this paragraph, in the case of payments from a 329.28 trust or portions of a trust that are considered transfers of 329.29 assets under federal law, any transfers made within 60 months 329.30 before or any time after an institutionalized person applies for 329.31 medical assistance and within 60 months before or any time after 329.32 a medical assistance recipient becomes institutionalized, may be 329.33 considered. 329.34 (c) This section applies to transfers, for less than fair 329.35 market value, of income or assets, including assets that are 329.36 considered income in the month received, such as inheritances, 330.1 court settlements, and retroactive benefit payments or income to 330.2 which the person or the person's spouse is entitled but does not 330.3 receive due to action by the person, the person's spouse, or any 330.4 person, court, or administrative body with legal authority to 330.5 act in place of, on behalf of, at the direction of, or upon the 330.6 request of the person or the person's spouse. 330.7 (d) This section applies to payments for care or personal 330.8 services provided by a relative, unless the compensation was 330.9 stipulated in a notarized, written agreement which was in 330.10 existence when the service was performed, the care or services 330.11 directly benefited the person, and the payments made represented 330.12 reasonable compensation for the care or services provided. A 330.13 notarized written agreement is not required if payment for the 330.14 services was made within 60 days after the service was provided. 330.15 (e) This section applies to the portion of any asset or 330.16 interest that a person, a person's spouse, or any person, court, 330.17 or administrative body with legal authority to act in place of, 330.18 on behalf of, at the direction of, or upon the request of the 330.19 person or the person's spouse, transfers to any annuity that 330.20 exceeds the value of the benefit likely to be returned to the 330.21 person or spouse while alive, based on estimated life expectancy 330.22 using the life expectancy tables employed by the supplemental 330.23 security income program to determine the value of an agreement 330.24 for services for life. The commissioner may adopt rules 330.25 reducing life expectancies based on the need for long-term 330.26 care. This section applies to an annuity described in this 330.27 paragraph purchased on or after March 1, 2002, that: 330.28 (1) is not purchased from an insurance company or financial 330.29 institution that is subject to licensing or regulation by the 330.30 Minnesota department of commerce or a similar regulatory agency 330.31 of another state; 330.32 (2) does not pay out principal and interest in equal 330.33 monthly installments; or 330.34 (3) does not begin payment at the earliest possible date 330.35 after annuitization. 330.36 (f) For purposes of this section, long-term care services 331.1 include services in a nursing facility, services that are 331.2 eligible for payment according to section 256B.0625, subdivision 331.3 2, because they are provided in a swing bed, intermediate care 331.4 facility for persons with mental retardation, and home and 331.5 community-based services provided pursuant to sections 331.6 256B.0915, 256B.092, and 256B.49. For purposes of this 331.7 subdivision and subdivisions 2, 3, and 4, "institutionalized 331.8 person" includes a person who is an inpatient in a nursing 331.9 facility or in a swing bed, or intermediate care facility for 331.10 persons with mental retardation or who is receiving home and 331.11 community-based services under sections 256B.0915, 256B.092, and 331.12 256B.49. 331.13 [EFFECTIVE DATE.] This section is effective July 1, 2003. 331.14 Sec. 2. Minnesota Statutes 2002, section 256B.0595, is 331.15 amended by adding a subdivision to read: 331.16 Subd. 1b. [PROHIBITED TRANSFERS.] (a) Notwithstanding any 331.17 contrary provisions of this section, this subdivision applies to 331.18 transfers involving recipients of medical assistance that are 331.19 made on or after July 1, 2003, and to all transfers involving 331.20 persons who apply for medical assistance on or after July 1, 331.21 2003, if the transfer occurred within 72 months before the 331.22 person applies for medical assistance, except that this 331.23 subdivision does not apply to transfers made prior to July 1, 331.24 2003. A person, a person's spouse, or any person, court, or 331.25 administrative body with legal authority to act in place of, on 331.26 behalf of, at the direction of, or upon the request of the 331.27 person or the person's spouse, may not give away, sell, dispose 331.28 of, or reduce ownership or control of any income, asset, or 331.29 interest therein for less than fair market value for the purpose 331.30 of establishing or maintaining medical assistance eligibility. 331.31 This applies to all transfers, including those made by a 331.32 community spouse after the month in which the institutionalized 331.33 spouse is determined eligible for medical assistance. For 331.34 purposes of determining eligibility for medical assistance 331.35 services, any transfer of such income or assets for less than 331.36 fair market value within 72 months before or any time after a 332.1 person applies for medical assistance may be considered. Any 332.2 such transfer is presumed to have been made for the purpose of 332.3 establishing or maintaining medical assistance eligibility, and 332.4 the person is ineligible for medical assistance services for the 332.5 period of time determined under subdivision 2b, unless the 332.6 person furnishes convincing evidence to establish that the 332.7 transaction was exclusively for another purpose or unless the 332.8 transfer is permitted under subdivision 3b or 4b. 332.9 (b) This section applies to transfers to trusts. The 332.10 commissioner shall determine valid trust purposes under this 332.11 section. Assets placed into a trust that is not for a valid 332.12 purpose shall always be considered available for the purposes of 332.13 medical assistance eligibility, regardless of when the trust is 332.14 established. 332.15 (c) This section applies to transfers of income or assets 332.16 for less than fair market value, including assets that are 332.17 considered income in the month received, such as inheritances, 332.18 court settlements, and retroactive benefit payments or income to 332.19 which the person or the person's spouse is entitled but does not 332.20 receive due to action by the person, the person's spouse, or any 332.21 person, court, or administrative body with legal authority to 332.22 act in place of, on behalf of, at the direction of, or upon the 332.23 request of the person or the person's spouse. 332.24 (d) This section applies to payments for care or personal 332.25 services provided by a relative, unless the compensation was 332.26 stipulated in a notarized written agreement that was in 332.27 existence when the service was performed, the care or services 332.28 directly benefited the person, and the payments made represented 332.29 reasonable compensation for the care or services provided. A 332.30 notarized written agreement is not required if payment for the 332.31 services was made within 60 days after the service was provided. 332.32 (e) This section applies to the portion of any income, 332.33 asset, or interest therein that a person, a person's spouse, or 332.34 any person, court, or administrative body with legal authority 332.35 to act in place of, on behalf of, at the direction of, or upon 332.36 the request of the person or the person's spouse, transfers to 333.1 any annuity that exceeds the value of the benefit likely to be 333.2 returned to the person or the person's spouse while alive, based 333.3 on estimated life expectancy, using the life expectancy tables 333.4 employed by the supplemental security income program, or based 333.5 on a shorter life expectancy if the annuitant had a medical 333.6 condition that would shorten his or her life expectancy and that 333.7 was diagnosed before funds were placed into the annuity. The 333.8 agency may request and receive a physician's statement to 333.9 determine if the annuitant had a diagnosed medical condition 333.10 that would shorten his or her life expectancy. If so, the 333.11 agency shall determine the expected value of the benefits based 333.12 upon the physician's statement instead of using a life 333.13 expectancy table. This section applies to an annuity described 333.14 in this paragraph purchased on or after March 1, 2002, that: 333.15 (1) is not purchased from an insurance company or financial 333.16 institution that is subject to licensing or regulation by the 333.17 Minnesota department of commerce or a similar regulatory agency 333.18 of another state; 333.19 (2) does not pay out principal and interest in equal 333.20 monthly installments; or 333.21 (3) does not begin payment at the earliest possible date 333.22 after annuitization. 333.23 (f) Transfers under this section shall affect 333.24 determinations of eligibility for all medical assistance 333.25 services or long-term care services, whichever receives federal 333.26 approval. 333.27 [EFFECTIVE DATE.] (a) This section is effective July 1, 333.28 2003, to the extent permitted by federal law. If any provision 333.29 of this section is prohibited by federal law, the provision 333.30 shall become effective when federal law is changed to permit its 333.31 application or a waiver is received. The commissioner of human 333.32 services shall notify the revisor of statutes when federal law 333.33 is enacted or a waiver or other federal approval is received and 333.34 publish a notice in the State Register. The commissioner must 333.35 include the notice in the first State Register published after 333.36 the effective date of the federal changes. 334.1 (b) If, by July 1, 2003, any provision of this section is 334.2 not effective because of prohibitions in federal law, the 334.3 commissioner of human services shall apply to the federal 334.4 government by August 1, 2003, for a waiver of those prohibitions 334.5 or other federal authority, and that provision shall become 334.6 effective upon receipt of a federal waiver or other federal 334.7 approval, notification to the revisor of statutes, and 334.8 publication of a notice in the State Register to that effect. 334.9 In applying for federal approval to extend the lookback period, 334.10 the commissioner shall seek the longest lookback period the 334.11 federal government will approve, not to exceed 72 months. 334.12 Sec. 3. Minnesota Statutes 2002, section 256B.0595, 334.13 subdivision 2, is amended to read: 334.14 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 334.15 uncompensated transfer occurring on or before August 10, 1993, 334.16 the number of months of ineligibility for long-term care 334.17 services shall be the lesser of 30 months, or the uncompensated 334.18 transfer amount divided by the average medical assistance rate 334.19 for nursing facility services in the state in effect on the date 334.20 of application. The amount used to calculate the average 334.21 medical assistance payment rate shall be adjusted each July 1 to 334.22 reflect payment rates for the previous calendar year. The 334.23 period of ineligibility begins with the month in which the 334.24 assets were transferred. If the transfer was not reported to 334.25 the local agency at the time of application, and the applicant 334.26 received long-term care services during what would have been the 334.27 period of ineligibility if the transfer had been reported, a 334.28 cause of action exists against the transferee for the cost of 334.29 long-term care services provided during the period of 334.30 ineligibility, or for the uncompensated amount of the transfer, 334.31 whichever is less. The action may be brought by the state or 334.32 the local agency responsible for providing medical assistance 334.33 under chapter 256G. The uncompensated transfer amount is the 334.34 fair market value of the asset at the time it was given away, 334.35 sold, or disposed of, less the amount of compensation received. 334.36 (b) For uncompensated transfers made after August 10, 1993, 335.1 the number of months of ineligibility for long-term care 335.2 services shall be the total uncompensated value of the resources 335.3 transferred divided by the average medical assistance rate for 335.4 nursing facility services in the state in effect on the date of 335.5 application. The amount used to calculate the average medical 335.6 assistance payment rate shall be adjusted each July 1 to reflect 335.7 payment rates for the previous calendar year. The period of 335.8 ineligibility begins with the first day of the month after the 335.9 month in which the assets were transferred except that if one or 335.10 more uncompensated transfers are made during a period of 335.11 ineligibility, the total assets transferred during the 335.12 ineligibility period shall be combined and a penalty period 335.13 calculated to begininon the first day of the month after the 335.14 month in which the first uncompensated transfer was made. If 335.15 the transfer was not reported to the local agencyat the time of335.16application, and the applicant received medical assistance 335.17 services during what would have been the period of ineligibility 335.18 if the transfer had been reported, a cause of action exists 335.19 against the transferee for the cost of medical assistance 335.20 services provided during the period of ineligibility, or for the 335.21 uncompensated amount of the transfer, whichever is less. The 335.22 action may be brought by the state or the local agency 335.23 responsible for providing medical assistance under chapter 335.24 256G. The uncompensated transfer amount is the fair market 335.25 value of the asset at the time it was given away, sold, or 335.26 disposed of, less the amount of compensation received. 335.27 Effective for transfers made on or after March 1, 1996, 335.28 involving persons who apply for medical assistance on or after 335.29 April 13, 1996, no cause of action exists for a transfer unless: 335.30 (1) the transferee knew or should have known that the 335.31 transfer was being made by a person who was a resident of a 335.32 long-term care facility or was receiving that level of care in 335.33 the community at the time of the transfer; 335.34 (2) the transferee knew or should have known that the 335.35 transfer was being made to assist the person to qualify for or 335.36 retain medical assistance eligibility; or 336.1 (3) the transferee actively solicited the transfer with 336.2 intent to assist the person to qualify for or retain eligibility 336.3 for medical assistance. 336.4 (c) If a calculation of a penalty period results in a 336.5 partial month, payments for long-term care services shall be 336.6 reduced in an amount equal to the fraction, except that in 336.7 calculating the value of uncompensated transfers, if the total 336.8 value of all uncompensated transfers made in a month not 336.9 included in an existing penalty period does not exceed $200, 336.10 then such transfers shall be disregarded for each month prior to 336.11 the month of application for or during receipt of medical 336.12 assistance. 336.13 [EFFECTIVE DATE.] Paragraph (b) of this section is 336.14 effective July 1, 2003. 336.15 Sec. 4. Minnesota Statutes 2002, section 256B.0595, is 336.16 amended by adding a subdivision to read: 336.17 Subd. 2b. [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 336.18 any contrary provisions of this section, this subdivision 336.19 applies to transfers, including transfers to trusts, involving 336.20 recipients of medical assistance that are made on or after July 336.21 1, 2003, and to all transfers involving persons who apply for 336.22 medical assistance on or after July 1, 2003, regardless of when 336.23 the transfer occurred, except that this subdivision does not 336.24 apply to transfers made prior to July 1, 2003. For any 336.25 uncompensated transfer occurring within 72 months prior to the 336.26 date of application, at any time after application, or while 336.27 eligible, the number of months of cumulative ineligibility for 336.28 medical assistance services shall be the total uncompensated 336.29 value of the assets and income transferred divided by the 336.30 statewide average per-person nursing facility payment made by 336.31 the state in effect at the time a penalty for a transfer is 336.32 determined. The amount used to calculate the average per-person 336.33 nursing facility payment shall be adjusted each July 1 to 336.34 reflect average payments for the previous calendar year. For 336.35 applicants, the period of ineligibility begins with the month in 336.36 which the person applied for medical assistance and satisfied 337.1 all other requirements for eligibility, or the first month the 337.2 local agency becomes aware of the transfer and can give proper 337.3 notice, if later. For recipients, the period of ineligibility 337.4 begins in the first month after the month the agency becomes 337.5 aware of the transfer and can give proper notice, except that 337.6 penalty periods for transfers made during a period of 337.7 ineligibility as determined under this section shall begin in 337.8 the month following the existing period of ineligibility. If 337.9 the transfer was not reported to the local agency, and the 337.10 applicant received medical assistance services during what would 337.11 have been the period of ineligibility if the transfer had been 337.12 reported, a cause of action exists against the transferee for 337.13 the cost of medical assistance services provided during the 337.14 period of ineligibility or for the uncompensated amount of the 337.15 transfer that was not recovered from the transferor through the 337.16 implementation of a penalty period under this subdivision, 337.17 whichever is less. Recovery shall include the costs incurred 337.18 due to the action. The action may be brought by the state or 337.19 the local agency responsible for providing medical assistance 337.20 under chapter 256B. The total uncompensated value is the fair 337.21 market value of the income or asset at the time it was given 337.22 away, sold, or disposed of, less the amount of compensation 337.23 received. No cause of action exists for a transfer unless: 337.24 (1) the transferee knew or should have known that the 337.25 transfer was being made by a person who was a resident of a 337.26 long-term care facility or was receiving that level of care in 337.27 the community at the time of the transfer; 337.28 (2) the transferee knew or should have known that the 337.29 transfer was being made to assist the person to qualify for or 337.30 retain medical assistance eligibility; or 337.31 (3) the transferee actively solicited the transfer with 337.32 intent to assist the person to qualify for or retain eligibility 337.33 for medical assistance. 337.34 (b) If a calculation of a penalty period results in a 337.35 partial month, payments for medical assistance services shall be 337.36 reduced in an amount equal to the fraction, except that in 338.1 calculating the value of uncompensated transfers, if the total 338.2 value of all uncompensated transfers made in a month not 338.3 included in an existing penalty period does not exceed $200, 338.4 then such transfers shall be disregarded for each month prior to 338.5 the month of application for or during receipt of medical 338.6 assistance. 338.7 (c) Ineligibility under this section shall apply to medical 338.8 assistance services or long-term care services, whichever 338.9 receives federal approval. 338.10 [EFFECTIVE DATE.] (a) This section is effective July 1, 338.11 2003, to the extent permitted by federal law. If any provision 338.12 of this section is prohibited by federal law, the provision 338.13 shall become effective when federal law is changed to permit its 338.14 application or a waiver is received. The commissioner of human 338.15 services shall notify the revisor of statutes when federal law 338.16 is enacted or a waiver or other federal approval is received and 338.17 publish a notice in the State Register. The commissioner must 338.18 include the notice in the first State Register published after 338.19 the effective date of the federal changes. 338.20 (b) If, by July 1, 2003, any provision of this section is 338.21 not effective because of prohibitions in federal law, the 338.22 commissioner of human services shall apply to the federal 338.23 government by August 1, 2003, for a waiver of those prohibitions 338.24 or other federal authority, and that provision shall become 338.25 effective upon receipt of a federal waiver or other federal 338.26 approval, notification to the revisor of statutes, and 338.27 publication of a notice in the State Register to that effect. 338.28 In applying for federal approval to extend the lookback period, 338.29 the commissioner shall seek the longest lookback period the 338.30 federal government will approve, not to exceed 72 months. 338.31 Sec. 5. Minnesota Statutes 2002, section 256B.0595, is 338.32 amended by adding a subdivision to read: 338.33 Subd. 3b. [HOMESTEAD EXCEPTION TO TRANSFER 338.34 PROHIBITION.] (a) This subdivision applies to transfers 338.35 involving recipients of medical assistance that are made on or 338.36 after July 1, 2003, and to all transfers involving persons who 339.1 apply for medical assistance on or after July 1, 2003, 339.2 regardless of when the transfer occurred, except that this 339.3 subdivision does not apply to transfers made prior to July 1, 339.4 2003. A person is not ineligible for medical assistance 339.5 services due to a transfer of assets for less than fair market 339.6 value as described in subdivision 1b, if the asset transferred 339.7 was a homestead, and: 339.8 (1) a satisfactory showing is made that the individual 339.9 intended to dispose of the homestead at fair market value or for 339.10 other valuable consideration; or 339.11 (2) the local agency grants a waiver of a penalty resulting 339.12 from a transfer for less than fair market value because denial 339.13 of eligibility would cause undue hardship for the individual and 339.14 there exists an imminent threat to the individual's health and 339.15 well-being. Whenever an applicant or recipient is denied 339.16 eligibility because of a transfer for less than fair market 339.17 value, the local agency shall notify the applicant or recipient 339.18 that the applicant or recipient may request a waiver of the 339.19 penalty if the denial of eligibility will cause undue hardship. 339.20 In evaluating a waiver, the local agency shall take into account 339.21 whether the individual was the victim of financial exploitation, 339.22 whether the individual has made reasonable efforts to recover 339.23 the transferred property or resource, and other factors relevant 339.24 to a determination of hardship. If the local agency does not 339.25 approve a hardship waiver, the local agency shall issue a 339.26 written notice to the individual stating the reasons for the 339.27 denial and the process for appealing the local agency's decision. 339.28 (b) When a waiver is granted under paragraph (a), clause 339.29 (2), a cause of action exists against the person to whom the 339.30 homestead was transferred for that portion of medical assistance 339.31 services granted within 72 months of the date the transferor 339.32 applied for medical assistance and satisfied all other 339.33 requirements for eligibility or the amount of the uncompensated 339.34 transfer, whichever is less, together with the costs incurred 339.35 due to the action. The action shall be brought by the state 339.36 unless the state delegates this responsibility to the local 340.1 agency responsible for providing medical assistance under 340.2 chapter 256B. 340.3 [EFFECTIVE DATE.] (a) This section is effective July 1, 340.4 2003, to the extent permitted by federal law. If any provision 340.5 of this section is prohibited by federal law, the provision 340.6 shall become effective when federal law is changed to permit its 340.7 application or a waiver is received. The commissioner of human 340.8 services shall notify the revisor of statutes when federal law 340.9 is enacted or a waiver or other federal approval is received and 340.10 publish a notice in the State Register. The commissioner must 340.11 include the notice in the first State Register published after 340.12 the effective date of the federal changes. 340.13 (b) If, by July 1, 2003, any provision of this section is 340.14 not effective because of prohibitions in federal law, the 340.15 commissioner of human services shall apply to the federal 340.16 government by August 1, 2003, for a waiver of those prohibitions 340.17 or other federal authority, and that provision shall become 340.18 effective upon receipt of a federal waiver or other federal 340.19 approval, notification to the revisor of statutes, and 340.20 publication of a notice in the State Register to that effect. 340.21 In applying for federal approval to extend the lookback period, 340.22 the commissioner shall seek the longest lookback period the 340.23 federal government will approve, not to exceed 72 months. 340.24 Sec. 6. Minnesota Statutes 2002, section 256B.0595, is 340.25 amended by adding a subdivision to read: 340.26 Subd. 4b. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] This 340.27 subdivision applies to transfers involving recipients of medical 340.28 assistance that are made on or after July 1, 2003, and to all 340.29 transfers involving persons who apply for medical assistance on 340.30 or after July 1, 2003, regardless of when the transfer occurred, 340.31 except that this subdivision does not apply to transfers made 340.32 prior to July 1, 2003. A person or a person's spouse who made a 340.33 transfer prohibited by subdivision 1b is not ineligible for 340.34 medical assistance services if one of the following conditions 340.35 applies: 340.36 (1) the assets or income were transferred to the 341.1 individual's spouse or to another for the sole benefit of the 341.2 spouse, except that after eligibility is established and the 341.3 assets have been divided between the spouses as part of the 341.4 asset allowance under section 256B.059, no further transfers 341.5 between spouses may be made; 341.6 (2) the institutionalized spouse, prior to being 341.7 institutionalized, transferred assets or income to a spouse, 341.8 provided that the spouse to whom the assets or income were 341.9 transferred does not then transfer those assets or income to 341.10 another person for less than fair market value. At the time 341.11 when one spouse is institutionalized, assets must be allocated 341.12 between the spouses as provided under section 256B.059; 341.13 (3) the assets or income were transferred to a trust for 341.14 the sole benefit of the individual's child who is blind or 341.15 permanently and totally disabled as determined in the 341.16 supplemental security income program and the trust reverts to 341.17 the state upon the disabled child's death to the extent the 341.18 medical assistance has paid for services for the grantor or 341.19 beneficiary of the trust. This clause applies to a trust 341.20 established after the commissioner publishes a notice in the 341.21 State Register that the commissioner has been authorized to 341.22 implement this clause due to a change in federal law or the 341.23 approval of a federal waiver; 341.24 (4) a satisfactory showing is made that the individual 341.25 intended to dispose of the assets or income either at fair 341.26 market value or for other valuable consideration; or 341.27 (5) the local agency determines that denial of eligibility 341.28 for medical assistance services would cause undue hardship and 341.29 grants a waiver of a penalty resulting from a transfer for less 341.30 than fair market value because there exists an imminent threat 341.31 to the individual's health and well-being. Whenever an 341.32 applicant or recipient is denied eligibility because of a 341.33 transfer for less than fair market value, the local agency shall 341.34 notify the applicant or recipient that the applicant or 341.35 recipient may request a waiver of the penalty if the denial of 341.36 eligibility will cause undue hardship. In evaluating a waiver, 342.1 the local agency shall take into account whether the individual 342.2 was the victim of financial exploitation, whether the individual 342.3 has made reasonable efforts to recover the transferred property 342.4 or resource, and other factors relevant to a determination of 342.5 hardship. If the local agency does not approve a hardship 342.6 waiver, the local agency shall issue a written notice to the 342.7 individual stating the reasons for the denial and the process 342.8 for appealing the local agency's decision. When a waiver is 342.9 granted, a cause of action exists against the person to whom the 342.10 assets were transferred for that portion of medical assistance 342.11 services granted within 72 months of the date the transferor 342.12 applied for medical assistance and satisfied all other 342.13 requirements for eligibility, or the amount of the uncompensated 342.14 transfer, whichever is less, together with the costs incurred 342.15 due to the action. The action shall be brought by the state 342.16 unless the state delegates this responsibility to the local 342.17 agency responsible for providing medical assistance under this 342.18 chapter. 342.19 [EFFECTIVE DATE.] (a) This section is effective July 1, 342.20 2003, to the extent permitted by federal law. If any provision 342.21 of this section is prohibited by federal law, the provision 342.22 shall become effective when federal law is changed to permit its 342.23 application or a waiver is received. The commissioner of human 342.24 services shall notify the revisor of statutes when federal law 342.25 is enacted or a waiver or other federal approval is received and 342.26 publish a notice in the State Register. The commissioner must 342.27 include the notice in the first State Register published after 342.28 the effective date of the federal changes. 342.29 (b) If, by July 1, 2003, any provision of this section is 342.30 not effective because of prohibitions in federal law, the 342.31 commissioner of human services shall apply to the federal 342.32 government by August 1, 2003, for a waiver of those prohibitions 342.33 or other federal authority, and that provision shall become 342.34 effective upon receipt of a federal waiver or other federal 342.35 approval, notification to the revisor of statutes, and 342.36 publication of a notice in the State Register to that effect. 343.1 In applying for federal approval to extend the lookback period, 343.2 the commissioner shall seek the longest lookback period the 343.3 federal government will approve, not to exceed 72 months. 343.4 Sec. 7. Minnesota Statutes 2002, section 256B.15, 343.5 subdivision 1, is amended to read: 343.6 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 343.7 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 343.8 that individuals or couples, either or both of whom participate 343.9 in the medical assistance program, use their own assets to pay 343.10 their share of the total cost of their care during or after 343.11 their enrollment in the program according to applicable federal 343.12 law and the laws of this state. The following provisions apply: 343.13 (1) subdivisions 1c to 1k shall not apply to claims arising 343.14 under this section which are presented under section 525.313; 343.15 (2) the provisions of subdivisions 1c to 1k expanding the 343.16 interests included in an estate for purposes of recovery under 343.17 this section give effect to the provisions of United States 343.18 Code, title 42, section 1396p, governing recoveries, but do not 343.19 give rise to any express or implied liens in favor of any other 343.20 parties not named in these provisions; 343.21 (3) the continuation of a recipient's life estate or joint 343.22 tenancy interest in real property after the recipient's death 343.23 for the purpose of recovering medical assistance under this 343.24 section modifies common law principles holding that these 343.25 interests terminate on the death of the holder; 343.26 (4) all laws, rules, and regulations governing or involved 343.27 with a recovery of medical assistance shall be liberally 343.28 construed to accomplish their intended purposes; and 343.29 (5) a deceased recipient's life estate and joint tenancy 343.30 interests continued under this section shall be owned by the 343.31 remaindermen or surviving joint tenants as their interests may 343.32 appear on the date of the recipient's death. They shall not be 343.33 merged into the remainder interest or the interests of the 343.34 surviving joint tenants by reason of ownership. They shall be 343.35 subject to the provisions of this section. Any conveyance, 343.36 transfer, sale, assignment, or encumbrance by a remainderman, a 344.1 surviving joint tenant, or their heirs, successors, and assigns 344.2 shall be deemed to include all of their interest in the deceased 344.3 recipient's life estate or joint tenancy interest continued 344.4 under this section. 344.5 (b) For purposes of this section, "medical assistance" 344.6 includes the medical assistance program under this chapterand, 344.7 the general assistance medical care program under chapter 256D, 344.8but does not includeand the alternative care program for 344.9 nonmedical assistance recipients under section 256B.0913,344.10subdivision 4. 344.11 [EFFECTIVE DATE.] Paragraph (a) of this section is 344.12 effective August 1, 2003, and applies to estates of decedents 344.13 who die on or after that date. The amendments to paragraph (b) 344.14 are effective July 1, 2003, and apply to estates of decedents 344.15 who die on or after that date. 344.16 Sec. 8. Minnesota Statutes 2002, section 256B.15, 344.17 subdivision 1a, is amended to read: 344.18 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 344.19 receives any medical assistance hereunder, on the person's 344.20 death, if single, or on the death of the survivor of a married 344.21 couple, either or both of whom received medical assistance, or 344.22 as otherwise provided for in this section, the total amount paid 344.23 for medical assistance rendered for the person and spouse shall 344.24 be filed as a claim against the estate of the person or the 344.25 estate of the surviving spouse in the court having jurisdiction 344.26 to probate the estate or to issue a decree of descent according 344.27 to sections 525.31 to 525.313. 344.28 A claim shall be filed if medical assistance was rendered 344.29 for either or both persons under one of the following 344.30 circumstances: 344.31 (a) the person was over 55 years of age, and received 344.32 services under this chapter, excluding alternative care; 344.33 (b) the person resided in a medical institution for six 344.34 months or longer, received services under this chapterexcluding344.35alternative care, and, at the time of institutionalization or 344.36 application for medical assistance, whichever is later, the 345.1 person could not have reasonably been expected to be discharged 345.2 and returned home, as certified in writing by the person's 345.3 treating physician. For purposes of this section only, a 345.4 "medical institution" means a skilled nursing facility, 345.5 intermediate care facility, intermediate care facility for 345.6 persons with mental retardation, nursing facility, or inpatient 345.7 hospital; or 345.8 (c) the person received general assistance medical care 345.9 services under chapter 256D. 345.10 The claim shall be considered an expense of the last 345.11 illness of the decedent for the purpose of section 524.3-805. 345.12 Any statute of limitations that purports to limit any county 345.13 agency or the state agency, or both, to recover for medical 345.14 assistance granted hereunder shall not apply to any claim made 345.15 hereunder for reimbursement for any medical assistance granted 345.16 hereunder. Notice of the claim shall be given to all heirs and 345.17 devisees of the decedent whose identity can be ascertained with 345.18 reasonable diligence. The notice must include procedures and 345.19 instructions for making an application for a hardship waiver 345.20 under subdivision 5; time frames for submitting an application 345.21 and determination; and information regarding appeal rights and 345.22 procedures. Counties are entitled to one-half of the nonfederal 345.23 share of medical assistance collections from estates that are 345.24 directly attributable to county effort. Counties are entitled 345.25 to ten percent of the collections for alternative care directly 345.26 attributable to county effort. 345.27 [EFFECTIVE DATE.] The amendments in this section relating 345.28 to the alternative care program are effective July 1, 2003, and 345.29 apply to the estates of decedents who die on or after that 345.30 date. The remaining amendments in this section are effective 345.31 August 1, 2003, and apply to the estates of decedents who die on 345.32 and after that date. 345.33 Sec. 9. Minnesota Statutes 2002, section 256B.15, is 345.34 amended by adding a subdivision to read: 345.35 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 345.36 with a claim or potential claim under this section may file a 346.1 notice of potential claim under this subdivision anytime before 346.2 or within one year after a medical assistance recipient dies. 346.3 The claimant shall be the state agency. A notice filed prior to 346.4 the recipient's death shall not take effect and shall not be 346.5 effective as notice until the recipient dies. A notice filed 346.6 after a recipient dies shall be effective from the time of 346.7 filing. 346.8 (b) The notice of claim shall be filed or recorded in the 346.9 real estate records in the office of the county recorder or 346.10 registrar of titles for each county in which any part of the 346.11 property is located. The recorder shall accept the notice for 346.12 recording or filing. The registrar of titles shall accept the 346.13 notice for filing if the recipient has a recorded interest in 346.14 the property. The registrar of titles shall not carry forward 346.15 to a new certificate of title any notice filed more than one 346.16 year from the date of the recipient's death. 346.17 (c) The notice must be dated, state the name of the 346.18 claimant, the medical assistance recipient's name and social 346.19 security number if filed before their death and their date of 346.20 death if filed after they die, the name and date of death of any 346.21 predeceased spouse of the medical assistance recipient for whom 346.22 a claim may exist, a statement that the claimant may have a 346.23 claim arising under this section, generally identify the 346.24 recipient's interest in the property, contain a legal 346.25 description for the property and whether it is abstract or 346.26 registered property, a statement of when the notice becomes 346.27 effective and the effect of the notice, be signed by an 346.28 authorized representative of the state agency, and may include 346.29 such other contents as the state agency may deem appropriate. 346.30 [EFFECTIVE DATE.] This section is effective August 1, 2003, 346.31 and applies to the estates of decedents who die on or after that 346.32 date. 346.33 Sec. 10. Minnesota Statutes 2002, section 256B.15, is 346.34 amended by adding a subdivision to read: 346.35 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 346.36 effect, the notice shall be notice to remaindermen, joint 347.1 tenants, or to anyone else owning or acquiring an interest in or 347.2 encumbrance against the property described in the notice that 347.3 the medical assistance recipient's life estate, joint tenancy, 347.4 or other interests in the real estate described in the notice: 347.5 (1) shall, in the case of life estate and joint tenancy 347.6 interests, continue to exist for purposes of this section, and 347.7 be subject to liens and claims as provided in this section; 347.8 (2) shall be subject to a lien in favor of the claimant 347.9 effective upon the death of the recipient and dealt with as 347.10 provided in this section; 347.11 (3) may be included in the recipient's estate, as defined 347.12 in this section; and 347.13 (4) may be subject to administration and all other 347.14 provisions of chapter 524 and may be sold, assigned, 347.15 transferred, or encumbered free and clear of their interest or 347.16 encumbrance to satisfy claims under this section. 347.17 [EFFECTIVE DATE.] This section is effective August 1, 2003, 347.18 and applies to the estates of decedents who die on or after that 347.19 date. 347.20 Sec. 11. Minnesota Statutes 2002, section 256B.15, is 347.21 amended by adding a subdivision to read: 347.22 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 347.23 claimant may fully or partially release the notice and the lien 347.24 arising out of the notice of record in the real estate records 347.25 where the notice is filed or recorded at any time. The claimant 347.26 may give a full or partial release to extinguish any life 347.27 estates or joint tenancy interests which are or may be continued 347.28 under this section or whose existence or nonexistence may create 347.29 a cloud on the title to real property at any time whether or not 347.30 a notice has been filed. The recorder or registrar of titles 347.31 shall accept the release for recording or filing. If the 347.32 release is a partial release, it must include a legal 347.33 description of the property being released. 347.34 (b) At any time, the claimant may, at the claimant's 347.35 discretion, wholly or partially release, subordinate, modify, or 347.36 amend the recorded notice and the lien arising out of the notice. 348.1 [EFFECTIVE DATE.] This section is effective August 1, 2003, 348.2 and applies to the estates of decedents who die on or after that 348.3 date. 348.4 Sec. 12. Minnesota Statutes 2002, section 256B.15, is 348.5 amended by adding a subdivision to read: 348.6 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 348.7 lien in favor of the department of human services against the 348.8 recipient's interests in the real estate it describes for a 348.9 period of 20 years from the date of filing or the date of the 348.10 recipient's death, whichever is later. Notwithstanding any law 348.11 or rule to the contrary, a recipient's life estate and joint 348.12 tenancy interests shall not end upon the recipient's death but 348.13 shall continue according to subdivisions 1h, 1i, and 1j. The 348.14 amount of the lien shall be equal to the total amount of the 348.15 claims that could be presented in the recipient's estate under 348.16 this section. 348.17 (b) If no estate has been opened for the deceased 348.18 recipient, any holder of an interest in the property may apply 348.19 to the lienholder for a statement of the amount of the lien or 348.20 for a full or partial release of the lien. The application 348.21 shall include the applicant's name, current mailing address, 348.22 current home and work telephone numbers, and a description of 348.23 their interest in the property, a legal description of the 348.24 recipient's interest in the property, and the deceased 348.25 recipient's name, date of birth, and social security number. 348.26 The lienholder shall send the applicant by certified mail, 348.27 return receipt requested, a written statement showing the amount 348.28 of the lien, whether the lienholder is willing to release the 348.29 lien and under what conditions, and inform them of the right to 348.30 a hearing under section 256.045. The lienholder shall have the 348.31 discretion to compromise and settle the lien upon any terms and 348.32 conditions the lienholder deems appropriate. 348.33 (c) Any holder of an interest in property subject to the 348.34 lien has a right to request a hearing under section 256.045 to 348.35 determine the validity, extent, or amount of the lien. The 348.36 request must be in writing, and must include the names, current 349.1 addresses, and home and business telephone numbers for all other 349.2 parties holding an interest in the property. A request for a 349.3 hearing by any holder of an interest in the property shall be 349.4 deemed to be a request for a hearing by all parties owning 349.5 interests in the property. Notice of the hearing shall be given 349.6 to the lienholder, the party filing the appeal, and all of the 349.7 other holders of interests in the property at the addresses 349.8 listed in the appeal by certified mail, return receipt 349.9 requested, or by ordinary mail. Any owner of an interest in the 349.10 property to whom notice of the hearing is mailed shall be deemed 349.11 to have waived any and all claims or defenses in respect to the 349.12 lien unless they appear and assert any claims or defenses at the 349.13 hearing. 349.14 (d) If the claim the lien secures could be filed under 349.15 subdivision 1h, the lienholder may collect, compromise, settle, 349.16 or release the lien upon any terms and conditions it deems 349.17 appropriate. If the claim the lien secures could be filed under 349.18 subdivision 1i or 1j, the lien may be adjusted or enforced to 349.19 the same extent had it been filed under subdivisions 1i and 1j, 349.20 and the provisions of subdivisions 1i, clause (f), and lj, 349.21 clause (d), shall apply to voluntary payment, settlement, or 349.22 satisfaction of the lien. 349.23 (e) If no probate proceedings have been commenced for the 349.24 recipient as of the date the lienholder executes a release of 349.25 the lien on a recipient's life estate or joint tenancy interest, 349.26 created for purposes of this section, the release shall 349.27 terminate the life estate or joint tenancy interest created 349.28 under this section as of the date it is recorded or filed to the 349.29 extent of the release. If the claimant executes a release for 349.30 purposes of extinguishing a life estate or a joint tenancy 349.31 interest created under this section to remove a cloud on title 349.32 to real property, the release shall have the effect of 349.33 extinguishing any life estate or joint tenancy interests in the 349.34 property it describes which may have been continued by reason of 349.35 this section retroactive to the date of death of the deceased 349.36 life tenant or joint tenant except as provided for in section 350.1 514.981, subdivision 6. 350.2 (f) If the deceased recipient's estate is probated, a claim 350.3 shall be filed under this section. The amount of the lien shall 350.4 be limited to the amount of the claim as finally allowed. If 350.5 the claim the lien secures is filed under subdivision 1h, the 350.6 lien may be released in full after any allowance of the claim 350.7 becomes final or according to any agreement to settle and 350.8 satisfy the claim. The release shall release the lien but shall 350.9 not extinguish or terminate the interest being released. If the 350.10 claim the lien secures is filed under subdivision 1i or 1j, the 350.11 lien shall be released after the lien under subdivision 1i or 1j 350.12 is filed or recorded, or settled according to any agreement to 350.13 settle and satisfy the claim. The release shall not extinguish 350.14 or terminate the interest being released. If the claim is 350.15 finally disallowed in full, the claimant shall release the 350.16 claimant's lien at the claimant's expense. 350.17 [EFFECTIVE DATE.] This section takes effect on August 1, 350.18 2003, and applies to the estates of decedents who die on or 350.19 after that date. 350.20 Sec. 13. Minnesota Statutes 2002, section 256B.15, is 350.21 amended by adding a subdivision to read: 350.22 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 350.23 rule to the contrary, if a claim is presented under this 350.24 section, interests or the proceeds of interests in real property 350.25 a decedent owned as a life tenant or a joint tenant with a right 350.26 of survivorship shall be part of the decedent's estate, subject 350.27 to administration, and shall be dealt with as provided in this 350.28 section. 350.29 [EFFECTIVE DATE.] This section takes effect on August 1, 350.30 2003, and applies to the estates of decedents who die on or 350.31 after that date. 350.32 Sec. 14. Minnesota Statutes 2002, section 256B.15, is 350.33 amended by adding a subdivision to read: 350.34 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 350.35 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 350.36 (k) apply if a person received medical assistance for which a 351.1 claim may be filed under this section and died single, or the 351.2 surviving spouse of the couple and was not survived by any of 351.3 the persons described in subdivisions 3 and 4. 351.4 (b) For purposes of this section, the person's estate 351.5 consists of: (1) their probate estate; (2) all of the person's 351.6 interests or proceeds of those interests in real property the 351.7 person owned as a life tenant or as a joint tenant with a right 351.8 of survivorship at the time of the person's death; (3) all of 351.9 the person's interests or proceeds of those interests in 351.10 securities the person owned in beneficiary form as provided 351.11 under sections 524.6-301 to 524.6-311 at the time of the 351.12 person's death, to the extent they become part of the probate 351.13 estate under section 524.6-307; and (4) all of the person's 351.14 interests in joint accounts, multiple party accounts, and pay on 351.15 death accounts, or the proceeds of those accounts, as provided 351.16 under sections 524.6-201 to 524.6-214 at the time of the 351.17 person's death to the extent they become part of the probate 351.18 estate under section 524.6-207. Notwithstanding any law or rule 351.19 to the contrary, a state or county agency with a claim under 351.20 this section shall be a creditor under section 524.6-307. 351.21 (c) Notwithstanding any law or rule to the contrary, the 351.22 person's life estate or joint tenancy interest in real property 351.23 not subject to a medical assistance lien under sections 514.980 351.24 to 514.985 on the date of the person's death shall not end upon 351.25 the person's death and shall continue as provided in this 351.26 subdivision. The life estate in the person's estate shall be 351.27 that portion of the interest in the real property subject to the 351.28 life estate that is equal to the life estate percentage factor 351.29 for the life estate as listed in the Life Estate Mortality Table 351.30 of the health care program's manual for a person who was the age 351.31 of the medical assistance recipient on the date of the person's 351.32 death. The joint tenancy interest in real property in the 351.33 estate shall be equal to the fractional interest the person 351.34 would have owned in the jointly held interest in the property 351.35 had they and the other owners held title to the property as 351.36 tenants in common on the date the person died. 352.1 (d) The court upon its own motion, or upon motion by the 352.2 personal representative or any interested party, may enter an 352.3 order directing the remaindermen or surviving joint tenants and 352.4 their spouses, if any, to sign all documents, take all actions, 352.5 and otherwise fully cooperate with the personal representative 352.6 and the court to liquidate the decedent's life estate or joint 352.7 tenancy interests in the estate and deliver the cash or the 352.8 proceeds of those interests to the personal representative and 352.9 provide for any legal and equitable sanctions as the court deems 352.10 appropriate to enforce and carry out the order, including an 352.11 award of reasonable attorney fees. 352.12 (e) The personal representative may make, execute, and 352.13 deliver any conveyances or other documents necessary to convey 352.14 the decedent's life estate or joint tenancy interest in the 352.15 estate that are necessary to liquidate and reduce to cash the 352.16 decedent's interest or for any other purposes. 352.17 (f) Subject to administration, all costs, including 352.18 reasonable attorney fees, directly and immediately related to 352.19 liquidating the decedent's life estate or joint tenancy interest 352.20 in the decedent's estate, shall be paid from the gross proceeds 352.21 of the liquidation allocable to the decedent's interest and the 352.22 net proceeds shall be turned over to the personal representative 352.23 and applied to payment of the claim presented under this section. 352.24 (g) The personal representative shall bring a motion in the 352.25 district court in which the estate is being probated to compel 352.26 the remaindermen or surviving joint tenants to account for and 352.27 deliver to the personal representative all or any part of the 352.28 proceeds of any sale, mortgage, transfer, conveyance, or any 352.29 disposition of real property allocable to the decedent's life 352.30 estate or joint tenancy interest in the decedent's estate, and 352.31 do everything necessary to liquidate and reduce to cash the 352.32 decedent's interest and turn the proceeds of the sale or other 352.33 disposition over to the personal representative. The court may 352.34 grant any legal or equitable relief including, but not limited 352.35 to, ordering a partition of real estate under chapter 558 352.36 necessary to make the value of the decedent's life estate or 353.1 joint tenancy interest available to the estate for payment of a 353.2 claim under this section. 353.3 (h) Subject to administration, the personal representative 353.4 shall use all of the cash or proceeds of interests to pay an 353.5 allowable claim under this section. The remaindermen or 353.6 surviving joint tenants and their spouses, if any, may enter 353.7 into a written agreement with the personal representative or the 353.8 claimant to settle and satisfy obligations imposed at any time 353.9 before or after a claim is filed. 353.10 (i) The personal representative may provide any or all of 353.11 the other owners, remaindermen, or surviving joint tenants with 353.12 an affidavit terminating the decedent's estate's interest in 353.13 real property the decedent owned as a life tenant or as a joint 353.14 tenant with others, if the personal representative determines 353.15 that neither the decedent nor any of the decedent's predeceased 353.16 spouses received any medical assistance for which a claim could 353.17 be filed under this section, or if the personal representative 353.18 has filed an affidavit with the court that the estate has other 353.19 assets sufficient to pay a claim, as presented, or if there is a 353.20 written agreement under paragraph (h), or if the claim, as 353.21 allowed, has been paid in full or to the full extent of the 353.22 assets the estate has available to pay it. The affidavit may be 353.23 recorded in the office of the county recorder or filed in the 353.24 office of the registrar of titles for the county in which the 353.25 real property is located. Except as provided in section 353.26 514.981, subdivision 6, when recorded or filed, the affidavit 353.27 shall terminate the decedent's interest in real estate the 353.28 decedent owned as a life tenant or a joint tenant with others. 353.29 The affidavit shall: (1) be signed by the personal 353.30 representative; (2) identify the decedent and the interest being 353.31 terminated; (3) give recording information sufficient to 353.32 identify the instrument that created the interest in real 353.33 property being terminated; (4) legally describe the affected 353.34 real property; (5) state that the personal representative has 353.35 determined that neither the decedent nor any of the decedent's 353.36 predeceased spouses received any medical assistance for which a 354.1 claim could be filed under this section; (6) state that the 354.2 decedent's estate has other assets sufficient to pay the claim, 354.3 as presented, or that there is a written agreement between the 354.4 personal representative and the claimant and the other owners or 354.5 remaindermen or other joint tenants to satisfy the obligations 354.6 imposed under this subdivision; and (7) state that the affidavit 354.7 is being given to terminate the estate's interest under this 354.8 subdivision, and any other contents as may be appropriate. 354.9 The recorder or registrar of titles shall accept the affidavit 354.10 for recording or filing. The affidavit shall be effective as 354.11 provided in this section and shall constitute notice even if it 354.12 does not include recording information sufficient to identify 354.13 the instrument creating the interest it terminates. The 354.14 affidavit shall be conclusive evidence of the stated facts. 354.15 (j) The holder of a lien arising under subdivision 1c shall 354.16 release the lien at the holder's expense against an interest 354.17 terminated under paragraph (h) to the extent of the termination. 354.18 (k) If a lien arising under subdivision 1c is not released 354.19 under paragraph (j), prior to closing the estate, the personal 354.20 representative shall deed the interest subject to the lien to 354.21 the remaindermen or surviving joint tenants as their interests 354.22 may appear. Upon recording or filing, the deed shall work a 354.23 merger of the recipient's life estate or joint tenancy interest, 354.24 subject to the lien, into the remainder interest or interest the 354.25 decedent and others owned jointly. The lien shall attach to and 354.26 run with the property to the extent of the decedent's interest 354.27 at the time of the decedent's death. 354.28 [EFFECTIVE DATE.] This section takes effect on August 1, 354.29 2003, and applies to the estates of decedents who die on or 354.30 after that date. 354.31 Sec. 15. Minnesota Statutes 2002, section 256B.15, is 354.32 amended by adding a subdivision to read: 354.33 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 354.34 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 354.35 the person's estate consists of the person's probate estate and 354.36 all of the person's interests in real property the person owned 355.1 as a life tenant or a joint tenant at the time of the person's 355.2 death. 355.3 (b) Notwithstanding any law or rule to the contrary, this 355.4 subdivision applies if a person received medical assistance for 355.5 which a claim could be filed under this section but for the fact 355.6 the person was survived by a spouse or by a person listed in 355.7 subdivision 3, or if subdivision 4 applies to a claim arising 355.8 under this section. 355.9 (c) The person's life estate or joint tenancy interests in 355.10 real property not subject to a medical assistance lien under 355.11 sections 514.980 to 514.985 on the date of the person's death 355.12 shall not end upon death and shall continue as provided in this 355.13 subdivision. The life estate in the estate shall be the portion 355.14 of the interest in the property subject to the life estate that 355.15 is equal to the life estate percentage factor for the life 355.16 estate as listed in the Life Estate Mortality Table of the 355.17 health care program's manual for a person who was the age of the 355.18 medical assistance recipient on the date of the person's death. 355.19 The joint tenancy interest in the estate shall be equal to the 355.20 fractional interest the medical assistance recipient would have 355.21 owned in the jointly held interest in the property had they and 355.22 the other owners held title to the property as tenants in common 355.23 on the date the medical assistance recipient died. 355.24 (d) The county agency shall file a claim in the estate 355.25 under this section on behalf of the claimant who shall be the 355.26 commissioner of human services, notwithstanding that the 355.27 decedent is survived by a spouse or a person listed in 355.28 subdivision 3. The claim, as allowed, shall not be paid by the 355.29 estate and shall be disposed of as provided in this paragraph. 355.30 The personal representative or the court shall make, execute, 355.31 and deliver a lien in favor of the claimant on the decedent's 355.32 interest in real property in the estate in the amount of the 355.33 allowed claim on forms provided by the commissioner to the 355.34 county agency filing the lien. The lien shall bear interest as 355.35 provided under section 524.3-806, shall attach to the property 355.36 it describes upon filing or recording, and shall remain a lien 356.1 on the real property it describes for a period of 20 years from 356.2 the date it is filed or recorded. The lien shall be a 356.3 disposition of the claim sufficient to permit the estate to 356.4 close. 356.5 (e) The state or county agency shall file or record the 356.6 lien in the office of the county recorder or registrar of titles 356.7 for each county in which any of the real property is located. 356.8 The recorder or registrar of titles shall accept the lien for 356.9 filing or recording. All recording or filing fees shall be paid 356.10 by the department of human services. The recorder or registrar 356.11 of titles shall mail the recorded lien to the department of 356.12 human services. The lien need not be attested, certified, or 356.13 acknowledged as a condition of recording or filing. Upon 356.14 recording or filing of a lien against a life estate or a joint 356.15 tenancy interest, the interest subject to the lien shall merge 356.16 into the remainder interest or the interest the recipient and 356.17 others owned jointly. The lien shall attach to and run with the 356.18 property to the extent of the decedent's interest in the 356.19 property at the time of the decedent's death as determined under 356.20 this section. 356.21 (f) The department shall make no adjustment or recovery 356.22 under the lien until after the decedent's spouse, if any, has 356.23 died, and only at a time when the decedent has no surviving 356.24 child described in subdivision 3. The estate, any owner of an 356.25 interest in the property which is or may be subject to the lien, 356.26 or any other interested party, may voluntarily pay off, settle, 356.27 or otherwise satisfy the claim secured or to be secured by the 356.28 lien at any time before or after the lien is filed or recorded. 356.29 Such payoffs, settlements, and satisfactions shall be deemed to 356.30 be voluntary repayments of past medical assistance payments for 356.31 the benefit of the deceased recipient, and neither the process 356.32 of settling the claim, the payment of the claim, or the 356.33 acceptance of a payment shall constitute an adjustment or 356.34 recovery that is prohibited under this subdivision. 356.35 (g) The lien under this subdivision may be enforced or 356.36 foreclosed in the manner provided by law for the enforcement of 357.1 judgment liens against real estate or by a foreclosure by action 357.2 under chapter 581. When the lien is paid, satisfied, or 357.3 otherwise discharged, the state or county agency shall prepare 357.4 and file a release of lien at its own expense. No action to 357.5 foreclose the lien shall be commenced unless the lienholder has 357.6 first given 30 days' prior written notice to pay the lien to the 357.7 owners and parties in possession of the property subject to the 357.8 lien. The notice shall: (1) include the name, address, and 357.9 telephone number of the lienholder; (2) describe the lien; (3) 357.10 give the amount of the lien; (4) inform the owner or party in 357.11 possession that payment of the lien in full must be made to the 357.12 lienholder within 30 days after service of the notice or the 357.13 lienholder may begin proceedings to foreclose the lien; and (5) 357.14 be served by personal service, certified mail, return receipt 357.15 requested, ordinary first class mail, or by publishing it once 357.16 in a newspaper of general circulation in the county in which any 357.17 part of the property is located. Service of the notice shall be 357.18 complete upon mailing or publication. 357.19 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 357.20 and applies to estates of decedents who die on and after that 357.21 date. 357.22 Sec. 16. Minnesota Statutes 2002, section 256B.15, is 357.23 amended by adding a subdivision to read: 357.24 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 357.25 OTHER SURVIVORS.] For purposes of this subdivision, the 357.26 provisions in subdivision 1i, paragraphs (a) to (c) apply. 357.27 (a) If payment of a claim filed under this section is 357.28 limited as provided in subdivision 4, and if the estate does not 357.29 have other assets sufficient to pay the claim in full, as 357.30 allowed, the personal representative or the court shall make, 357.31 execute, and deliver a lien on the property in the estate that 357.32 is exempt from the claim under subdivision 4 in favor of the 357.33 commissioner of human services on forms provided by the 357.34 commissioner to the county agency filing the claim. If the 357.35 estate pays a claim filed under this section in full from other 357.36 assets of the estate, no lien shall be filed against the 358.1 property described in subdivision 4. 358.2 (b) The lien shall be in an amount equal to the unpaid 358.3 balance of the allowed claim under this section remaining after 358.4 the estate has applied all other available assets of the estate 358.5 to pay the claim. The property exempt under subdivision 4 shall 358.6 not be sold, assigned, transferred, conveyed, encumbered, or 358.7 distributed until after the personal representative has 358.8 determined the estate has other assets sufficient to pay the 358.9 allowed claim in full, or until after the lien has been filed or 358.10 recorded. The lien shall bear interest as provided under 358.11 section 524.3-806, shall attach to the property it describes 358.12 upon filing or recording, and shall remain a lien on the real 358.13 property it describes for a period of 20 years from the date it 358.14 is filed or recorded. The lien shall be a disposition of the 358.15 claim sufficient to permit the estate to close. 358.16 (c) The state or county agency shall file or record the 358.17 lien in the office of the county recorder or registrar of titles 358.18 in each county in which any of the real property is located. 358.19 The department shall pay the filing fees. The lien need not be 358.20 attested, certified, or acknowledged as a condition of recording 358.21 or filing. The recorder or registrar of titles shall accept the 358.22 lien for filing or recording. 358.23 (d) The commissioner shall make no adjustment or recovery 358.24 under the lien until none of the persons listed in subdivision 4 358.25 are residing on the property or until the property is sold or 358.26 transferred. The estate or any owner of an interest in the 358.27 property that is or may be subject to the lien, or any other 358.28 interested party, may voluntarily pay off, settle, or otherwise 358.29 satisfy the claim secured or to be secured by the lien at any 358.30 time before or after the lien is filed or recorded. The 358.31 payoffs, settlements, and satisfactions shall be deemed to be 358.32 voluntary repayments of past medical assistance payments for the 358.33 benefit of the deceased recipient and neither the process of 358.34 settling the claim, the payment of the claim, or acceptance of a 358.35 payment shall constitute an adjustment or recovery that is 358.36 prohibited under this subdivision. 359.1 (e) A lien under this subdivision may be enforced or 359.2 foreclosed in the manner provided for by law for the enforcement 359.3 of judgment liens against real estate or by a foreclosure by 359.4 action under chapter 581. When the lien has been paid, 359.5 satisfied, or otherwise discharged, the claimant shall prepare 359.6 and file a release of lien at the claimant's expense. No action 359.7 to foreclose the lien shall be commenced unless the lienholder 359.8 has first given 30 days prior written notice to pay the lien to 359.9 the record owners of the property and the parties in possession 359.10 of the property subject to the lien. The notice shall: (1) 359.11 include the name, address, and telephone number of the 359.12 lienholder; (2) describe the lien; (3) give the amount of the 359.13 lien; (4) inform the owner or party in possession that payment 359.14 of the lien in full must be made to the lienholder within 30 359.15 days after service of the notice or the lienholder may begin 359.16 proceedings to foreclose the lien; and (5) be served by personal 359.17 service, certified mail, return receipt requested, ordinary 359.18 first class mail, or by publishing it once in a newspaper of 359.19 general circulation in the county in which any part of the 359.20 property is located. Service shall be complete upon mailing or 359.21 publication. 359.22 (f) Upon filing or recording of a lien against a life 359.23 estate or joint tenancy interest under this subdivision, the 359.24 interest subject to the lien shall merge into the remainder 359.25 interest or the interest the decedent and others owned jointly, 359.26 effective on the date of recording and filing. The lien shall 359.27 attach to and run with the property to the extent of the 359.28 decedent's interest in the property at the time of the 359.29 decedent's death as determined under this section. 359.30 (g)(1) An affidavit may be provided by a personal 359.31 representative stating the personal representative has 359.32 determined in good faith that a decedent survived by a spouse or 359.33 a person listed in subdivision 3, or by a person listed in 359.34 subdivision 4, or the decedent's predeceased spouse did not 359.35 receive any medical assistance giving rise to a claim under this 359.36 section, or that the real property described in subdivision 4 is 360.1 not needed to pay in full a claim arising under this section. 360.2 (2) The affidavit shall: (i) describe the property and the 360.3 interest being extinguished; (ii) name the decedent and give the 360.4 date of death; (iii) state the facts listed in clause (1); (iv) 360.5 state that the affidavit is being filed to terminate the life 360.6 estate or joint tenancy interest created under this subdivision; 360.7 (v) be signed by the personal representative; and (vi) contain 360.8 any other information that the affiant deems appropriate. 360.9 (3) Except as provided in section 514.981, subdivision 6, 360.10 when the affidavit is filed or recorded, the life estate or 360.11 joint tenancy interest in real property that the affidavit 360.12 describes shall be terminated effective as of the date of filing 360.13 or recording. The termination shall be final and may not be set 360.14 aside for any reason. 360.15 [EFFECTIVE DATE.] This section takes effect on August 1, 360.16 2003, and applies to the estates of decedents who die on or 360.17 after that date. 360.18 Sec. 17. Minnesota Statutes 2002, section 256B.15, is 360.19 amended by adding a subdivision to read: 360.20 Subd. 1k. [FILING.] Any notice, lien, release, or other 360.21 document filed under subdivisions 1c to 1l, and any lien, 360.22 release of lien, or other documents relating to a lien filed 360.23 under subdivisions 1h, 1i, and 1j must be filed or recorded in 360.24 the office of the county recorder or registrar of titles, as 360.25 appropriate, in the county where the affected real property is 360.26 located. Notwithstanding section 386.77, the state or county 360.27 agency shall pay any applicable filing fee. An attestation, 360.28 certification, or acknowledgment is not required as a condition 360.29 of filing. If the property described in the filing is 360.30 registered property, the registrar of titles shall record the 360.31 filing on the certificate of title for each parcel of property 360.32 described in the filing. If the property described in the 360.33 filing is abstract property, the recorder shall file and index 360.34 the property in the county's grantor-grantee indexes and any 360.35 tract indexes the county maintains for each parcel of property 360.36 described in the filing. The recorder or registrar of titles 361.1 shall return the filed document to the party filing it at no 361.2 cost. If the party making the filing provides a duplicate copy 361.3 of the filing, the recorder or registrar of titles shall show 361.4 the recording or filing data on the copy and return it to the 361.5 party at no extra cost. 361.6 [EFFECTIVE DATE.] This section takes effect on August 1, 361.7 2003, and applies to the estates of decedents who die on or 361.8 after that date. 361.9 Sec. 18. Minnesota Statutes 2002, section 256B.15, 361.10 subdivision 2, is amended to read: 361.11 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 361.12 only the total amount of medical assistance rendered after age 361.13 55 or during a period of institutionalization described in 361.14 subdivision 1a, clause (b), and the total amount of general 361.15 assistance medical care rendered, and shall not include 361.16 interest. Claims that have been allowed but not paid shall bear 361.17 interest according to section 524.3-806, paragraph (d). A claim 361.18 against the estate of a surviving spouse who did not receive 361.19 medical assistance, for medical assistance rendered for the 361.20 predeceased spouse, is limited to the value of the assets of the 361.21 estate that were marital property or jointly owned property at 361.22 any time during the marriage. Claims for alternative care shall 361.23 be net of all premiums paid under section 256B.0913, subdivision 361.24 12, on or after July 1, 2003, and shall be limited to services 361.25 provided on or after July 1, 2003. 361.26 [EFFECTIVE DATE.] This section is effective July 1, 2003, 361.27 for decedents dying on or after that date. 361.28 Sec. 19. Minnesota Statutes 2002, section 256B.15, 361.29 subdivision 3, is amended to read: 361.30 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 361.31 CHILDREN.] If a decedentwhois survived by a spouse, or was 361.32 single,orwho wasthe surviving spouse of a married couple,and 361.33 is survived by a child who is under age 21 or blind or 361.34 permanently and totally disabled according to the supplemental 361.35 security income program criteria,noa claim shall be filed 361.36 against the estate according to this section. 362.1 [EFFECTIVE DATE.] This section is effective August 1, 2003, 362.2 and applies to decedents who die on or after that date. 362.3 Sec. 20. Minnesota Statutes 2002, section 256B.15, 362.4 subdivision 4, is amended to read: 362.5 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 362.6 or the surviving spouse of a married couple is survived by one 362.7 of the following persons, a claim exists against the estate in 362.8 an amount not to exceed the value of the nonhomestead property 362.9 included in the estate and the personal representative shall 362.10 make, execute, and deliver to the county agency a lien against 362.11 the homestead property in the estate for any unpaid balance of 362.12 the claim to the claimant as provided under this section: 362.13 (a) a sibling who resided in the decedent medical 362.14 assistance recipient's home at least one year before the 362.15 decedent's institutionalization and continuously since the date 362.16 of institutionalization; or 362.17 (b) a son or daughter or a grandchild who resided in the 362.18 decedent medical assistance recipient's home for at least two 362.19 years immediately before the parent's or grandparent's 362.20 institutionalization and continuously since the date of 362.21 institutionalization, and who establishes by a preponderance of 362.22 the evidence having provided care to the parent or grandparent 362.23 who received medical assistance, that the care was provided 362.24 before institutionalization, and that the care permitted the 362.25 parent or grandparent to reside at home rather than in an 362.26 institution. 362.27 [EFFECTIVE DATE.] This section is effective August 1, 2003, 362.28 and applies to decedents who die on or after that date. 362.29 Sec. 21. Minnesota Statutes 2002, section 514.981, 362.30 subdivision 6, is amended to read: 362.31 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 362.32 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 362.33 the real property it describes for a period of ten years from 362.34 the date it attaches according to section 514.981, subdivision 362.35 2, paragraph (a), except as otherwise provided for in sections 362.36 514.980 to 514.985. The agency may renew a medical assistance 363.1 lien for an additional ten years from the date it would 363.2 otherwise expire by recording or filing a certificate of renewal 363.3 before the lien expires. The certificate shall be recorded or 363.4 filed in the office of the county recorder or registrar of 363.5 titles for the county in which the lien is recorded or filed. 363.6 The certificate must refer to the recording or filing data for 363.7 the medical assistance lien it renews. The certificate need not 363.8 be attested, certified, or acknowledged as a condition for 363.9 recording or filing. The registrar of titles or the recorder 363.10 shall file, record, index, and return the certificate of renewal 363.11 in the same manner as provided for medical assistance liens in 363.12 section 514.982, subdivision 2. 363.13 (b) A medical assistance lien is not enforceable against 363.14 the real property of an estate to the extent there is a 363.15 determination by a court of competent jurisdiction, or by an 363.16 officer of the court designated for that purpose, that there are 363.17 insufficient assets in the estate to satisfy the agency's 363.18 medical assistance lien in whole or in part because of the 363.19 homestead exemption under section 256B.15, subdivision 4, the 363.20 rights of the surviving spouse or minor children under section 363.21 524.2-403, paragraphs (a) and (b), or claims with a priority 363.22 under section 524.3-805, paragraph (a), clauses (1) to (4). For 363.23 purposes of this section, the rights of the decedent's adult 363.24 children to exempt property under section 524.2-403, paragraph 363.25 (b), shall not be considered costs of administration under 363.26 section 524.3-805, paragraph (a), clause (1). 363.27 (c) Notwithstanding any law or rule to the contrary, the 363.28 provisions in clauses (1) to (7) apply if a life estate subject 363.29 to a medical assistance lien ends according to its terms, or if 363.30 a medical assistance recipient who owns a life estate or any 363.31 interest in real property as a joint tenant that is subject to a 363.32 medical assistance lien dies. 363.33 (1) The medical assistance recipient's life estate or joint 363.34 tenancy interest in the real property shall not end upon the 363.35 recipient's death but shall merge into the remainder interest or 363.36 other interest in real property the medical assistance recipient 364.1 owned in joint tenancy with others. The medical assistance lien 364.2 shall attach to and run with the remainder or other interest in 364.3 the real property to the extent of the medical assistance 364.4 recipient's interest in the property at the time of the 364.5 recipient's death as determined under this section. 364.6 (2) If the medical assistance recipient's interest was a 364.7 life estate in real property, the lien shall be a lien against 364.8 the portion of the remainder equal to the percentage factor for 364.9 the life estate of a person the medical assistance recipient's 364.10 age on the date the life estate ended according to its terms or 364.11 the date of the medical assistance recipient's death as listed 364.12 in the Life Estate Mortality Table in the health care program's 364.13 manual. 364.14 (3) If the medical assistance recipient owned the interest 364.15 in real property in joint tenancy with others, the lien shall be 364.16 a lien against the portion of that interest equal to the 364.17 fractional interest the medical assistance recipient would have 364.18 owned in the jointly owned interest had the medical assistance 364.19 recipient and the other owners held title to that interest as 364.20 tenants in common on the date the medical assistance recipient 364.21 died. 364.22 (4) The medical assistance lien shall remain a lien against 364.23 the remainder or other jointly owned interest for the length of 364.24 time and be renewable as provided in paragraph (a). 364.25 (5) Subdivision 5, paragraphs (a), clause (4), (b), clauses 364.26 (1) and (2); and subdivision 6, paragraph (b), do not apply to 364.27 medical assistance liens which attach to interests in real 364.28 property as provided under this subdivision. 364.29 (6) The continuation of a medical assistance recipient's 364.30 life estate or joint tenancy interest in real property after the 364.31 medical assistance recipient's death for the purpose of 364.32 recovering medical assistance provided for in sections 514.980 364.33 to 514.985 modifies common law principles holding that these 364.34 interests terminate on the death of the holder. 364.35 (7) Notwithstanding any law or rule to the contrary, no 364.36 release, satisfaction, discharge, or affidavit under section 365.1 256B.15 shall extinguish or terminate the life estate or joint 365.2 tenancy interest of a medical assistance recipient subject to a 365.3 lien under sections 514.980 to 514.985 on the date the recipient 365.4 dies. 365.5 [EFFECTIVE DATE.] This section is effective August 1, 2003, 365.6 and applies to all medical assistance liens recorded or filed on 365.7 or after that date. 365.8 Sec. 22. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 365.9 Subdivision 1. [APPLICABILITY.] The definitions in this 365.10 section apply to sections 514.991 to 514.995. 365.11 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 365.12 DEPARTMENT.] "Alternative care agency," "agency," or "department" 365.13 means the department of human services when it pays for or 365.14 provides alternative care benefits for a nonmedical assistance 365.15 recipient directly or through a county social services agency 365.16 under chapter 256B according to section 256B.0913. 365.17 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 365.18 BENEFITS.] "Alternative care benefit" or "benefits" means a 365.19 benefit provided to a nonmedical assistance recipient under 365.20 chapter 256B according to section 256B.0913. 365.21 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 365.22 RECIPIENT.] "Alternative care recipient" or "recipient" means a 365.23 person who receives alternative care grant benefits. 365.24 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 365.25 care lien" or "lien" means a lien filed under sections 514.992 365.26 to 514.995. 365.27 [EFFECTIVE DATE.] This section is effective July 1, 2003, 365.28 for services for persons first enrolling in the alternative care 365.29 program on or after that date and on the first day of the first 365.30 eligibility renewal period for persons enrolled in the 365.31 alternative care program prior to July 1, 2003. 365.32 Sec. 23. [514.992] [ALTERNATIVE CARE LIEN.] 365.33 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 365.34 Subject to sections 514.991 to 514.995, payments made by an 365.35 alternative care agency to provide benefits to a recipient or to 365.36 the recipient's spouse who owns property in this state 366.1 constitute a lien in favor of the agency on all real property 366.2 the recipient owns at and after the time the benefits are first 366.3 paid. 366.4 (b) The amount of the lien is limited to benefits paid for 366.5 services provided to recipients over 55 years of age and 366.6 provided on and after July 1, 2003. 366.7 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 366.8 enforceable against specific real property as of the date when 366.9 all of the following conditions are met: 366.10 (1) the agency has paid benefits for a recipient; 366.11 (2) the recipient has been given notice and an opportunity 366.12 for a hearing under paragraph (b); 366.13 (3) the lien has been filed as provided for in section 366.14 514.993 or memorialized on the certificate of title for the 366.15 property it describes; and 366.16 (4) all restrictions against enforcement have ceased to 366.17 apply. 366.18 (b) An agency may not file a lien until it has sent the 366.19 recipient, their authorized representative, or their legal 366.20 representative written notice of its lien rights by certified 366.21 mail, return receipt requested, or registered mail and there has 366.22 been an opportunity for a hearing under section 256.045. No 366.23 person other than the recipient shall have a right to a hearing 366.24 under section 256.045 prior to the time the lien is filed. The 366.25 hearing shall be limited to whether the agency has met all of 366.26 the prerequisites for filing the lien and whether any of the 366.27 exceptions in this section apply. 366.28 (c) An agency may not file a lien against the recipient's 366.29 homestead when any of the following exceptions apply: 366.30 (1) while the recipient's spouse is also physically present 366.31 and lawfully and continuously residing in the homestead; 366.32 (2) a child of the recipient who is under age 21 or who is 366.33 blind or totally and permanently disabled according to 366.34 supplemental security income criteria is also physically present 366.35 on the property and lawfully and continuously residing on the 366.36 property from and after the date the recipient first receives 367.1 benefits; 367.2 (3) a child of the recipient who has also lawfully and 367.3 continuously resided on the property for a period beginning at 367.4 least two years before the first day of the month in which the 367.5 recipient began receiving alternative care, and who provided 367.6 uncompensated care to the recipient which enabled the recipient 367.7 to live without alternative care services for the two-year 367.8 period; 367.9 (4) a sibling of the recipient who has an ownership 367.10 interest in the property of record in the office of the county 367.11 recorder or registrar of titles for the county in which the real 367.12 property is located and who has also continuously occupied the 367.13 homestead for a period of at least one year immediately prior to 367.14 the first day of the first month in which the recipient received 367.15 benefits and continuously since that date. 367.16 (d) A lien only applies to the real property it describes. 367.17 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 367.18 from the time it is filed until it is paid, satisfied, 367.19 discharged, or becomes unenforceable under sections 514.991 to 367.20 514.995. 367.21 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 367.22 the real property it describes is subject to the rights of 367.23 anyone else whose interest in the real property is perfected of 367.24 record before the lien has been recorded or filed under section 367.25 514.993, including: 367.26 (1) an owner, other than the recipient or the recipient's 367.27 spouse; 367.28 (2) a good faith purchaser for value without notice of the 367.29 lien; 367.30 (3) a holder of a mortgage or security interest; or 367.31 (4) a judgment lien creditor whose judgment lien has 367.32 attached to the recipient's interest in the real property. 367.33 (b) The rights of the other person have the same 367.34 protections against an alternative care lien as are afforded 367.35 against a judgment lien that arises out of an unsecured 367.36 obligation and arises as of the time of the filing of an 368.1 alternative care grant lien under section 514.993. The lien 368.2 shall be inferior to a lien for property taxes and special 368.3 assessments and shall be superior to all other matters first 368.4 appearing of record after the time and date the lien is filed or 368.5 recorded. 368.6 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 368.7 agency may, with absolute discretion, settle or subordinate the 368.8 lien to any other lien or encumbrance of record upon the terms 368.9 and conditions it deems appropriate. 368.10 (b) The agency filing the lien shall release and discharge 368.11 the lien: 368.12 (1) if it has been paid, discharged, or satisfied; 368.13 (2) if it has received reimbursement for the amounts 368.14 secured by the lien, has entered into a binding and legally 368.15 enforceable agreement under which it is reimbursed for the 368.16 amount of the lien, or receives other collateral sufficient to 368.17 secure payment of the lien; 368.18 (3) against some, but not all, of the property it describes 368.19 upon the terms, conditions, and circumstances the agency deems 368.20 appropriate; 368.21 (4) to the extent it cannot be lawfully enforced against 368.22 the property it describes because of an error, omission, or 368.23 other material defect in the legal description contained in the 368.24 lien or a necessary prerequisite to enforcement of the lien; and 368.25 (5) if, in its discretion, it determines the filing or 368.26 enforcement of the lien is contrary to the public interest. 368.27 (c) The agency executing the lien shall execute and file 368.28 the release as provided for in section 514.993, subdivision 2. 368.29 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 368.30 the real property it describes for a period of ten years from 368.31 the date it attaches according to subdivision 2, paragraph (a), 368.32 except as otherwise provided for in sections 514.992 to 368.33 514.995. The agency filing the lien may renew the lien for one 368.34 additional ten-year period from the date it would otherwise 368.35 expire by recording or filing a certificate of renewal before 368.36 the lien expires. The certificate of renewal shall be recorded 369.1 or filed in the office of the county recorder or registrar of 369.2 titles for the county in which the lien is recorded or filed. 369.3 The certificate must refer to the recording or filing data for 369.4 the lien it renews. The certificate need not be attested, 369.5 certified, or acknowledged as a condition for recording or 369.6 filing. The recorder or registrar of titles shall record, file, 369.7 index, and return the certificate of renewal in the same manner 369.8 provided for liens in section 514.993, subdivision 2. 369.9 (b) An alternative care lien is not enforceable against the 369.10 real property of an estate to the extent there is a 369.11 determination by a court of competent jurisdiction, or by an 369.12 officer of the court designated for that purpose, that there are 369.13 insufficient assets in the estate to satisfy the lien in whole 369.14 or in part because of the homestead exemption under section 369.15 256B.15, subdivision 4, the rights of a surviving spouse or a 369.16 minor child under section 524.2-403, paragraphs (a) and (b), or 369.17 claims with a priority under section 524.3-805, paragraph (a), 369.18 clauses (1) to (4). For purposes of this section, the rights of 369.19 the decedent's adult children to exempt property under section 369.20 524.2-403, paragraph (b), shall not be considered costs of 369.21 administration under section 524.3-805, paragraph (a), clause 369.22 (1). 369.23 [EFFECTIVE DATE.] This section is effective July 1, 2003, 369.24 for services for persons first enrolling in the alternative care 369.25 program on or after that date and on the first day of the first 369.26 eligibility renewal period for persons enrolled in the 369.27 alternative care program prior to July 1, 2003. 369.28 Sec. 24. [514.993] [LIEN; CONTENTS AND FILING.] 369.29 Subdivision 1. [CONTENTS.] A lien shall be dated and must 369.30 contain: 369.31 (1) the recipient's full name, last known address, and 369.32 social security number; 369.33 (2) a statement that benefits have been paid to or for the 369.34 recipient's benefit; 369.35 (3) a statement that all of the recipient's interests in 369.36 the real property described in the lien may be subject to or 370.1 affected by the agency's right to reimbursement for benefits; 370.2 (4) a legal description of the real property subject to the 370.3 lien and whether it is registered or abstract property; and 370.4 (5) such other contents, if any, as the agency deems 370.5 appropriate. 370.6 Subd. 2. [FILING.] Any lien, release, or other document 370.7 required or permitted to be filed under sections 514.991 to 370.8 514.995 must be recorded or filed in the office of the county 370.9 recorder or registrar of titles, as appropriate, in the county 370.10 where the real property is located. Notwithstanding section 370.11 386.77, the agency shall pay the applicable filing fee for any 370.12 documents filed under sections 514.991 to 514.995. An 370.13 attestation, certification, or acknowledgment is not required as 370.14 a condition of filing. If the property described in the lien is 370.15 registered property, the registrar of titles shall record it on 370.16 the certificate of title for each parcel of property described 370.17 in the lien. If the property described in the lien is abstract 370.18 property, the recorder shall file the lien in the county's 370.19 grantor-grantee indexes and any tract indexes the county 370.20 maintains for each parcel of property described in the lien. 370.21 The recorder or registrar shall return the recorded or filed 370.22 lien to the agency at no cost. If the agency provides a 370.23 duplicate copy of the lien, the recorder or registrar of titles 370.24 shall show the recording or filing data on the copy and return 370.25 it to the agency at no cost. The agency is responsible for 370.26 filing any lien, release, or other documents under sections 370.27 514.991 to 514.995. 370.28 [EFFECTIVE DATE.] This section is effective July 1, 2003, 370.29 for services for persons first enrolling in the alternative care 370.30 program on or after that date and on the first day of the first 370.31 eligibility renewal period for persons enrolled in the 370.32 alternative care program prior to July 1, 2003. 370.33 Sec. 25. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 370.34 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 370.35 agency may enforce or foreclose a lien filed under sections 370.36 514.991 to 514.995 in the manner provided for by law for 371.1 enforcement of judgment liens against real estate or by a 371.2 foreclosure by action under chapter 581. The lien shall remain 371.3 enforceable as provided for in sections 514.991 to 514.995 371.4 notwithstanding any laws limiting the enforceability of 371.5 judgments. 371.6 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 371.7 enforced against the homestead property of the recipient or the 371.8 spouse while they physically occupy it as their lawful residence. 371.9 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 371.10 514.995 do not limit the agency's right to file a claim against 371.11 the recipient's estate or the estate of the recipient's spouse, 371.12 do not limit any other claims for reimbursement the agency may 371.13 have, and do not limit the availability of any other remedy to 371.14 the agency. 371.15 [EFFECTIVE DATE.] This section is effective July 1, 2003, 371.16 for services for persons first enrolling in the alternative care 371.17 program on or after that date and on the first day of the first 371.18 eligibility renewal period for persons enrolled in the 371.19 alternative care program prior to July 1, 2003. 371.20 Sec. 26. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 371.21 Amounts the agency receives to satisfy the lien must be 371.22 deposited in the state treasury and credited to the fund from 371.23 which the benefits were paid. 371.24 [EFFECTIVE DATE.] This section is effective July 1, 2003, 371.25 for services for persons first enrolling in the alternative care 371.26 program on or after that date and on the first day of the first 371.27 eligibility renewal period for persons enrolled in the 371.28 alternative care program prior to July 1, 2003. 371.29 Sec. 27. Minnesota Statutes 2002, section 524.3-805, is 371.30 amended to read: 371.31 524.3-805 [CLASSIFICATION OF CLAIMS.] 371.32 (a) If the applicable assets of the estate are insufficient 371.33 to pay all claims in full, the personal representative shall 371.34 make payment in the following order: 371.35 (1) costs and expenses of administration; 371.36 (2) reasonable funeral expenses; 372.1 (3) debts and taxes with preference under federal law; 372.2 (4) reasonable and necessary medical, hospital, or nursing 372.3 home expenses of the last illness of the decedent, including 372.4 compensation of persons attending the decedent, a claim filed 372.5 under section 256B.15 for recovery of expenditures for 372.6 alternative care for nonmedical assistance recipients under 372.7 section 256B.0913, and including a claim filed pursuant to 372.8 section 256B.15; 372.9 (5) reasonable and necessary medical, hospital, and nursing 372.10 home expenses for the care of the decedent during the year 372.11 immediately preceding death; 372.12 (6) debts with preference under other laws of this state, 372.13 and state taxes; 372.14 (7) all other claims. 372.15 (b) No preference shall be given in the payment of any 372.16 claim over any other claim of the same class, and a claim due 372.17 and payable shall not be entitled to a preference over claims 372.18 not due, except that if claims for expenses of the last illness 372.19 involve only claims filed under section 256B.15 for recovery of 372.20 expenditures for alternative care for nonmedical assistance 372.21 recipients under section 256B.0913, section 246.53 for costs of 372.22 state hospital care and claims filed under section 256B.15, 372.23 claims filed to recover expenditures for alternative care for 372.24 nonmedical assistance recipients under section 256B.0913 shall 372.25 have preference over claims filed under both section 246.53 and 372.26 other claims filed under section 256B.15, and claims filed under 372.27 section 246.53 have preference over claims filed under section 372.28 256B.15 for recovery of amounts other than those for 372.29 expenditures for alternative care for nonmedical assistance 372.30 recipients under section 256B.0913. 372.31 [EFFECTIVE DATE.] This section is effective July 1, 2003, 372.32 for decedents dying on or after that date. 372.33 ARTICLE 9 372.34 ADULT MENTAL HEALTH AND ALTERNATIVE PROGRAMS 372.35 FOR OFFENDERS WITH MENTAL ILLNESS 372.36 Section 1. [256B.0596] [MENTAL HEALTH CASE MANAGEMENT.] 373.1 Counties shall contract with eligible providers willing to 373.2 provide mental health case management services under section 373.3 256B.0625, subdivision 20. In order to be eligible, in addition 373.4 to general provider requirements under this chapter, the 373.5 provider must: 373.6 (1) be willing to provide the mental health case management 373.7 services; and 373.8 (2) have a minimum of at least one contact with the client 373.9 per week. 373.10 Sec. 2. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 373.11 HEALTH SERVICES.] 373.12 Subdivision 1. [SCOPE.] Subject to federal approval, 373.13 medical assistance covers medically necessary, intensive 373.14 nonresidential and residential rehabilitative mental health 373.15 services as defined in subdivision 2, for recipients as defined 373.16 in subdivision 3, when the services are provided by an entity 373.17 meeting the standards in this section. 373.18 Subd. 2. [DEFINITIONS.] For purposes of this section, the 373.19 following terms have the meanings given them. 373.20 (a) "Intensive nonresidential rehabilitative mental health 373.21 services" means adult rehabilitative mental health services as 373.22 defined in section 256B.0623, subdivision 2, paragraph (a), 373.23 except that these services are provided by a multidisciplinary 373.24 staff using a total team approach consistent with assertive 373.25 community treatment, fair weather lodge, and other 373.26 evidence-based practices, and directed to recipients with a 373.27 serious mental illness who require intensive services. 373.28 (b) "Intensive residential rehabilitative mental health 373.29 services" means short-term, time-limited services provided in a 373.30 residential setting to recipients who are in need of more 373.31 restrictive settings and are at risk of significant functional 373.32 deterioration if they do not receive these services. Services 373.33 are designed to develop and enhance psychiatric stability, 373.34 personal and emotional adjustment, self-sufficiency, and skills 373.35 to live in a more independent setting. Services must be 373.36 directed toward a targeted discharge date with specified client 374.1 outcomes and must be consistent with evidence-based practices. 374.2 (c) "Evidence-based practices" are nationally recognized 374.3 mental health services that are proven by substantial research 374.4 to be effective in helping individuals with serious mental 374.5 illness obtain specific treatment goals. 374.6 (d) "Overnight staff" means a member of the intensive 374.7 residential rehabilitative mental health treatment team who is 374.8 responsible during hours when recipients are typically asleep. 374.9 (e) "Treatment team" means all staff who provide services 374.10 under this section to recipients. At a minimum, this includes 374.11 the clinical supervisor, mental health professionals, mental 374.12 health practitioners, and mental health rehabilitation workers. 374.13 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 374.14 individual who: 374.15 (1) is age 18 or older; 374.16 (2) is eligible for medical assistance; 374.17 (3) is diagnosed with a mental illness; 374.18 (4) because of a mental illness, has substantial disability 374.19 and functional impairment in three or more of the areas listed 374.20 in section 245.462, subdivision 11a, so that self-sufficiency is 374.21 markedly reduced; 374.22 (5) has one or more of the following: a history of two or 374.23 more inpatient hospitalizations in the past year, significant 374.24 independent living instability, homelessness, or very frequent 374.25 use of mental health and related services yielding poor 374.26 outcomes; and 374.27 (6) in the written opinion of a licensed mental health 374.28 professional, has the need for mental health services that 374.29 cannot be met with other available community-based services, or 374.30 is likely to experience a mental health crisis or require a more 374.31 restrictive setting if intensive rehabilitative mental health 374.32 services are not provided. 374.33 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 374.34 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 374.35 mental health services provider must: 374.36 (1) have a contract with the host county to provide 375.1 intensive adult rehabilitative mental health services; and 375.2 (2) be certified by the commissioner as being in compliance 375.3 with this section and section 256B.0623. 375.4 (b) The intensive residential rehabilitative mental health 375.5 services provider must: 375.6 (1) be licensed under Minnesota Rules, parts 9520.0500 to 375.7 9520.0670; 375.8 (2) not exceed 16 beds per site; 375.9 (3) comply with the additional standards in this section; 375.10 and 375.11 (4) have a contract with the host county to provide these 375.12 services. 375.13 (c) The commissioner shall develop procedures for counties 375.14 and providers to submit contracts and other documentation as 375.15 needed to allow the commissioner to determine whether the 375.16 standards in this section are met. 375.17 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 375.18 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 375.19 qualified staff as defined in section 256B.0623, subdivision 5, 375.20 who are trained and supervised according to section 256B.0623, 375.21 subdivision 6, except that mental health rehabilitation workers 375.22 acting as overnight staff are not required to comply with 375.23 section 256B.0623, subdivision 5, clause (3)(iv). 375.24 (b) The clinical supervisor must be an active member of the 375.25 treatment team. The treatment team must meet with the clinical 375.26 supervisor at least weekly to discuss recipients' progress and 375.27 make rapid adjustments to meet recipients' needs. The team 375.28 meeting shall include recipient-specific case reviews and 375.29 general treatment discussions among team members. 375.30 Recipient-specific case reviews and planning must be documented 375.31 in the individual recipient's treatment record. 375.32 (c) Treatment staff must have prompt access in person or by 375.33 telephone to a mental health practitioner or mental health 375.34 professional. The provider must have the capacity to promptly 375.35 and appropriately respond to emergent needs and make any 375.36 necessary staffing adjustments to assure the health and safety 376.1 of recipients. 376.2 (d) The initial functional assessment must be completed 376.3 within ten days of intake and updated at least every three 376.4 months or prior to discharge from the service, whichever comes 376.5 first. 376.6 (e) The initial individual treatment plan must be completed 376.7 within ten days of intake and reviewed and updated at least 376.8 monthly with the recipient. 376.9 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 376.10 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 376.11 SERVICES.] (a) The provider of intensive residential services 376.12 must have sufficient staff to provide 24 hour per day coverage 376.13 to deliver the rehabilitative services described in the 376.14 treatment plan and to safely supervise and direct the activities 376.15 of recipients given the recipient's level of behavioral and 376.16 psychiatric stability, cultural needs, and vulnerability. The 376.17 provider must have the capacity within the facility to provide 376.18 integrated services for chemical dependency, illness management 376.19 services, and family education when appropriate. 376.20 (b) At a minimum: 376.21 (1) staff must be available and provide direction and 376.22 supervision whenever recipients are present in the facility; 376.23 (2) staff must remain awake during all work hours; 376.24 (3) there must be a staffing ratio of at least one to nine 376.25 recipients for each day and evening shift. If more than nine 376.26 recipients are present at the residential site, there must be a 376.27 minimum of two staff during day and evening shifts, one of whom 376.28 must be a mental health practitioner or mental health 376.29 professional; 376.30 (4) if services are provided to recipients who need the 376.31 services of a medical professional, the provider shall assure 376.32 that these services are provided either by the provider's own 376.33 medical staff or through referral to a medical professional; and 376.34 (5) the provider must employ or contract with a licensed 376.35 registered nurse to ensure the effectiveness and safety of 376.36 medication administration in the facility. 377.1 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 377.2 SERVICES.] The standards in this subdivision apply to intensive 377.3 nonresidential rehabilitative mental health services. 377.4 (1) The treatment team must use team treatment, not an 377.5 individual treatment model. 377.6 (2) The clinical supervisor must function as a practicing 377.7 clinician at least on a part-time basis. 377.8 (3) The staffing ratio must not exceed ten recipients to 377.9 one full-time equivalent treatment team position. 377.10 (4) Services must be available at times that meet client 377.11 needs. 377.12 (5) The treatment team must actively and assertively engage 377.13 and reach out to the recipient's family members and significant 377.14 others, after obtaining the recipient's permission. 377.15 (6) The treatment team must establish ongoing communication 377.16 and collaboration between the team, family, and significant 377.17 others and educate the family and significant others about 377.18 mental illness, symptom management, and the family's role in 377.19 treatment. 377.20 (7) The treatment team must provide interventions to 377.21 promote positive interpersonal relationships. 377.22 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 377.23 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 377.24 residential and nonresidential services in this section shall be 377.25 based on one daily rate per provider inclusive of the following 377.26 services received by an eligible recipient in a given calendar 377.27 day: all rehabilitative services under this section and crisis 377.28 stabilization services under section 256B.0624. 377.29 (b) Except as indicated in paragraph (c), payment will not 377.30 be made to more than one entity for each recipient for services 377.31 provided under this section on a given day. If services under 377.32 this section are provided by a team that includes staff from 377.33 more than one entity, the team must determine how to distribute 377.34 the payment among the members. 377.35 (c) The host county shall recommend to the commissioner one 377.36 rate for each entity that will bill medical assistance for 378.1 residential services under this section and two rates for each 378.2 nonresidential provider. The first nonresidential rate is for 378.3 recipients who are not receiving residential services. The 378.4 second nonresidential rate is for recipients who are temporarily 378.5 receiving residential services and need continued contact with 378.6 the nonresidential team to assure timely discharge from 378.7 residential services. In developing these rates, the host 378.8 county shall consider and document: 378.9 (1) the cost for similar services in the local trade area; 378.10 (2) actual costs incurred by entities providing the 378.11 services; 378.12 (3) the intensity and frequency of services to be provided 378.13 to each recipient; 378.14 (4) the degree to which recipients will receive services 378.15 other than services under this section; 378.16 (5) the costs of other services, such as case management, 378.17 that will be separately reimbursed; and 378.18 (6) input from the local planning process authorized by the 378.19 adult mental health initiative under section 245.4661, regarding 378.20 recipients' service needs. 378.21 (d) The rate for intensive rehabilitative mental health 378.22 services must exclude room and board, as defined in section 378.23 256I.03, subdivision 6, and services not covered under this 378.24 section, such as case management, partial hospitalization, home 378.25 care, and inpatient services. Physician services that are not 378.26 separately billed may be included in the rate to the extent that 378.27 a psychiatrist is a member of the treatment team. The county's 378.28 recommendation shall specify the period for which the rate will 378.29 be applicable, not to exceed two years. 378.30 (e) When services under this section are provided by an 378.31 assertive community team, case management functions must be an 378.32 integral part of the team. The county must allocate costs which 378.33 are reimbursable under this section versus costs which are 378.34 reimbursable through case management or other reimbursement, so 378.35 that payment is not duplicated. 378.36 (f) The rate for a provider must not exceed the rate 379.1 charged by that provider for the same service to other payors. 379.2 (g) The commissioner shall approve or reject the county's 379.3 rate recommendation, based on the commissioner's own analysis of 379.4 the criteria in paragraph (c). 379.5 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 379.6 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 379.7 to provide services under this section shall apply directly to 379.8 the commissioner for enrollment and rate setting. In this case, 379.9 a county contract is not required and the commissioner shall 379.10 perform the program review and rate setting duties which would 379.11 otherwise be required of counties under this section. 379.12 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 379.13 SPECIALIZED PROGRAM.] A provider proposing to serve a 379.14 subpopulation of eligible recipients may bypass the county 379.15 approval procedures in this section and receive approval for 379.16 provider enrollment and rate setting directly from the 379.17 commissioner under the following circumstances: 379.18 (1) the provider demonstrates that the subpopulation to be 379.19 served requires a specialized program which is not available 379.20 from county-approved entities; and 379.21 (2) the subpopulation to be served is of such a low 379.22 incidence that it is not feasible to develop a program serving a 379.23 single county or regional group of counties. 379.24 For providers meeting the criteria in clauses (1) and (2), 379.25 the commissioner shall perform the program review and rate 379.26 setting duties which would otherwise be required of counties 379.27 under this section. 379.28 Sec. 3. Minnesota Statutes 2002, section 256B.0623, 379.29 subdivision 2, is amended to read: 379.30 Subd. 2. [DEFINITIONS.] For purposes of this section, the 379.31 following terms have the meanings given them. 379.32 (a) "Adult rehabilitative mental health services" means 379.33 mental health services which are rehabilitative and enable the 379.34 recipient to develop and enhance psychiatric stability, social 379.35 competencies, personal and emotional adjustment, and independent 379.36 living and community skills, when these abilities are impaired 380.1 by the symptoms of mental illness. Adult rehabilitative mental 380.2 health services are also appropriate when provided to enable a 380.3 recipient to retain stability and functioning, if the recipient 380.4 would be at risk of significant functional decompensation or 380.5 more restrictive service settings without these services. 380.6 (1) Adult rehabilitative mental health services instruct, 380.7 assist, and support the recipient in areas such as: 380.8 interpersonal communication skills, community resource 380.9 utilization and integration skills, crisis assistance, relapse 380.10 prevention skills, health care directives, budgeting and 380.11 shopping skills, healthy lifestyle skills and practices, cooking 380.12 and nutrition skills, transportation skills, medication 380.13 education and monitoring, mental illness symptom management 380.14 skills, household management skills, employment-related skills, 380.15 and transition to community living services. 380.16 (2) These services shall be provided to the recipient on a 380.17 one-to-one basis in the recipient's home or another community 380.18 setting or in groups. 380.19 (b) "Medication education services" means services provided 380.20 individually or in groups which focus on educating the recipient 380.21 about mental illness and symptoms; the role and effects of 380.22 medications in treating symptoms of mental illness; and the side 380.23 effects of medications. Medication education is coordinated 380.24 with medication management services and does not duplicate it. 380.25 Medication education services are provided by physicians, 380.26 pharmacists, physician's assistants, or registered nurses. 380.27 (c) "Transition to community living services" means 380.28 services which maintain continuity of contact between the 380.29 rehabilitation services provider and the recipient and which 380.30 facilitate discharge from a hospital, residential treatment 380.31 program under Minnesota Rules, chapter 9505, board and lodging 380.32 facility, or nursing home. Transition to community living 380.33 services are not intended to provide other areas of adult 380.34 rehabilitative mental health services. 380.35 Sec. 4. Minnesota Statutes 2002, section 256B.0623, 380.36 subdivision 4, is amended to read: 381.1 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 381.2 entity must be:381.3(1) a county operated entity certified by the state; or381.4(2) a noncounty entity certified by the entity's host381.5countycertified by the state following the certification 381.6 process and procedures developed by the commissioner. 381.7 (b) The certification process is a determination as to 381.8 whether the entity meets the standards in this subdivision. The 381.9 certification must specify which adult rehabilitative mental 381.10 health services the entity is qualified to provide. 381.11 (c)If an entity seeks to provide services outside its host381.12county, itA noncounty provider entity must obtain additional 381.13 certification from each county in which it will provide 381.14 services. The additional certification must be based on the 381.15 adequacy of the entity's knowledge of that county's local health 381.16 and human service system, and the ability of the entity to 381.17 coordinate its services with the other services available in 381.18 that county. A county-operated entity must obtain this 381.19 additional certification from any other county in which it will 381.20 provide services. 381.21 (d) Recertification must occur at least everytwothree 381.22 years. 381.23 (e) The commissioner may intervene at any time and 381.24 decertify providers with cause. The decertification is subject 381.25 to appeal to the state. A county board may recommend that the 381.26 state decertify a provider for cause. 381.27 (f) The adult rehabilitative mental health services 381.28 provider entity must meet the following standards: 381.29 (1) have capacity to recruit, hire, manage, and train 381.30 mental health professionals, mental health practitioners, and 381.31 mental health rehabilitation workers; 381.32 (2) have adequate administrative ability to ensure 381.33 availability of services; 381.34 (3) ensure adequate preservice and inservice and ongoing 381.35 training for staff; 381.36 (4) ensure that mental health professionals, mental health 382.1 practitioners, and mental health rehabilitation workers are 382.2 skilled in the delivery of the specific adult rehabilitative 382.3 mental health services provided to the individual eligible 382.4 recipient; 382.5 (5) ensure that staff is capable of implementing culturally 382.6 specific services that are culturally competent and appropriate 382.7 as determined by the recipient's culture, beliefs, values, and 382.8 language as identified in the individual treatment plan; 382.9 (6) ensure enough flexibility in service delivery to 382.10 respond to the changing and intermittent care needs of a 382.11 recipient as identified by the recipient and the individual 382.12 treatment plan; 382.13 (7) ensure that the mental health professional or mental 382.14 health practitioner, who is under the clinical supervision of a 382.15 mental health professional, involved in a recipient's services 382.16 participates in the development of the individual treatment 382.17 plan; 382.18 (8) assist the recipient in arranging needed crisis 382.19 assessment, intervention, and stabilization services; 382.20 (9) ensure that services are coordinated with other 382.21 recipient mental health services providers and the county mental 382.22 health authority and the federally recognized American Indian 382.23 authority and necessary others after obtaining the consent of 382.24 the recipient. Services must also be coordinated with the 382.25 recipient's case manager or care coordinator if the recipient is 382.26 receiving case management or care coordination services; 382.27 (10) develop and maintain recipient files, individual 382.28 treatment plans, and contact charting; 382.29 (11) develop and maintain staff training and personnel 382.30 files; 382.31 (12) submit information as required by the state; 382.32 (13) establish and maintain a quality assurance plan to 382.33 evaluate the outcome of services provided; 382.34 (14) keep all necessary records required by law; 382.35 (15) deliver services as required by section 245.461; 382.36 (16) comply with all applicable laws; 383.1 (17) be an enrolled Medicaid provider; 383.2 (18) maintain a quality assurance plan to determine 383.3 specific service outcomes and the recipient's satisfaction with 383.4 services; and 383.5 (19) develop and maintain written policies and procedures 383.6 regarding service provision and administration of the provider 383.7 entity. 383.8(g) The commissioner shall develop statewide procedures for383.9provider certification, including timelines for counties to383.10certify qualified providers.383.11 Sec. 5. Minnesota Statutes 2002, section 256B.0623, 383.12 subdivision 5, is amended to read: 383.13 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 383.14 rehabilitative mental health services must be provided by 383.15 qualified individual provider staff of a certified provider 383.16 entity. Individual provider staff must be qualified under one 383.17 of the following criteria: 383.18 (1) a mental health professional as defined in section 383.19 245.462, subdivision 18, clauses (1) to (5). If the recipient 383.20 has a current diagnostic assessment by a licensed mental health 383.21 professional as defined in section 245.462, subdivision 18, 383.22 clauses (1) to (5), recommending receipt of adult mental health 383.23 rehabilitative services, the definition of mental health 383.24 professional for purposes of this section includes a person who 383.25 is qualified under section 245.462, subdivision 18, clause (6), 383.26 and who holds a current and valid national certification as a 383.27 certified rehabilitation counselor or certified psychosocial 383.28 rehabilitation practitioner; 383.29 (2) a mental health practitioner as defined in section 383.30 245.462, subdivision 17. The mental health practitioner must 383.31 work under the clinical supervision of a mental health 383.32 professional; or 383.33 (3) a mental health rehabilitation worker. A mental health 383.34 rehabilitation worker means a staff person working under the 383.35 direction of a mental health practitioner or mental health 383.36 professional and under the clinical supervision of a mental 384.1 health professional in the implementation of rehabilitative 384.2 mental health services as identified in the recipient's 384.3 individual treatment plan who: 384.4 (i) is at least 21 years of age; 384.5 (ii) has a high school diploma or equivalent; 384.6 (iii) has successfully completed 30 hours of training 384.7 during the past two years in all of the following areas: 384.8 recipient rights, recipient-centered individual treatment 384.9 planning, behavioral terminology, mental illness, co-occurring 384.10 mental illness and substance abuse, psychotropic medications and 384.11 side effects, functional assessment, local community resources, 384.12 adult vulnerability, recipient confidentiality; and 384.13 (iv) meets the qualifications in subitem (A) or (B): 384.14 (A) has an associate of arts degree in one of the 384.15 behavioral sciences or human services, or is a registered nurse 384.16 without a bachelor's degree, or who within the previous ten 384.17 years has: 384.18 (1) three years of personal life experience with serious 384.19 and persistent mental illness; 384.20 (2) three years of life experience as a primary caregiver 384.21 to an adult with a serious mental illness or traumatic brain 384.22 injury; or 384.23 (3) 4,000 hours of supervised paid work experience in the 384.24 delivery of mental health services to adults with a serious 384.25 mental illness or traumatic brain injury; or 384.26 (B)(1) is fluent in the non-English language or competent 384.27 in the culture of the ethnic group to which at least5020 384.28 percent of the mental health rehabilitation worker's clients 384.29 belong; 384.30 (2) receives during the first 2,000 hours of work, monthly 384.31 documented individual clinical supervision by a mental health 384.32 professional; 384.33 (3) has 18 hours of documented field supervision by a 384.34 mental health professional or practitioner during the first 160 384.35 hours of contact work with recipients, and at least six hours of 384.36 field supervision quarterly during the following year; 385.1 (4) has review and cosignature of charting of recipient 385.2 contacts during field supervision by a mental health 385.3 professional or practitioner; and 385.4 (5) has 40 hours of additional continuing education on 385.5 mental health topics during the first year of employment. 385.6 Sec. 6. Minnesota Statutes 2002, section 256B.0623, 385.7 subdivision 6, is amended to read: 385.8 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 385.9 health rehabilitation workers must receive ongoing continuing 385.10 education training of at least 30 hours every two years in areas 385.11 of mental illness and mental health services and other areas 385.12 specific to the population being served. Mental health 385.13 rehabilitation workers must also be subject to the ongoing 385.14 direction and clinical supervision standards in paragraphs (c) 385.15 and (d). 385.16 (b) Mental health practitioners must receive ongoing 385.17 continuing education training as required by their professional 385.18 license; or if the practitioner is not licensed, the 385.19 practitioner must receive ongoing continuing education training 385.20 of at least 30 hours every two years in areas of mental illness 385.21 and mental health services. Mental health practitioners must 385.22 meet the ongoing clinical supervision standards in paragraph (c). 385.23 (c) Clinical supervision may be provided by a full- or 385.24 part-time qualified professional employed by or under contract 385.25 with the provider entity. Clinical supervision may be provided 385.26 by interactive videoconferencing according to procedures 385.27 developed by the commissioner. A mental health professional 385.28 providing clinical supervision of staff delivering adult 385.29 rehabilitative mental health services must provide the following 385.30 guidance: 385.31 (1) review the information in the recipient's file; 385.32 (2) review and approve initial and updates of individual 385.33 treatment plans; 385.34 (3) meet with mental health rehabilitation workers and 385.35 practitioners, individually or in small groups, at least monthly 385.36 to discuss treatment topics of interest to the workers and 386.1 practitioners; 386.2 (4) meet with mental health rehabilitation workers and 386.3 practitioners, individually or in small groups, at least monthly 386.4 to discuss treatment plans of recipients, and approve by 386.5 signature and document in the recipient's file any resulting 386.6 plan updates; 386.7 (5) meet at leasttwice a monthmonthly with the directing 386.8 mental health practitioner, if there is one, to review needs of 386.9 the adult rehabilitative mental health services program, review 386.10 staff on-site observations and evaluate mental health 386.11 rehabilitation workers, plan staff training, review program 386.12 evaluation and development, and consult with the directing 386.13 practitioner; and 386.14 (6) be available for urgent consultation as the individual 386.15 recipient needs or the situation necessitates; and386.16(7) provide clinical supervision by full- or part-time386.17mental health professionals employed by or under contract with386.18the provider entity. 386.19 (d) An adult rehabilitative mental health services provider 386.20 entity must have a treatment director who is a mental health 386.21 practitioner or mental health professional. The treatment 386.22 director must ensure the following: 386.23 (1) while delivering direct services to recipients, a newly 386.24 hired mental health rehabilitation worker must be directly 386.25 observed delivering services to recipients bythea mental 386.26 health practitioner or mental health professional for at least 386.27 six hours per 40 hours worked during the first 160 hours that 386.28 the mental health rehabilitation worker works; 386.29 (2) the mental health rehabilitation worker must receive 386.30 ongoing on-site direct service observation by a mental health 386.31 professional or mental health practitioner for at least six 386.32 hours for every six months of employment; 386.33 (3) progress notes are reviewed from on-site service 386.34 observation prepared by the mental health rehabilitation worker 386.35 and mental health practitioner for accuracy and consistency with 386.36 actual recipient contact and the individual treatment plan and 387.1 goals; 387.2 (4) immediate availability by phone or in person for 387.3 consultation by a mental health professional or a mental health 387.4 practitioner to the mental health rehabilitation services worker 387.5 during service provision; 387.6 (5) oversee the identification of changes in individual 387.7 recipient treatment strategies, revise the plan, and communicate 387.8 treatment instructions and methodologies as appropriate to 387.9 ensure that treatment is implemented correctly; 387.10 (6) model service practices which: respect the recipient, 387.11 include the recipient in planning and implementation of the 387.12 individual treatment plan, recognize the recipient's strengths, 387.13 collaborate and coordinate with other involved parties and 387.14 providers; 387.15 (7) ensure that mental health practitioners and mental 387.16 health rehabilitation workers are able to effectively 387.17 communicate with the recipients, significant others, and 387.18 providers; and 387.19 (8) oversee the record of the results of on-site 387.20 observation and charting evaluation and corrective actions taken 387.21 to modify the work of the mental health practitioners and mental 387.22 health rehabilitation workers. 387.23 (e) A mental health practitioner who is providing treatment 387.24 direction for a provider entity must receive supervision at 387.25 least monthly from a mental health professional to: 387.26 (1) identify and plan for general needs of the recipient 387.27 population served; 387.28 (2) identify and plan to address provider entity program 387.29 needs and effectiveness; 387.30 (3) identify and plan provider entity staff training and 387.31 personnel needs and issues; and 387.32 (4) plan, implement, and evaluate provider entity quality 387.33 improvement programs. 387.34 Sec. 7. Minnesota Statutes 2002, section 256B.0623, 387.35 subdivision 8, is amended to read: 387.36 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 388.1 rehabilitative mental health services must complete a diagnostic 388.2 assessment as defined in section 245.462, subdivision 9, within 388.3 five days after the recipient's second visit or within 30 days 388.4 after intake, whichever occurs first. In cases where a 388.5 diagnostic assessment is available that reflects the recipient's 388.6 current status, and has been completed within 180 days preceding 388.7 admission, an update must be completed. An update shall include 388.8 a written summary by a mental health professional of the 388.9 recipient's current mental health status and service needs. If 388.10 the recipient's mental health status has changed significantly 388.11 since the adult's most recent diagnostic assessment, a new 388.12 diagnostic assessment is required. For initial implementation of 388.13 adult rehabilitative mental health services, until June 30, 388.14 2005, a diagnostic assessment that reflects the recipient's 388.15 current status and has been completed within the past three 388.16 years preceding admission is acceptable. 388.17 Sec. 8. Minnesota Statutes 2002, section 256B.82, is 388.18 amended to read: 388.19 256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 388.20 SERVICES.] 388.21 Medical assistance and MinnesotaCare prepaid health plans 388.22 may include coverage for adult mental health rehabilitative 388.23 services under section 256B.0623, intensive rehabilitative 388.24 services under section 256B.0622, and adult mental health crisis 388.25 response services under section 256B.0624, beginning January 1, 388.2620042005. 388.27 By January 15,20032004, the commissioner shall report to 388.28 the legislature how these services should be included in prepaid 388.29 plans. The commissioner shall consult with mental health 388.30 advocates, health plans, and counties in developing this 388.31 report. The report recommendations must include a plan to 388.32 ensure coordination of these services between health plans and 388.33 counties, assure recipient access to essential community 388.34 providers, and monitor the health plans' delivery of services 388.35 through utilization review and quality standards. 388.36 Sec. 9. [609.1055] [OFFENDERS WITH SERIOUS AND PERSISTENT 389.1 MENTAL ILLNESS; ALTERNATIVE PLACEMENT.] 389.2 When a court intends to commit an offender with a serious 389.3 and persistent mental illness, as defined in section 245.462, 389.4 subdivision 20, paragraph (c), to the custody of the 389.5 commissioner of corrections for imprisonment at a state 389.6 correctional facility, either when initially pronouncing a 389.7 sentence or when revoking an offender's probation, the court, 389.8 when consistent with public safety, may instead place the 389.9 offender on probation or continue the offender's probation and 389.10 require as a condition of the probation that the offender 389.11 successfully complete an appropriate supervised alternative 389.12 living program having a mental health treatment component. This 389.13 section applies only to offenders who would have a remaining 389.14 term of imprisonment after adjusting for credit for prior 389.15 imprisonment, if any, of more than one year. 389.16 Sec. 10. [ALTERNATIVE LIVING PROGRAMS FOR CERTAIN 389.17 OFFENDERS WITH MENTAL ILLNESS.] 389.18 The commissioner of corrections shall cooperate with 389.19 nonprofit entities to establish supervised alternative living 389.20 programs for offenders with serious and persistent mental 389.21 illness, as defined in Minnesota Statutes, section 245.462, 389.22 subdivision 20, paragraph (c). Each program must be structured 389.23 to accommodate between eight and 13 offenders who are required 389.24 to successfully complete the program as a condition of probation. 389.25 Each program must provide a residential component and include 389.26 mental health treatment and counseling, living and employment 389.27 skills development, and supported employment. Program directors 389.28 shall report program violations by participating offenders to 389.29 the offender's correctional agent. 389.30 By January 15, 2006, the commissioners of corrections and 389.31 human services shall evaluate the alternative placements 389.32 provided to offenders with mental illness under Minnesota 389.33 Statutes, section 609.1055. The evaluation shall address the 389.34 following issues: number of offenders who obtain and maintain 389.35 employment in the community, number sentenced to prison, costs, 389.36 and other issues deemed appropriate by the commissioners. The 390.1 commissioners shall identify barriers to successful 390.2 implementation and recommend any legislative changes needed. 390.3 The evaluation and other information required under this section 390.4 must be provided to the chairs of the house of representatives 390.5 and senate finance and policy committees having jurisdiction 390.6 over corrections and human services issues by the date specified 390.7 in this section. 390.8 Sec. 11. [RULE 36, MINNESOTA RULES, PARTS 9520.0500 TO 390.9 9520.0690, LICENSURE FOR ALTERNATIVE LIVING PROGRAMS FOR CERTAIN 390.10 OFFENDERS WITH MENTAL ILLNESS.] 390.11 The commissioner of human services shall approve additional 390.12 Rule 36 licenses in order to accommodate alternative living 390.13 programs for certain offenders with mental illness if: 390.14 (1) the provider meets applicable licensing standards; and 390.15 (2) additional Rule 36 programs are necessary to meet the 390.16 demand for alternative living programs for certain offenders 390.17 with mental illness. 390.18 Sec. 12. [FINANCING FOR RULE 36 PROGRAMS FOR ALTERNATIVE 390.19 LIVING PROGRAMS FOR CERTAIN OFFENDERS WITH MENTAL ILLNESS.] 390.20 Applicants for licensure of a Rule 36 program to provide an 390.21 alternative living program for certain offenders with mental 390.22 illness must be given special consideration and priority from 390.23 the Minnesota housing finance agency, as allowed, in order to 390.24 secure home loans for an alternative living program for certain 390.25 offenders with mental illness. 390.26 ARTICLE 10 390.27 DEPARTMENT OF HUMAN SERVICES MISCELLANEOUS 390.28 Section 1. [245.945] [REIMBURSEMENT TO OMBUDSMAN FOR 390.29 MENTAL HEALTH AND MENTAL RETARDATION.] 390.30 The commissioner shall obtain federal financial 390.31 participation for eligible activity by the ombudsman for mental 390.32 health and mental retardation. The ombudsman shall maintain and 390.33 transmit to the department of human services documentation that 390.34 is necessary in order to obtain federal funds. 390.35 Sec. 2. Minnesota Statutes 2002, section 245A.10, is 390.36 amended to read: 391.1 245A.10 [FEES.] 391.2 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 391.3 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 391.4 (b), the commissioner shall charge a fee for evaluation of 391.5 applications and inspection of programs,other than family day391.6care and foster care,which are licensed under this chapter. 391.7The commissioner may charge a fee for the licensing of school391.8age child care programs, in an amount sufficient to cover the391.9cost to the state agency of processing the license.391.10 (b) Notwithstanding paragraph (a), no application or 391.11 license fee shall be charged by the commissioner for family 391.12 child care, child foster care, adult foster care, or 391.13 state-operated programs, unless the state-operated program is an 391.14 intermediate care facility for persons with mental retardation 391.15 or related conditions (ICF/MR). 391.16 Subd. 2. [APPLICATION FEE FOR INITIAL LICENSE OR 391.17 CERTIFICATION.] (a) Unless exempt from paying a license fee 391.18 under subdivision 1, an applicant for an initial license or 391.19 certification issued by the commissioner shall submit a $500 391.20 application fee with each new application required under this 391.21 subdivision. The application fee shall not be prorated, is 391.22 nonrefundable, and is in lieu of the annual license or 391.23 certification fee that expires on December 31. The commissioner 391.24 shall not process an application until the application fee is 391.25 paid. 391.26 (b) Except as provided in clauses (1) to (3), an applicant 391.27 shall apply for a license to provide services at a specific 391.28 location. 391.29 (1) For a license to provide waivered services to persons 391.30 with developmental disabilities or related conditions, an 391.31 applicant shall submit an application for each county in which 391.32 the waivered services will be provided. 391.33 (2) For a license to provide semi-independent living 391.34 services to persons with developmental disabilities or related 391.35 conditions, an applicant shall submit a single application to 391.36 provide services statewide. 392.1 (3) For a license to provide independent living assistance 392.2 for youth under section 245A.22, an applicant shall submit a 392.3 single application to provide services statewide. 392.4 Subd. 3. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 392.5 WITH LICENSED CAPACITY.] (a) Child care centers and programs 392.6 with a licensed capacity shall pay an annual nonrefundable 392.7 license or certification fee based on the following schedule: 392.8 Licensed Capacity Child Care Residential 392.9 Center Program 392.10 License Fee License Fee 392.11 1 to 24 persons $300 $400 392.12 25 to 49 persons $450 $600 392.13 50 to 74 persons $600 $800 392.14 75 to 99 persons $750 $1,000 392.15 100 to 124 persons $900 $1,200 392.16 125 to 149 persons $1,200 $1,400 392.17 150 to 174 persons $1,400 $1,600 392.18 175 to 199 persons $1,600 $1,800 392.19 200 to 224 persons $1,800 $2,000 392.20 225 or more persons $2,000 $2,500 392.21 (b) A day training and habilitation program serving persons 392.22 with developmental disabilities or related conditions shall be 392.23 assessed a license fee based on the schedule in paragraph (a) 392.24 unless the license holder serves more than 50 percent of the 392.25 same persons at two or more locations in the community. When a 392.26 day training and habilitation program serves more than 50 392.27 percent of the same persons in two or more locations in a 392.28 community, the day training and habilitation program shall pay a 392.29 license fee based on the licensed capacity of the largest 392.30 facility and the other facility or facilities shall be charged a 392.31 license fee based on a licensed capacity of a residential 392.32 program serving one to 24 persons. 392.33 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 392.34 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 392.35 paragraph (b), a program without a stated licensed capacity 392.36 shall pay a license or certification fee of $400. 393.1 (b) A mental health center or mental health clinic 393.2 requesting certification for purposes of insurance and 393.3 subscriber contract reimbursement under Minnesota Rules, parts 393.4 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 393.5 per year. If the mental health center or mental health clinic 393.6 provides services at a primary location with satellite 393.7 facilities, the satellite facilities shall be certified with the 393.8 primary location without an additional charge. 393.9 Subd. 5. [LICENSE NOT ISSUED UNTIL LICENSE OR 393.10 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 393.11 license or certification until the license or certification fee 393.12 is paid. The commissioner shall send a bill for the license or 393.13 certification fee to the billing address identified by the 393.14 license holder. If the license holder does not submit the 393.15 license or certification fee payment by the due date, the 393.16 commissioner shall send the license holder a past due notice. 393.17 If the license holder fails to pay the license or certification 393.18 fee by the due date on the past due notice, the commissioner 393.19 shall send a final notice to the license holder informing the 393.20 license holder that the program license will expire on December 393.21 31 unless the license fee is paid before December 31. If a 393.22 license expires, the program is no longer licensed and, unless 393.23 exempt from licensure under section 245A.03, subdivision 2, must 393.24 not operate after the expiration date. After a license expires, 393.25 if the former license holder wishes to provide licensed 393.26 services, the former license holder must submit a new license 393.27 application and application fee under subdivision 2. 393.28 Sec. 3. Minnesota Statutes 2002, section 245A.11, 393.29 subdivision 2a, is amended to read: 393.30 Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 393.31 adult foster care license holder may have a maximum license 393.32 capacity of five if all persons in care are age 55 or over and 393.33 do not have a serious and persistent mental illness or a 393.34 developmental disability. 393.35 (b) The commissioner may grant variances to paragraph (a) 393.36 to allow a foster care provider with a licensed capacity of five 394.1 persons to admit an individual under the age of 55 if the 394.2 variance complies with section 245A.04, subdivision 9, and 394.3 approval of the variance is recommended by the county in which 394.4 the licensed foster care provider is located. 394.5 (c) The commissioner may grant variances to paragraph (a) 394.6 to allow the use of a fifth bed for emergency crisis services 394.7 for a person with serious and persistent mental illness or a 394.8 developmental disability, regardless of age, if the variance 394.9 complies with section 245A.04, subdivision 9, and approval of 394.10 the variance is recommended by the county in which the licensed 394.11 foster care provider is located. 394.12 (d) Notwithstanding paragraph (a), the commissioner may 394.13 issue an adult foster care license with a capacity of five 394.14 adults when the capacity is recommended by the county licensing 394.15 agency of the county in which the facility is located and if the 394.16 recommendation verifies that: 394.17 (1) the facility meets the physical environment 394.18 requirements in the adult foster care licensing rule; 394.19 (2) the five-bed living arrangement is specified for each 394.20 resident in the resident's: 394.21 (i) individualized plan of care; 394.22 (ii) individual service plan under section 256B.092, 394.23 subdivision 1b, if required; or 394.24 (iii) individual resident placement agreement under 394.25 Minnesota Rules, part 9555.5105, subpart 19, if required; 394.26 (3) the license holder obtains written and signed informed 394.27 consent from each resident or resident's legal representative 394.28 documenting the resident's informed choice to living in the home 394.29 and that the resident's refusal to consent would not have 394.30 resulted in service termination; and 394.31 (4) the facility was licensed for adult foster care before 394.32 March 1, 2003. 394.33 (e) The commissioner shall not issue a new adult foster 394.34 care license under paragraph (d) after June 30, 2005. The 394.35 commissioner shall allow a facility with an adult foster care 394.36 license issued under paragraph (d) before June 30, 2005, to 395.1 continue with a capacity of five or six adults if the license 395.2 holder continues to comply with the requirements in paragraph 395.3 (d). 395.4 Sec. 4. [245A.146] [CRIB USE IN LICENSED CHILD CARE 395.5 SETTINGS.] 395.6 Subdivision 1. [CONSUMER PRODUCT SAFETY COMMISSION WEB 395.7 LINK.] The commissioner shall maintain a link from the licensing 395.8 division Web site to the United States Consumer Product Safety 395.9 Commission Web site that addresses crib safety information. 395.10 Subd. 2. [DOCUMENTATION REQUIREMENT FOR LICENSE 395.11 HOLDERS.] (a) Effective January 1, 2004, all licensed child care 395.12 providers must maintain the following documentation for every 395.13 crib used by or that is accessible to any child in care: 395.14 (1) the crib's brand name; and 395.15 (2) the crib's model number. 395.16 (b) Any crib for which the license holder does not have the 395.17 documentation required under paragraph (a) must not be used by 395.18 or be accessible to children in care. 395.19 Subd. 3. [LICENSE HOLDER CERTIFICATION OF CRIBS.] (a) 395.20 Annually, from the date printed on the license, all license 395.21 holders shall check all their cribs' brand names and model 395.22 numbers against the United States Consumer Product Safety 395.23 Commission Web site listing of unsafe cribs. 395.24 (b) The license holder shall maintain written documentation 395.25 to be reviewed on site for each crib showing that the review 395.26 required in paragraph (a) has been completed, and which of the 395.27 following conditions applies: 395.28 (1) the crib was not identified as unsafe on the United 395.29 States Consumer Product Safety Commission Web site; 395.30 (2) the crib was identified as unsafe on the United States 395.31 Consumer Product Safety Commission Web site, but the license 395.32 holder has taken the action directed by the United States 395.33 Consumer Product Safety Commission to make the crib safe; or 395.34 (3) the crib was identified as unsafe on the United States 395.35 Consumer Product Safety Commission Web site, and the license 395.36 holder has removed the crib so that it is no longer used by or 396.1 accessible to children in care. 396.2 (c) Documentation of the review completed under this 396.3 subdivision shall be maintained by the license holder on site 396.4 and made available to parents of children in care and the 396.5 commissioner. 396.6 Subd. 4. [CRIB SAFETY STANDARDS AND INSPECTION.] (a) On at 396.7 least a monthly basis, the license holder shall perform safety 396.8 inspections of every crib used by or that is accessible to any 396.9 child in care, and must document the following: 396.10 (1) no corner posts extend more than 1/16 of an inch; 396.11 (2) no spaces between side slats exceed 2.375 inches; 396.12 (3) no mattress supports can be easily dislodged from any 396.13 point of the crib; 396.14 (4) no cutout designs are present on end panels; 396.15 (5) no heights of the rail and end panel are less than 26 396.16 inches when measured from the top of the rail or panel in the 396.17 highest position to the top of the mattress support in its 396.18 lowest position; 396.19 (6) no heights of the rail and end panel are less than nine 396.20 inches when measured from the top of the rail or panel in its 396.21 lowest position to the top of the mattress support in its 396.22 highest position; 396.23 (7) no screws, bolts, or hardware are loose or not secured, 396.24 and there is no use of woodscrews in components that are 396.25 designed to be assembled and disassembled by the crib owner; 396.26 (8) no sharp edges, points, or rough surfaces are present; 396.27 (9) no wood surfaces are rough, splintered, split, or 396.28 cracked; 396.29 (10) there are no tears in mesh of fabric sides in 396.30 non-full-size cribs; 396.31 (11) no mattress pads in non-full-size mesh or fabric cribs 396.32 exceed one inch; and 396.33 (12) no gaps between the mattress and any sides of the crib 396.34 are present. 396.35 (b) Upon discovery of any unsafe condition identified by 396.36 the license holder during the safety inspection required under 397.1 paragraph (a), the license holder shall immediately remove the 397.2 crib so that it is no longer used by or accessible to children 397.3 in care until necessary repairs are completed or the crib is 397.4 destroyed. 397.5 (c) Documentation of the inspections and actions taken with 397.6 unsafe cribs required in paragraphs (a) and (b) shall be 397.7 maintained on site by the license holder and made available to 397.8 parents of children in care and the commissioner. 397.9 Subd. 5. [COMMISSIONER INSPECTION.] During routine 397.10 licensing inspections, and when investigating complaints 397.11 regarding alleged violations of this section, the commissioner 397.12 shall review the provider's documentation required under 397.13 subdivisions 3 and 4. 397.14 Subd. 6. [FAILURE TO COMPLY.] The commissioner may issue a 397.15 licensing action under section 245A.06 or 245A.07 if a license 397.16 holder fails to comply with the requirements of this section. 397.17 [EFFECTIVE DATE.] This section is effective January 1, 2004. 397.18 Sec. 5. Minnesota Statutes 2002, section 252.27, 397.19 subdivision 2a, is amended to read: 397.20 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 397.21 adoptive parents of a minor child, including a child determined 397.22 eligible for medical assistance without consideration of 397.23 parental income, must contribute monthly to the cost of 397.24 services, unless the child is married or has been married, 397.25 parental rights have been terminated, or the child's adoption is 397.26 subsidized according to section 259.67 or through title IV-E of 397.27 the Social Security Act. 397.28 (b) For households with adjusted gross income equal to or 397.29 greater than 100 percent of federal poverty guidelines, the 397.30 parental contribution shall bethe greater of a minimum monthly397.31fee of $25 for households with adjusted gross income of $30,000397.32and over, or an amount to becomputed by applying the following 397.33 schedule of rates to the adjusted gross income of the natural or 397.34 adoptive parentsthat exceeds 150 percent of the federal poverty397.35guidelines for the applicable household size, the following397.36schedule of rates: 398.1 (1)on the amount of adjusted gross income over 150 percent398.2of poverty, but not over $50,000, ten percentif the adjusted 398.3 gross income is equal to or greater than 100 percent of federal 398.4 poverty guidelines and less than 175 percent of federal poverty 398.5 guidelines, the parental contribution is $4 per month; 398.6 (2)onif theamount ofadjusted gross incomeover 150398.7percent of poverty and over $50,000 but not over $60,000, 12398.8percentis equal to or greater than 175 percent of federal 398.9 poverty guidelines and less than or equal to 375 percent of 398.10 federal poverty guidelines, the parental contribution shall be 398.11 determined using a sliding fee scale established by the 398.12 commissioner of human services which begins at one percent of 398.13 adjusted gross income at 175 percent of federal poverty 398.14 guidelines and increases to 7.5 percent of adjusted gross income 398.15 for those with adjusted gross income up to 375 percent of 398.16 federal poverty guidelines; 398.17 (3)onif theamount ofadjusted gross incomeover 150is 398.18 greater than 375 percent of federal poverty, and over $60,000398.19but not over $75,000, 14 percentguidelines and less than 675 398.20 percent of federal poverty guidelines, the parental contribution 398.21 shall be 7.5 percent of adjusted gross income;and398.22 (4)on allif the adjusted gross incomeamounts over 150is 398.23 equal to or greater than 675 percent of federal poverty, and398.24over $75,000, 15 percentguidelines and less than 975 percent of 398.25 federal poverty guidelines, the parental contribution shall be 398.26 ten percent of adjusted gross income; and 398.27 (5) if the adjusted gross income is equal to or greater 398.28 than 975 percent of federal poverty guidelines, the parental 398.29 contribution shall be 12.5 percent of adjusted gross income. 398.30 If the child lives with the parent, theparental398.31contributionannual adjusted gross income is reduced by$200,398.32except that the parent must pay the minimum monthly $25 fee398.33under this paragraph$2,400 prior to calculating the parental 398.34 contribution. If the child resides in an institution specified 398.35 in section 256B.35, the parent is responsible for the personal 398.36 needs allowance specified under that section in addition to the 399.1 parental contribution determined under this section. The 399.2 parental contribution is reduced by any amount required to be 399.3 paid directly to the child pursuant to a court order, but only 399.4 if actually paid. 399.5 (c) The household size to be used in determining the amount 399.6 of contribution under paragraph (b) includes natural and 399.7 adoptive parents and their dependents under age 21, including 399.8 the child receiving services. Adjustments in the contribution 399.9 amount due to annual changes in the federal poverty guidelines 399.10 shall be implemented on the first day of July following 399.11 publication of the changes. 399.12 (d) For purposes of paragraph (b), "income" means the 399.13 adjusted gross income of the natural or adoptive parents 399.14 determined according to the previous year's federal tax form. 399.15 (e) The contribution shall be explained in writing to the 399.16 parents at the time eligibility for services is being 399.17 determined. The contribution shall be made on a monthly basis 399.18 effective with the first month in which the child receives 399.19 services. Annually upon redetermination or at termination of 399.20 eligibility, if the contribution exceeded the cost of services 399.21 provided, the local agency or the state shall reimburse that 399.22 excess amount to the parents, either by direct reimbursement if 399.23 the parent is no longer required to pay a contribution, or by a 399.24 reduction in or waiver of parental fees until the excess amount 399.25 is exhausted. 399.26 (f) The monthly contribution amount must be reviewed at 399.27 least every 12 months; when there is a change in household size; 399.28 and when there is a loss of or gain in income from one month to 399.29 another in excess of ten percent. The local agency shall mail a 399.30 written notice 30 days in advance of the effective date of a 399.31 change in the contribution amount. A decrease in the 399.32 contribution amount is effective in the month that the parent 399.33 verifies a reduction in income or change in household size. 399.34 (g) Parents of a minor child who do not live with each 399.35 other shall each pay the contribution required under paragraph 399.36 (a), except that a. An amount equal to the annual court-ordered 400.1 child support payment actually paid on behalf of the child 400.2 receiving services shall be deducted from thecontribution400.3 adjusted gross income of the parent making the payment prior to 400.4 calculating the parental contribution under paragraph (b). 400.5 (h) The contribution under paragraph (b) shall be increased 400.6 by an additional five percent if the local agency determines 400.7 that insurance coverage is available but not obtained for the 400.8 child. For purposes of this section, "available" means the 400.9 insurance is a benefit of employment for a family member at an 400.10 annual cost of no more than five percent of the family's annual 400.11 income. For purposes of this section, "insurance" means health 400.12 and accident insurance coverage, enrollment in a nonprofit 400.13 health service plan, health maintenance organization, 400.14 self-insured plan, or preferred provider organization. 400.15 Parents who have more than one child receiving services 400.16 shall not be required to pay more than the amount for the child 400.17 with the highest expenditures. There shall be no resource 400.18 contribution from the parents. The parent shall not be required 400.19 to pay a contribution in excess of the cost of the services 400.20 provided to the child, not counting payments made to school 400.21 districts for education-related services. Notice of an increase 400.22 in fee payment must be given at least 30 days before the 400.23 increased fee is due. 400.24 (i) The contribution under paragraph (b) shall be reduced 400.25 by $300 per fiscal year if, in the 12 months prior to July 1: 400.26 (1) the parent applied for insurance for the child; 400.27 (2) the insurer denied insurance; 400.28 (3) the parents submitted a complaint or appeal, in writing 400.29 to the insurer, submitted a complaint or appeal, in writing, to 400.30 the commissioner of health or the commissioner of commerce, or 400.31 litigated the complaint or appeal; and 400.32 (4) as a result of the dispute, the insurer reversed its 400.33 decision and granted insurance. 400.34 For purposes of this section, "insurance" has the meaning 400.35 given in paragraph (h). 400.36 A parent who has requested a reduction in the contribution 401.1 amount under this paragraph shall submit proof in the form and 401.2 manner prescribed by the commissioner or county agency, 401.3 including, but not limited to, the insurer's denial of 401.4 insurance, the written letter or complaint of the parents, court 401.5 documents, and the written response of the insurer approving 401.6 insurance. The determinations of the commissioner or county 401.7 agency under this paragraph are not rules subject to chapter 14. 401.8 [EFFECTIVE DATE.] This section is effective July 1, 2003. 401.9 Sec. 6. Minnesota Statutes 2002, section 253B.05, is 401.10 amended by adding a subdivision to read: 401.11 Subd. 5. [DETOXIFICATION.] If a person is intoxicated in 401.12 public and held under this section for detoxification, a 401.13 treatment facility may release the person without providing 401.14 notice under subdivision 3, paragraph (c), as soon as the 401.15 treatment facility determines the person is no longer 401.16 intoxicated. Notice must be provided to the peace officer or 401.17 health officer who transported the person, or the appropriate 401.18 law enforcement agency, if the officer or agency requests 401.19 notification. 401.20 [EFFECTIVE DATE.] This section is effective the day 401.21 following final enactment. 401.22 Sec. 7. Minnesota Statutes 2002, section 256.012, is 401.23 amended to read: 401.24 256.012 [MINNESOTA MERIT SYSTEM.] 401.25 Subdivision 1. [MINNESOTA MERIT SYSTEM.] The commissioner 401.26 of human services shall promulgate by rule personnel standards 401.27 on a merit basis in accordance with federal standards for a 401.28 merit system of personnel administration for all employees of 401.29 county boards engaged in the administration of community social 401.30 services or income maintenance programs, all employees of human 401.31 services boards that have adopted the rules of the Minnesota 401.32 merit system, and all employees of local social services 401.33 agencies. 401.34 Excluded from the rules are employees of institutions and 401.35 hospitals under the jurisdiction of the aforementioned boards 401.36 and agencies; employees of county personnel systems otherwise 402.1 provided for by law that meet federal merit system requirements; 402.2 duly appointed or elected members of the aforementioned boards 402.3 and agencies; and the director of community social services and 402.4 employees in positions that, upon the request of the appointing 402.5 authority, the commissioner chooses to exempt, provided the 402.6 exemption accords with the federal standards for a merit system 402.7 of personnel administration. 402.8 Subd. 2. [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 402.9 merit system operations shall be paid by counties and other 402.10 entities that utilize merit system services. Total costs shall 402.11 be determined by the commissioner annually and must be set at a 402.12 level that neither significantly overrecovers nor underrecovers 402.13 the costs of providing the service. The costs of merit system 402.14 services shall be prorated among participating counties in 402.15 accordance with an agreement between the commissioner and these 402.16 counties. Participating counties will be billed quarterly in 402.17 advance and shall pay their share of the costs upon receipt of 402.18 the billing. 402.19 (b) This subdivision does not apply to counties with 402.20 personnel systems otherwise provided for by law that meet 402.21 federal merit system requirements. A county that applies to 402.22 withdraw from the merit system must notify the commissioner of 402.23 the county's intent to develop its own personnel system. This 402.24 notice must be provided in writing by December 31 of the year 402.25 preceding the year of final participation in the merit system. 402.26 The county may withdraw once the commissioner has certified that 402.27 its personnel system meets federal merit system requirements. 402.28 (c) A county merit systems operations account is 402.29 established in the special revenue fund. Payments received by 402.30 the commissioner for merit system costs must be deposited into 402.31 the merit system operations account and must be used for the 402.32 purpose of providing the services and administering the merit 402.33 system. 402.34 (d) County payment of merit system costs is effective July 402.35 1, 2003; however, payment for the period from July 1, 2003, 402.36 through December 31, 2003, shall be made no later than January 403.1 31, 2004. 403.2 Subd. 3. [PARTICIPATING COUNTY CONSULTATION.] The 403.3 commissioner shall ensure that participating counties are 403.4 consulted regularly and offered the opportunity to provide input 403.5 on the management of the merit system to ensure effective use of 403.6 resources and to monitor system performance. 403.7 Sec. 8. [256.0451] [HEARING PROCEDURES.] 403.8 Subdivision 1. [SCOPE.] The requirements in this section 403.9 apply to all fair hearings and appeals under section 256.045, 403.10 subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6), 403.11 and (7). Except as provided in subdivisions 3 and 19, the 403.12 requirements under this section apply to fair hearings and 403.13 appeals under section 256.045, subdivision 3, paragraph (a), 403.14 clauses (4), (8), and (9). 403.15 The term "person" is used in this section to mean an 403.16 individual who, on behalf of themselves or their household, is 403.17 appealing or disputing or challenging an action, a decision, or 403.18 a failure to act, by an agency in the human services system. 403.19 When a person involved in a proceeding under this section is 403.20 represented by an attorney or by an authorized representative, 403.21 the term "person" also refers to the person's attorney or 403.22 authorized representative. Any notice sent to the person 403.23 involved in the hearing must also be sent to the person's 403.24 attorney or authorized representative. 403.25 The term "agency" includes the county human services 403.26 agency, the state human services agency, and, where applicable, 403.27 any entity involved under a contract, subcontract, grant, or 403.28 subgrant with the state agency or with a county agency, that 403.29 provides or operates programs or services in which appeals are 403.30 governed by section 256.045. 403.31 Subd. 2. [ACCESS TO FILES.] A person involved in a fair 403.32 hearing appeal has the right of access to the person's complete 403.33 case files and to examine all private welfare data on the person 403.34 which has been generated, collected, stored, or disseminated by 403.35 the agency. A person involved in a fair hearing appeal has the 403.36 right to a free copy of all documents in the case file involved 404.1 in a fair hearing appeal. "Case file" means the information, 404.2 documents, and data, in whatever form, which have been 404.3 generated, collected, stored, or disseminated by the agency in 404.4 connection with the person and the program or service involved. 404.5 Subd. 3. [AGENCY APPEAL SUMMARY.] (a) Except in fair 404.6 hearings and appeals under section 256.045, subdivision 3, 404.7 paragraph (a), clauses (4), (8), and (9), the agency involved in 404.8 an appeal must prepare a state agency appeal summary for each 404.9 fair hearing appeal. The state agency appeal summary shall be 404.10 mailed or otherwise delivered to the person who is involved in 404.11 the appeal at least three working days before the date of the 404.12 hearing. The state agency appeal summary must also be mailed or 404.13 otherwise delivered to the department's appeals office at least 404.14 three working days before the date of the fair hearing appeal. 404.15 (b) In addition, the appeals referee shall confirm that the 404.16 state agency appeal summary is mailed or otherwise delivered to 404.17 the person involved in the appeal as required under paragraph 404.18 (a). The person involved in the fair hearing should be 404.19 provided, through the state agency appeal summary or other 404.20 reasonable methods, appropriate information about the procedures 404.21 for the fair hearing and an adequate opportunity to prepare. 404.22 These requirements apply equally to the state agency or an 404.23 entity under contract when involved in the appeal. 404.24 (c) The contents of the state agency appeal summary must be 404.25 adequate to inform the person involved in the appeal of the 404.26 evidence on which the agency relies and the legal basis for the 404.27 agency's action or determination. 404.28 Subd. 4. [ENFORCING ACCESS TO FILES.] A person involved in 404.29 a fair hearing appeal may enforce the right of access to data 404.30 and copies of the case file by making a request to the appeals 404.31 referee. The appeals referee will make an appropriate order 404.32 enforcing the person's rights under the Minnesota Government 404.33 Data Practices Act, including but not limited to, ordering 404.34 access to files, data, and documents; continuing a hearing to 404.35 allow adequate time for access to data; or prohibiting use by 404.36 the agency of files, data, or documents which have been 405.1 generated, collected, stored, or disseminated without compliance 405.2 with the Minnesota Government Data Practices Act and which have 405.3 not been provided to the person involved in the appeal. 405.4 Subd. 5. [PREHEARING CONFERENCES.] (a) The appeals referee 405.5 prior to a fair hearing appeal may hold a prehearing conference 405.6 to further the interests of justice or efficiency and must 405.7 include the person involved in the appeal. A person involved in 405.8 a fair hearing appeal or the agency may request a prehearing 405.9 conference. The prehearing conference may be conducted by 405.10 telephone, in person, or in writing. The prehearing conference 405.11 may address the following: 405.12 (1) disputes regarding access to files, evidence, 405.13 subpoenas, or testimony; 405.14 (2) the time required for the hearing or any need for 405.15 expedited procedures or decision; 405.16 (3) identification or clarification of legal or other 405.17 issues that may arise at the hearing; 405.18 (4) identification of and possible agreement to factual 405.19 issues; and 405.20 (5) scheduling and any other matter which will aid in the 405.21 proper and fair functioning of the hearing. 405.22 (b) The appeals referee shall make a record or otherwise 405.23 contemporaneously summarize the prehearing conference in 405.24 writing, which shall be sent to both the person involved in the 405.25 hearing, the person's attorney or authorized representative, and 405.26 the agency. 405.27 Subd. 6. [APPEAL REQUEST FOR EMERGENCY ASSISTANCE OR 405.28 URGENT MATTER.] (a) When an appeal involves an application for 405.29 emergency assistance, the agency involved shall mail or 405.30 otherwise deliver the state agency appeal summary to the 405.31 department's appeals office within two working days of receiving 405.32 the request for an appeal. A person may also request that a 405.33 fair hearing be held on an emergency basis when the issue 405.34 requires an immediate resolution. The appeals referee shall 405.35 schedule the fair hearing on the earliest available date 405.36 according to the urgency of the issue involved. Issuance of the 406.1 recommended decision after an emergency hearing shall be 406.2 expedited. 406.3 (b) The commissioner shall issue a written decision within 406.4 five working days of receiving the recommended decision, shall 406.5 immediately inform the parties of the outcome by telephone, and 406.6 shall mail the decision no later than two working days following 406.7 the date of the decision. 406.8 Subd. 7. [CONTINUANCE, RESCHEDULING, OR ADJOURNING A 406.9 HEARING.] (a) A person involved in a fair hearing, or the 406.10 agency, may request a continuance, a rescheduling, or an 406.11 adjournment of a hearing for a reasonable period of time. The 406.12 grounds for granting a request for a continuance, a 406.13 rescheduling, or adjournment of a hearing include, but are not 406.14 limited to, the following: 406.15 (1) to reasonably accommodate the appearance of a witness; 406.16 (2) to ensure that the person has adequate opportunity for 406.17 preparation and for presentation of evidence and argument; 406.18 (3) to ensure that the person or the agency has adequate 406.19 opportunity to review, evaluate, and respond to new evidence, or 406.20 where appropriate, to require that the person or agency review, 406.21 evaluate, and respond to new evidence; 406.22 (4) to permit the person involved and the agency to 406.23 negotiate toward resolution of some or all of the issues where 406.24 both agree that additional time is needed; 406.25 (5) to permit the agency to reconsider a previous action or 406.26 determination; 406.27 (6) to permit or to require the performance of actions not 406.28 previously taken; and 406.29 (7) to provide additional time or to permit or require 406.30 additional activity by the person or agency as the interests of 406.31 fairness may require. 406.32 (b) Requests for continuances or for rescheduling may be 406.33 made orally or in writing. The person or agency requesting the 406.34 continuance or rescheduling must first make reasonable efforts 406.35 to contact the other participants in the hearing or their 406.36 representatives, and seek to obtain an agreement on the 407.1 request. Requests for continuance or rescheduling should be 407.2 made no later than three working days before the scheduled date 407.3 of the hearing, unless there is a good cause as specified in 407.4 subdivision 13. Granting a continuance or rescheduling may be 407.5 conditioned upon a waiver by the requester of applicable time 407.6 limits, but should not cause unreasonable delay. 407.7 Subd. 8. [SUBPOENAS.] A person involved in a fair hearing 407.8 or the agency may request a subpoena for a witness, for 407.9 evidence, or for both. A reasonable number of subpoenas shall 407.10 be issued to require the attendance and the testimony of 407.11 witnesses, and the production of evidence relating to any issue 407.12 of fact in the appeal hearing. The request for a subpoena must 407.13 show a need for the subpoena and the general relevance to the 407.14 issues involved. The subpoena shall be issued in the name of 407.15 the department and shall be served and enforced as provided in 407.16 section 357.22 and the Minnesota Rules of Civil Procedure. 407.17 An individual or entity served with a subpoena may petition 407.18 the appeals referee in writing to vacate or modify a subpoena. 407.19 The appeals referee shall resolve such a petition in a 407.20 prehearing conference involving all parties and shall make a 407.21 written decision. A subpoena may be vacated or modified if the 407.22 appeals referee determines that the testimony or evidence sought 407.23 does not relate with reasonable directness to the issues of the 407.24 fair hearing appeal; that the subpoena is unreasonable, over 407.25 broad, or oppressive; that the evidence sought is repetitious or 407.26 cumulative; or that the subpoena has not been served reasonably 407.27 in advance of the time when the appeal hearing will be held. 407.28 Subd. 9. [NO EX PARTE CONTACT.] The appeals referee shall 407.29 not have ex parte contact on substantive issues with the agency 407.30 or with any person or witness in a fair hearing appeal. No 407.31 employee of the department or agency shall review, interfere 407.32 with, change, or attempt to influence the recommended decision 407.33 of the appeals referee in any fair hearing appeal, except 407.34 through the procedure allowed in subdivision 18. The 407.35 limitations in this subdivision do not affect the commissioner's 407.36 authority to review or reconsider decisions or make final 408.1 decisions. 408.2 Subd. 10. [TELEPHONE OR FACE-TO-FACE HEARING.] A fair 408.3 hearing appeal may be conducted by telephone, by other 408.4 electronic media, or by an in-person, face-to-face hearing. At 408.5 the request of the person involved in a fair hearing appeal or 408.6 their representative, a face-to-face hearing shall be conducted 408.7 with all participants personally present before the appeals 408.8 referee. 408.9 Subd. 11. [HEARING FACILITIES AND EQUIPMENT.] The appeals 408.10 referee shall conduct the hearing in the county where the person 408.11 involved resides, unless an alternate location is mutually 408.12 agreed upon before the hearing, or unless the person has agreed 408.13 to a hearing by telephone. Hearings under section 256.045, 408.14 subdivision 3, paragraph (a), clauses (4), (8), and (9), must be 408.15 conducted in the county where the determination was made, unless 408.16 an alternate location is mutually agreed upon before the 408.17 hearing. The hearing room shall be of sufficient size and 408.18 layout to adequately accommodate both the number of individuals 408.19 participating in the hearing and any identified special needs of 408.20 any individual participating in the hearing. The appeals 408.21 referee shall ensure that all communication and recording 408.22 equipment that is necessary to conduct the hearing and to create 408.23 an adequate record is present and functioning properly. If any 408.24 necessary communication or recording equipment fails or ceases 408.25 to operate effectively, the appeals referee shall take any steps 408.26 necessary, including stopping or adjourning the hearing, until 408.27 the necessary equipment is present and functioning properly. 408.28 All reasonable efforts shall be undertaken to prevent and avoid 408.29 any delay in the hearing process caused by defective 408.30 communication or recording equipment. 408.31 Subd. 12. [INTERPRETER AND TRANSLATION SERVICES.] The 408.32 appeals referee has a duty to inquire and to determine whether 408.33 any participant in the hearing needs the services of an 408.34 interpreter or translator in order to participate in or to 408.35 understand the hearing process. Necessary interpreter or 408.36 translation services must be provided at no charge to the person 409.1 involved in the hearing. If it appears that interpreter or 409.2 translation services are needed but are not available for the 409.3 scheduled hearing, the appeals referee shall continue or 409.4 postpone the hearing until appropriate services can be provided. 409.5 Subd. 13. [FAILURE TO APPEAR; GOOD CAUSE.] If a person 409.6 involved in a fair hearing appeal fails to appear at the 409.7 hearing, the appeals referee may dismiss the appeal. The person 409.8 may reopen the appeal if within ten working days the person 409.9 submits information to the appeals referee to show good cause 409.10 for not appearing. Good cause can be shown when there is: 409.11 (1) a death or serious illness in the person's family; 409.12 (2) a personal injury or illness which reasonably prevents 409.13 the person from attending the hearing; 409.14 (3) an emergency, crisis, or unforeseen event which 409.15 reasonably prevents the person from attending the hearing; 409.16 (4) an obligation or responsibility of the person which a 409.17 reasonable person, in the conduct of one's affairs, could 409.18 reasonably determine takes precedence over attending the 409.19 hearing; 409.20 (5) lack of or failure to receive timely notice of the 409.21 hearing in the preferred language of the person involved in the 409.22 hearing; and 409.23 (6) excusable neglect, excusable inadvertence, excusable 409.24 mistake, or other good cause as determined by the appeals 409.25 referee. 409.26 Subd. 14. [COMMENCEMENT OF HEARING.] The appeals referee 409.27 shall begin each hearing by describing the process to be 409.28 followed in the hearing, including the swearing-in of witnesses, 409.29 how testimony and evidence are presented, the order of examining 409.30 and cross-examining witnesses, and the opportunity for an 409.31 opening statement and a closing statement. The appeals referee 409.32 shall identify for the participants the issues to be addressed 409.33 at the hearing and shall explain to the participants the burden 409.34 of proof which applies to the person involved and the agency. 409.35 The appeals referee shall confirm, prior to proceeding with the 409.36 hearing, that the state agency appeal summary, if required under 410.1 subdivision 3, has been properly completed and provided to the 410.2 person involved in the hearing, and that the person has been 410.3 provided documents and an opportunity to review the case file, 410.4 as provided in this section. 410.5 Subd. 15. [CONDUCT OF THE HEARING.] The appeals referee 410.6 shall act in a fair and impartial manner at all times. At the 410.7 beginning of the hearing the agency must designate one person as 410.8 their representative who shall be responsible for presenting the 410.9 agency's evidence and questioning any witnesses. The appeals 410.10 referee shall make sure that the person and the agency are 410.11 provided sufficient time to present testimony and evidence, to 410.12 confront and cross-examine all adverse witnesses, and to make 410.13 any relevant statement at the hearing. The appeals referee 410.14 shall make reasonable efforts to explain the hearing process to 410.15 persons who are not represented, and shall ensure that the 410.16 hearing is conducted fairly and efficiently. Upon the 410.17 reasonable request of the person or the agency involved, the 410.18 appeals referee may direct witnesses to remain outside the 410.19 hearing room, except during their individual testimony. The 410.20 appeals referee shall not terminate the hearing before affording 410.21 the person and the agency a complete opportunity to submit all 410.22 admissible evidence, and reasonable opportunity for oral or 410.23 written statement. When a hearing extends beyond the time which 410.24 was anticipated, the hearing shall be rescheduled or continued 410.25 from day-to-day until completion. Hearings that have been 410.26 continued shall be timely scheduled to minimize delay in the 410.27 disposition of the appeal. 410.28 Subd. 16. [SCOPE OF ISSUES ADDRESSED AT THE HEARING.] The 410.29 hearing shall address the correctness and legality of the 410.30 agency's action and shall not be limited simply to a review of 410.31 the propriety of the agency's action. The person involved may 410.32 raise and present evidence on all legal claims or defenses 410.33 arising under state or federal law as a basis for appealing or 410.34 disputing an agency action, but not constitutional claims beyond 410.35 the jurisdiction of the fair hearing. The appeals referee may 410.36 take official notice of adjudicative facts. 411.1 Subd. 17. [BURDEN OF PERSUASION.] The burden of persuasion 411.2 is governed by specific state or federal law and regulations 411.3 that apply to the subject of the hearing. If there is no 411.4 specific law, then the participant in the hearing who asserts 411.5 the truth of a claim is under the burden to persuade the appeals 411.6 referee that the claim is true. 411.7 Subd. 18. [INVITING COMMENT BY DEPARTMENT.] The appeals 411.8 referee or the commissioner may determine that a written comment 411.9 by the department about the policy implications of a specific 411.10 legal issue could help resolve a pending appeal. Such a written 411.11 policy comment from the department shall be obtained only by a 411.12 written request that is also sent to the person involved and to 411.13 the agency or its representative. When such a written comment 411.14 is received, both the person involved in the hearing and the 411.15 agency shall have adequate opportunity to review, evaluate, and 411.16 respond to the written comment, including submission of 411.17 additional testimony or evidence, and cross-examination 411.18 concerning the written comment. 411.19 Subd. 19. [DEVELOPING THE RECORD.] The appeals referee 411.20 shall accept all evidence, except evidence privileged by law, 411.21 that is commonly accepted by reasonable people in the conduct of 411.22 their affairs as having probative value on the issues to be 411.23 addressed at the hearing. Except in fair hearings and appeals 411.24 under section 256.045, subdivision 3, paragraph (a), clauses 411.25 (4), (8), and (9), in cases involving medical issues such as a 411.26 diagnosis, a physician's report, or a review team's decision, 411.27 the appeals referee shall consider whether it is necessary to 411.28 have a medical assessment other than that of the individual 411.29 making the original decision. When necessary, the appeals 411.30 referee shall require an additional assessment be obtained at 411.31 agency expense and made part of the hearing record. The appeals 411.32 referee shall ensure for all cases that the record is 411.33 sufficiently complete to make a fair and accurate decision. 411.34 Subd. 20. [UNREPRESENTED PERSONS.] In cases involving 411.35 unrepresented persons, the appeals referee shall take 411.36 appropriate steps to identify and develop in the hearing 412.1 relevant facts necessary for making an informed and fair 412.2 decision. These steps may include, but are not limited to, 412.3 asking questions of witnesses, and referring the person to a 412.4 legal services office. An unrepresented person shall be 412.5 provided an adequate opportunity to respond to testimony or 412.6 other evidence presented by the agency at the hearing. The 412.7 appeals referee shall ensure that an unrepresented person has a 412.8 full and reasonable opportunity at the hearing to establish a 412.9 record for appeal. 412.10 Subd. 21. [CLOSING OF THE RECORD.] The agency must present 412.11 its evidence prior to or at the hearing. The agency shall not 412.12 be permitted to submit evidence after the hearing except by 412.13 agreement at the hearing between the person involved, the 412.14 agency, and the appeals referee. If evidence is submitted after 412.15 the hearing, based on such an agreement, the person involved and 412.16 the agency must be allowed sufficient opportunity to respond to 412.17 the evidence. When necessary, the record shall remain open to 412.18 permit a person to submit additional evidence on the issues 412.19 presented at the hearing. 412.20 Subd. 22. [DECISIONS.] A timely, written decision must be 412.21 issued in every appeal. Each decision must contain a clear 412.22 ruling on the issues presented in the appeal hearing, and should 412.23 contain a ruling only on questions directly presented by the 412.24 appeal and the arguments raised in the appeal. 412.25 (a) [TIMELINESS.] A written decision must be issued within 412.26 90 days of the date the person involved requested the appeal 412.27 unless a shorter time is required by law. An additional 30 days 412.28 is provided in those cases where the commissioner refuses to 412.29 accept the recommended decision. 412.30 (b) [CONTENTS OF HEARING DECISION.] The decision must 412.31 contain both findings of fact and conclusions of law, clearly 412.32 separated and identified. The findings of fact must be based on 412.33 the entire record. Each finding of fact made by the appeals 412.34 referee shall be supported by a preponderance of the evidence 412.35 unless a different standard is required under the regulations of 412.36 a particular program. The "preponderance of the evidence" 413.1 means, in light of the record as a whole, the evidence leads the 413.2 appeals referee to believe that the finding of fact is more 413.3 likely to be true than not true. The legal claims or arguments 413.4 of a participant do not constitute either a finding of fact or a 413.5 conclusion of law, except to the extent the appeals referee 413.6 adopts an argument as a finding of fact or conclusion of law. 413.7 The decision shall contain at least the following: 413.8 (1) a listing of the date and place of the hearing and the 413.9 participants at the hearing; 413.10 (2) a clear and precise statement of the issues, including 413.11 the dispute under consideration and the specific points which 413.12 must be resolved in order to decide the case; 413.13 (3) a listing of the material, including exhibits, records, 413.14 reports, placed into evidence at the hearing, and upon which the 413.15 hearing decision is based; 413.16 (4) the findings of fact based upon the entire hearing 413.17 record. The findings of fact must be adequate to inform the 413.18 participants and any interested person in the public of the 413.19 basis of the decision. If the evidence is in conflict on an 413.20 issue which must be resolved, the findings of fact must state 413.21 the reasoning used in resolving the conflict; 413.22 (5) conclusions of law that address the legal authority for 413.23 the hearing and the ruling, and which give appropriate attention 413.24 to the claims of the participants to the hearing; 413.25 (6) a clear and precise statement of the decision made 413.26 resolving the dispute under consideration in the hearing; and 413.27 (7) written notice of the right to appeal to district court 413.28 or to request reconsideration, and of the actions required and 413.29 the time limits for taking appropriate action to appeal to 413.30 district court or to request a reconsideration. 413.31 (c) [NO INDEPENDENT INVESTIGATION.] The appeals referee 413.32 shall not independently investigate facts or otherwise rely on 413.33 information not presented at the hearing. The appeals referee 413.34 may not contact other agency personnel, except as provided in 413.35 subdivision 18. The appeals referee's recommended decision must 413.36 be based exclusively on the testimony and evidence presented at 414.1 the hearing, and legal arguments presented, and the appeals 414.2 referee's research and knowledge of the law. 414.3 (d) [RECOMMENDED DECISION.] The commissioner will review 414.4 the recommended decision and accept or refuse to accept the 414.5 decision according to section 256.045, subdivision 5. 414.6 Subd. 23. [REFUSAL TO ACCEPT RECOMMENDED ORDERS.] (a) If 414.7 the commissioner refuses to accept the recommended order from 414.8 the appeals referee, the person involved, the person's attorney 414.9 or authorized representative, and the agency shall be sent a 414.10 copy of the recommended order, a detailed explanation of the 414.11 basis for refusing to accept the recommended order, and the 414.12 proposed modified order. 414.13 (b) The person involved and the agency shall have at least 414.14 ten business days to respond to the proposed modification of the 414.15 recommended order. The person involved and the agency may 414.16 submit a legal argument concerning the proposed modification, 414.17 and may propose to submit additional evidence that relates to 414.18 the proposed modified order. 414.19 Subd. 24. [RECONSIDERATION.] Reconsideration may be 414.20 requested within 30 days of the date of the commissioner's final 414.21 order. If reconsideration is requested, the other participants 414.22 in the appeal shall be informed of the request. The person 414.23 seeking reconsideration has the burden to demonstrate why the 414.24 matter should be reconsidered. The request for reconsideration 414.25 may include legal argument and may include proposed additional 414.26 evidence supporting the request. The other participants shall 414.27 be sent a copy of all material submitted in support of the 414.28 request for reconsideration and must be given ten days to 414.29 respond. 414.30 (a) [FINDINGS OF FACT.] When the requesting party raises a 414.31 question as to the appropriateness of the findings of fact, the 414.32 commissioner shall review the entire record. 414.33 (b) [CONCLUSIONS OF LAW.] When the requesting party 414.34 questions the appropriateness of a conclusion of law, the 414.35 commissioner shall consider the recommended decision, the 414.36 decision under reconsideration, and the material submitted in 415.1 connection with the reconsideration. The commissioner shall 415.2 review the remaining record as necessary to issue a reconsidered 415.3 decision. 415.4 (c) [WRITTEN DECISION.] The commissioner shall issue a 415.5 written decision on reconsideration in a timely fashion. The 415.6 decision must clearly inform the parties that this constitutes 415.7 the final administrative decision, advise the participants of 415.8 the right to seek judicial review, and the deadline for doing so. 415.9 Subd. 25. [ACCESS TO APPEAL DECISIONS.] Appeal decisions 415.10 must be maintained in a manner so that the public has ready 415.11 access to previous decisions on particular topics, subject to 415.12 appropriate procedures for safeguarding names, personal 415.13 identifying information, and other private data on the 415.14 individual persons involved in the appeal. 415.15 Sec. 9. Minnesota Statutes 2002, section 256B.092, 415.16 subdivision 5, is amended to read: 415.17 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 415.18 apply for any federal waivers necessary to secure, to the extent 415.19 allowed by law, federal financial participation under United 415.20 States Code, title 42, sections 1396 et seq., as amended, for 415.21 the provision of services to persons who, in the absence of the 415.22 services, would need the level of care provided in a regional 415.23 treatment center or a community intermediate care facility for 415.24 persons with mental retardation or related conditions. The 415.25 commissioner may seek amendments to the waivers or apply for 415.26 additional waivers under United States Code, title 42, sections 415.27 1396 et seq., as amended, to contain costs. The commissioner 415.28 shall ensure that payment for the cost of providing home and 415.29 community-based alternative services under the federal waiver 415.30 plan shall not exceed the cost of intermediate care services 415.31 including day training and habilitation services that would have 415.32 been provided without the waivered services. 415.33 The commissioner shall seek an amendment to the 1915c home 415.34 and community-based waiver to allow properly licensed adult 415.35 foster care homes to provide residential services to up to five 415.36 individuals with mental retardation or a related condition. If 416.1 the amendment to the waiver is approved, adult foster care 416.2 providers that can accommodate five individuals shall increase 416.3 their capacity to five beds, provided the providers continue to 416.4 meet all applicable licensing requirements. 416.5 (b) The commissioner, in administering home and 416.6 community-based waivers for persons with mental retardation and 416.7 related conditions, shall ensure that day services for eligible 416.8 persons are not provided by the person's residential service 416.9 provider, unless the person or the person's legal representative 416.10 is offered a choice of providers and agrees in writing to 416.11 provision of day services by the residential service provider. 416.12 The individual service plan for individuals who choose to have 416.13 their residential service provider provide their day services 416.14 must describe how health, safety, and protection needs will be 416.15 met by frequent and regular contact with persons other than the 416.16 residential service provider. 416.17 Sec. 10. Minnesota Statutes 2002, section 256B.092, is 416.18 amended by adding a subdivision to read: 416.19 Subd. 5a. [INCREASING ADULT FOSTER CARE CAPACITY TO SERVE 416.20 FIVE PERSONS.] (a) When an adult foster care provider increases 416.21 the capacity of an existing home licensed to serve four persons 416.22 to serve a fifth person under this section, the county agency 416.23 shall reduce the contracted per diem cost for room and board and 416.24 the mental retardation or a related condition waiver services of 416.25 the existing foster care home by an average of 14 percent for 416.26 all individuals living in that home. A county agency may 416.27 average the required per diem rate reductions across several 416.28 adult foster care homes that expand capacity under this section, 416.29 to achieve the necessary overall per diem reduction. 416.30 (b) Following the contract changes in paragraph (a), the 416.31 commissioner shall adjust: 416.32 (1) individual county allocations for mental retardation or 416.33 a related condition waivered services by the amount of savings 416.34 that results from the changes made for mental retardation or a 416.35 related condition waiver recipients for whom the county is 416.36 financially responsible; and 417.1 (2) group residential housing rate payments to the adult 417.2 foster home by the amount of savings that results from the 417.3 changes made. 417.4 (c) Effective July 1, 2003, when a new five-person adult 417.5 foster care home is licensed under this section, county agencies 417.6 shall not establish group residential housing room and board 417.7 rates and mental retardation or a related condition waiver 417.8 service rates for the new home that exceed 86 percent of the 417.9 average per diem room and board and mental retardation or a 417.10 related condition waiver services costs of four-person homes 417.11 serving persons with comparable needs and in the same geographic 417.12 area. A county agency developing more than one new five-person 417.13 adult foster care home may average the required per diem rates 417.14 across the homes to achieve the necessary overall per diem 417.15 reductions. 417.16 (d) The commissioner shall reduce the individual county 417.17 allocations for mental retardation or a related condition 417.18 waivered services by the savings resulting from the per diem 417.19 limits on adult foster care recipients for whom the county is 417.20 financially responsible, and shall limit the group residential 417.21 housing rate for a new five-person adult foster care home. 417.22 Sec. 11. Minnesota Statutes 2002, section 257.0769, is 417.23 amended to read: 417.24 257.0769 [FUNDING FOR THE OMBUDSPERSON PROGRAM.] 417.25 Subdivision 1. [APPROPRIATIONS.] (a) Money is appropriated 417.26 from the special fund authorized by section 256.01, subdivision 417.27 2, clause (15), to the Indian affairs council for the purposes 417.28 of sections 257.0755 to 257.0768. 417.29 (b) Money is appropriated from the special fund authorized 417.30 by section 256.01, subdivision 2, clause (15), to the council on 417.31 affairs of Chicano/Latino people for the purposes of sections 417.32 257.0755 to 257.0768. 417.33 (c) Money is appropriated from the special fund authorized 417.34 by section 256.01, subdivision 2, clause (15), to the Council of 417.35 Black Minnesotans for the purposes of sections 257.0755 to 417.36 257.0768. 418.1 (d) Money is appropriated from the special fund authorized 418.2 by section 256.01, subdivision 2, clause (15), to the Council on 418.3 Asian-Pacific Minnesotans for the purposes of sections 257.0755 418.4 to 257.0768. 418.5 Subd. 2. [TITLE IV-E REIMBURSEMENT.] The commissioner 418.6 shall obtain federal title IV-E financial participation for 418.7 eligible activity by the ombudsperson for families under section 418.8 257.0755. The ombudsperson for families shall maintain and 418.9 transmit to the department of human services documentation that 418.10 is necessary in order to obtain federal funds. 418.11 Sec. 12. Minnesota Statutes 2002, section 259.21, 418.12 subdivision 6, is amended to read: 418.13 Subd. 6. [AGENCY.] "Agency" means an organization or 418.14 department of government designated or authorized by law to 418.15 place children for adoption or any person, group of persons, 418.16 organization, association or society licensed or certified by 418.17 the commissioner of human services to place children for 418.18 adoption, including a Minnesota federally recognized tribe. 418.19 Sec. 13. Minnesota Statutes 2002, section 259.67, 418.20 subdivision 7, is amended to read: 418.21 Subd. 7. [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 418.22 the commissioner, and the provisions of this subdivision a 418.23 child-placing agency licensed in Minnesota or any other state, 418.24 or local or tribal social services agency shall receive a 418.25 reimbursement from the commissioner equal to 100 percent of the 418.26 reasonable and appropriate cost of providing adoption services 418.27 for a child certified as eligible for adoption assistance under 418.28 subdivision 4. Such assistance may include adoptive family 418.29 recruitment, counseling, and special training when needed. A 418.30 child-placing agency licensed in Minnesota or any other state 418.31 shall receive reimbursement for adoption services it purchases 418.32 for or directly provides to an eligible child. A local or 418.33 tribal social services agency shall receive such reimbursement 418.34 only for adoption services it purchases for an eligible child. 418.35 (b) A child-placing agency licensed in Minnesota or any 418.36 other state or local or tribal social services agency seeking 419.1 reimbursement under this subdivision shall enter into a 419.2 reimbursement agreement with the commissioner before providing 419.3 adoption services for which reimbursement is sought. No 419.4 reimbursement under this subdivision shall be made to an agency 419.5 for services provided prior to entering a reimbursement 419.6 agreement. Separate reimbursement agreements shall be made for 419.7 each child and separate records shall be kept on each child for 419.8 whom a reimbursement agreement is made. Funds encumbered and 419.9 obligated under such an agreement for the child remain available 419.10 until the terms of the agreement are fulfilled or the agreement 419.11 is terminated. 419.12 (c) When a local or tribal social services agency uses a 419.13 purchase of service agreement to provide services reimbursable 419.14 under a reimbursement agreement, the commissioner may make 419.15 reimbursement payments directly to the agency providing the 419.16 service if direct reimbursement is specified by the purchase of 419.17 service agreement, and if the request for reimbursement is 419.18 submitted by the local or tribal social services agency along 419.19 with a verification that the service was provided. 419.20 Sec. 14. Minnesota Statutes 2002, section 393.07, 419.21 subdivision 5, is amended to read: 419.22 Subd. 5. [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 419.23 MERIT SYSTEM.] The commissioner of human services shall have 419.24 authority to require such methods of administration as are 419.25 necessary for compliance with requirements of the federal Social 419.26 Security Act, as amended, and for the proper and efficient 419.27 operation of all welfare programs. This authority to require 419.28 methods of administration includes methods relating to the 419.29 establishment and maintenance of personnel standards on a merit 419.30 basis as concerns all employees of local social services 419.31 agencies except those employed in an institution, sanitarium, or 419.32 hospital. The commissioner of human services shall exercise no 419.33 authority with respect to the selection, tenure of office, and 419.34 compensation of any individual employed in accordance with such 419.35 methods. The adoption of methods relating to the establishment 419.36 and maintenance of personnel standards on a merit basis of all 420.1 such employees of the local social services agencies and the 420.2 examination thereof, and the administration thereof shall be 420.3 directed and controlled exclusively by the commissioner of human 420.4 services. 420.5 Notwithstanding the provisions of any other law to the 420.6 contrary, every employee of every local social services agency 420.7 who occupies a position which requires as prerequisite to 420.8 eligibility therefor graduation from an accredited four year 420.9 college or a certificate of registration as a registered nurse 420.10 under section 148.231, must be employed in such position under 420.11 the merit system established under authority of this 420.12 subdivision. Every such employee now employed by a local social 420.13 services agency and who is not under said merit system is 420.14 transferred, as of January 1, 1962, to a position of comparable 420.15 classification in the merit system with the same status therein 420.16 as the employee had in the county of employment prior thereto 420.17 and every such employee shall be subject to and have the benefit 420.18 of the merit system, including seniority within the local social 420.19 services agency, as though the employee had served thereunder 420.20 from the date of entry into the service of the local social 420.21 services agency. 420.22By March 1, 1996, the commissioner of human services shall420.23report to the chair of the senate health care and family420.24services finance division and the chair of the house health and420.25human services finance division on options for the delivery of420.26merit-based employment services by entities other than the420.27department of human services in order to reduce the420.28administrative costs to the state while maintaining compliance420.29with applicable federal regulations.420.30 Sec. 15. [FEDERAL GRANTS TO MAINTAIN INDEPENDENCE AND 420.31 EMPLOYMENT.] 420.32 (a) The commissioner of human services shall seek federal 420.33 funding to participate in grant activities authorized under 420.34 Public Law 106-170, the Ticket to Work and Work Incentives 420.35 Improvement Act of 1999. The purpose of the federal grant funds 420.36 are to establish: 421.1 (1) a demonstration project to improve the availability of 421.2 health care services and benefits to workers with potentially 421.3 severe physical or mental impairments that are likely to lead to 421.4 disability without access to Medicaid services; and 421.5 (2) a comprehensive initiative to remove employment 421.6 barriers that includes linkages with non-Medicaid programs, 421.7 including those administered by the Social Security 421.8 Administration and the Department of Labor. 421.9 (b) The state's proposal for a demonstration project in 421.10 paragraph (a), clause (1), shall focus on assisting workers with: 421.11 (1) a serious mental illness as defined by the federal 421.12 Center for Mental Health Services; 421.13 (2) concurrent mental health and chemical dependency 421.14 conditions; and 421.15 (3) young adults up to the age of 24 who have a physical or 421.16 mental impairment that is severe and will potentially lead to a 421.17 determination of disability by the Social Security 421.18 Administration or state medical review team. 421.19 (c) The commissioner is authorized to take the actions 421.20 necessary to design and implement the demonstration project in 421.21 paragraph (a), clause (1), that include: 421.22 (1) establishing work-related requirements for 421.23 participation in the demonstration project; 421.24 (2) working with stakeholders to establish methods that 421.25 identify the population that will be served in the demonstration 421.26 project; 421.27 (3) seeking funding for activities to design, implement, 421.28 and evaluate the demonstration project; 421.29 (4) taking necessary administrative actions to implement 421.30 the demonstration project by July 1, 2004, or within 180 days of 421.31 receiving formal notice from the Centers for Medicare and 421.32 Medicaid Services that a grant has been awarded; 421.33 (5) establishing limits on income and resources; 421.34 (6) establishing a method to coordinate health care 421.35 benefits and payments with other coverage that is available to 421.36 the participants; 422.1 (7) establishing premiums based on guidelines that are 422.2 consistent with those found in Minnesota Statutes, section 422.3 256B.057, subdivision 9, for employed persons with disabilities; 422.4 (8) notifying local agencies of potentially eligible 422.5 individuals in accordance with Minnesota Statutes, section 422.6 256B.19, subdivision 2c; and 422.7 (9) limiting the caseload of qualifying individuals 422.8 participating in the demonstration project. 422.9 (d) The state's proposal for the comprehensive employment 422.10 initiative in paragraph (a), clause (2), shall focus on: 422.11 (1) infrastructure development that creates incentives for 422.12 greater work effort and participation by people with 422.13 disabilities or workers with severe physical or mental 422.14 impairments; 422.15 (2) consumer access to information and benefit assistance 422.16 that enables the person to maximize employment and career 422.17 advancement potential; 422.18 (3) improved consumer access to essential assistance and 422.19 support; 422.20 (4) enhanced linkages between state and federal agencies to 422.21 decrease the barriers to employment experienced by persons with 422.22 disabilities or workers with severe physical or mental 422.23 impairments; and 422.24 (5) research efforts to provide useful information to guide 422.25 future policy development on both the state and federal levels. 422.26 (e) Funds awarded by the federal government for the 422.27 purposes of this section are appropriated to the commissioner of 422.28 human services. 422.29 Sec. 16. [REPEALER.] 422.30 Minnesota Statutes 2002, section 256.482, subdivision 8, is 422.31 repealed. 422.32 ARTICLE 11 422.33 PROGRAMS AND FUNDING TRANSFERRED FROM 422.34 THE DEPARTMENT OF CHILDREN, FAMILIES AND LEARNING 422.35 Section 1. Minnesota Statutes 2002, section 119B.011, 422.36 subdivision 5, is amended to read: 423.1 Subd. 5. [CHILD CARE.] "Child care" means the care of a 423.2 child by someone other than a parentor, stepparent, legal 423.3 guardian, eligible relative caregiver, or the spouses of any of 423.4 the foregoing in or outside the child's own home for gain or 423.5 otherwise, on a regular basis, for any part of a 24-hour day. 423.6 Sec. 2. Minnesota Statutes 2002, section 119B.011, 423.7 subdivision 6, is amended to read: 423.8 Subd. 6. [CHILD CARE FUND.] "Child care fund" means a 423.9 program under this chapter providing: 423.10 (1) financial assistance for child care to parents engaged 423.11 in employment, job search, or education and training leading to 423.12 employment, or an at-home infant care subsidy; and 423.13 (2) grants to develop, expand, and improve the access and 423.14 availability of child care services statewide. 423.15 Sec. 3. Minnesota Statutes 2002, section 119B.011, 423.16 subdivision 15, is amended to read: 423.17 Subd. 15. [INCOME.] "Income" means earned or unearned 423.18 income received by all family members, including public 423.19 assistance cash benefitsand at-home infant care subsidy423.20payments, unless specifically excluded and child support and 423.21 maintenance distributed to the family under section 256.741, 423.22 subdivision 15. The following are excluded from income: funds 423.23 used to pay for health insurance premiums for family members, 423.24 Supplemental Security Income, scholarships, work-study income, 423.25 and grants that cover costs or reimbursement for tuition, fees, 423.26 books, and educational supplies; student loans for tuition, 423.27 fees, books, supplies, and living expenses; state and federal 423.28 earned income tax credits; assistance specifically excluded as 423.29 income by law; in-kind income such as food stamps, energy 423.30 assistance, foster care assistance, medical assistance, child 423.31 care assistance, and housing subsidies; earned income of 423.32 full-time or part-time students up to the age of 19, who have 423.33 not earned a high school diploma or GED high school equivalency 423.34 diploma including earnings from summer employment; grant awards 423.35 under the family subsidy program; nonrecurring lump sum income 423.36 only to the extent that it is earmarked and used for the purpose 424.1 for which it is paid; and any income assigned to the public 424.2 authority according to section 256.741. 424.3 Sec. 4. Minnesota Statutes 2002, section 119B.011, 424.4 subdivision 19, is amended to read: 424.5 Subd. 19. [PROVIDER.] "Provider" means (1) an individual 424.6 or child care center or facility, either licensed or unlicensed, 424.7 providing legal child care services as defined under section 424.8 245A.03, or (2) an individual or child care center or facility 424.9 holding a valid child care license issued by another state or a 424.10 tribe and providing child care services in the licensing state 424.11 or in the area under the licensing tribe's jurisdiction. A 424.12 legally unlicensedregisteredfamily child care provider must be 424.13 at least 18 years of age, and not a member of the MFIP 424.14 assistance unit or a member of the family receiving child care 424.15 assistance to be authorized under this chapter. 424.16 Sec. 5. Minnesota Statutes 2002, section 119B.011, is 424.17 amended by adding a subdivision to read: 424.18 Subd. 19a. [REGISTRATION.] "Registration" means the 424.19 process used by a county to determine whether the provider 424.20 selected by a family applying for or receiving child care 424.21 assistance to care for that family's children meets the 424.22 requirements necessary for payment of child care assistance for 424.23 care provided by that provider. 424.24 Sec. 6. Minnesota Statutes 2002, section 119B.02, 424.25 subdivision 1, is amended to read: 424.26 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 424.27 shall develop standards for county and human services boards to 424.28 provide child care services to enable eligible families to 424.29 participate in employment, training, or education programs. 424.30 Within the limits of available appropriations, the commissioner 424.31 shall distribute money to counties to reduce the costs of child 424.32 care for eligible families. The commissioner shall adopt rules 424.33 to govern the program in accordance with this section. The 424.34 rules must establish a sliding schedule of fees for parents 424.35 receiving child care services. The rules shall provide that 424.36 funds received as a lump sum payment of child support arrearages 425.1 shall not be counted as income to a family in the month received 425.2 but shall be prorated over the 12 months following receipt and 425.3 added to the family income during those months.In the rules425.4adopted under this section, county and human services boards425.5shall be authorized to establish policies for payment of child425.6care spaces for absent children, when the payment is required by425.7the child's regular provider. The rules shall not set a maximum425.8number of days for which absence payments can be made, but425.9instead shall direct the county agency to set limits and pay for425.10absences according to the prevailing market practice in the425.11county. County policies for payment of absences shall be425.12subject to the approval of the commissioner.The commissioner 425.13 shall maximize the use of federal money under title I and title 425.14 IV of Public LawNumber104-193, the Personal Responsibility and 425.15 Work Opportunity Reconciliation Act of 1996, and other programs 425.16 that provide federal or state reimbursement for child care 425.17 services for low-income families who are in education, training, 425.18 job search, or other activities allowed under those programs. 425.19 Money appropriated under this section must be coordinated with 425.20 the programs that provide federal reimbursement for child care 425.21 services to accomplish this purpose. Federal reimbursement 425.22 obtained must be allocated to the county that spent money for 425.23 child care that is federally reimbursable under programs that 425.24 provide federal reimbursement for child care services. The 425.25 counties shall use the federal money to expand child care 425.26 services. The commissioner may adopt rules under chapter 14 to 425.27 implement and coordinate federal program requirements. 425.28 Sec. 7. [119B.025] [DUTIES OF COUNTIES.] 425.29 Subdivision 1. [FACTORS WHICH MUST BE VERIFIED.] The 425.30 county shall use the universal application at the initial 425.31 application or at a redetermination if a universal application 425.32 has not been previously completed. When using the universal 425.33 application, the county shall verify the following: 425.34 (1) identity of adults; 425.35 (2) presence of the minor child in the home, if 425.36 questionable; 426.1 (3) age; 426.2 (4) immigration status, if related to eligibility; 426.3 (5) social security number, if given; 426.4 (6) income; 426.5 (7) spousal support and child support payments made to 426.6 persons outside the household; 426.7 (8) residence; and 426.8 (9) inconsistent information, if related to eligibility. 426.9 Subd. 2. [SOCIAL SECURITY NUMBERS.] The county must 426.10 request social security numbers from all applicants for child 426.11 care assistance under this chapter. A county may not deny child 426.12 care assistance solely on the basis of failure of an applicant 426.13 to report a social security number. 426.14 Sec. 8. Minnesota Statutes 2002, section 119B.03, 426.15 subdivision 9, is amended to read: 426.16 Subd. 9. [PORTABILITY POOL.] (a) The commissioner shall 426.17 establish a pool of up to five percent of the annual 426.18 appropriation for the basic sliding fee program to provide 426.19 continuous child care assistance for eligible families who move 426.20 between Minnesota counties. At the end of each allocation 426.21 period, any unspent funds in the portability pool must be used 426.22 for assistance under the basic sliding fee program. If 426.23 expenditures from the portability pool exceed the amount of 426.24 money available, the reallocation pool must be reduced to cover 426.25 these shortages. 426.26 (b) To be eligible for portable basic sliding fee 426.27 assistance, a family that has moved from a county in which it 426.28 was receiving basic sliding fee assistance to a county with a 426.29 waiting list for the basic sliding fee program must: 426.30 (1) meet the income and eligibility guidelines for the 426.31 basic sliding fee program; and 426.32 (2) notify the new county of residence within3060 days of 426.33 moving andapply for basic sliding fee assistance insubmit 426.34 information to the new county of residence to verify eligibility 426.35 for the basic sliding fee program. 426.36 (c) The receiving county must: 427.1 (1) accept administrative responsibility for applicants for 427.2 portable basic sliding fee assistance at the end of the two 427.3 months of assistance under the Unitary Residency Act; 427.4 (2) continue basic sliding fee assistance for the lesser of 427.5 six months or until the family is able to receive assistance 427.6 under the county's regular basic sliding program; and 427.7 (3) notify the commissioner through the quarterly reporting 427.8 process of any family that meets the criteria of the portable 427.9 basic sliding fee assistance pool. 427.10 Sec. 9. Minnesota Statutes 2002, section 119B.05, 427.11 subdivision 1, is amended to read: 427.12 Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible 427.13 for child care assistance under the MFIP child care program are: 427.14 (1) MFIP participants who are employed or in job search and 427.15 meet the requirements of section 119B.10; 427.16 (2) persons who are members of transition year families 427.17 under section 119B.011, subdivision 20, and meet the 427.18 requirements of section 119B.10; 427.19 (3) families who are participating in employment 427.20 orientation or job search, or other employment or training 427.21 activities that are included in an approved employability 427.22 development plan under chapter 256K; 427.23 (4) MFIP families who are participating in work job search, 427.24 job support, employment, or training activities as required in 427.25 their job search support or employment plan, or in appeals, 427.26 hearings, assessments, or orientations according to chapter 427.27 256J; 427.28 (5) MFIP families who are participating in social services 427.29 activities under chapter 256J or 256K as required in their 427.30 employment plan approved according to chapter 256J or 256K; and 427.31 (6) families who are participating in programs as required 427.32 in tribal contracts under section 119B.02, subdivision 2, or 427.33 256.01, subdivision 2. 427.34 Sec. 10. Minnesota Statutes 2002, section 119B.09, 427.35 subdivision 7, is amended to read: 427.36 Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 428.1 date of eligibility for child care assistance under this chapter 428.2 is the later of the date the application was signed; the 428.3 beginning date of employment, education, or training; or the 428.4 date a determination has been made that the applicant is a 428.5 participant in employment and training services under Minnesota 428.6 Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.The428.7date of eligibility for the basic sliding fee at-home infant428.8child care program is the later of the date the infant is born428.9or, in a county with a basic sliding fee waiting list, the date428.10the family applies for at-home infant child care.428.11 (b)Payment ceases for a family under the at-home infant428.12child care program when a family has used a total of 12 months428.13of assistance as specified under section 119B.061.Payment of 428.14 child care assistance for employed persons on MFIP is effective 428.15 the date of employment or the date of MFIP eligibility, 428.16 whichever is later. Payment of child care assistance for MFIP 428.17 or work first participants in employment and training services 428.18 is effective the date of commencement of the services or the 428.19 date of MFIP or work first eligibility, whichever is later. 428.20 Payment of child care assistance for transition year child care 428.21 must be made retroactive to the date of eligibility for 428.22 transition year child care. 428.23 Sec. 11. Minnesota Statutes 2002, section 119B.11, 428.24 subdivision 2a, is amended to read: 428.25 Subd. 2a. [RECOVERY OF OVERPAYMENTS.] An amount of child 428.26 care assistance paid to a recipient in excess of the payment due 428.27 is recoverable by the county agency. If the family remains 428.28 eligible for child care assistance, the overpayment must be 428.29 recovered through recoupment as identified in Minnesota Rules, 428.30 part 3400.0140, subpart 19, except that the overpayments must be 428.31 calculated and collected on a service period basis. If the 428.32 family no longer remains eligible for child care assistance, the 428.33 county may choose to initiate efforts to recover overpayments 428.34 from the family for overpayment less than $50. If the 428.35 overpayment is greater than or equal to $50, the county shall 428.36 seek voluntary repayment of the overpayment from the family. If 429.1 the county is unable to recoup the overpayment through voluntary 429.2 repayment, the county shall initiate civil court proceedings to 429.3 recover the overpayment unless the county's costs to recover the 429.4 overpayment will exceed the amount of the overpayment. A family 429.5 with an outstanding debt under this subdivision is not eligible 429.6 for child care assistance until: (1) the debt is paid in full; 429.7 or (2) satisfactory arrangements are made with the county to 429.8 retire the debt consistent with the requirements of this chapter 429.9 and Minnesota Rules, chapter 3400, and the family is in 429.10 compliance with the arrangements. 429.11 Sec. 12. Minnesota Statutes 2002, section 119B.12, 429.12 subdivision 2, is amended to read: 429.13 Subd. 2. [PARENT FEE.] A family must be assessed a parent 429.14 fee for each service period. A family'smonthlyparent fee must 429.15 be a fixed percentage of its annual gross income. Parent fees 429.16 must apply to families eligible for child care assistance under 429.17 sections 119B.03 and 119B.05. Income must be as defined in 429.18 section 119B.011, subdivision 15. The fixed percent is based on 429.19 the relationship of the family's annual gross income to 100 429.20 percent of state median income. Beginning January 1, 1998, 429.21 parent fees must begin at 75 percent of the poverty level. The 429.22 minimum parent fees for families between 75 percent and 100 429.23 percent of poverty level must be $5 permonthservice period. 429.24 Parent fees must be established in rule and must provide for 429.25 graduated movement to full payment. 429.26 Sec. 13. [119B.125] [PROVIDER REQUIREMENTS.] 429.27 Subdivision 1. [AUTHORIZATION.] Except as provided in 429.28 subdivision 3, a county must authorize the provider chosen by an 429.29 applicant or a participant before the county can authorize 429.30 payment for care provided by that provider. The commissioner 429.31 must establish the requirements necessary for authorization of 429.32 providers. 429.33 Subd. 2. [UNSAFE CARE.] A county may deny authorization as 429.34 a child care provider to any applicant or rescind authorization 429.35 of any provider when the county knows or has reason to believe 429.36 that the provider is unsafe or that the circumstances of the 430.1 chosen child care arrangement are unsafe. The county must 430.2 include the conditions under which a provider or care 430.3 arrangement will be determined to be unsafe in the county's 430.4 child care fund plan under section 119B.08, subdivision 3. 430.5 Subd. 3. [PROVISIONAL PAYMENT.] After a county receives a 430.6 completed application from a provider, the county may issue 430.7 provisional authorization and payment to the provider during the 430.8 time needed to determine whether to give final authorization to 430.9 the provider. 430.10 Subd. 4. [RECORD KEEPING REQUIREMENT.] All providers must 430.11 keep daily attendance records for children receiving child care 430.12 assistance and must make those records available immediately to 430.13 the county upon request. The daily attendance records must be 430.14 retained for six years after the date of service. A county may 430.15 deny authorization as a child care provider to any applicant or 430.16 rescind authorization of any provider when the county knows or 430.17 has reason to believe that the provider has not complied with 430.18 the record keeping requirement in this subdivision. 430.19 Sec. 14. Minnesota Statutes 2002, section 119B.13, is 430.20 amended by adding a subdivision to read: 430.21 Subd. 1a. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 430.22 RATES.] (a) Legal nonlicensed family child care providers 430.23 receiving reimbursement under this chapter must be paid in 430.24 hourly blocks of time for families receiving assistance. 430.25 (b) The maximum rate paid to legal nonlicensed family child 430.26 care providers must be 90 percent of the county maximum hourly 430.27 rate for licensed family child care providers. In counties 430.28 where the maximum hourly rate for licensed family child care 430.29 providers is higher than the maximum weekly rate for those 430.30 providers divided by 50, the maximum hourly rate that may be 430.31 paid to legal nonlicensed family child care providers is the 430.32 rate equal to the maximum weekly rate for licensed family child 430.33 care providers divided by 50 and then multiplied by 0.90. 430.34 (c) A rate which includes a provider bonus paid under 430.35 subdivision 2 or a special needs rate paid under subdivision 3 430.36 may be in excess of the maximum rate allowed under this 431.1 subdivision. 431.2 (d) Legal nonlicensed family child care providers receiving 431.3 reimbursement under this chapter may not be paid registration 431.4 fees for families receiving assistance. 431.5 Sec. 15. Minnesota Statutes 2002, section 119B.13, 431.6 subdivision 2, is amended to read: 431.7 Subd. 2. [PROVIDER RATE BONUS FOR ACCREDITATION.] A family 431.8 child care provider or child care center shall be paid a ten 431.9 percent bonus above the maximum rate established in subdivision 431.10 1 or 1a, if the provider or center holds a current early 431.11 childhood development credential approved by the commissioner, 431.12 up to the actual provider rate. 431.13 Sec. 16. Minnesota Statutes 2002, section 119B.13, 431.14 subdivision 6, is amended to read: 431.15 Subd. 6. [PROVIDER PAYMENTS.] (a) Counties or the state 431.16 shall make vendor payments to the child care provider or pay the 431.17 parent directly for eligible child care expenses. 431.18 (b) If payments for child care assistance are made to 431.19 providers, the provider shall bill the county for services 431.20 provided within ten days of the end of themonth ofservice 431.21 period. If bills are submittedin accordance with the431.22provisions of this subdivisionwithin ten days of the end of the 431.23 service period, a county or the state shall issue payment to the 431.24 provider of child care under the child care fund within 30 days 431.25 of receivingan invoicea bill from the provider. Counties or 431.26 the state may establish policies that make payments on a more 431.27 frequent basis. 431.28 (c) All bills must be submitted within 60 days of the last 431.29 date of service on the bill. A county may pay a bill submitted 431.30 more than 60 days after the last date of service if the provider 431.31 shows good cause why the bill was not submitted within 60 days. 431.32 Good cause must be defined in the county's child care fund plan 431.33 under section 119B.08, subdivision 3, and the definition of good 431.34 cause must include county error. A county may not pay any bill 431.35 submitted more than a year after the last date of service on the 431.36 bill. 432.1 (d) A county may stop payment issued to a provider or may 432.2 refuse to pay a bill submitted by a provider if: 432.3 (1) the provider admits to intentionally giving the county 432.4 materially false information on the provider's billing forms; or 432.5 (2) a county finds by a preponderance of the evidence that 432.6 the provider intentionally gave the county materially false 432.7 information on the provider's billing forms. 432.8 (e) A county's payment policies must be included in the 432.9 county's child care plan under section 119B.08, subdivision 3. 432.10 If payments are made by the state, in addition to being in 432.11 compliance with this subdivision, the payments must be made in 432.12 compliance with section 16A.124. 432.13 Sec. 17. Minnesota Statutes 2002, section 119B.19, 432.14 subdivision 7, is amended to read: 432.15 Subd. 7. [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 432.16 Within each region, a child care resource and referral program 432.17 must: 432.18 (1) maintain one database of all existing child care 432.19 resources and services and one database of family referrals; 432.20 (2) provide a child care referral service for families; 432.21 (3) develop resources to meet the child care service needs 432.22 of families; 432.23 (4) increase the capacity to provide culturally responsive 432.24 child care services; 432.25 (5) coordinate professional development opportunities for 432.26 child care and school-age care providers; 432.27 (6) administer and award child care services grants; 432.28 (7) administer and provide loans for child development 432.29 education and training;and432.30 (8) cooperate with the Minnesota Child Care Resource and 432.31 Referral Network and its member programs to develop effective 432.32 child care services and child care resources; and 432.33 (9) assist in fostering coordination, collaboration, and 432.34 planning among child care programs and community programs such 432.35 as school readiness, Head Start, early childhood family 432.36 education, local interagency early intervention committees, 433.1 early childhood screening, special education services, and other 433.2 early childhood care and education services and programs that 433.3 provide flexible, family-focused services to families with young 433.4 children to the extent possible. 433.5 Sec. 18. Minnesota Statutes 2002, section 119B.21, 433.6 subdivision 11, is amended to read: 433.7 Subd. 11. [STATEWIDE ADVISORY TASK FORCE.] The 433.8 commissioner may convene a statewide advisory task force to 433.9 advise the commissioner on statewide grants or other child care 433.10 issues. The following groups must be represented: family child 433.11 care providers, child care center programs, school-age care 433.12 providers, parents who use child care services, health services, 433.13 social services, Head Start, public schools, school-based early 433.14 childhood programs, special education programs, employers, and 433.15 other citizens with demonstrated interest in child care issues. 433.16 Additional members may be appointed by the commissioner. The 433.17 commissioner may compensate members for their travel, child 433.18 care, and child care provider substitute expenses for attending 433.19 task force meetings. The commissioner may also pay a stipend to 433.20 parent representatives for participating in task force meetings. 433.21 Sec. 19. Minnesota Statutes 2002, section 256.046, 433.22 subdivision 1, is amended to read: 433.23 Subdivision 1. [HEARING AUTHORITY.] A local agency must 433.24 initiate an administrative fraud disqualification hearing for 433.25 individuals accused of wrongfully obtaining assistance or 433.26 intentional program violations, in lieu of a criminal action 433.27 when it has not been pursued, in the aid to families with 433.28 dependent children program formerly codified in sections 256.72 433.29 to 256.87, MFIP, child care assistance programs, general 433.30 assistance, family general assistance program formerly codified 433.31 in section 256D.05, subdivision 1, clause (15), Minnesota 433.32 supplemental aid, medical care, or food stamp programs. The 433.33 hearing is subject to the requirements of section 256.045 and 433.34 the requirements in Code of Federal Regulations, title 7, 433.35 section 273.16, for the food stamp program and title 45, section 433.36 235.112, as of September 30, 1995, for the cash grant, child 434.1 care assistance administered under chapter 119B, and medical 434.2 care programs. 434.3 Sec. 20. Minnesota Statutes 2002, section 256.0471, 434.4 subdivision 1, is amended to read: 434.5 Subdivision 1. [QUALIFYING OVERPAYMENT.] Any overpayment 434.6 for assistance granted undersection 119B.05chapter 119B, the 434.7 MFIP program formerly codified under sections 256.031 to 434.8 256.0361, and the AFDC program formerly codified under sections 434.9 256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 434.10 and the food stamp program, except agency error claims, become a 434.11 judgment by operation of law 90 days after the notice of 434.12 overpayment is personally served upon the recipient in a manner 434.13 that is sufficient under rule 4.03(a) of the Rules of Civil 434.14 Procedure for district courts, or by certified mail, return 434.15 receipt requested. This judgment shall be entitled to full 434.16 faith and credit in this and any other state. 434.17 Sec. 21. Minnesota Statutes 2002, section 256.98, 434.18 subdivision 8, is amended to read: 434.19 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 434.20 found to be guilty of wrongfully obtaining assistance by a 434.21 federal or state court or by an administrative hearing 434.22 determination, or waiver thereof, through a disqualification 434.23 consent agreement, or as part of any approved diversion plan 434.24 under section 401.065, or any court-ordered stay which carries 434.25 with it any probationary or other conditions, in the Minnesota 434.26 family investment program, the food stamp program, the general 434.27 assistance program, the group residential housing program, or 434.28 the Minnesota supplemental aid program shall be disqualified 434.29 from that program. In addition, any person disqualified from 434.30 the Minnesota family investment program shall also be 434.31 disqualified from the food stamp program. The needs of that 434.32 individual shall not be taken into consideration in determining 434.33 the grant level for that assistance unit: 434.34 (1) for one year after the first offense; 434.35 (2) for two years after the second offense; and 434.36 (3) permanently after the third or subsequent offense. 435.1 The period of program disqualification shall begin on the 435.2 date stipulated on the advance notice of disqualification 435.3 without possibility of postponement for administrative stay or 435.4 administrative hearing and shall continue through completion 435.5 unless and until the findings upon which the sanctions were 435.6 imposed are reversed by a court of competent jurisdiction. The 435.7 period for which sanctions are imposed is not subject to 435.8 review. The sanctions provided under this subdivision are in 435.9 addition to, and not in substitution for, any other sanctions 435.10 that may be provided for by law for the offense involved. A 435.11 disqualification established through hearing or waiver shall 435.12 result in the disqualification period beginning immediately 435.13 unless the person has become otherwise ineligible for 435.14 assistance. If the person is ineligible for assistance, the 435.15 disqualification period begins when the person again meets the 435.16 eligibility criteria of the program from which they were 435.17 disqualified and makes application for that program. 435.18 (b) A family receiving assistance through child care 435.19 assistance programs under chapter 119B with a family member who 435.20 is found to be guilty of wrongfully obtaining child care 435.21 assistance by a federal court, state court, or an administrative 435.22 hearing determination or waiver, through a disqualification 435.23 consent agreement, as part of an approved diversion plan under 435.24 section 401.065, or a court-ordered stay with probationary or 435.25 other conditions, is disqualified from child care assistance 435.26 programs. The disqualifications must be for periods of three 435.27 months, six months, and two years for the first, second, and 435.28 third offenses respectively. Subsequent violations must result 435.29 in permanent disqualification. During the disqualification 435.30 period, disqualification from any child care program must extend 435.31 to all child care programs and must be immediately applied. 435.32 (c) A provider caring for children receiving assistance 435.33 through child care assistance programs under chapter 119B is 435.34 disqualified from receiving payment for child care services from 435.35 the child care assistance program under chapter 119B when the 435.36 provider is found to have wrongfully obtained child care 436.1 assistance by a federal court, state court, or an administrative 436.2 hearing determination or waiver under section 256.046, through a 436.3 disqualification consent agreement, as part of an approved 436.4 diversion plan under section 401.065, or a court-ordered stay 436.5 with probationary or other conditions. The disqualification 436.6 must be for a period of one year for the first offense and two 436.7 years for the second offense. Any subsequent violation must 436.8 result in permanent disqualification. The disqualification 436.9 period must be imposed immediately after a determination is made 436.10 under this paragraph. During the disqualification period, the 436.11 provider is disqualified from receiving payment from any child 436.12 care program under chapter 119B. 436.13 Sec. 22. [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 436.14 The parent fee schedule in Minnesota Rules, part 3400.0100, 436.15 subpart 4, is amended as follows: 436.16 (1) parent fees for families with incomes greater than 100 436.17 percent of the federal poverty guidelines but less than 35.01 436.18 percent of the state median income must equal 2.42 percent of 436.19 adjusted gross income for families at 35 percent of the state 436.20 median income; 436.21 (2) parent fees for families with incomes equal to or 436.22 greater than 35.01 percent of the state median income but less 436.23 than 42.01 percent of the state median income must equal 2.97 436.24 percent of adjusted gross income for families at 42 percent of 436.25 the state median income; 436.26 (3) parent fees for families with incomes equal to or 436.27 greater than 42.01 percent of the state median income but less 436.28 than 75 percent of the state median income must begin at 4.13 436.29 percent of adjusted gross income and provide for graduated 436.30 movement of fee increases using the fixed percentages of income 436.31 listed in Minnesota Rules, part 3400.0100, subpart 4, increased 436.32 by ten percent; and 436.33 (4) parent fees for families equal to 75 percent of the 436.34 state median income must equal 22 percent of gross annual income. 436.35 Sec. 23. [REPEALER.] 436.36 (a) Minnesota Statutes 2002, section 119B.061, is repealed. 437.1 (b) Laws 2001, First Special Session chapter 3, article 1, 437.2 section 16, is repealed. 437.3 ARTICLE 12 437.4 APPROPRIATIONS 437.5 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 437.6 The sums shown in the columns marked "APPROPRIATIONS" are 437.7 appropriated from the general fund, or any other fund named, to 437.8 the agencies and for the purposes specified in the sections of 437.9 this article, to be available for the fiscal years indicated for 437.10 each purpose. The figures "2004" and "2005" where used in this 437.11 article, mean that the appropriation or appropriations listed 437.12 under them are available for the fiscal year ending June 30, 437.13 2004, or June 30, 2005, respectively. Where a dollar amount 437.14 appears in parentheses, it means a reduction of an appropriation. 437.15 SUMMARY BY FUND 437.16 BIENNIAL 437.17 2004 2005 TOTAL 437.18 General $3,922,794,000 $3,854,676,000 $7,777,470,000 437.19 State Government 437.20 Special Revenue 45,274,000 44,995,000 90,269,000 437.21 Health Care 437.22 Access 332,944,000 377,340,000 710,284,000 437.23 Federal TANF 267,369,000 269,318,000 536,687,000 437.24 Lottery Prize 437.25 Fund 1,556,000 1,556,000 3,112,000 437.26 TOTAL $4,569,937,000 $4,547,885,000 $9,117,822,000 437.27 APPROPRIATIONS 437.28 Available for the Year 437.29 Ending June 30 437.30 2004 2005 437.31 Sec. 2. COMMISSIONER OF 437.32 HUMAN SERVICES 437.33 Subdivision 1. Total 437.34 Appropriation $4,271,836,000 $4,249,978,000 437.35 Summary by Fund 437.36 General 3,675,770,000 3,607,503,000 437.37 State Government 437.38 Special Revenue 534,000 534,000 437.39 Health Care 437.40 Access 326,607,000 371,067,000 437.41 Federal TANF 267,369,000 269,318,000 438.1 Lottery Cash 438.2 Flow 1,556,000 1,556,000 438.3 [RECEIPTS FOR SYSTEMS PROJECTS.] 438.4 Appropriations and federal receipts for 438.5 information system projects for MAXIS, 438.6 PRISM, MMIS, and SSIS must be deposited 438.7 in the state system account authorized 438.8 in Minnesota Statutes, section 438.9 256.014. Money appropriated for 438.10 computer projects approved by the 438.11 Minnesota office of technology, funded 438.12 by the legislature, and approved by the 438.13 commissioner of finance may be 438.14 transferred from one project to another 438.15 and from development to operations as 438.16 the commissioner of human services 438.17 considers necessary. Any unexpended 438.18 balance in the appropriation for these 438.19 projects does not cancel but is 438.20 available for ongoing development and 438.21 operations. 438.22 [GIFTS.] Notwithstanding Minnesota 438.23 Statutes, chapter 7, the commissioner 438.24 may accept on behalf of the state 438.25 additional funding from sources other 438.26 than state funds for the purpose of 438.27 financing the cost of assistance 438.28 program grants or nongrant 438.29 administration. All additional funding 438.30 is appropriated to the commissioner for 438.31 use as designated by the grantor of 438.32 funding. 438.33 [SYSTEMS CONTINUITY.] In the event of 438.34 disruption of technical systems or 438.35 computer operations, the commissioner 438.36 may use available grant appropriations 438.37 to ensure continuity of payments for 438.38 maintaining the health, safety, and 438.39 well-being of clients served by 438.40 programs administered by the department 438.41 of human services. Grant funds must be 438.42 used in a manner consistent with the 438.43 original intent of the appropriation. 438.44 [NONFEDERAL SHARE TRANSFERS.] The 438.45 nonfederal share of activities for 438.46 which federal administrative 438.47 reimbursement is appropriated to the 438.48 commissioner may be transferred to the 438.49 special revenue fund. 438.50 [TANF FUNDS APPROPRIATED TO OTHER 438.51 ENTITIES.] Any expenditures from the 438.52 TANF block grant shall be expended in 438.53 accordance with the requirements and 438.54 limitations of part A of title IV of 438.55 the Social Security Act, as amended, 438.56 and any other applicable federal 438.57 requirement or limitation. Prior to 438.58 any expenditure of these funds, the 438.59 commissioner shall assure that funds 438.60 are expended in compliance with the 438.61 requirements and limitations of federal 438.62 law and that any reporting requirements 438.63 of federal law are met. It shall be 438.64 the responsibility of any entity to 438.65 which these funds are appropriated to 438.66 implement a memorandum of understanding 439.1 with the commissioner that provides the 439.2 necessary assurance of compliance prior 439.3 to any expenditure of funds. The 439.4 commissioner shall receipt TANF funds 439.5 appropriated to other state agencies 439.6 and coordinate all related interagency 439.7 accounting transactions necessary to 439.8 implement these appropriations. 439.9 Unexpended TANF funds appropriated to 439.10 any state, local, or nonprofit entity 439.11 cancel at the end of the state fiscal 439.12 year unless appropriating language 439.13 permits otherwise. 439.14 [TANF FUNDS TRANSFERRED TO OTHER 439.15 FEDERAL GRANTS.] The commissioner must 439.16 authorize transfers from TANF to other 439.17 federal block grants so that funds are 439.18 available to meet the annual 439.19 expenditure needs as appropriated. 439.20 Transfers may be authorized prior to 439.21 the expenditure year with the agreement 439.22 of the receiving entity. Transferred 439.23 funds must be expended in the year for 439.24 which the funds were appropriated 439.25 unless appropriation language permits 439.26 otherwise. In accelerating transfer 439.27 authorizations, the commissioner must 439.28 aim to preserve the future potential 439.29 transfer capacity from TANF to other 439.30 block grants. 439.31 [TANF MAINTENANCE OF EFFORT.] (a) In 439.32 order to meet the basic maintenance of 439.33 effort (MOE) requirements of the TANF 439.34 block grant specified under Code of 439.35 Federal Regulations, title 45, section 439.36 263.1, the commissioner may only report 439.37 nonfederal money expended for allowable 439.38 activities listed in the following 439.39 clauses as TANF/MOE expenditures: 439.40 (1) MFIP cash, diversionary work 439.41 program, and food assistance benefits 439.42 under Minnesota Statutes, chapter 256J; 439.43 (2) the child care assistance programs 439.44 under Minnesota Statutes, sections 439.45 119B.03 and 119B.05, and county child 439.46 care administrative costs under 439.47 Minnesota Statutes, section 119B.15; 439.48 (3) state and county MFIP 439.49 administrative costs under Minnesota 439.50 Statutes, chapters 256J and 256K; 439.51 (4) state, county, and tribal MFIP 439.52 employment services under Minnesota 439.53 Statutes, chapters 256J and 256K; and 439.54 (5) expenditures made on behalf of 439.55 noncitizen MFIP recipients who qualify 439.56 for the medical assistance without 439.57 federal financial participation program 439.58 under Minnesota Statutes, section 439.59 256B.06, subdivision 4, paragraphs (d), 439.60 (e), and (j). 439.61 (b) The commissioner shall ensure that 439.62 sufficient qualified nonfederal 439.63 expenditures are made each year to meet 440.1 the state's TANF/MOE requirements. For 440.2 the activities listed in paragraph (a), 440.3 clauses (2) to (5), the commissioner 440.4 may only report expenditures that are 440.5 excluded from the definition of 440.6 assistance under Code of Federal 440.7 Regulations, title 45, section 260.31. 440.8 (c) By August 31 of each year, the 440.9 commissioner shall make a preliminary 440.10 calculation to determine the likelihood 440.11 that the state will meet its annual 440.12 federal work participation requirement 440.13 under Code of Federal Regulations, 440.14 title 45, sections 261.21 and 261.23, 440.15 after adjustment for any caseload 440.16 reduction credit under Code of Federal 440.17 Regulations, title 45, section 261.41. 440.18 If the commissioner determines that the 440.19 state will meet its federal work 440.20 participation rate for the federal 440.21 fiscal year ending that September, the 440.22 commissioner may reduce the expenditure 440.23 under paragraph (a), clause (1), to the 440.24 extent allowed under Code of Federal 440.25 Regulations, title 45, section 440.26 263.1(a)(2). 440.27 (d) For fiscal years beginning with 440.28 state fiscal year 2003, the 440.29 commissioner shall assure that the 440.30 maintenance of effort used by the 440.31 commissioner of finance for the 440.32 February and November forecasts 440.33 required under Minnesota Statutes, 440.34 section 16A.103, contains expenditures 440.35 under paragraph (a), clause (1), equal 440.36 to at least 25 percent of the total 440.37 required under Code of Federal 440.38 Regulations, title 45, section 263.1. 440.39 (e) If nonfederal expenditures for the 440.40 programs and purposes listed in 440.41 paragraph (a) are insufficient to meet 440.42 the state's TANF/MOE requirements, the 440.43 commissioner shall recommend additional 440.44 allowable sources of nonfederal 440.45 expenditures to the legislature, if the 440.46 legislature is or will be in session to 440.47 take action to specify additional 440.48 sources of nonfederal expenditures for 440.49 TANF/MOE before a federal penalty is 440.50 imposed. The commissioner shall 440.51 otherwise provide notice to the 440.52 legislative commission on planning and 440.53 fiscal policy under paragraph (g). 440.54 (f) If the commissioner uses authority 440.55 granted under section 11, or similar 440.56 authority granted by a subsequent 440.57 legislature, to meet the state's 440.58 TANF/MOE requirement in a reporting 440.59 period, the commissioner shall inform 440.60 the chairs of the appropriate 440.61 legislative committees about all 440.62 transfers made under that authority for 440.63 this purpose. 440.64 (g) If the commissioner determines that 440.65 nonfederal expenditures under paragraph 440.66 (a) are insufficient to meet TANF/MOE 441.1 expenditure requirements, and if the 441.2 legislature is not or will not be in 441.3 session to take timely action to avoid 441.4 a federal penalty, the commissioner may 441.5 report nonfederal expenditures from 441.6 other allowable sources as TANF/MOE 441.7 expenditures after the requirements of 441.8 this paragraph are met. The 441.9 commissioner may report nonfederal 441.10 expenditures in addition to those 441.11 specified under paragraph (a) as 441.12 nonfederal TANF/MOE expenditures, but 441.13 only ten days after the commissioner of 441.14 finance has first submitted the 441.15 commissioner's recommendations for 441.16 additional allowable sources of 441.17 nonfederal TANF/MOE expenditures to the 441.18 members of the legislative commission 441.19 on planning and fiscal policy for their 441.20 review. 441.21 (h) The commissioner of finance shall 441.22 not incorporate any changes in federal 441.23 TANF expenditures or nonfederal 441.24 expenditures for TANF/MOE that may 441.25 result from reporting additional 441.26 allowable sources of nonfederal 441.27 TANF/MOE expenditures under the interim 441.28 procedures in paragraph (g) into the 441.29 February or November forecasts required 441.30 under Minnesota Statutes, section 441.31 16A.103, unless the commissioner of 441.32 finance has approved the additional 441.33 sources of expenditures under paragraph 441.34 (g). 441.35 (i) Minnesota Statutes, section 441.36 256.011, subdivision 3, which requires 441.37 that federal grants or aids secured or 441.38 obtained under that subdivision be used 441.39 to reduce any direct appropriations 441.40 provided by law, do not apply if the 441.41 grants or aids are federal TANF funds. 441.42 (j) Notwithstanding section 14, 441.43 paragraph (a), clauses (1) to (5), and 441.44 paragraphs (b) to (j) expire June 30, 441.45 2007. 441.46 [TANF APPROPRIATION CANCELLATION.] 441.47 Notwithstanding the provisions of Laws 441.48 2000, chapter 488, article 1, section 441.49 16, any prior appropriations of TANF 441.50 funds to the department of trade and 441.51 economic development or to the job 441.52 skills partnership board or any 441.53 transfers of TANF funds from another 441.54 agency to the department of trade and 441.55 economic development or to the job 441.56 skills partnership board are not 441.57 available until expended, and if 441.58 unexpended as of June 30, 2003, these 441.59 appropriations or transfers shall 441.60 cancel to the TANF fund. 441.61 [CSSA TRADITIONAL APPROPRIATION.] 441.62 Notwithstanding Minnesota Statutes, 441.63 section 256E.06, subdivisions 1 and 2, 441.64 the appropriations available under that 441.65 section in fiscal years 2004 and 2005 441.66 must be distributed to each county 442.1 proportionately to the aid received by 442.2 the county in calendar year 2002. 442.3 [SHIFT COUNTY PAYMENT.] The 442.4 commissioner shall make up to 100 442.5 percent of the calendar year 2005 442.6 payments to counties for family 442.7 preservation grants, developmental 442.8 disabilities semi-independent living 442.9 services grants, developmental 442.10 disabilities family support grants, 442.11 adult mental health grants, and 442.12 children's mental health grants from 442.13 fiscal year 2006 appropriations. This 442.14 is a onetime payment shift. Calendar 442.15 year 2006 and future payments for these 442.16 grants are not affected by this shift. 442.17 This provision expires June 30, 2006. 442.18 [CAPITATION RATE INCREASE.] Of the 442.19 health care access fund appropriations 442.20 to the University of Minnesota in the 442.21 higher education omnibus appropriation 442.22 bill, $2,157,000 in fiscal year 2004 442.23 and $2,157,000 in fiscal year 2005 are 442.24 to be used to increase the capitation 442.25 payments under Minnesota Statutes, 442.26 section 256B.69. Notwithstanding the 442.27 provisions of section 13, this 442.28 provision shall not expire. 442.29 Subd. 2. Agency Management 442.30 Summary by Fund 442.31 General 40,473,000 26,868,000 442.32 State Government 442.33 Special Revenue 415,000 415,000 442.34 Health Care Access 3,673,000 3,673,000 442.35 Federal TANF 320,000 320,000 442.36 The amounts that may be spent from the 442.37 appropriation for each purpose are as 442.38 follows: 442.39 (a) Financial Operations 442.40 Summary by Fund 442.41 General 8,751,000 9,056,000 442.42 Health Care Access 828,000 828,000 442.43 Federal TANF 220,000 220,000 442.44 [SPECIAL REVENUE FUND TRANSFER.] 442.45 Notwithstanding any law to the 442.46 contrary, excluding accounts authorized 442.47 under Minnesota Statutes, section 442.48 16A.1286, and chapter 254B, the 442.49 commissioner shall transfer $1,400,000 442.50 of uncommitted special revenue fund 442.51 balances to the general fund upon final 442.52 enactment. The actual transfers shall 442.53 be identified within the standard 442.54 information provided to the chairs of 442.55 the house health and human services 442.56 finance committee and the senate 443.1 health, human services, and corrections 443.2 budget division in December 2003. 443.3 (b) Legal and 443.4 Regulation Operations 443.5 Summary by Fund 443.6 General 7,896,000 8,168,000 443.7 State Government 443.8 Special Revenue 415,000 415,000 443.9 Health Care Access 244,000 244,000 443.10 Federal TANF 100,000 100,000 443.11 (c) Management Operations 443.12 Summary by Fund 443.13 General 16,373,000 2,076,000 443.14 Health Care Access 1,623,000 1,623,000 443.15 (d) Information Technology 443.16 Operations 443.17 Summary by Fund 443.18 General 7,453,000 7,568,000 443.19 Health Care Access 978,000 978,000 443.20 Subd. 3. Revenue and Pass-Through 443.21 Summary by Fund 443.22 Federal TANF 69,130,000 64,442,000 443.23 [INCREASE IN TANF TRANSFER TO CHILD 443.24 CARE AND DEVELOPMENT FUND.] Transfers 443.25 of TANF to the child care development 443.26 fund for the purposes of MFIP child 443.27 care assistance shall be increased by 443.28 $1,297,000 in fiscal year 2004 and 443.29 $1,241,000 in fiscal year 2005. 443.30 Subd. 4. Children's Services Grants 443.31 Summary by Fund 443.32 General 68,560,000 64,115,000 443.33 Federal TANF 640,000 640,000 443.34 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 443.35 Federal funds available during fiscal 443.36 year 2004 and fiscal year 2005, for 443.37 adoption incentive grants are 443.38 appropriated to the commissioner for 443.39 these purposes. 443.40 [ADOPTION ASSISTANCE AND RELATIVE 443.41 CUSTODY ASSISTANCE.] The commissioner 443.42 may transfer unencumbered appropriation 443.43 balances for adoption assistance and 443.44 relative custody assistance between 443.45 fiscal years and between programs. 443.46 [OUT-OF-HOME PLACEMENT.] Minnesota 444.1 youth who require out-of-home placement 444.2 through a corrections order must be 444.3 placed in a Minnesota program or 444.4 facility unless a program in a border 444.5 state is closer to the youth's home or 444.6 there is no vacancy in an appropriate 444.7 in-state program or facility. If no 444.8 appropriate regional or in-state 444.9 program is available, this must be 444.10 documented in the case plan prior to 444.11 placement in an out-of-state facility. 444.12 Justification for out-of-state 444.13 placement of Minnesota youth must be 444.14 included in reports to the Minnesota 444.15 department of corrections. 444.16 [FETAL ALCOHOL.] Of the appropriation 444.17 from the general fund, $400,000 each 444.18 year is to the commissioner to contract 444.19 with the Minnesota Organization on 444.20 Fetal Alcohol Syndrome to award grants 444.21 for fetal alcohol spectrum disorder 444.22 (FASD) programs and services, 444.23 including, but not limited to: 444.24 (1) professional training and education 444.25 about FASD to health care, education, 444.26 human service, judicial, and 444.27 correctional professionals; 444.28 (2) grants to community organizations 444.29 and coalitions to provide FASD 444.30 prevention and intervention services; 444.31 (3) FASD diagnostic clinics that 444.32 utilize a multidisciplinary team to 444.33 provide a complete and comprehensive 444.34 assessment of children and adults with 444.35 FASD; 444.36 (4) intensive, one-to-one services for 444.37 high-risk women who are heavy drinkers 444.38 or drug users, are not connected to 444.39 existing community resources, receive 444.40 little or no prenatal care, and have 444.41 delivered one baby affected by prenatal 444.42 substance abuse; and 444.43 (5) programs and services specifically 444.44 designed for those affected by FASD. 444.45 The Minnesota Organization on Fetal 444.46 Alcohol Syndrome may retain five 444.47 percent of the appropriation for 444.48 administrative costs. Any unencumbered 444.49 balance in the first year does not 444.50 cancel but is available for the second 444.51 year. 444.52 Subd. 5. Children's Services Management 444.53 5,221,000 5,283,000 444.54 Subd. 6. Basic Health Care Grants 444.55 Summary by Fund 444.56 General 1,560,179,000 1,582,159,000 444.57 Health Care Access 307,406,000 351,866,000 445.1 [UPDATING FEDERAL POVERTY GUIDELINES.] 445.2 Annual updates to the federal poverty 445.3 guidelines are effective each July 1, 445.4 following publication by the United 445.5 States Department of Health and Human 445.6 Services for health care programs under 445.7 Minnesota Statutes, chapters 256, 256B, 445.8 256D, and 256L. 445.9 The amounts that may be spent from this 445.10 appropriation for each purpose are as 445.11 follows: 445.12 (a) MinnesotaCare Grants 445.13 Summary by Fund 445.14 Health Care Access 306,656,000 351,116,000 445.15 [MINNESOTACARE FEDERAL RECEIPTS.] 445.16 Receipts received as a result of 445.17 federal participation pertaining to 445.18 administrative costs of the Minnesota 445.19 health care reform waiver shall be 445.20 deposited as nondedicated revenue in 445.21 the health care access fund. Receipts 445.22 received as a result of federal 445.23 participation pertaining to grants 445.24 shall be deposited in the federal fund 445.25 and shall offset health care access 445.26 funds for payments to providers. 445.27 [MINNESOTACARE FUNDING.] The 445.28 commissioner may expend money 445.29 appropriated from the health care 445.30 access fund for MinnesotaCare in either 445.31 fiscal year of the biennium. 445.32 (b) MA Basic Health Care Grants - 445.33 Families and Children 445.34 570,732,000 576,295,000 445.35 [SERVICES TO PREGNANT WOMEN.] The 445.36 commissioner shall use available 445.37 federal money for the State-Children's 445.38 Health Insurance Program for medical 445.39 assistance services provided to 445.40 pregnant women who are not otherwise 445.41 eligible for federal financial 445.42 participation beginning in fiscal year 445.43 2003. Notwithstanding section 14, this 445.44 paragraph shall not expire. 445.45 [MANAGED CARE RATE INCREASE.] (a) 445.46 Effective January 1, 2004, the 445.47 commissioner of human services shall 445.48 increase the total payments to managed 445.49 care plans under Minnesota Statutes, 445.50 section 256B.69, by an amount equal to 445.51 the cost increases to the managed care 445.52 plans from by the elimination of: (1) 445.53 the exemption from the taxes imposed 445.54 under Minnesota Statutes, section 445.55 297I.05, subdivision 5, for premiums 445.56 paid by the state for medical 445.57 assistance, general assistance medical 445.58 care, and the MinnesotaCare program; 445.59 and (2) the exemption of gross revenues 445.60 subject to the taxes imposed under 445.61 Minnesota Statutes, sections 295.50 to 446.1 295.57, for payments paid by the state 446.2 for services provided under medical 446.3 assistance, general assistance medical 446.4 care, and the MinnesotaCare program. 446.5 Any increase based on clause (2) must 446.6 be reflected in provider rates paid by 446.7 the managed care plan unless the 446.8 managed care plan is a staff model 446.9 health plan company. 446.10 (b) The commissioner of human services 446.11 shall increase by two percent the 446.12 fee-for-service payments under medical 446.13 assistance, general assistance medical 446.14 care, and the MinnesotaCare program for 446.15 services subject to the hospital, 446.16 surgical center, or health care 446.17 provider taxes under Minnesota 446.18 Statutes, sections 295.50 to 295.57, 446.19 effective for services rendered on or 446.20 after January 1, 2004. 446.21 (c) The commissioner of finance shall 446.22 transfer from the health care access 446.23 fund to the general fund the following 446.24 amounts in the fiscal years indicated: 446.25 2004, $16,587,000; 2005, $46,322,000; 446.26 2006, $49,413,000; and 2007, 446.27 $52,659,000. 446.28 (d) For fiscal years after 2007, the 446.29 commissioner of finance shall transfer 446.30 from the health care access fund to the 446.31 general fund an amount equal to the 446.32 revenue collected by the commissioner 446.33 of revenue on the following: 446.34 (1) gross revenues received by 446.35 hospitals, surgical centers, and health 446.36 care providers as payments for services 446.37 provided under medical assistance, 446.38 general assistance medical care, and 446.39 the MinnesotaCare program, including 446.40 payments received directly from the 446.41 state or from a prepaid plan, under 446.42 Minnesota Statutes, sections 295.50 to 446.43 295.57; and 446.44 (2) premiums paid by the state under 446.45 medical assistance, general assistance 446.46 medical care, and the MinnesotaCare 446.47 program under Minnesota Statutes, 446.48 section 297I.05, subdivision 5. 446.49 The commissioner of finance shall 446.50 monitor and adjust if necessary the 446.51 amount transferred each fiscal year 446.52 from the health care access fund to the 446.53 general fund to ensure that the amount 446.54 transferred equals the tax revenue 446.55 collected for the items described in 446.56 clauses (1) and (2) for that fiscal 446.57 year. 446.58 (e) Notwithstanding section 14, these 446.59 provisions shall not expire. 446.60 (c) MA Basic Health Care Grants - Elderly 446.61 and Disabled 446.62 684,129,000 696,776,000 447.1 [DELAY MEDICAL ASSISTANCE 447.2 FEE-FOR-SERVICE - ACUTE CARE.] The 447.3 following payments in fiscal year 2005 447.4 from the Medicaid Management 447.5 Information System that would otherwise 447.6 have been made to providers for medical 447.7 assistance and general assistance 447.8 medical care services shall be delayed 447.9 and included in the first payment in 447.10 fiscal year 2006: 447.11 (1) for hospitals, the last two 447.12 payments; and 447.13 (2) for nonhospital providers, the last 447.14 payment. 447.15 This payment delay shall not include 447.16 payments to skilled nursing facilities, 447.17 intermediate care facilities for mental 447.18 retardation, prepaid health plans, home 447.19 health agencies, personal care nursing 447.20 providers, and providers of only waiver 447.21 services. The provisions of Minnesota 447.22 Statutes, section 16A.124, shall not 447.23 apply to these delayed payments. 447.24 Notwithstanding section 14, this 447.25 provision shall not expire. 447.26 [DEAF AND HARD-OF-HEARING SERVICES.] If 447.27 the service provider for mental health 447.28 services to persons who are deaf or 447.29 hearing impaired is not able to qualify 447.30 as a medical assistance provider after 447.31 making reasonable efforts, the 447.32 commissioner shall transfer $227,000 in 447.33 fiscal year 2005 from medical 447.34 assistance to deaf and hard-of-hearing 447.35 grants in order to enable the provider 447.36 to continue providing services to 447.37 eligible persons. 447.38 (d) General Assistance Medical Care 447.39 Grants 447.40 289,788,000 291,115,000 447.41 (e) Health Care Grants - Other 447.42 Assistance 447.43 Summary by Fund 447.44 General 4,905,000 5,278,000 447.45 Health Care Access 750,000 750,000 447.46 [GRANT FOR PHYSICIAN RESIDENT 447.47 TRAINING.] Of this appropriation, 447.48 $25,000 each year is to a nursing 447.49 facility in the city of Waseca to 447.50 continue a training program for 447.51 University of Minnesota medical school 447.52 physician residents. 447.53 [DENTAL ACCESS GRANTS CARRYOVER 447.54 AUTHORITY.] Any unspent portion of the 447.55 appropriation from the health care 447.56 access fund in fiscal years 2002 and 447.57 2003 for dental access grants under 447.58 Minnesota Statutes, section 256B.53, 447.59 shall not cancel but shall be allowed 448.1 to carry forward to be spent in the 448.2 biennium beginning July 1, 2003, for 448.3 these purposes. 448.4 [STOP-LOSS FUND ACCOUNT.] The 448.5 appropriation to the purchasing 448.6 alliance stop-loss fund account 448.7 established under Minnesota Statutes, 448.8 section 256.956, subdivision 2, for 448.9 fiscal years 2004 and 2005 shall only 448.10 be available for claim reimbursements 448.11 for qualifying enrollees who are 448.12 members of purchasing alliances that 448.13 meet the requirements described under 448.14 Minnesota Statutes, section 256.956, 448.15 subdivision 1, paragraph (f), clauses 448.16 (1), (2), and (3). 448.17 (f) Prescription Drug Program 448.18 10,625,000 12,705,000 448.19 [PRESCRIPTION DRUG ASSISTANCE PROGRAM.] 448.20 Of the appropriation for the 448.21 prescription drug program under 448.22 Minnesota Statutes, section 256.955, 448.23 $300,000 each year is for the 448.24 commissioner to establish and 448.25 administer the prescription drug 448.26 assistance program through the 448.27 Minnesota board on aging under 448.28 Minnesota Statutes, section 256.975, 448.29 subdivision 9. Any federal match 448.30 earned on these activities is dedicated 448.31 to the prescription drug program. 448.32 [REBATE REVENUE RECAPTURE.] Any funds 448.33 received by the state from a drug 448.34 manufacturer due to errors in the 448.35 pharmaceutical pricing used by the 448.36 manufacturer in determining the 448.37 prescription drug rebate are 448.38 appropriated to the commissioner to 448.39 augment funding of the prescription 448.40 drug program established in Minnesota 448.41 Statutes, section 256.955. 448.42 Subd. 7. Health Care Management 448.43 Summary by Fund 448.44 General 25,150,000 26,191,000 448.45 Health Care Access 14,179,000 14,179,000 448.46 The amounts that may be spent from this 448.47 appropriation for each purpose are as 448.48 follows: 448.49 (a) Health Care Policy Administration 448.50 Summary by Fund 448.51 General 5,674,000 7,215,000 448.52 Health Care Access 846,000 846,000 448.53 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 448.54 Federal administrative reimbursement 448.55 resulting from MinnesotaCare outreach 448.56 is appropriated to the commissioner for 449.1 this activity. 449.2 [MINNESOTA SENIOR HEALTH OPTIONS 449.3 REIMBURSEMENT.] Federal administrative 449.4 reimbursement resulting from the 449.5 Minnesota senior health options project 449.6 is appropriated to the commissioner for 449.7 this activity. 449.8 [UTILIZATION REVIEW.] Federal 449.9 administrative reimbursement resulting 449.10 from prior authorization and inpatient 449.11 admission certification by a 449.12 professional review organization shall 449.13 be dedicated to the commissioner for 449.14 these purposes. A portion of these 449.15 funds must be used for activities to 449.16 decrease unnecessary pharmaceutical 449.17 costs in medical assistance. 449.18 (b) Health Care Operations 449.19 Summary by Fund 449.20 General 19,476,000 18,976,000 449.21 Health Care Access 13,333,000 13,333,000 449.22 [TRIBAL PREPAID MEDICAL PROGRAMS.] A 449.23 portion of state funding for the 449.24 nonfederal share of prepaid medical 449.25 assistance program (PMAP) 449.26 administrative costs for county managed 449.27 care advocacy and enrollment may be 449.28 allocated to tribes that are 449.29 establishing new PMAP programs. 449.30 Subd. 8. State-operated Services 449.31 195,162,000 186,775,000 449.32 [MITIGATION RELATED TO STATE-OPERATED 449.33 SERVICES RESTRUCTURING.] Money 449.34 appropriated to finance mitigation 449.35 expenses related to restructuring 449.36 state-operated services programs and 449.37 administrative services may be 449.38 transferred between fiscal years within 449.39 the biennium. 449.40 [STATE-OPERATED SERVICES 449.41 RESTRUCTURING.] For purposes of 449.42 restructuring state-operated services, 449.43 any state-operated services employee 449.44 whose position is to be eliminated 449.45 shall be afforded the options provided 449.46 in applicable collective bargaining 449.47 agreements. All salary and mitigation 449.48 allocations from fiscal year 2004 shall 449.49 be carried forward into fiscal year 449.50 2005. Provided there is no conflict 449.51 with any collective bargaining 449.52 agreement, any state-operated services 449.53 position reduction must only be 449.54 accomplished through mitigation, 449.55 attrition, transfer, and other measures 449.56 as provided in state or applicable 449.57 collective bargaining agreements and in 449.58 Minnesota Statutes, section 252.50, 449.59 subdivision 11, and not through layoff. 450.1 [REPAIRS AND BETTERMENTS.] The 450.2 commissioner may transfer unencumbered 450.3 appropriation balances between fiscal 450.4 years within the biennium for the state 450.5 residential facilities repairs and 450.6 betterments account and special 450.7 equipment. 450.8 [NAMES REQUIRED ON MONUMENTS.] (a) Of 450.9 this appropriation, $100,000 in fiscal 450.10 year 2004 is to the commissioner for 450.11 grants to community-based or statewide 450.12 organizations for the purpose of 450.13 purchasing and placing cemetery grave 450.14 markers or memorial monuments that 450.15 include the available names of 450.16 individuals at cemeteries located at 450.17 regional treatment centers operated or 450.18 formerly operated by the commissioner. 450.19 Individual monuments shall not be 450.20 placed if the family of the deceased 450.21 resident objects to the placement of 450.22 the monument. 450.23 (b) To be eligible for a grant, a 450.24 community-based or statewide 450.25 organization must include members of 450.26 local service or charitable 450.27 organizations, members of the business 450.28 community, persons with mental illness 450.29 or developmental disabilities, and, to 450.30 the extent possible, family members of 450.31 deceased residents of the regional 450.32 treatment center and present or former 450.33 employees of the regional treatment 450.34 center sites. 450.35 (c) Any unexpended portion of the 450.36 appropriation shall not cancel, but 450.37 shall be available in fiscal year 2005 450.38 for these purposes. 450.39 [DEVELOPMENT OF COMMUNITY MENTAL HEALTH 450.40 SYSTEM REPORT.] As the community mental 450.41 health system is restructured, the 450.42 commissioner of human services shall 450.43 report quarterly, beginning July 1, 450.44 2003, to the chairs of the senate and 450.45 house of representatives health and 450.46 human services finance and policy 450.47 committees on: 450.48 (1) buildings vacated or offered for 450.49 sale or lease at each regional 450.50 treatment center campus; 450.51 (2) the development of community 450.52 services that result in a reduced 450.53 utilization of campus-based adult 450.54 mental health programs; and 450.55 (3) client census for the adult mental 450.56 health programs at each of the regional 450.57 treatment center campuses. 450.58 [ONETIME REDUCTION TO DEDICATED 450.59 REVENUES.] (a) For fiscal year 2003 450.60 only, the commissioner shall transfer 450.61 $4,700,000 of state-operated services 450.62 fund balances from the accounts 450.63 indicated to the general fund as 451.1 follows: 451.2 (1) $3,200,000 from traumatic brain 451.3 injury enterprises; 451.4 (2) $1,000,000 from lease income; and 451.5 (3) $500,000 from ICF/MR depreciation. 451.6 (b) Paragraph (a) is effective the day 451.7 following final enactment. 451.8 Subd. 9. Continuing Care Grants 451.9 Summary by Fund 451.10 General 1,581,064,000 1,533,320,000 451.11 Lottery Prize Fund 1,408,000 1,408,000 451.12 The amounts that may be spent from this 451.13 appropriation for each purpose are as 451.14 follows: 451.15 (a) Community Social Services 451.16 55,700,000 55,700,000 451.17 (b) Aging and Adult Service Grants 451.18 13,361,000 14,129,000 451.19 [AREA AGENCY ON AGING GRANTS.] Of this 451.20 appropriation, $391,000 each year is 451.21 for seniors agenda for independent 451.22 living grants to three nonprofit area 451.23 agencies on aging to be used to match 451.24 federal Older American Act grants. 451.25 (c) Deaf and Hard-of-hearing 451.26 Service Grants 451.27 1,725,000 1,498,000 451.28 (d) Mental Health Grants 451.29 Summary by Fund 451.30 General 53,909,000 35,002,000 451.31 Lottery Prize Fund 1,408,000 1,408,000 451.32 [RESTRUCTURING OF ADULT MENTAL HEALTH 451.33 SERVICES.] The commissioner may make 451.34 transfers that do not increase the 451.35 state share of costs to effectively 451.36 implement the restructuring of adult 451.37 mental health services. 451.38 [MENTAL HEALTH COUNSELING FOR FARM 451.39 FAMILIES.] Of the general fund 451.40 appropriation, $150,000 in fiscal year 451.41 2004 is to the commissioner to be 451.42 transferred to the board of trustees of 451.43 the Minnesota state colleges and 451.44 universities for mental health 451.45 counseling support to farm families and 451.46 business operators to be provided 451.47 through the farm business management 451.48 program at Central Lakes college and 451.49 Ridgewater college. This appropriation 452.1 is available until June 30, 2005. 452.2 [COMPULSIVE GAMBLING.] Of the 452.3 appropriation from the lottery prize 452.4 fund, $250,000 each year is for the 452.5 following purposes: 452.6 (1) $100,000 each year is for a grant 452.7 to the Southeast Asian Problem Gambling 452.8 Consortium. The consortium must 452.9 provide statewide compulsive gambling 452.10 prevention and treatment services for 452.11 Lao, Hmong, Vietnamese, and Cambodian 452.12 families, adults, and adolescents. The 452.13 appropriation in this clause shall not 452.14 become part of base level funding for 452.15 the biennium beginning July 1, 2005. 452.16 Any unencumbered balance of the 452.17 appropriation in the first year does 452.18 not cancel but is available for the 452.19 second year; and 452.20 (2) $150,000 each year is for a grant 452.21 to a compulsive gambling council 452.22 located in St. Louis county. The 452.23 gambling council must provide a 452.24 statewide compulsive gambling 452.25 prevention and education project for 452.26 adolescents. Any unencumbered balance 452.27 of the appropriation in the first year 452.28 of the biennium does not cancel but is 452.29 available for the second year. 452.30 (e) Community Support Grants 452.31 11,725,000 8,794,000 452.32 [CENTERS FOR INDEPENDENT LIVING STUDY.] 452.33 The commissioner of human services, in 452.34 consultation with the commissioner of 452.35 economic security, the centers for 452.36 independent living, and consumer 452.37 representatives, shall study the 452.38 financing of the centers for 452.39 independent living authorized under 452.40 Minnesota Statutes, section 268A.11, 452.41 and make recommendations on options to 452.42 maximize federal financial 452.43 participation. Study components shall 452.44 include: 452.45 (1) the demographics of individuals 452.46 served by the centers for independent 452.47 living; 452.48 (2) the range of services the centers 452.49 for independent living provide to these 452.50 individuals; 452.51 (3) other publicly funded services 452.52 received by individuals supported by 452.53 the centers; and 452.54 (4) strategies for maximizing federal 452.55 financial participation for eligible 452.56 activities carried out by centers for 452.57 independent living. 452.58 The commissioner shall report with 452.59 fiscal and programmatic recommendations 452.60 to the chairs of the appropriate house 453.1 of representatives and senate finance 453.2 and policy committees by January 15, 453.3 2004. 453.4 (f) Medical Assistance Long-term 453.5 Care Waivers and Home Care Grants 453.6 665,124,000 698,676,000 453.7 [REDUCE GROWTH IN MR/RC WAIVER.] The 453.8 commissioner shall reduce the growth in 453.9 the MR/RC waiver by not allocating the 453.10 300 additional diversion allocations 453.11 that are included in the February 2003 453.12 forecast for the fiscal years that 453.13 begin on July 1, 2003, and July 1, 2004. 453.14 [MANAGE THE GROWTH IN THE TBI WAIVER.] 453.15 During the fiscal years beginning on 453.16 July 1, 2003, and July 1, 2004, the 453.17 commissioner shall allocate money for 453.18 home and community-based programs 453.19 covered under Minnesota Statutes, 453.20 section 256B.49, to ensure a reduction 453.21 in state spending that is equivalent to 453.22 limiting the caseload growth of the TBI 453.23 waiver to 150 in each year of the 453.24 biennium. Priorities for the 453.25 allocation of funds shall be for 453.26 individuals anticipated to be 453.27 discharged from institutional settings 453.28 or who are at imminent risk of a 453.29 placement in an institutional setting. 453.30 [TARGETED CASE MANAGEMENT FOR HOME CARE 453.31 RECIPIENTS.] Implementation of the 453.32 targeted case management benefit for 453.33 home care recipients, according to 453.34 Minnesota Statutes, section 256B.0621, 453.35 subdivisions 2, 3, 5, 6, 7, 9, and 10, 453.36 will be delayed until July 1, 2005. 453.37 [COMMON SERVICE MENU.] Implementation 453.38 of the common service menu option 453.39 within the home and community-based 453.40 waivers, according to Minnesota 453.41 Statutes, section 256B.49, subdivision 453.42 16, will be delayed until July 1, 2005. 453.43 (g) Medical Assistance Long-term 453.44 Care Facilities Grants 453.45 545,401,000 503,624,000 453.46 [CASH FLOW LOANS.] Of this 453.47 appropriation, $2,000,000 in fiscal 453.48 year 2004 is for interest-free cash 453.49 flow loans to nursing facilities 453.50 adversely affected by Minnesota 453.51 Statutes, section 256B.431, subdivision 453.52 2t. Loans under this paragraph must be 453.53 repaid upon the receipt of Medicare 453.54 reimbursements for bad debt reported as 453.55 a result of subdivision 2t, or by June 453.56 30, 2004, whichever occurs first. 453.57 [MORATORIUM EXCEPTIONS.] During fiscal 453.58 year 2005, the commissioner of health 453.59 may approve moratorium exception 453.60 projects under Minnesota Statutes, 453.61 section 144A.073, for which the full 454.1 annualized state share of medical 454.2 assistance costs does not exceed 454.3 $220,000. 454.4 (h) Alternative Care Grants 454.5 83,270,000 77,359,000 454.6 [ALTERNATIVE CARE TRANSFER.] Any money 454.7 allocated to the alternative care 454.8 program that is not spent for the 454.9 purposes indicated does not cancel but 454.10 shall be transferred to the medical 454.11 assistance account. 454.12 [ALTERNATIVE CARE APPROPRIATION.] The 454.13 commissioner may expend the money 454.14 appropriated for the alternative care 454.15 program for that purpose in either year 454.16 of the biennium. 454.17 [ALTERNATIVE CARE IMPLEMENTATION OF 454.18 CHANGES TO ELIGIBILITY.] Changes to 454.19 Minnesota Statutes, section 256B.0913, 454.20 subdivision 4, paragraph (d), and 454.21 subdivision 12, are effective July 1, 454.22 2003, for all persons found eligible 454.23 for the alternative care program on or 454.24 after July 1, 2003. All recipients of 454.25 alternative care funding as of June 30, 454.26 2003, shall be subject to Minnesota 454.27 Statutes, section 256B.0913, 454.28 subdivision 4, paragraph (d), and 454.29 subdivision 12, on the annual 454.30 reassessment and review of their 454.31 eligibility after July 1, 2003, but no 454.32 later than January 1, 2004. 454.33 (i) Group Residential Housing Grants 454.34 95,096,000 81,625,000 454.35 [GROUP RESIDENTIAL HOUSING COSTS 454.36 REFINANCED.] (1) Effective July 1, 454.37 2004, the commissioner shall increase 454.38 the home and community-based service 454.39 rates and county allocations provided 454.40 to programs for persons with 454.41 disabilities established under section 454.42 1915(c) of the Social Security Act to 454.43 the extent that these programs will be 454.44 paying for the costs above the rate 454.45 established in Minnesota Statutes, 454.46 section 256I.05, subdivision 1. 454.47 (2) For persons in receipt of services 454.48 under Minnesota Statutes, section 454.49 256B.0915, who reside in licensed adult 454.50 foster care beds for which a 454.51 supplemental room and board payment was 454.52 being made under Minnesota Statutes, 454.53 section 256I.05, subdivision 1, 454.54 counties may request an exception to 454.55 the individual caps specified in 454.56 Minnesota Statutes, section 256B.0915, 454.57 subdivision 3, paragraph (b), not to 454.58 exceed the difference between the 454.59 individual cap and the client's monthly 454.60 service expenditures plus the amount of 454.61 the supplemental room and board rate. 454.62 The county must submit a request to 455.1 exceed the individual cap to the 455.2 commissioner for approval. 455.3 (j) Chemical Dependency 455.4 Entitlement Grants 455.5 49,673,000 50,848,000 455.6 (k) Chemical Dependency Nonentitlement 455.7 Grants 455.8 6,080,000 6,065,000 455.9 Subd. 10. Continuing Care Management 455.10 Summary by Fund 455.11 General 21,374,000 21,114,000 455.12 State Government 455.13 Special Revenue 119,000 119,000 455.14 Lottery Prize Fund 148,000 148,000 455.15 Subd. 11. Economic Support Grants 455.16 Summary by Fund 455.17 General 139,832,000 122,511,000 455.18 Federal TANF 196,911,000 203,548,000 455.19 The amounts that may be spent from this 455.20 appropriation for each purpose are as 455.21 follows: 455.22 (a) Minnesota Family Investment Program 455.23 Summary by Fund 455.24 General 64,138,000 45,212,000 455.25 Federal TANF 152,428,000 159,500,000 455.26 (b) Work Grants 455.27 Summary by Fund 455.28 General 9,440,000 9,440,000 455.29 Federal TANF 44,223,000 43,788,000 455.30 [SUPPORTED WORK.] (a) $3,065,000 is 455.31 appropriated from the TANF fund to the 455.32 commissioner for the fiscal year ending 455.33 July 30, 2005, for allocation to 455.34 counties and tribes that submit a plan 455.35 that describes the county's supported 455.36 work program under Minnesota Statutes, 455.37 section 256J.425, subdivision 4, 455.38 paragraph (b), clause (5), and provides 455.39 the number of individuals to be served 455.40 in the supported work program. This 455.41 appropriation shall become part of base 455.42 level funding for the biennium 455.43 beginning July 1, 2005. 455.44 (b) Counties and tribes that submit a 455.45 supported work plan that is approved by 455.46 the commissioner shall receive an 455.47 allocation based on the average 456.1 proportion of the MFIP case-load that 456.2 has received MFIP assistance for 48 out 456.3 of the last 60 months, as sampled on 456.4 March 31, June 30, September 30, and 456.5 December 31 of the previous calendar 456.6 year, less the number of child only 456.7 cases and cases where all the 456.8 caregivers are age 60 or over, provided 456.9 the county documents the need for 456.10 supported work. Two-parent cases, with 456.11 the exception of those with a caregiver 456.12 age 60 or over, will be multiplied by a 456.13 factor of two. 456.14 (c) Economic Support Grants - Other 456.15 Assistance 456.16 4,372,000 4,700,000 456.17 [SUPPORTIVE HOUSING.] Of the general 456.18 fund appropriation, $600,000 each year 456.19 is to provide services to families who 456.20 are participating in the supportive 456.21 housing and managed care pilot project 456.22 under Minnesota Statutes, section 456.23 256K.25. This appropriation shall not 456.24 become part of base level funding for 456.25 the biennium beginning July 1, 2005. 456.26 (d) Child Support Enforcement Grants 456.27 Summary by Fund 456.28 General 4,139,000 4,139,000 456.29 TANF 260,000 260,000 456.30 (e) General Assistance Grants 456.31 27,095,000 26,969,000 456.32 [GENERAL ASSISTANCE STANDARD.] The 456.33 commissioner shall set the monthly 456.34 standard of assistance for general 456.35 assistance units consisting of an adult 456.36 recipient who is childless and 456.37 unmarried or living apart from parents 456.38 or a legal guardian at $203. The 456.39 commissioner may reduce this amount 456.40 according to Laws 1997, chapter 85, 456.41 article 3, section 54. 456.42 (f) Minnesota Supplemental Aid Grants 456.43 30,398,000 31,801,000 456.44 (g) Refugee Services Grants 456.45 250,000 250,000 456.46 Subd. 12. Economic Support 456.47 Management 456.48 Summary by Fund 456.49 General 38,755,000 39,167,000 456.50 Health Care Access 1,349,000 1,349,000 456.51 Federal TANF 368,000 368,000 457.1 The amounts that may be spent from this 457.2 appropriation for each purpose are as 457.3 follows: 457.4 (a) Economic Support 457.5 Policy Administration 457.6 Summary by Fund 457.7 General 5,224,000 5,451,000 457.8 Federal TANF 368,000 368,000 457.9 (b) Economic Support 457.10 Operations 457.11 Summary by Fund 457.12 General 33,531,000 33,716,000 457.13 Health Care Access 1,349,000 1,349,000 457.14 [ELECTRONIC BENEFIT TRANSFER 457.15 TRANSACTION COSTS.] Notwithstanding the 457.16 provisions of Laws 1998, chapter 407, 457.17 article 6, section 116, the 457.18 commissioner shall not reimburse 457.19 retailers for electronic benefit 457.20 transfer transaction costs. 457.21 [CHILD SUPPORT PAYMENT CENTER.] 457.22 Payments to the commissioner from other 457.23 governmental units, private 457.24 enterprises, and individuals for 457.25 services performed by the child support 457.26 payment center must be deposited in the 457.27 state systems account authorized under 457.28 Minnesota Statutes, section 256.014. 457.29 These payments are appropriated to the 457.30 commissioner for the operation of the 457.31 child support payment center or system, 457.32 according to Minnesota Statutes, 457.33 section 256.014. 457.34 [FINANCIAL INSTITUTION DATA MATCH AND 457.35 PAYMENT OF FEES.] The commissioner is 457.36 authorized to allocate up to $310,000 457.37 each year in fiscal year 2004 and 457.38 fiscal year 2005 from the PRISM special 457.39 revenue account to make payments to 457.40 financial institutions in exchange for 457.41 performing data matches between account 457.42 information held by financial 457.43 institutions and the public authority's 457.44 database of child support obligors as 457.45 authorized by Minnesota Statutes, 457.46 section 13B.06, subdivision 7. 457.47 Sec. 3. COMMISSIONER OF CHILDREN, 457.48 FAMILIES, AND LEARNING 457.49 [APPROPRIATIONS.] The sums indicated in 457.50 this section are appropriated from the 457.51 general fund to the department of 457.52 children, families, and learning for 457.53 the fiscal years designated. 457.54 Subdivision 1. Total 457.55 Appropriation 131,093,000 131,562,000 457.56 [TRANSFER OF RESERVES.] On July 1, 458.1 2003, the commissioner of finance shall 458.2 transfer $6,000,000 of the contingency 458.3 reserve within the employee insurance 458.4 trust fund maintained under Minnesota 458.5 Statutes, section 43A.30, subdivision 458.6 6, to the general fund. 458.7 Subd. 2. Child Care Programs 122,315,000 123,284,000 458.8 (a) Basic Sliding Fee Child Care 458.9 42,528,000 41,774,000 458.10 (b) MFIP Child Care 458.11 78,247,000 79,970,000 458.12 (c) Child Care Program Integrity 458.13 175,000 175,000 458.14 (d) Child Care Development 458.15 1,365,000 1,365,000 458.16 Subd. 3. Self-Sufficiency and 458.17 Long-Life Learning 8,778,000 8,278,000 458.18 (a) Minnesota Economic Opportunity Grants 458.19 7,000,000 7,000,000 458.20 (b) Food Shelf Programs 458.21 1,278,000 1,278,000 458.22 (c) Family Assets for Independents 458.23 500,000 -0- 458.24 Sec. 4. COMMISSIONER OF HEALTH 458.25 Subdivision 1. Total 458.26 Appropriation 120,499,000 119,916,000 458.27 Summary by Fund 458.28 General 81,346,000 81,026,000 458.29 State Government 458.30 Special Revenue 32,880,000 32,617,000 458.31 Health Care Access 6,273,000 6,273,000 458.32 Subd. 2. Health Improvement 458.33 Summary by Fund 458.34 General 65,788,000 65,528,000 458.35 State Government 458.36 Special Revenue 1,987,000 1,987,000 458.37 Health Care Access 3,510,000 3,510,000 458.38 [TOBACCO PREVENTION ENDOWMENT FUND 458.39 TRANSFERS.] (a) On July 1, 2003, the 458.40 commissioner of finance shall transfer 458.41 $7,400,000 from the tobacco use 458.42 prevention and local public health 458.43 endowment expendable trust fund to the 459.1 general fund. 459.2 (b) Notwithstanding Minnesota Statutes, 459.3 section 16A.62, any remaining 459.4 unexpended balance in the fund after 459.5 the transfer in paragraph (a) shall be 459.6 transferred to the miscellaneous 459.7 special revenue fund and dedicated to 459.8 the commissioner of health for a youth 459.9 tobacco prevention program. These 459.10 funds are available until expended. 459.11 [TRANSFER OF ENDOWMENT FUNDS.] On July 459.12 1, 2003, the commissioner of finance 459.13 shall transfer the tobacco use 459.14 prevention and local public health 459.15 endowment fund and the medical 459.16 education endowment fund to the general 459.17 fund. 459.18 [TOBACCO USE PREVENTION AND PUBLIC 459.19 HEALTH GRANTS.] (a) Of the general fund 459.20 appropriation, $7,500,000 each year is 459.21 for the following purposes: 459.22 (1) $3,750,000 each year is for local 459.23 tobacco prevention grants under 459.24 Minnesota Statutes, section 144.396, 459.25 subdivision 6; and 459.26 (2) $3,750,000 each year is for 459.27 distribution under Minnesota Statutes, 459.28 section 144.396, subdivision 7, for 459.29 local public health promotion and 459.30 protection activities. 459.31 (b) Of the amount appropriated under 459.32 paragraph (a), the commissioner may 459.33 retain up to $150,000 each year for 459.34 administrative costs. 459.35 [FETAL ALCOHOL.] Of the appropriation 459.36 from the general fund, $1,350,000 each 459.37 year is to the commissioner to contract 459.38 with the Minnesota Organization on 459.39 Fetal Alcohol Syndrome to award grants 459.40 for fetal alcohol spectrum disorder 459.41 (FASD) programs and services, 459.42 including, but not limited to: 459.43 (1) professional training and education 459.44 about FASD to health care, education, 459.45 human service, judicial, and 459.46 correctional professionals; 459.47 (2) grants to community organizations 459.48 and coalitions to provide FASD 459.49 prevention and intervention services; 459.50 (3) FASD diagnostic clinics that 459.51 utilize a multidisciplinary team to 459.52 provide a complete and comprehensive 459.53 assessment of children and adults with 459.54 FASD; 459.55 (4) intensive, one-to-one services for 459.56 high-risk women who are heavy drinkers 459.57 or drug users, are not connected to 459.58 existing community resources, receive 459.59 little or no prenatal care, and have 459.60 delivered one baby affected by prenatal 460.1 substance abuse; and 460.2 (5) programs and services specifically 460.3 designed for those affected by FASD. 460.4 The Minnesota Organization on Fetal 460.5 Alcohol Syndrome may retain five 460.6 percent of the appropriation for 460.7 administrative costs. Any unencumbered 460.8 balance in the first year does not 460.9 cancel but is available for the second 460.10 year. 460.11 Subd. 3. Health Quality and 460.12 Access 460.13 Summary by Fund 460.14 General 1,017,000 1,017,000 460.15 State Government 460.16 Special Revenue 8,888,000 8,888,000 460.17 Health Care Access 2,763,000 2,763,000 460.18 [STATE GOVERNMENT SPECIAL REVENUE FUND 460.19 TRANSFERS.] On July 1, 2003, the 460.20 commissioner of finance shall transfer 460.21 $3,000,000 from the state government 460.22 special revenue fund to the general 460.23 fund. 460.24 Subd. 4. Health Protection 460.25 Summary by Fund 460.26 General 9,309,000 9,309,000 460.27 State Government 460.28 Special Revenue 22,005,000 21,742,000 460.29 [HIV/STI EDUCATION.] Of the general 460.30 fund appropriation, $150,000 may be 460.31 transferred to the commissioner of 460.32 children, families and learning for 460.33 regional training sites for HIV/STI 460.34 education in schools established under 460.35 Laws 1997, First Special Session 460.36 chapter 4, article 6, section 18, and 460.37 to implement Minnesota Statutes, 460.38 section 121A.23, subdivision 1. Funds 460.39 may support three of the existing 460.40 regional sites selected in a manner to 460.41 achieve geographic balance. This 460.42 appropriation is available until June 460.43 30, 2005. 460.44 Subd. 5. Management and Support 460.45 Services 460.46 5,232,000 5,226,000 460.47 Sec. 5. VETERANS NURSING 460.48 HOMES BOARD 30,030,000 30,030,000 460.49 [VETERANS HOMES SPECIAL REVENUE 460.50 ACCOUNT.] The general fund 460.51 appropriations made to the board may be 460.52 transferred to a veterans homes special 460.53 revenue account in the special revenue 460.54 fund in the same manner as other 461.1 receipts are deposited according to 461.2 Minnesota Statutes, section 198.34, and 461.3 are appropriated to the board for the 461.4 operation of board facilities and 461.5 programs. 461.6 Sec. 6. HEALTH-RELATED BOARDS 461.7 Subdivision 1. Total 461.8 Appropriation 11,378,000 11,298,000 461.9 Summary by Fund 461.10 General 11,314,000 11,298,000 461.11 HCAF 64,000 -0- 461.12 [STATE GOVERNMENT SPECIAL REVENUE 461.13 FUND.] The appropriations in this 461.14 section are from the state government 461.15 special revenue fund, except where 461.16 noted. 461.17 [NO SPENDING IN EXCESS OF REVENUES.] 461.18 The commissioner of finance shall not 461.19 permit the allotment, encumbrance, or 461.20 expenditure of money appropriated in 461.21 this section in excess of the 461.22 anticipated biennial revenues or 461.23 accumulated surplus revenues from fees 461.24 collected by the boards. Neither this 461.25 provision nor Minnesota Statutes, 461.26 section 214.06, applies to transfers 461.27 from the general contingent account. 461.28 [STATE GOVERNMENT SPECIAL REVENUE FUND 461.29 TRANSFERS.] On July 1, 2003, the 461.30 commissioner of finance shall transfer 461.31 $7,500,000 from the state government 461.32 special revenue fund to the general 461.33 fund. 461.34 Subd. 2. Board of Chiropractic 461.35 Examiners 461.36 384,000 384,000 461.37 [CONTESTED CASE EXPENSES.] In fiscal 461.38 year 2003, $70,000 in state government 461.39 special revenue funds is transferred 461.40 from Laws 2001, chapter 10, article 1, 461.41 section 33, to the board of 461.42 chiropractic examiners to pay for 461.43 contested case activity. These funds 461.44 are available until September 30, 2003. 461.45 Subd. 3. Board of Dentistry 461.46 Summary by Fund 461.47 State Government Special 461.48 Revenue Fund 970,000 954,000 461.49 Health Care 461.50 Access Fund 64,000 -0- 461.51 Subd. 4. Board of Dietetic and 461.52 Nutrition Practice 461.53 101,000 101,000 462.1 Subd. 5. Board of Marriage and 462.2 Family Therapy 462.3 118,000 118,000 462.4 Subd. 6. Board of Medical 462.5 Practice 462.6 3,498,000 3,498,000 462.7 Subd. 7. Board of Nursing 462.8 2,405,000 2,405,000 462.9 Subd. 8. Board of Nursing 462.10 Home Administrators 462.11 198,000 198,000 462.12 Subd. 9. Board of Optometry 462.13 96,000 96,000 462.14 Subd. 10. Board of Pharmacy 462.15 1,386,000 1,386,000 462.16 [ADMINISTRATIVE SERVICES UNIT.] Of this 462.17 appropriation, $359,000 the first year 462.18 and $359,000 the second year are for 462.19 the health boards administrative 462.20 services unit. The administrative 462.21 services unit may receive and expend 462.22 reimbursements for services performed 462.23 for other agencies. 462.24 Subd. 11. Board of Physical 462.25 Therapy 462.26 197,000 197,000 462.27 Subd. 12. Board of Podiatry 462.28 45,000 45,000 462.29 Subd. 13. Board of Psychology 462.30 680,000 680,000 462.31 Subd. 14. Board of Social 462.32 Work 462.33 1,073,000 1,073,000 462.34 Subd. 15. Board of Veterinary 462.35 Medicine 462.36 163,000 163,000 462.37 Sec. 7. EMERGENCY MEDICAL SERVICES 462.38 REGULATORY BOARD 462.39 Subdivision 1. Total 462.40 Appropriation 2,787,000 2,787,000 462.41 Summary by Fund 462.42 General 2,241,000 2,241,000 462.43 State Government 462.44 Special Revenue 546,000 546,000 463.1 [HEALTH PROFESSIONAL SERVICES 463.2 ACTIVITY.] $546,000 each year from the 463.3 state government special revenue fund 463.4 is for the health professional services 463.5 activity. 463.6 [ROYALTY PAYMENTS DEDICATED TO BOARD.] 463.7 Royalty payments from the sale of the 463.8 Internet-based ambulance reporting 463.9 program are appropriated to the board 463.10 and shall remain available until 463.11 expended. Notwithstanding section 14, 463.12 this provision shall not expire. 463.13 [EMERGENCY MEDICAL SERVICES REGIONAL 463.14 GRANTS.] Of this appropriation, 463.15 $417,000 each year is for the purposes 463.16 of Minnesota Statutes, section 144E.50. 463.17 [AMBULANCE TRAINING GRANT CARRYFORWARD 463.18 AND TRANSFER.] (a) Effective for fiscal 463.19 year 2003 and succeeding fiscal years, 463.20 any unspent portion of the 463.21 appropriation for ambulance training 463.22 grants shall not cancel but shall carry 463.23 forward and be used in the following 463.24 fiscal year for the purposes of 463.25 Minnesota Statutes, section 144E.50. 463.26 The board shall not retain any portion 463.27 of the appropriation carried forward 463.28 for administrative costs. 463.29 (b) Notwithstanding section 14, this 463.30 provision shall not expire. 463.31 (c) This provision is effective the day 463.32 following final enactment. 463.33 Sec. 8. COUNCIL ON DISABILITY 607,000 607,000 463.34 Sec. 9. OMBUDSMAN FOR MENTAL HEALTH 463.35 AND MENTAL RETARDATION 1,462,000 1,462,000 463.36 Sec. 10. OMBUDSMAN FOR 463.37 FAMILIES 245,000 245,000 463.38 Sec. 11. [TRANSFERS.] 463.39 Subdivision 1. [GRANTS.] The commissioner of human 463.40 services, with the approval of the commissioner of finance, and 463.41 after notification of the chair of the senate health, human 463.42 services and corrections budget division and the chair of the 463.43 house health and human services finance committee, may transfer 463.44 unencumbered appropriation balances for the biennium ending June 463.45 30, 2005, within fiscal years among the MFIP, general 463.46 assistance, general assistance medical care, medical assistance, 463.47 Minnesota supplemental aid, and group residential housing 463.48 programs, and the entitlement portion of the chemical dependency 463.49 consolidated treatment fund, and between fiscal years of the 464.1 biennium. 464.2 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 464.3 nonsalary administrative money may be transferred within the 464.4 departments of human services and health and within the programs 464.5 operated by the veterans nursing homes board as the 464.6 commissioners and the board consider necessary, with the advance 464.7 approval of the commissioner of finance. The commissioner or 464.8 the board shall inform the chairs of the house health and human 464.9 services finance committee and the senate health, human services 464.10 and corrections budget division quarterly about transfers made 464.11 under this provision. 464.12 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 464.13 transferred to operations within the departments of human 464.14 services and health and within the programs operated by the 464.15 veterans nursing homes board without the approval of the 464.16 legislature. 464.17 Sec. 12. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 464.18 The commissioners of health and of human services shall not 464.19 use indirect cost allocations to pay for the operational costs 464.20 of any program for which they are responsible. 464.21 Sec. 13. [CARRYOVER LIMITATION.] 464.22 The appropriations in this article which are allowed to be 464.23 carried forward from fiscal year 2004 to fiscal year 2005 shall 464.24 not become part of the base level funding for the 2006-2007 464.25 biennial budget, unless specifically directed by the legislature. 464.26 Sec. 14. [SUNSET OF UNCODIFIED LANGUAGE.] 464.27 All uncodified language contained in this article expires 464.28 on June 30, 2005, unless a different expiration date is explicit. 464.29 Sec. 15. [REPEALER.] 464.30 Laws 2002, chapter 374, article 9, section 8, is repealed 464.31 effective upon final enactment. 464.32 Sec. 16. [EFFECTIVE DATE.] 464.33 The provisions in this article are effective July 1, 2003, 464.34 unless a different effective date is specified. 464.35 ARTICLE 13 464.36 HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 465.1 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 465.2 The dollar amounts shown in the columns marked 465.3 "APPROPRIATIONS" are added to or, if shown in parentheses, are 465.4 subtracted from the appropriations in Laws 2001, First Special 465.5 Session chapter 9, as amended by Laws 2002, chapter 220, and 465.6 Laws 2002, chapter 374, and are appropriated from the general 465.7 fund, or any other fund named, to the agencies and for the 465.8 purposes specified in this article, to be available for the 465.9 fiscal year indicated for each purpose. The figure "2003" used 465.10 in this article means that the appropriation or appropriations 465.11 listed under them are available for the fiscal year ending June 465.12 30, 2003. 465.13 SUMMARY BY FUND 465.14 2003 465.15 General $103,756,000 465.16 Health Care Access (1,492,000) 465.17 Federal TANF 20,419,000 465.18 APPROPRIATIONS 465.19 Available for the Year 465.20 Ending June 30, 2003 465.21 Sec. 2. COMMISSIONER OF 465.22 HUMAN SERVICES 465.23 Subdivision 1. Total 465.24 Appropriation $128,203,000 465.25 Summary by Fund 465.26 General 109,276,000 465.27 Health Care Access (1,492,000) 465.28 Federal TANF 20,419,000 465.29 Subd. 2. Administrative 465.30 Reimbursement/Pass-through 1,180,000 465.31 Subd. 3. Basic Health Care 465.32 Grants 465.33 General 59,364,000 465.34 Health Care Access (1,492,000) 465.35 The amounts that may be spent from this 465.36 appropriation for each purpose are as 465.37 follows: 465.38 (a) MinnesotaCare Grants 465.39 Health Care Access (1,492,000) 465.40 (b) MA Basic Health Care Grants - 466.1 Families and Children 466.2 General 14,708,000 466.3 (c) MA Basic Health Care Grants - 466.4 Elderly and Disabled 466.5 General 15,137,000 466.6 (d) General Assistance Medical Care 466.7 Grants 466.8 General 29,519,000 466.9 Subd. 4. Continuing Care Grants 466.10 General 56,615,000 466.11 The amounts that may be spent from this 466.12 appropriation for each purpose are as 466.13 follows: 466.14 (a) Medical Assistance Long-Term Care 466.15 Waivers and Home Care Grants 466.16 General 57,388,000 466.17 (b) Medical Assistance Long-Term Care 466.18 Facilities Grants 466.19 General 678,000 466.20 (c) Group Residential Housing Grants 466.21 General (1,451,000) 466.22 Subd. 5. Economic Support Grants 466.23 General (6,703,000) 466.24 Federal TANF 19,239,000 466.25 The amounts that may be spent from the 466.26 appropriation for each purpose are as 466.27 follows: 466.28 (a) Assistance to Families Grants 466.29 General (9,306,000) 466.30 Federal TANF 19,239,000 466.31 (b) General Assistance Grants 466.32 General 3,491,000 466.33 (c) Minnesota Supplemental Aid Grants 466.34 General (888,000) 466.35 Sec. 3. COMMISSIONER OF HEALTH 466.36 Subdivision 1. Total Appropriation (5,520,000) 466.37 Summary by Fund 466.38 General (5,520,000) 466.39 Subd. 2. Access and Quality Improvement (5,520,000) 466.40 Sec. 4. [EFFECTIVE DATE.] 467.1 Sections 1 to 3 are effective the day following final 467.2 enactment. 467.3 ARTICLE 14 467.4 DEPARTMENT OF HUMAN SERVICES 467.5 HEALTH CARE POLICY AMENDMENTS 467.6 Section 1. [144A.351] [BALANCING LONG-TERM CARE: REPORT 467.7 REQUIRED.] 467.8 The commissioners of health and human services, with the 467.9 cooperation of counties and regional entities, shall prepare a 467.10 report to the legislature by January 15, 2004, and biennially 467.11 thereafter, regarding the status of the full range of long-term 467.12 care services for the elderly in Minnesota. The report shall 467.13 address: 467.14 (1) demographics and need for long-term care in Minnesota; 467.15 (2) summary of county and regional reports on long-term 467.16 care gaps, surpluses, imbalances, and corrective action plans; 467.17 (3) status of long-term care services by county and region 467.18 including: 467.19 (i) changes in availability of the range of long-term care 467.20 services and housing options; 467.21 (ii) access problems regarding long-term care; and 467.22 (iii) comparative measures of long-term care availability 467.23 and progress over time; and 467.24 (4) recommendations regarding goals for the future of 467.25 long-term care services, policy changes, and resource needs. 467.26 Sec. 2. Minnesota Statutes 2002, section 245A.035, 467.27 subdivision 3, is amended to read: 467.28 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 467.29 emergency license may be issued, the following requirements must 467.30 be met: 467.31 (1) the county agency must conduct an initial inspection of 467.32 the premises where the foster care is to be provided to ensure 467.33 the health and safety of any child placed in the home. The 467.34 county agency shall conduct the inspection using a form 467.35 developed by the commissioner; 467.36 (2) at the time of the inspection or placement, whichever 468.1 is earlier, the relative being considered for an emergency 468.2 license shall receive an application form for a child foster 468.3 care license; 468.4 (3) whenever possible, prior to placing the child in the 468.5 relative's home, the relative being considered for an emergency 468.6 license shall provide the information required by section 468.7 245A.04, subdivision 3, paragraph(b)(k); and 468.8 (4) if the county determines, prior to the issuance of an 468.9 emergency license, that anyone requiring a background study may 468.10 be disqualified under section 245A.04, and the disqualification 468.11 is one which the commissioner cannot set aside, an emergency 468.12 license shall not be issued. 468.13 Sec. 3. Minnesota Statutes 2002, section 245A.04, 468.14 subdivision 3b, is amended to read: 468.15 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 468.16 individual who is the subject of the disqualification may 468.17 request a reconsideration of the disqualification. 468.18 The individual must submit the request for reconsideration 468.19 to the commissioner in writing. A request for reconsideration 468.20 for an individual who has been sent a notice of disqualification 468.21 under subdivision 3a, paragraph (b), clause (1) or (2), must be 468.22 submitted within 30 calendar days of the disqualified 468.23 individual's receipt of the notice of disqualification. Upon 468.24 showing that the information in clause (1) or (2) cannot be 468.25 obtained within 30 days, the disqualified individual may request 468.26 additional time, not to exceed 30 days, to obtain that 468.27 information. A request for reconsideration for an individual 468.28 who has been sent a notice of disqualification under subdivision 468.29 3a, paragraph (b), clause (3), must be submitted within 15 468.30 calendar days of the disqualified individual's receipt of the 468.31 notice of disqualification. An individual who was determined to 468.32 have maltreated a child under section 626.556 or a vulnerable 468.33 adult under section 626.557, and who was disqualified under this 468.34 section on the basis of serious or recurring maltreatment, may 468.35 request reconsideration of both the maltreatment and the 468.36 disqualification determinations. The request for 469.1 reconsideration of the maltreatment determination and the 469.2 disqualification must be submitted within 30 calendar days of 469.3 the individual's receipt of the notice of disqualification. 469.4 Removal of a disqualified individual from direct contact shall 469.5 be ordered if the individual does not request reconsideration 469.6 within the prescribed time, and for an individual who submits a 469.7 timely request for reconsideration, if the disqualification is 469.8 not set aside. The individual must present information showing 469.9 that: 469.10 (1) the information the commissioner relied upon in 469.11 determining that the underlying conduct giving rise to the 469.12 disqualification occurred, and for maltreatment, that the 469.13 maltreatment was serious or recurring, is incorrect; or 469.14 (2) the subject of the study does not pose a risk of harm 469.15 to any person served by the applicant, license holder, or 469.16 registrant under section 144A.71, subdivision 1. 469.17 (b) The commissioner shall rescind the disqualification if 469.18 the commissioner finds that the information relied on to 469.19 disqualify the subject is incorrect. The commissioner may set 469.20 aside the disqualification under this section if the 469.21 commissioner finds that the individual does not pose a risk of 469.22 harm to any person served by the applicant, license holder, or 469.23 registrant under section 144A.71, subdivision 1. In determining 469.24 that an individual does not pose a risk of harm, the 469.25 commissioner shall consider the nature, severity, and 469.26 consequences of the event or events that lead to 469.27 disqualification, whether there is more than one disqualifying 469.28 event, the age and vulnerability of the victim at the time of 469.29 the event, the harm suffered by the victim, the similarity 469.30 between the victim and persons served by the program, the time 469.31 elapsed without a repeat of the same or similar event, 469.32 documentation of successful completion by the individual studied 469.33 of training or rehabilitation pertinent to the event, and any 469.34 other information relevant to reconsideration. In reviewing a 469.35 disqualification under this section, the commissioner shall give 469.36 preeminent weight to the safety of each person to be served by 470.1 the license holder, applicant, or registrant under section 470.2 144A.71, subdivision 1, over the interests of the license 470.3 holder, applicant, or registrant under section 144A.71, 470.4 subdivision 1. 470.5 (c) Unless the information the commissioner relied on in 470.6 disqualifying an individual is incorrect, the commissioner may 470.7 not set aside the disqualification of an individual in 470.8 connection with a license to provide family day care for 470.9 children, foster care for children in the provider's own home, 470.10 or foster care or day care services for adults in the provider's 470.11 own home if: 470.12 (1) less than ten years have passed since the discharge of 470.13 the sentence imposed for the offense; and the individual has 470.14 been convicted of a violation of any offense listed in sections 470.15 609.165 (felon ineligible to possess firearm), criminal 470.16 vehicular homicide under 609.21 (criminal vehicular homicide and 470.17 injury), 609.215 (aiding suicide or aiding attempted suicide), 470.18 felony violations under 609.223 or 609.2231 (assault in the 470.19 third or fourth degree), 609.713 (terroristic threats), 609.235 470.20 (use of drugs to injure or to facilitate crime), 609.24 (simple 470.21 robbery), 609.255 (false imprisonment), 609.562 (arson in the 470.22 second degree), 609.71 (riot), 609.498, subdivision 1 or1a470.23 1b (aggravated first degree or first degree tampering with a 470.24 witness), burglary in the first or second degree under 609.582 470.25 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 470.26 609.67 (machine guns and short-barreled shotguns), 609.749, 470.27 subdivision 2 (gross misdemeanor harassment; stalking), 152.021 470.28 or 152.022 (controlled substance crime in the first or second 470.29 degree), 152.023, subdivision 1, clause (3) or (4), or 470.30 subdivision 2, clause (4) (controlled substance crime in the 470.31 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 470.32 (controlled substance crime in the fourth degree), 609.224, 470.33 subdivision 2, paragraph (c) (fifth-degree assault by a 470.34 caregiver against a vulnerable adult), 609.23 (mistreatment of 470.35 persons confined), 609.231 (mistreatment of residents or 470.36 patients), 609.2325 (criminal abuse of a vulnerable adult), 471.1 609.233 (criminal neglect of a vulnerable adult), 609.2335 471.2 (financial exploitation of a vulnerable adult), 609.234 (failure 471.3 to report), 609.265 (abduction), 609.2664 to 609.2665 471.4 (manslaughter of an unborn child in the first or second degree), 471.5 609.267 to 609.2672 (assault of an unborn child in the first, 471.6 second, or third degree), 609.268 (injury or death of an unborn 471.7 child in the commission of a crime), 617.293 (disseminating or 471.8 displaying harmful material to minors), a felony level 471.9 conviction involving alcohol or drug use, a gross misdemeanor 471.10 offense under 609.324, subdivision 1 (other prohibited acts), a 471.11 gross misdemeanor offense under 609.378 (neglect or endangerment 471.12 of a child), a gross misdemeanor offense under 609.377 471.13 (malicious punishment of a child), 609.72, subdivision 3 471.14 (disorderly conduct against a vulnerable adult); or an attempt 471.15 or conspiracy to commit any of these offenses, as each of these 471.16 offenses is defined in Minnesota Statutes; or an offense in any 471.17 other state, the elements of which are substantially similar to 471.18 the elements of any of the foregoing offenses; 471.19 (2) regardless of how much time has passed since the 471.20 involuntary termination of parental rights under section 471.21 260C.301 or the discharge of the sentence imposed for the 471.22 offense, the individual was convicted of a violation of any 471.23 offense listed in sections 609.185 to 609.195 (murder in the 471.24 first, second, or third degree), 609.20 (manslaughter in the 471.25 first degree), 609.205 (manslaughter in the second degree), 471.26 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 471.27 (arson in the first degree), 609.749, subdivision 3, 4, or 5 471.28 (felony-level harassment; stalking), 609.228 (great bodily harm 471.29 caused by distribution of drugs), 609.221 or 609.222 (assault in 471.30 the first or second degree), 609.66, subdivision 1e (drive-by 471.31 shooting), 609.855, subdivision 5 (shooting in or at a public 471.32 transit vehicle or facility), 609.2661 to 609.2663 (murder of an 471.33 unborn child in the first, second, or third degree), a felony 471.34 offense under 609.377 (malicious punishment of a child), a 471.35 felony offense under 609.324, subdivision 1 (other prohibited 471.36 acts), a felony offense under 609.378 (neglect or endangerment 472.1 of a child), 609.322 (solicitation, inducement, and promotion of 472.2 prostitution), 609.342 to 609.345 (criminal sexual conduct in 472.3 the first, second, third, or fourth degree), 609.352 472.4 (solicitation of children to engage in sexual conduct), 617.246 472.5 (use of minors in a sexual performance), 617.247 (possession of 472.6 pictorial representations of a minor), 609.365 (incest), a 472.7 felony offense under sections 609.2242 and 609.2243 (domestic 472.8 assault), a felony offense of spousal abuse, a felony offense of 472.9 child abuse or neglect, a felony offense of a crime against 472.10 children, or an attempt or conspiracy to commit any of these 472.11 offenses as defined in Minnesota Statutes, or an offense in any 472.12 other state, the elements of which are substantially similar to 472.13 any of the foregoing offenses; 472.14 (3) within the seven years preceding the study, the 472.15 individual committed an act that constitutes maltreatment of a 472.16 child under section 626.556, subdivision 10e, and that resulted 472.17 in substantial bodily harm as defined in section 609.02, 472.18 subdivision 7a, or substantial mental or emotional harm as 472.19 supported by competent psychological or psychiatric evidence; or 472.20 (4) within the seven years preceding the study, the 472.21 individual was determined under section 626.557 to be the 472.22 perpetrator of a substantiated incident of maltreatment of a 472.23 vulnerable adult that resulted in substantial bodily harm as 472.24 defined in section 609.02, subdivision 7a, or substantial mental 472.25 or emotional harm as supported by competent psychological or 472.26 psychiatric evidence. 472.27 In the case of any ground for disqualification under 472.28 clauses (1) to (4), if the act was committed by an individual 472.29 other than the applicant, license holder, or registrant under 472.30 section 144A.71, subdivision 1, residing in the applicant's or 472.31 license holder's home, or the home of a registrant under section 472.32 144A.71, subdivision 1, the applicant, license holder, or 472.33 registrant under section 144A.71, subdivision 1, may seek 472.34 reconsideration when the individual who committed the act no 472.35 longer resides in the home. 472.36 The disqualification periods provided under clauses (1), 473.1 (3), and (4) are the minimum applicable disqualification 473.2 periods. The commissioner may determine that an individual 473.3 should continue to be disqualified from licensure or 473.4 registration under section 144A.71, subdivision 1, because the 473.5 license holder, applicant, or registrant under section 144A.71, 473.6 subdivision 1, poses a risk of harm to a person served by that 473.7 individual after the minimum disqualification period has passed. 473.8 (d) The commissioner shall respond in writing or by 473.9 electronic transmission to all reconsideration requests for 473.10 which the basis for the request is that the information relied 473.11 upon by the commissioner to disqualify is incorrect or 473.12 inaccurate within 30 working days of receipt of a request and 473.13 all relevant information. If the basis for the request is that 473.14 the individual does not pose a risk of harm, the commissioner 473.15 shall respond to the request within 15 working days after 473.16 receiving the request for reconsideration and all relevant 473.17 information. If the request is based on both the correctness or 473.18 accuracy of the information relied on to disqualify the 473.19 individual and the risk of harm, the commissioner shall respond 473.20 to the request within 45 working days after receiving the 473.21 request for reconsideration and all relevant information. If 473.22 the disqualification is set aside, the commissioner shall notify 473.23 the applicant or license holder in writing or by electronic 473.24 transmission of the decision. 473.25 (e) Except as provided in subdivision 3c, if a 473.26 disqualification for which reconsideration was requested is not 473.27 set aside or is not rescinded, an individual who was 473.28 disqualified on the basis of a preponderance of evidence that 473.29 the individual committed an act or acts that meet the definition 473.30 of any of the crimes listed in subdivision 3d, paragraph (a), 473.31 clauses (1) to (4); or for failure to make required reports 473.32 under section 626.556, subdivision 3, or 626.557, subdivision 3, 473.33 pursuant to subdivision 3d, paragraph (a), clause (4), may 473.34 request a fair hearing under section 256.045. Except as 473.35 provided under subdivision 3c, the fair hearing is the only 473.36 administrative appeal of the final agency determination, 474.1 specifically, including a challenge to the accuracy and 474.2 completeness of data under section 13.04. 474.3 (f) Except as provided under subdivision 3c, if an 474.4 individual was disqualified on the basis of a determination of 474.5 maltreatment under section 626.556 or 626.557, which was serious 474.6 or recurring, and the individual has requested reconsideration 474.7 of the maltreatment determination under section 626.556, 474.8 subdivision 10i, or 626.557, subdivision 9d, and also requested 474.9 reconsideration of the disqualification under this subdivision, 474.10 reconsideration of the maltreatment determination and 474.11 reconsideration of the disqualification shall be consolidated 474.12 into a single reconsideration. For maltreatment and 474.13 disqualification determinations made by county agencies, the 474.14 consolidated reconsideration shall be conducted by the county 474.15 agency. If the county agency has disqualified an individual on 474.16 multiple bases, one of which is a county maltreatment 474.17 determination for which the individual has a right to request 474.18 reconsideration, the county shall conduct the reconsideration of 474.19 all disqualifications. Except as provided under subdivision 3c, 474.20 if an individual who was disqualified on the basis of serious or 474.21 recurring maltreatment requests a fair hearing on the 474.22 maltreatment determination under section 626.556, subdivision 474.23 10i, or 626.557, subdivision 9d, and requests a fair hearing on 474.24 the disqualification, which has not been set aside or rescinded 474.25 under this subdivision, the scope of the fair hearing under 474.26 section 256.045 shall include the maltreatment determination and 474.27 the disqualification. Except as provided under subdivision 3c, 474.28 a fair hearing is the only administrative appeal of the final 474.29 agency determination, specifically, including a challenge to the 474.30 accuracy and completeness of data under section 13.04. 474.31 (g) In the notice from the commissioner that a 474.32 disqualification has been set aside, the license holder must be 474.33 informed that information about the nature of the 474.34 disqualification and which factors under paragraph (b) were the 474.35 bases of the decision to set aside the disqualification is 474.36 available to the license holder upon request without consent of 475.1 the background study subject. With the written consent of a 475.2 background study subject, the commissioner may release to the 475.3 license holder copies of all information related to the 475.4 background study subject's disqualification and the 475.5 commissioner's decision to set aside the disqualification as 475.6 specified in the written consent. 475.7 Sec. 4. Minnesota Statutes 2002, section 245A.04, 475.8 subdivision 3d, is amended to read: 475.9 Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of 475.10 information showing, or when a background study completed under 475.11 subdivision 3 shows any of the following: a conviction of one 475.12 or more crimes listed in clauses (1) to (4); the individual has 475.13 admitted to or a preponderance of the evidence indicates the 475.14 individual has committed an act or acts that meet the definition 475.15 of any of the crimes listed in clauses (1) to (4); or an 475.16 investigation results in an administrative determination listed 475.17 under clause (4), the individual shall be disqualified from any 475.18 position allowing direct contact with persons receiving services 475.19 from the license holder, entity identified in subdivision 3, 475.20 paragraph (a), or registrant under section 144A.71, subdivision 475.21 1, and for individuals studied under section 245A.04, 475.22 subdivision 3, paragraph (c), clauses (2), (6), and (7), the 475.23 individual shall also be disqualified from access to a person 475.24 receiving services from the license holder: 475.25 (1) regardless of how much time has passed since the 475.26 involuntary termination of parental rights under section 475.27 260C.301 or the discharge of the sentence imposed for the 475.28 offense, and unless otherwise specified, regardless of the level 475.29 of the conviction, the individual was convicted of any of the 475.30 following offenses: sections 609.185 (murder in the first 475.31 degree); 609.19 (murder in the second degree); 609.195 (murder 475.32 in the third degree); 609.2661 (murder of an unborn child in the 475.33 first degree); 609.2662 (murder of an unborn child in the second 475.34 degree); 609.2663 (murder of an unborn child in the third 475.35 degree); 609.20 (manslaughter in the first degree); 609.205 475.36 (manslaughter in the second degree); 609.221 or 609.222 (assault 476.1 in the first or second degree); 609.228 (great bodily harm 476.2 caused by distribution of drugs); 609.245 (aggravated robbery); 476.3 609.25 (kidnapping); 609.561 (arson in the first degree); 476.4 609.749, subdivision 3, 4, or 5 (felony-level harassment; 476.5 stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 476.6 subdivision 5 (shooting at or in a public transit vehicle or 476.7 facility); 609.322 (solicitation, inducement, and promotion of 476.8 prostitution); 609.342 (criminal sexual conduct in the first 476.9 degree); 609.343 (criminal sexual conduct in the second degree); 476.10 609.344 (criminal sexual conduct in the third degree); 609.345 476.11 (criminal sexual conduct in the fourth degree); 609.352 476.12 (solicitation of children to engage in sexual conduct); 609.365 476.13 (incest); felony offense under 609.377 (malicious punishment of 476.14 a child); a felony offense under 609.378 (neglect or 476.15 endangerment of a child); a felony offense under 609.324, 476.16 subdivision 1 (other prohibited acts); 617.246 (use of minors in 476.17 sexual performance prohibited); 617.247 (possession of pictorial 476.18 representations of minors); a felony offense under sections 476.19 609.2242 and 609.2243 (domestic assault), a felony offense of 476.20 spousal abuse, a felony offense of child abuse or neglect, a 476.21 felony offense of a crime against children; or attempt or 476.22 conspiracy to commit any of these offenses as defined in 476.23 Minnesota Statutes, or an offense in any other state or country, 476.24 where the elements are substantially similar to any of the 476.25 offenses listed in this clause; 476.26 (2) if less than 15 years have passed since the discharge 476.27 of the sentence imposed for the offense; and the individual has 476.28 received a felony conviction for a violation of any of these 476.29 offenses: sections 609.21 (criminal vehicular homicide and 476.30 injury); 609.165 (felon ineligible to possess firearm); 609.215 476.31 (suicide); 609.223 or 609.2231 (assault in the third or fourth 476.32 degree); repeat offenses under 609.224 (assault in the fifth 476.33 degree); repeat offenses under 609.3451 (criminal sexual conduct 476.34 in the fifth degree); 609.498, subdivision 1 or1a476.35 1b (aggravated first degree or first degree tampering with a 476.36 witness); 609.713 (terroristic threats); 609.235 (use of drugs 477.1 to injure or facilitate crime); 609.24 (simple robbery); 609.255 477.2 (false imprisonment); 609.562 (arson in the second degree); 477.3 609.563 (arson in the third degree); repeat offenses under 477.4 617.23 (indecent exposure; penalties); repeat offenses under 477.5 617.241 (obscene materials and performances; distribution and 477.6 exhibition prohibited; penalty); 609.71 (riot); 609.66 477.7 (dangerous weapons); 609.67 (machine guns and short-barreled 477.8 shotguns); 609.2325 (criminal abuse of a vulnerable adult); 477.9 609.2664 (manslaughter of an unborn child in the first degree); 477.10 609.2665 (manslaughter of an unborn child in the second degree); 477.11 609.267 (assault of an unborn child in the first degree); 477.12 609.2671 (assault of an unborn child in the second degree); 477.13 609.268 (injury or death of an unborn child in the commission of 477.14 a crime); 609.52 (theft); 609.2335 (financial exploitation of a 477.15 vulnerable adult); 609.521 (possession of shoplifting gear); 477.16 609.582 (burglary); 609.625 (aggravated forgery); 609.63 477.17 (forgery); 609.631 (check forgery; offering a forged check); 477.18 609.635 (obtaining signature by false pretense); 609.27 477.19 (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 477.20 260C.301 (grounds for termination of parental rights); chapter 477.21 152 (drugs; controlled substance); and a felony level conviction 477.22 involving alcohol or drug use. An attempt or conspiracy to 477.23 commit any of these offenses, as each of these offenses is 477.24 defined in Minnesota Statutes; or an offense in any other state 477.25 or country, the elements of which are substantially similar to 477.26 the elements of the offenses in this clause. If the individual 477.27 studied is convicted of one of the felonies listed in this 477.28 clause, but the sentence is a gross misdemeanor or misdemeanor 477.29 disposition, the lookback period for the conviction is the 477.30 period applicable to the disposition, that is the period for 477.31 gross misdemeanors or misdemeanors; 477.32 (3) if less than ten years have passed since the discharge 477.33 of the sentence imposed for the offense; and the individual has 477.34 received a gross misdemeanor conviction for a violation of any 477.35 of the following offenses: sections 609.224 (assault in the 477.36 fifth degree); 609.2242 and 609.2243 (domestic assault); 478.1 violation of an order for protection under 518B.01, subdivision 478.2 14; 609.3451 (criminal sexual conduct in the fifth degree); 478.3 repeat offenses under 609.746 (interference with privacy); 478.4 repeat offenses under 617.23 (indecent exposure); 617.241 478.5 (obscene materials and performances); 617.243 (indecent 478.6 literature, distribution); 617.293 (harmful materials; 478.7 dissemination and display to minors prohibited); 609.71 (riot); 478.8 609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 478.9 stalking); 609.224, subdivision 2, paragraph (c) (assault in the 478.10 fifth degree by a caregiver against a vulnerable adult); 609.23 478.11 (mistreatment of persons confined); 609.231 (mistreatment of 478.12 residents or patients); 609.2325 (criminal abuse of a vulnerable 478.13 adult); 609.233 (criminal neglect of a vulnerable adult); 478.14 609.2335 (financial exploitation of a vulnerable adult); 609.234 478.15 (failure to report maltreatment of a vulnerable adult); 609.72, 478.16 subdivision 3 (disorderly conduct against a vulnerable adult); 478.17 609.265 (abduction); 609.378 (neglect or endangerment of a 478.18 child); 609.377 (malicious punishment of a child); 609.324, 478.19 subdivision 1a (other prohibited acts; minor engaged in 478.20 prostitution); 609.33 (disorderly house); 609.52 (theft); 478.21 609.582 (burglary); 609.631 (check forgery; offering a forged 478.22 check); 609.275 (attempt to coerce); or an attempt or conspiracy 478.23 to commit any of these offenses, as each of these offenses is 478.24 defined in Minnesota Statutes; or an offense in any other state 478.25 or country, the elements of which are substantially similar to 478.26 the elements of any of the offenses listed in this clause. If 478.27 the defendant is convicted of one of the gross misdemeanors 478.28 listed in this clause, but the sentence is a misdemeanor 478.29 disposition, the lookback period for the conviction is the 478.30 period applicable to misdemeanors; or 478.31 (4) if less than seven years have passed since the 478.32 discharge of the sentence imposed for the offense; and the 478.33 individual has received a misdemeanor conviction for a violation 478.34 of any of the following offenses: sections 609.224 (assault in 478.35 the fifth degree); 609.2242 (domestic assault); violation of an 478.36 order for protection under 518B.01 (Domestic Abuse Act); 479.1 violation of an order for protection under 609.3232 (protective 479.2 order authorized; procedures; penalties); 609.746 (interference 479.3 with privacy); 609.79 (obscene or harassing phone calls); 479.4 609.795 (letter, telegram, or package; opening; harassment); 479.5 617.23 (indecent exposure; penalties); 609.2672 (assault of an 479.6 unborn child in the third degree); 617.293 (harmful materials; 479.7 dissemination and display to minors prohibited); 609.66 479.8 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 479.9 exploitation of a vulnerable adult); 609.234 (failure to report 479.10 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 479.11 (coercion); or an attempt or conspiracy to commit any of these 479.12 offenses, as each of these offenses is defined in Minnesota 479.13 Statutes; or an offense in any other state or country, the 479.14 elements of which are substantially similar to the elements of 479.15 any of the offenses listed in this clause; a determination or 479.16 disposition of failure to make required reports under section 479.17 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 479.18 in which: (i) the final disposition under section 626.556 or 479.19 626.557 was substantiated maltreatment, and (ii) the 479.20 maltreatment was recurring or serious; or a determination or 479.21 disposition of substantiated serious or recurring maltreatment 479.22 of a minor under section 626.556 or of a vulnerable adult under 479.23 section 626.557 for which there is a preponderance of evidence 479.24 that the maltreatment occurred, and that the subject was 479.25 responsible for the maltreatment. 479.26 For the purposes of this section, "serious maltreatment" 479.27 means sexual abuse; maltreatment resulting in death; or 479.28 maltreatment resulting in serious injury which reasonably 479.29 requires the care of a physician whether or not the care of a 479.30 physician was sought; or abuse resulting in serious injury. For 479.31 purposes of this section, "abuse resulting in serious injury" 479.32 means: bruises, bites, skin laceration or tissue damage; 479.33 fractures; dislocations; evidence of internal injuries; head 479.34 injuries with loss of consciousness; extensive second-degree or 479.35 third-degree burns and other burns for which complications are 479.36 present; extensive second-degree or third-degree frostbite, and 480.1 others for which complications are present; irreversible 480.2 mobility or avulsion of teeth; injuries to the eyeball; 480.3 ingestion of foreign substances and objects that are harmful; 480.4 near drowning; and heat exhaustion or sunstroke. For purposes 480.5 of this section, "care of a physician" is treatment received or 480.6 ordered by a physician, but does not include diagnostic testing, 480.7 assessment, or observation. For the purposes of this section, 480.8 "recurring maltreatment" means more than one incident of 480.9 maltreatment for which there is a preponderance of evidence that 480.10 the maltreatment occurred, and that the subject was responsible 480.11 for the maltreatment. For purposes of this section, "access" 480.12 means physical access to an individual receiving services or the 480.13 individual's personal property without continuous, direct 480.14 supervision as defined in section 245A.04, subdivision 3. 480.15 (b) Except for background studies related to child foster 480.16 care, adult foster care, or family child care licensure, when 480.17 the subject of a background study is regulated by a 480.18 health-related licensing board as defined in chapter 214, and 480.19 the regulated person has been determined to have been 480.20 responsible for substantiated maltreatment under section 626.556 480.21 or 626.557, instead of the commissioner making a decision 480.22 regarding disqualification, the board shall make a determination 480.23 whether to impose disciplinary or corrective action under 480.24 chapter 214. 480.25 (1) The commissioner shall notify the health-related 480.26 licensing board: 480.27 (i) upon completion of a background study that produces a 480.28 record showing that the individual was determined to have been 480.29 responsible for substantiated maltreatment; 480.30 (ii) upon the commissioner's completion of an investigation 480.31 that determined the individual was responsible for substantiated 480.32 maltreatment; or 480.33 (iii) upon receipt from another agency of a finding of 480.34 substantiated maltreatment for which the individual was 480.35 responsible. 480.36 (2) The commissioner's notice shall indicate whether the 481.1 individual would have been disqualified by the commissioner for 481.2 the substantiated maltreatment if the individual were not 481.3 regulated by the board. The commissioner shall concurrently 481.4 send this notice to the individual. 481.5 (3) Notwithstanding the exclusion from this subdivision for 481.6 individuals who provide child foster care, adult foster care, or 481.7 family child care, when the commissioner or a local agency has 481.8 reason to believe that the direct contact services provided by 481.9 the individual may fall within the jurisdiction of a 481.10 health-related licensing board, a referral shall be made to the 481.11 board as provided in this section. 481.12 (4) If, upon review of the information provided by the 481.13 commissioner, a health-related licensing board informs the 481.14 commissioner that the board does not have jurisdiction to take 481.15 disciplinary or corrective action, the commissioner shall make 481.16 the appropriate disqualification decision regarding the 481.17 individual as otherwise provided in this chapter. 481.18 (5) The commissioner has the authority to monitor the 481.19 facility's compliance with any requirements that the 481.20 health-related licensing board places on regulated persons 481.21 practicing in a facility either during the period pending a 481.22 final decision on a disciplinary or corrective action or as a 481.23 result of a disciplinary or corrective action. The commissioner 481.24 has the authority to order the immediate removal of a regulated 481.25 person from direct contact or access when a board issues an 481.26 order of temporary suspension based on a determination that the 481.27 regulated person poses an immediate risk of harm to persons 481.28 receiving services in a licensed facility. 481.29 (6) A facility that allows a regulated person to provide 481.30 direct contact services while not complying with the 481.31 requirements imposed by the health-related licensing board is 481.32 subject to action by the commissioner as specified under 481.33 sections 245A.06 and 245A.07. 481.34 (7) The commissioner shall notify a health-related 481.35 licensing board immediately upon receipt of knowledge of 481.36 noncompliance with requirements placed on a facility or upon a 482.1 person regulated by the board. 482.2 Sec. 5. Minnesota Statutes 2002, section 256B.056, 482.3 subdivision 6, is amended to read: 482.4 Subd. 6. [ASSIGNMENT OF BENEFITS.] To be eligible for 482.5 medical assistance a person must have applied or must agree to 482.6 apply all proceeds received or receivable by the person or the 482.7 person'sspouselegal representative from any thirdpersonparty 482.8 liable for the costs of medical carefor the person, the spouse,482.9and children.The state agency shall require from any applicant482.10or recipient of medical assistance the assignment of any rights482.11to medical support and third party payments.By accepting or 482.12 receiving assistance, the person is deemed to have assigned the 482.13 person's rights to medical support and third party payments as 482.14 required by Title 19 of the Social Security Act. Persons must 482.15 cooperate with the state in establishing paternity and obtaining 482.16 third party payments. Bysigning an application foraccepting 482.17 medical assistance, a person assigns to the department of human 482.18 services all rights the person may have to medical support or 482.19 payments for medical expenses from any other person or entity on 482.20 their own or their dependent's behalf and agrees to cooperate 482.21 with the state in establishing paternity and obtaining third 482.22 party payments. Any rights or amounts so assigned shall be 482.23 applied against the cost of medical care paid for under this 482.24 chapter. Any assignment takes effect upon the determination 482.25 that the applicant is eligible for medical assistance and up to 482.26 three months prior to the date of application if the applicant 482.27 is determined eligible for and receives medical assistance 482.28 benefits. The application must contain a statement explaining 482.29 this assignment.Any assignment shall not be effective as to482.30benefits paid or provided under automobile accident coverage and482.31private health care coverage prior to notification of the482.32assignment by the person or organization providing the482.33benefits.For the purposes of this section, "the department of 482.34 human services or the state" includes prepaid health plans under 482.35 contract with the commissioner according to sections 256B.031, 482.36 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 483.1 children's mental health collaboratives under section 245.493; 483.2 demonstration projects for persons with disabilities under 483.3 section 256B.77; nursing facilities under the alternative 483.4 payment demonstration project under section 256B.434; and the 483.5 county-based purchasing entities under section 256B.692. 483.6 Sec. 6. Minnesota Statutes 2002, section 256B.057, 483.7 subdivision 10, is amended to read: 483.8 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 483.9 CERVICAL CANCER.] (a) Medical assistance may be paid for a 483.10 person who: 483.11 (1) has been screened for breast or cervical cancer by the 483.12 Minnesota breast and cervical cancer control program, and 483.13 program funds have been used to pay for the person's screening; 483.14 (2) according to the person's treating health professional, 483.15 needs treatment, including diagnostic services necessary to 483.16 determine the extent and proper course of treatment, for breast 483.17 or cervical cancer, including precancerous conditions and early 483.18 stage cancer; 483.19 (3) meets the income eligibility guidelines for the 483.20 Minnesota breast and cervical cancer control program; 483.21 (4) is under age 65; 483.22 (5) is not otherwise eligible for medical assistance under 483.23 United States Code, title 42, section 1396(a)(10)(A)(i); and 483.24 (6) is not otherwise covered under creditable coverage, as 483.25 defined under United States Code, title 42, section 483.26300gg(c)1396a(aa). 483.27 (b) Medical assistance provided for an eligible person 483.28 under this subdivision shall be limited to services provided 483.29 during the period that the person receives treatment for breast 483.30 or cervical cancer. 483.31 (c) A person meeting the criteria in paragraph (a) is 483.32 eligible for medical assistance without meeting the eligibility 483.33 criteria relating to income and assets in section 256B.056, 483.34 subdivisions 1a to 5b. 483.35 Sec. 7. Minnesota Statutes 2002, section 256B.064, 483.36 subdivision 2, is amended to read: 484.1 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 484.2 (a) The commissioner shall determine any monetary amounts to be 484.3 recovered and sanctions to be imposed upon a vendor of medical 484.4 care under this section. Except as provided in 484.5paragraphparagraphs (b) and (d), neither a monetary recovery 484.6 nor a sanction will be imposed by the commissioner without prior 484.7 notice and an opportunity for a hearing, according to chapter 484.8 14, on the commissioner's proposed action, provided that the 484.9 commissioner may suspend or reduce payment to a vendor of 484.10 medical care, except a nursing home or convalescent care 484.11 facility, after notice and prior to the hearing if in the 484.12 commissioner's opinion that action is necessary to protect the 484.13 public welfare and the interests of the program. 484.14 (b) Except for a nursing home or convalescent care 484.15 facility, the commissioner may withhold or reduce payments to a 484.16 vendor of medical care without providing advance notice of such 484.17 withholding or reduction if either of the following occurs: 484.18 (1) the vendor is convicted of a crime involving the 484.19 conduct described in subdivision 1a; or 484.20 (2) the commissioner receives reliable evidence of fraud or 484.21 willful misrepresentation by the vendor. 484.22 (c) The commissioner must send notice of the withholding or 484.23 reduction of payments under paragraph (b) within five days of 484.24 taking such action. The notice must: 484.25 (1) state that payments are being withheld according to 484.26 paragraph (b); 484.27 (2) except in the case of a conviction for conduct 484.28 described in subdivision 1a, state that the withholding is for a 484.29 temporary period and cite the circumstances under which 484.30 withholding will be terminated; 484.31 (3) identify the types of claims to which the withholding 484.32 applies; and 484.33 (4) inform the vendor of the right to submit written 484.34 evidence for consideration by the commissioner. 484.35 The withholding or reduction of payments will not continue 484.36 after the commissioner determines there is insufficient evidence 485.1 of fraud or willful misrepresentation by the vendor, or after 485.2 legal proceedings relating to the alleged fraud or willful 485.3 misrepresentation are completed, unless the commissioner has 485.4 sent notice of intention to impose monetary recovery or 485.5 sanctions under paragraph (a). 485.6 (d) The commissioner may suspend or terminate a vendor's 485.7 participation in the program without providing advance notice 485.8 and an opportunity for a hearing when the suspension or 485.9 termination is required because of the vendor's exclusion from 485.10 participation in Medicare. Within five days of taking such 485.11 action, the commissioner must send notice of the suspension or 485.12 termination. The notice must: 485.13 (1) state that suspension or termination is the result of 485.14 the vendor's exclusion from Medicare; 485.15 (2) identify the effective date of the suspension or 485.16 termination; 485.17 (3) inform the vendor of the need to be reinstated to 485.18 Medicare before reapplying for participation in the program; and 485.19 (4) inform the vendor of the right to submit written 485.20 evidence for consideration by the commissioner. 485.21 (e) Upon receipt of a notice under paragraph (a) that a 485.22 monetary recovery or sanction is to be imposed, a vendor may 485.23 request a contested case, as defined in section 14.02, 485.24 subdivision 3, by filing with the commissioner a written request 485.25 of appeal. The appeal request must be received by the 485.26 commissioner no later than 30 days after the date the 485.27 notification of monetary recovery or sanction was mailed to the 485.28 vendor. The appeal request must specify: 485.29 (1) each disputed item, the reason for the dispute, and an 485.30 estimate of the dollar amount involved for each disputed item; 485.31 (2) the computation that the vendor believes is correct; 485.32 (3) the authority in statute or rule upon which the vendor 485.33 relies for each disputed item; 485.34 (4) the name and address of the person or entity with whom 485.35 contacts may be made regarding the appeal; and 485.36 (5) other information required by the commissioner. 486.1 Sec. 8. Minnesota Statutes 2002, section 256B.437, 486.2 subdivision 2, is amended to read: 486.3 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY-BASED 486.4 SERVICES.] (a) The commissioner of human services shall 486.5 establish a process to adjust the capacity and distribution of 486.6 long-term care services to equalize the supply and demand for 486.7 different types of services. This process must include 486.8 community planning, expansion or establishment of needed 486.9 services, and analysis of voluntary nursing facility closures. 486.10 (b) The purpose of this process is to support the planning 486.11 and development of community-based services. This process must 486.12 support early intervention, advocacy, and consumer protection 486.13 while providing resources and incentives for expanded county 486.14 planning and for nursing facilities to transition to meet 486.15 community needs. 486.16 (c) The process shall support and facilitate expansion of 486.17 community-based services under the county-administered 486.18 alternative care program under section 256B.0913 and waivers for 486.19 elderly under section 256B.0915, including, but not limited to, 486.20 the development of supportive services such as housing and 486.21 transportation. The process shall utilize community assessments 486.22 and planning developed for the community health services plan 486.23 and plan update and for the community social services act plan, 486.24 and other relevant information. 486.25 (d) The commissioners of health and human services, as 486.26 appropriate, shall provide, by July 15, 2001, available data 486.27 necessary for the county, including, but not limited to, data on 486.28 nursing facility bed distribution, housing with services 486.29 options, the closure of nursing facilities that occur outside of 486.30 the planned closure process, and approval of planned closures in 486.31 the county and contiguous counties. 486.32 (e) Each county shall submit to the commissioner of human 486.33 services, by October 15, 2001, a gaps analysis that identifies 486.34 local service needs, pending development of services, and any 486.35 other issues that would contribute to or impede further 486.36 development of community-based services. The gaps analysis must 487.1 also be sent to the local area agency on aging and, if 487.2 applicable, local SAIL projects, for review and comment. The 487.3 review and comment must assess needs across county boundaries. 487.4 The area agencies on aging and SAIL projects must provide the 487.5 commissioner and the counties with their review and analyses by 487.6 November 15, 2001. 487.7 (f) The addendum to the biennial plan shall be submitted 487.8 biennially, beginning December 31, 2001, and every other year 487.9 thereafter in accordance with the Community Social Services Act 487.10 plan timeline, and shall include recommendations for development 487.11 of community-based services. Area agencies on aging and SAIL 487.12 projects must provide the commissioner and the counties with 487.13 their review and analyses within 60 days following the Community 487.14 Social Services Act plan submission date. Both planning and 487.15 implementation shall be implemented within the amount of funding 487.16 made available to the county board for these purposes. 487.17 (g) The plan, within the funding allocated, shall: 487.18 (1) include the gaps analysis required by paragraph (e); 487.19 (2) involve providers, consumers, cities, townships, 487.20 businesses, and area agencies on aging in the planning process; 487.21 (3) address the availability of alternative care and 487.22 elderly waiver services for eligible recipients; 487.23 (4) address the development of other supportive services, 487.24 such as transit, housing, and workforce and economic 487.25 development; and 487.26 (5) estimate the cost and timelines for development. 487.27 (h) The biennial plan addendum shall be coordinated with 487.28 the county mental health plan for inclusion in the community 487.29 health services plan and included as an addendum to the 487.30 community social services plan. 487.31 (i) The county board having financial responsibility for 487.32 persons present in another county shall cooperate with that 487.33 county for planning and development of services. 487.34 (j) The county board shall cooperate in planning and 487.35 development of community-based services with other counties, as 487.36 necessary, and coordinate planning for long-term care services 488.1 that involve more than one county, within the funding allocated 488.2 for these purposes. 488.3(k) The commissioners of health and human services, in488.4cooperation with county boards, shall report biennially to the488.5legislature, beginning February 1, 2002, regarding the488.6development of community-based services, transition or closure488.7of nursing facilities, and specific gaps in services in488.8identified geographic areas that may require additional488.9resources or flexibility, as documented by the process in this488.10subdivision.488.11 Sec. 9. Minnesota Statutes 2002, section 256B.76, is 488.12 amended to read: 488.13 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 488.14 (a) Effective for services rendered on or after October 1, 488.15 1992, the commissioner shall make payments for physician 488.16 services as follows: 488.17 (1) payment for level one Centers for Medicare and Medicaid 488.18 Services' common procedural coding system codes titled "office 488.19 and other outpatient services," "preventive medicine new and 488.20 established patient," "delivery, antepartum, and postpartum 488.21 care," "critical care," cesarean delivery and pharmacologic 488.22 management provided to psychiatric patients, and level three 488.23 codes for enhanced services for prenatal high risk, shall be 488.24 paid at the lower of (i) submitted charges, or (ii) 25 percent 488.25 above the rate in effect on June 30, 1992. If the rate on any 488.26 procedure code within these categories is different than the 488.27 rate that would have been paid under the methodology in section 488.28 256B.74, subdivision 2, then the larger rate shall be paid; 488.29 (2) payments for all other services shall be paid at the 488.30 lower of (i) submitted charges, or (ii) 15.4 percent above the 488.31 rate in effect on June 30, 1992; 488.32 (3) all physician rates shall be converted from the 50th 488.33 percentile of 1982 to the 50th percentile of 1989, less the 488.34 percent in aggregate necessary to equal the above increases 488.35 except that payment rates for home health agency services shall 488.36 be the rates in effect on September 30, 1992; 489.1 (4) effective for services rendered on or after January 1, 489.2 2000, payment rates for physician and professional services 489.3 shall be increased by three percent over the rates in effect on 489.4 December 31, 1999, except for home health agency and family 489.5 planning agency services; and 489.6 (5) the increases in clause (4) shall be implemented 489.7 January 1, 2000, for managed care. 489.8 (b) Effective for services rendered on or after October 1, 489.9 1992, the commissioner shall make payments for dental services 489.10 as follows: 489.11 (1) dental services shall be paid at the lower of (i) 489.12 submitted charges, or (ii) 25 percent above the rate in effect 489.13 on June 30, 1992; 489.14 (2) dental rates shall be converted from the 50th 489.15 percentile of 1982 to the 50th percentile of 1989, less the 489.16 percent in aggregate necessary to equal the above increases; 489.17 (3) effective for services rendered on or after January 1, 489.18 2000, payment rates for dental services shall be increased by 489.19 three percent over the rates in effect on December 31, 1999; 489.20 (4) the commissioner shall award grants to community 489.21 clinics or other nonprofit community organizations, political 489.22 subdivisions, professional associations, or other organizations 489.23 that demonstrate the ability to provide dental services 489.24 effectively to public program recipients. Grants may be used to 489.25 fund the costs related to coordinating access for recipients, 489.26 developing and implementing patient care criteria, upgrading or 489.27 establishing new facilities, acquiring furnishings or equipment, 489.28 recruiting new providers, or other development costs that will 489.29 improve access to dental care in a region. In awarding grants, 489.30 the commissioner shall give priority to applicants that plan to 489.31 serve areas of the state in which the number of dental providers 489.32 is not currently sufficient to meet the needs of recipients of 489.33 public programs or uninsured individuals. The commissioner 489.34 shall consider the following in awarding the grants: 489.35 (i) potential to successfully increase access to an 489.36 underserved population; 490.1 (ii) the ability to raise matching funds; 490.2 (iii) the long-term viability of the project to improve 490.3 access beyond the period of initial funding; 490.4 (iv) the efficiency in the use of the funding; and 490.5 (v) the experience of the proposers in providing services 490.6 to the target population. 490.7 The commissioner shall monitor the grants and may terminate 490.8 a grant if the grantee does not increase dental access for 490.9 public program recipients. The commissioner shall consider 490.10 grants for the following: 490.11 (i) implementation of new programs or continued expansion 490.12 of current access programs that have demonstrated success in 490.13 providing dental services in underserved areas; 490.14 (ii) a pilot program for utilizing hygienists outside of a 490.15 traditional dental office to provide dental hygiene services; 490.16 and 490.17 (iii) a program that organizes a network of volunteer 490.18 dentists, establishes a system to refer eligible individuals to 490.19 volunteer dentists, and through that network provides donated 490.20 dental care services to public program recipients or uninsured 490.21 individuals; 490.22 (5) beginning October 1, 1999, the payment for tooth 490.23 sealants and fluoride treatments shall be the lower of (i) 490.24 submitted charge, or (ii) 80 percent of median 1997 charges; 490.25 (6) the increases listed in clauses (3) and (5) shall be 490.26 implemented January 1, 2000, for managed care; and 490.27 (7) effective for services provided on or after January 1, 490.28 2002, payment for diagnostic examinations and dental x-rays 490.29 provided to children under age 21 shall be the lower of (i) the 490.30 submitted charge, or (ii) 85 percent of median 1999 charges. 490.31 (c) Effective for dental services rendered on or after 490.32 January 1, 2002, the commissioner may, within the limits of 490.33 available appropriation, increase reimbursements to dentists and 490.34 dental clinics deemed by the commissioner to be critical access 490.35 dental providers. Reimbursement to a critical access dental 490.36 provider may be increased by not more than 50 percent above the 491.1 reimbursement rate that would otherwise be paid to the 491.2 provider. Payments to health plan companies shall be adjusted 491.3 to reflect increased reimbursements to critical access dental 491.4 providers as approved by the commissioner. In determining which 491.5 dentists and dental clinics shall be deemed critical access 491.6 dental providers, the commissioner shall review: 491.7 (1) the utilization rate in the service area in which the 491.8 dentist or dental clinic operates for dental services to 491.9 patients covered by medical assistance, general assistance 491.10 medical care, or MinnesotaCare as their primary source of 491.11 coverage; 491.12 (2) the level of services provided by the dentist or dental 491.13 clinic to patients covered by medical assistance, general 491.14 assistance medical care, or MinnesotaCare as their primary 491.15 source of coverage; and 491.16 (3) whether the level of services provided by the dentist 491.17 or dental clinic is critical to maintaining adequate levels of 491.18 patient access within the service area. 491.19 In the absence of a critical access dental provider in a service 491.20 area, the commissioner may designate a dentist or dental clinic 491.21 as a critical access dental provider if the dentist or dental 491.22 clinic is willing to provide care to patients covered by medical 491.23 assistance, general assistance medical care, or MinnesotaCare at 491.24 a level which significantly increases access to dental care in 491.25 the service area. 491.26 (d)Effective July 1, 2001, the medical assistance rates491.27for outpatient mental health services provided by an entity that491.28operates:491.29(1) a Medicare-certified comprehensive outpatient491.30rehabilitation facility; and491.31(2) a facility that was certified prior to January 1, 1993,491.32with at least 33 percent of the clients receiving rehabilitation491.33services in the most recent calendar year who are medical491.34assistance recipients, will be increased by 38 percent, when491.35those services are provided within the comprehensive outpatient491.36rehabilitation facility and provided to residents of nursing492.1facilities owned by the entity.492.2(e)An entity that operates both a Medicare certified 492.3 comprehensive outpatient rehabilitation facility and a facility 492.4 which was certified prior to January 1, 1993, that is licensed 492.5 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 492.6 whom at least 33 percent of the clients receiving rehabilitation 492.7 services in the most recent calendar year are medical assistance 492.8 recipients, shall be reimbursed by the commissioner for 492.9 rehabilitation services at rates that are 38 percent greater 492.10 than the maximum reimbursement rate allowed under paragraph (a), 492.11 clause (2), when those services are (1) provided within the 492.12 comprehensive outpatient rehabilitation facility and (2) 492.13 provided to residents of nursing facilities owned by the entity. 492.14 Sec. 10. Minnesota Statutes 2002, section 256B.761, is 492.15 amended to read: 492.16 256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 492.17 (a) Effective for services rendered on or after July 1, 492.18 2001, payment for medication management provided to psychiatric 492.19 patients, outpatient mental health services, day treatment 492.20 services, home-based mental health services, and family 492.21 community support services shall be paid at the lower of (1) 492.22 submitted charges, or (2) 75.6 percent of the 50th percentile of 492.23 1999 charges. 492.24 (b) Effective July 1, 2001, the medical assistance rates 492.25 for outpatient mental health services provided by an entity that 492.26 operates: (1) a Medicare-certified comprehensive outpatient 492.27 rehabilitation facility; and (2) a facility that was certified 492.28 prior to January 1, 1993, with at least 33 percent of the 492.29 clients receiving rehabilitation services in the most recent 492.30 calendar year who are medical assistance recipients, will be 492.31 increased by 38 percent, when those services are provided within 492.32 the comprehensive outpatient rehabilitation facility and 492.33 provided to residents of nursing facilities owned by the entity. 492.34 Sec. 11. Minnesota Statutes 2002, section 256D.03, 492.35 subdivision 3a, is amended to read: 492.36 Subd. 3a. [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 493.1 filed pursuant to section 256D.16. General assistance medical 493.2 care applicants and recipients must apply or agree to apply 493.3 third party health and accident benefits to the costs of medical 493.4 care. They must cooperate with the state in establishing 493.5 paternity and obtaining third party payments. Bysigning an493.6application foraccepting general assistance, a person assigns 493.7 to the department of human services all rights to medical 493.8 support or payments for medical expenses from another person or 493.9 entity on their own or their dependent's behalf and agrees to 493.10 cooperate with the state in establishing paternity and obtaining 493.11 third party payments. The application shall contain a statement 493.12 explaining the assignment. Any rights or amounts assigned shall 493.13 be applied against the cost of medical care paid for under this 493.14 chapter. An assignment is effective on the date general 493.15 assistance medical care eligibility takes effect.The493.16assignment shall not affect benefits paid or provided under493.17automobile accident coverage and private health care coverage493.18until the person or organization providing the benefits has493.19received notice of the assignment.493.20 Sec. 12. Minnesota Statutes 2002, section 256L.12, 493.21 subdivision 6, is amended to read: 493.22 Subd. 6. [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 493.23 responsible for all copayments in section 256L.03, subdivision4493.24 5, and shall pay copayments to the managed care plan or to its 493.25 participating providers. The enrollee is also responsible for 493.26 payment of inpatient hospital charges which exceed the 493.27 MinnesotaCare benefit limit. 493.28 Sec. 13. Minnesota Statutes 2002, section 260C.141, 493.29 subdivision 2, is amended to read: 493.30 Subd. 2. [REVIEW OF FOSTER CARE STATUS.] The social 493.31 services agency responsible for the placement of a child in a 493.32 residential facility, as defined in section 260C.212, 493.33 subdivision 1, pursuant to a voluntary release by the child's 493.34 parent or parents must proceed in juvenile court to review the 493.35 foster care status of the child in the manner provided in this 493.36 section. 494.1 (a) Except for a child in placement due solely to the 494.2 child's developmental disability or emotional disturbance, when 494.3 a child continues in voluntary placement according to section 494.4 260C.212, subdivision 8, a petition shall be filed alleging the 494.5 child to be in need of protection or services or seeking 494.6 termination of parental rights or other permanent placement of 494.7 the child away from the parent within 90 days of the date of the 494.8 voluntary placement agreement. The petition shall state the 494.9 reasons why the child is in placement, the progress on the 494.10 out-of-home placement plan required under section 260C.212, 494.11 subdivision 1, and the statutory basis for the petition under 494.12 section 260C.007, subdivision 6, 260C.201, subdivision 11, or 494.13 260C.301. 494.14 (1) In the case of a petition alleging the child to be in 494.15 need of protection or services filed under this paragraph, if 494.16 all parties agree and the court finds it is in the best 494.17 interests of the child, the court may find the petition states a 494.18 prima facie case that: 494.19 (i) the child's needs are being met; 494.20 (ii) the placement of the child in foster care is in the 494.21 best interests of the child; 494.22 (iii) reasonable efforts to reunify the child and the 494.23 parent or guardian are being made; and 494.24 (iv) the child will be returned home in the next three 494.25 months. 494.26 (2) If the court makes findings under paragraph (1), the 494.27 court shall approve the voluntary arrangement and continue the 494.28 matter for up to three more months to ensure the child returns 494.29 to the parents' home. The responsible social services agency 494.30 shall: 494.31 (i) report to the court when the child returns home and the 494.32 progress made by the parent on the out-of-home placement plan 494.33 required under section 260C.212, in which case the court shall 494.34 dismiss jurisdiction; 494.35 (ii) report to the court that the child has not returned 494.36 home, in which case the matter shall be returned to the court 495.1 for further proceedings under section 260C.163; or 495.2 (iii) if any party does not agree to continue the matter 495.3 under paragraph (1) and this paragraph, the matter shall proceed 495.4 under section 260C.163. 495.5 (b) In the case of a child in voluntary placement due 495.6 solely to the child's developmental disability or emotional 495.7 disturbance according to section 260C.212, subdivision 9, the 495.8 following procedures apply: 495.9 (1) [REPORT TO COURT.] (i) Unless the county attorney 495.10 determines that a petition under subdivision 1 is appropriate, 495.11 without filing a petition, a written report shall be forwarded 495.12 to the court within 165 days of the date of the voluntary 495.13 placement agreement. The written report shall contain necessary 495.14 identifying information for the court to proceed, a copy of the 495.15 out-of-home placement plan required under section 260C.212, 495.16 subdivision 1, a written summary of the proceedings of any 495.17 administrative review required under section 260C.212, 495.18 subdivision 7, and any other information the responsible social 495.19 services agency, parent or guardian, the child or the foster 495.20 parent or other residential facility wants the court to consider. 495.21 (ii) The responsible social services agency, where 495.22 appropriate, must advise the child, parent or guardian, the 495.23 foster parent, or representative of the residential facility of 495.24 the requirements of this section and of their right to submit 495.25 information to the court. If the child, parent or guardian, 495.26 foster parent, or representative of the residential facility 495.27 wants to send information to the court, the responsible social 495.28 services agency shall advise those persons of the reporting date 495.29 and the identifying information necessary for the court 495.30 administrator to accept the information and submit it to a judge 495.31 with the agency's report. The responsible social services 495.32 agency must also notify those persons that they have the right 495.33 to be heard in person by the court and how to exercise that 495.34 right. The responsible social services agency must also provide 495.35 notice that an in-court hearing will not be held unless 495.36 requested by a parent or guardian, foster parent, or the child. 496.1 (iii) After receiving the required report, the court has 496.2 jurisdiction to make the following determinations and must do so 496.3 within ten days of receiving the forwarded report: (A) whether 496.4 or not the placement of the child is in the child's best 496.5 interests; and (B) whether the parent and agency are 496.6 appropriately planning for the child. Unless requested by a 496.7 parent or guardian, foster parent, or child, no in-court hearing 496.8 need be held in order for the court to make findings and issue 496.9 an order under this paragraph. 496.10 (iv) If the court finds the placement is in the child's 496.11 best interests and that the agency and parent are appropriately 496.12 planning for the child, the court shall issue an order 496.13 containing explicit, individualized findings to support its 496.14 determination. The court shall send a copy of the order to the 496.15 county attorney, the responsible social services agency, the 496.16 parent or guardian, the child, and the foster parents. The 496.17 court shall also send the parent or guardian, the child, and the 496.18 foster parent notice of the required review under clause (2). 496.19 (v) If the court finds continuing the placement not to be 496.20 in the child's best interests or that the agency or the parent 496.21 or guardian is not appropriately planning for the child, the 496.22 court shall notify the county attorney, the responsible social 496.23 services agency, the parent or guardian, the foster parent, the 496.24 child, and the county attorney of the court's determinations and 496.25 the basis for the court's determinations. 496.26 (2) [PERMANENCY REVIEW BY PETITION.] If a child with a 496.27 developmental disability or an emotional disturbance continues 496.28 in out-of-home placement for 13 months from the date of a 496.29 voluntary placement, a petition alleging the child to be in need 496.30 of protection or services, for termination of parental rights, 496.31 or for permanent placement of the child away from the parent 496.32 under section 260C.201 shall be filed. The court shall conduct 496.33 a permanency hearing on the petition no later than 14 months 496.34 after the date of the voluntary placement. At the permanency 496.35 hearing, the court shall determine the need for an order 496.36 permanently placing the child away from the parent or determine 497.1 whether there are compelling reasons that continued voluntary 497.2 placement is in the child's best interests. A petition alleging 497.3 the child to be in need of protection or services shall state 497.4 the date of the voluntary placement agreement, the nature of the 497.5 child's developmental disability or emotional disturbance, the 497.6 plan for the ongoing care of the child, the parents' 497.7 participation in the plan, the responsible social services 497.8 agency's efforts to finalize a plan for the permanent placement 497.9 of the child, and the statutory basis for the petition. 497.10 (i) If a petition alleging the child to be in need of 497.11 protection or services is filed under this paragraph, the court 497.12 may find, based on the contents of the sworn petition, and the 497.13 agreement of all parties, including the child, where 497.14 appropriate, that there are compelling reasons that the 497.15 voluntary arrangement is in the best interests of the child and 497.16 that the responsible social services agency has made reasonable 497.17 efforts to finalize a plan for the permanent placement of the 497.18 child, approve the continued voluntary placement, and continue 497.19 the matter under the court's jurisdiction for the purpose of 497.20 reviewing the child's placement as a continued voluntary 497.21 arrangement every 12 months as long as the child continues in 497.22 out-of-home placement. The matter must be returned to the court 497.23 for further review every 12 months as long as the child remains 497.24 in placement. The court shall give notice to the parent or 497.25 guardian of the continued review requirements under this 497.26 section. Nothing in this paragraph shall be construed to mean 497.27 the court must order permanent placement for the child under 497.28 section 260C.201, subdivision 11, as long as the court finds 497.29 compelling reasons at the first review required under this 497.30 section. 497.31 (ii) If a petition for termination of parental rights, for 497.32 transfer of permanent legal and physical custody to a relative, 497.33 for long-term foster care, or for foster care for a specified 497.34 period of time is filed, the court must proceed under section 497.35 260C.201, subdivision 11. 497.36 (3) If any party, including the child, disagrees with the 498.1 voluntary arrangement, the court shall proceed under section 498.2 260C.163. 498.3 Sec. 14. [REPORT ON LONG-TERM CARE.] 498.4 The report on long-term care services required under 498.5 Minnesota Statutes, section 144A.351, that is presented to the 498.6 legislature by January 15, 2004, must also address strategies 498.7 for increasing the purchase of long-term care insurance and the 498.8 feasibility of offering government or private sector loans or 498.9 lines of credit to individuals age 65 and over, for the purchase 498.10 of long-term care services. 498.11 Sec. 15. [REPEALER.] 498.12 (a) Minnesota Statutes 2002, sections 62J.66; 62J.68; 498.13 144A.071, subdivision 5; and 144A.35, are repealed. 498.14 (b) Laws 1998, chapter 407, article 4, section 63, is 498.15 repealed. 498.16 (c) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 498.17 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 498.18 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 498.19 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 498.20 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 498.21 9505.3700, are repealed effective July 1, 2003. 498.22 ARTICLE 15 498.23 CHILD SUPPORT FEDERAL COMPLIANCE 498.24 Section 1. Minnesota Statutes 2002, section 13.69, 498.25 subdivision 1, is amended to read: 498.26 Subdivision 1. [CLASSIFICATIONS.] (a) The following 498.27 government data of the department of public safety are private 498.28 data: 498.29 (1) medical data on driving instructors, licensed drivers, 498.30 and applicants for parking certificates and special license 498.31 plates issued to physically handicapped persons; 498.32 (2) other data on holders of a disability certificate under 498.33 section 169.345, except that data that are not medical data may 498.34 be released to law enforcement agencies; 498.35 (3) social security numbers in driver's license and motor 498.36 vehicle registration records, except that social security 499.1 numbers must be provided to the department of revenue for 499.2 purposes of tax administrationand, the department of labor and 499.3 industry for purposes of workers' compensation administration 499.4 and enforcement, and the department of natural resources for 499.5 purposes of license application administration; and 499.6 (4) data on persons listed as standby or temporary 499.7 custodians under section 171.07, subdivision 11, except that the 499.8 data must be released to: 499.9 (i) law enforcement agencies for the purpose of verifying 499.10 that an individual is a designated caregiver; or 499.11 (ii) law enforcement agencies who state that the license 499.12 holder is unable to communicate at that time and that the 499.13 information is necessary for notifying the designated caregiver 499.14 of the need to care for a child of the license holder. 499.15 (b) The following government data of the department of 499.16 public safety are confidential data: data concerning an 499.17 individual's driving ability when that data is received from a 499.18 member of the individual's family. 499.19 Sec. 2. [97A.482] [LICENSE APPLICATIONS; COLLECTION OF 499.20 SOCIAL SECURITY NUMBERS.] 499.21 (a) All individual noncommercial game and fish license 499.22 applications under chapters 97A, 97B, and 97C, must include the 499.23 applicant's social security number. If the applicant does not 499.24 have a social security number, the applicant must certify that 499.25 the applicant does not have a social security number. 499.26 (b) The social security numbers of individuals collected by 499.27 the commissioner through game and fish license applications are 499.28 private data under section 13.49, subdivision 1, and must be 499.29 provided by the commissioner to the department of human services 499.30 for the purpose of child support enforcement. The collection of 499.31 social security numbers from game and fish license applications 499.32 for the purpose of child support enforcement is required by 499.33 section 466(a)(13) of the Social Security Act, United States 499.34 Code, title 42, section 666(a)(13). 499.35 (c) If the applicant refuses to provide the applicant's 499.36 social security number for data privacy reasons, the applicant 500.1 must be given the opportunity to manually enter the applicant's 500.2 social security number. 500.3 Sec. 3. Minnesota Statutes 2002, section 171.06, 500.4 subdivision 3, is amended to read: 500.5 Subd. 3. [CONTENTS OF APPLICATION; OTHER INFORMATION.] (a) 500.6 An application must: 500.7 (1) state the full name, date of birth, sex, and residence 500.8 address of the applicant; 500.9 (2) as may be required by the commissioner, contain a 500.10 description of the applicant and any other facts pertaining to 500.11 the applicant, the applicant's driving privileges, and the 500.12 applicant's ability to operate a motor vehicle with safety; 500.13 (3)for a class C, class B, or class A driver's license,500.14 state: 500.15 (i) the applicant's social security numberor, for a class500.16D driver's license, have a space for the applicant's social500.17security number and state that providing the number is optional,500.18or otherwise convey that the applicant is not required to enter500.19the social security number; or 500.20 (ii) if the applicant does not have a social security 500.21 number and is applying for a Minnesota identification card, 500.22 instruction permit, or class D provisional or driver's license, 500.23 that the applicant certifies that the applicant does not have a 500.24 social security number; 500.25 (4) contain a space where the applicant may indicate a 500.26 desire to make an anatomical gift according to paragraph (b); 500.27 and 500.28 (5) contain a notification to the applicant of the 500.29 availability of a living will/health care directive designation 500.30 on the license under section 171.07, subdivision 7. 500.31 (b) If the applicant does not indicate a desire to make an 500.32 anatomical gift when the application is made, the applicant must 500.33 be offered a donor document in accordance with section 171.07, 500.34 subdivision 5. The application must contain statements 500.35 sufficient to comply with the requirements of the Uniform 500.36 Anatomical Gift Act (1987), sections 525.921 to 525.9224, so 501.1 that execution of the application or donor document will make 501.2 the anatomical gift as provided in section 171.07, subdivision 501.3 5, for those indicating a desire to make an anatomical gift. 501.4 The application must be accompanied by information describing 501.5 Minnesota laws regarding anatomical gifts and the need for and 501.6 benefits of anatomical gifts, and the legal implications of 501.7 making an anatomical gift, including the law governing 501.8 revocation of anatomical gifts. The commissioner shall 501.9 distribute a notice that must accompany all applications for and 501.10 renewals of a driver's license or Minnesota identification 501.11 card. The notice must be prepared in conjunction with a 501.12 Minnesota organ procurement organization that is certified by 501.13 the federal Department of Health and Human Services and must 501.14 include: 501.15 (1) a statement that provides a fair and reasonable 501.16 description of the organ donation process, the care of the donor 501.17 body after death, and the importance of informing family members 501.18 of the donation decision; and 501.19 (2) a telephone number in a certified Minnesota organ 501.20 procurement organization that may be called with respect to 501.21 questions regarding anatomical gifts. 501.22 (c) The application must be accompanied also by information 501.23 containing relevant facts relating to: 501.24 (1) the effect of alcohol on driving ability; 501.25 (2) the effect of mixing alcohol with drugs; 501.26 (3) the laws of Minnesota relating to operation of a motor 501.27 vehicle while under the influence of alcohol or a controlled 501.28 substance; and 501.29 (4) the levels of alcohol-related fatalities and accidents 501.30 in Minnesota and of arrests for alcohol-related violations. 501.31 Sec. 4. Minnesota Statutes 2002, section 171.07, is 501.32 amended by adding a subdivision to read: 501.33 Subd. 14. [USE OF SOCIAL SECURITY NUMBER.] An applicant's 501.34 social security number must not be displayed, encrypted, or 501.35 encoded on the driver's license or Minnesota identification card 501.36 or included in a magnetic strip or bar code used to store data 502.1 on the license or Minnesota identification card. 502.2 Sec. 5. Minnesota Statutes 2002, section 518.551, 502.3 subdivision 12, is amended to read: 502.4 Subd. 12. [OCCUPATIONAL LICENSE SUSPENSION.] (a) Upon 502.5 motion of an obligee, if the court finds that the obligor is or 502.6 may be licensed by a licensing board listed in section 214.01 or 502.7 other state, county, or municipal agency or board that issues an 502.8 occupational license and the obligor is in arrears in 502.9 court-ordered child support or maintenance payments or both in 502.10 an amount equal to or greater than three times the obligor's 502.11 total monthly support and maintenance payments and is not in 502.12 compliance with a written payment agreement pursuant to section 502.13 518.553 that is approved by the court, a child support 502.14 magistrate, or the public authority, the court shall direct the 502.15 licensing board or other licensing agency to suspend the license 502.16 under section 214.101. The court's order must be stayed for 90 502.17 days in order to allow the obligor to execute a written payment 502.18 agreement pursuant to section 518.553. The payment agreement 502.19 must be approved by either the court or the public authority 502.20 responsible for child support enforcement. If the obligor has 502.21 not executed or is not in compliance with a written payment 502.22 agreement pursuant to section 518.553 after the 90 days expires, 502.23 the court's order becomes effective. If the obligor is a 502.24 licensed attorney, the court shall report the matter to the 502.25 lawyers professional responsibility board for appropriate action 502.26 in accordance with the rules of professional conduct. The 502.27 remedy under this subdivision is in addition to any other 502.28 enforcement remedy available to the court. 502.29 (b) If a public authority responsible for child support 502.30 enforcement finds that the obligor is or may be licensed by a 502.31 licensing board listed in section 214.01 or other state, county, 502.32 or municipal agency or board that issues an occupational license 502.33 and the obligor is in arrears in court-ordered child support or 502.34 maintenance payments or both in an amount equal to or greater 502.35 than three times the obligor's total monthly support and 502.36 maintenance payments and is not in compliance with a written 503.1 payment agreement pursuant to section 518.553 that is approved 503.2 by the court, a child support magistrate, or the public 503.3 authority, the court or the public authority shall direct the 503.4 licensing board or other licensing agency to suspend the license 503.5 under section 214.101. If the obligor is a licensed attorney, 503.6 the public authority may report the matter to the lawyers 503.7 professional responsibility board for appropriate action in 503.8 accordance with the rules of professional conduct. The remedy 503.9 under this subdivision is in addition to any other enforcement 503.10 remedy available to the public authority. 503.11 (c) At least 90 days before notifying a licensing authority 503.12 or the lawyers professional responsibility board under paragraph 503.13 (b), the public authority shall mail a written notice to the 503.14 license holder addressed to the license holder's last known 503.15 address that the public authority intends to seek license 503.16 suspension under this subdivision and that the license holder 503.17 must request a hearing within 30 days in order to contest the 503.18 suspension. If the license holder makes a written request for a 503.19 hearing within 30 days of the date of the notice, a court 503.20 hearing or a hearing under section 484.702 must be held. 503.21 Notwithstanding any law to the contrary, the license holder must 503.22 be served with 14 days' notice in writing specifying the time 503.23 and place of the hearing and the allegations against the license 503.24 holder. The notice may be served personally or by mail. If the 503.25 public authority does not receive a request for a hearing within 503.26 30 days of the date of the notice, and the obligor does not 503.27 execute a written payment agreement pursuant to section 518.553 503.28 that is approved by the public authority within 90 days of the 503.29 date of the notice, the public authority shall direct the 503.30 licensing board or other licensing agency to suspend the 503.31 obligor's license under paragraph (b), or shall report the 503.32 matter to the lawyers professional responsibility board. 503.33 (d) The public authority or the court shall notify the 503.34 lawyers professional responsibility board for appropriate action 503.35 in accordance with the rules of professional responsibility 503.36 conduct or order the licensing board or licensing agency to 504.1 suspend the license if the judge finds that: 504.2 (1) the person is licensed by a licensing board or other 504.3 state agency that issues an occupational license; 504.4 (2) the person has not made full payment of arrearages 504.5 found to be due by the public authority; and 504.6 (3) the person has not executed or is not in compliance 504.7 with a payment plan approved by the court, a child support 504.8 magistrate, or the public authority. 504.9 (e) Within 15 days of the date on which the obligor either 504.10 makes full payment of arrearages found to be due by the court or 504.11 public authority or executes and initiates good faith compliance 504.12 with a written payment plan approved by the court, a child 504.13 support magistrate, or the public authority, the court, a child 504.14 support magistrate, or the public authority responsible for 504.15 child support enforcement shall notify the licensing board or 504.16 licensing agency or the lawyers professional responsibility 504.17 board that the obligor is no longer ineligible for license 504.18 issuance, reinstatement, or renewal under this subdivision. 504.19 (f) In addition to the criteria established under this 504.20 section for the suspension of an obligor's occupational license, 504.21 a court, a child support magistrate, or the public authority may 504.22 direct the licensing board or other licensing agency to suspend 504.23 the license of a party who has failed, after receiving notice, 504.24 to comply with a subpoena relating to a paternity or child 504.25 support proceeding. Notice to an obligor of intent to suspend 504.26 must be served by first class mail at the obligor's last known 504.27 address. The notice must inform the obligor of the right to 504.28 request a hearing. If the obligor makes a written request 504.29 within ten days of the date of the hearing, a hearing must be 504.30 held. At the hearing, the only issues to be considered are 504.31 mistake of fact and whether the obligor received the subpoena. 504.32 (g) The license of an obligor who fails to remain in 504.33 compliance with an approved written payment agreement may be 504.34 suspended.Notice to the obligor of an intent to suspend under504.35this paragraph must be served by first class mail at the504.36obligor's last known address and must include a notice of505.1hearing. The notice must be served upon the obligor not less505.2than ten days before the date of the hearing.Prior to 505.3 suspending a license for noncompliance with an approved written 505.4 payment agreement, the public authority must mail to the 505.5 obligor's last known address a written notice that (1) the 505.6 public authority intends to seek suspension of the obligor's 505.7 occupational license under this paragraph, and (2) the obligor 505.8 must request a hearing, within 30 days of the date of the 505.9 notice, to contest the suspension. If, within 30 days of the 505.10 date of the notice, the public authority does not receive a 505.11 written request for a hearing and the obligor does not comply 505.12 with an approved written payment agreement, the public authority 505.13 must direct the licensing board or other licensing agency to 505.14 suspend the obligor's license under paragraph (b), and, if the 505.15 obligor is a licensed attorney, must report the matter to the 505.16 lawyers professional responsibility board. If the obligor makes 505.17 a written request for a hearing within 30 days of the date of 505.18 the notice, a court hearing must be held. Notwithstanding any 505.19 law to the contrary, the obligor must be served with 14 days' 505.20 notice in writing specifying the time and place of the hearing 505.21 and the allegations against the obligor. The notice may be 505.22 served personally or by mail to the obligor's last known 505.23 address. If the obligor appears at the hearing and thejudge505.24 court determines that the obligor has failed to comply with an 505.25 approved written payment agreement, thejudge shallcourt or 505.26 public authority must notify the occupational licensing board or 505.27 other licensing agency to suspend the obligor's license under 505.28 paragraph(c)(b) and, if the obligor is a licensed attorney, 505.29 must report the matter to the lawyers professional 505.30 responsibility board. If the obligor fails to appear at the 505.31 hearing, thepublic authority maycourt or public authority must 505.32 notify the occupationalorlicensing board or other licensing 505.33 agency to suspend the obligor's license under paragraph(c)(b), 505.34 and if the obligor is a licensed attorney, must report the 505.35 matter to the lawyers professional responsibility board. 505.36 Sec. 6. Minnesota Statutes 2002, section 518.551, 506.1 subdivision 13, is amended to read: 506.2 Subd. 13. [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion 506.3 of an obligee, which has been properly served on the obligor and 506.4 upon which there has been an opportunity for hearing, if a court 506.5 finds that the obligor has been or may be issued a driver's 506.6 license by the commissioner of public safety and the obligor is 506.7 in arrears in court-ordered child support or maintenance 506.8 payments, or both, in an amount equal to or greater than three 506.9 times the obligor's total monthly support and maintenance 506.10 payments and is not in compliance with a written payment 506.11 agreement pursuant to section 518.553 that is approved by the 506.12 court, a child support magistrate, or the public authority, the 506.13 court shall order the commissioner of public safety to suspend 506.14 the obligor's driver's license. The court's order must be 506.15 stayed for 90 days in order to allow the obligor to execute a 506.16 written payment agreement pursuant to section 518.553. The 506.17 payment agreement must be approved by either the court or the 506.18 public authority responsible for child support enforcement. If 506.19 the obligor has not executed or is not in compliance with a 506.20 written payment agreement pursuant to section 518.553 after the 506.21 90 days expires, the court's order becomes effective and the 506.22 commissioner of public safety shall suspend the obligor's 506.23 driver's license. The remedy under this subdivision is in 506.24 addition to any other enforcement remedy available to the 506.25 court. An obligee may not bring a motion under this paragraph 506.26 within 12 months of a denial of a previous motion under this 506.27 paragraph. 506.28 (b) If a public authority responsible for child support 506.29 enforcement determines that the obligor has been or may be 506.30 issued a driver's license by the commissioner of public safety 506.31 and the obligor is in arrears in court-ordered child support or 506.32 maintenance payments or both in an amount equal to or greater 506.33 than three times the obligor's total monthly support and 506.34 maintenance payments and not in compliance with a written 506.35 payment agreement pursuant to section 518.553 that is approved 506.36 by the court, a child support magistrate, or the public 507.1 authority, the public authority shall direct the commissioner of 507.2 public safety to suspend the obligor's driver's license. The 507.3 remedy under this subdivision is in addition to any other 507.4 enforcement remedy available to the public authority. 507.5 (c) At least 90 days prior to notifying the commissioner of 507.6 public safety according to paragraph (b), the public authority 507.7 must mail a written notice to the obligor at the obligor's last 507.8 known address, that it intends to seek suspension of the 507.9 obligor's driver's license and that the obligor must request a 507.10 hearing within 30 days in order to contest the suspension. If 507.11 the obligor makes a written request for a hearing within 30 days 507.12 of the date of the notice, a court hearing must be held. 507.13 Notwithstanding any law to the contrary, the obligor must be 507.14 served with 14 days' notice in writing specifying the time and 507.15 place of the hearing and the allegations against the obligor. 507.16 The notice must include information that apprises the obligor of 507.17 the requirement to develop a written payment agreement that is 507.18 approved by a court, a child support magistrate, or the public 507.19 authority responsible for child support enforcement regarding 507.20 child support, maintenance, and any arrearages in order to avoid 507.21 license suspension. The notice may be served personally or by 507.22 mail. If the public authority does not receive a request for a 507.23 hearing within 30 days of the date of the notice, and the 507.24 obligor does not execute a written payment agreement pursuant to 507.25 section 518.553 that is approved by the public authority within 507.26 90 days of the date of the notice, the public authority shall 507.27 direct the commissioner of public safety to suspend the 507.28 obligor's driver's license under paragraph (b). 507.29 (d) At a hearing requested by the obligor under paragraph 507.30 (c), and on finding that the obligor is in arrears in 507.31 court-ordered child support or maintenance payments or both in 507.32 an amount equal to or greater than three times the obligor's 507.33 total monthly support and maintenance payments, the district 507.34 court or child support magistrate shall order the commissioner 507.35 of public safety to suspend the obligor's driver's license or 507.36 operating privileges unless the court or child support 508.1 magistrate determines that the obligor has executed and is in 508.2 compliance with a written payment agreement pursuant to section 508.3 518.553 that is approved by the court, a child support 508.4 magistrate, or the public authority. 508.5 (e) An obligor whose driver's license or operating 508.6 privileges are suspended may: 508.7 (1) provide proof to the public authority responsible for 508.8 child support enforcement that the obligor is in compliance with 508.9 all written payment agreements pursuant to section 518.553; 508.10 (2) bring a motion for reinstatement of the driver's 508.11 license. At the hearing, if the court or child support 508.12 magistrate orders reinstatement of the driver's license, the 508.13 court or child support magistrate must establish a written 508.14 payment agreement pursuant to section 518.553; or 508.15 (3) seek a limited license under section 171.30. A limited 508.16 license issued to an obligor under section 171.30 expires 90 508.17 days after the date it is issued. 508.18 Within 15 days of the receipt of that proof or a court 508.19 order, the public authority shall inform the commissioner of 508.20 public safety that the obligor's driver's license or operating 508.21 privileges should no longer be suspended. 508.22 (f) On January 15, 1997, and every two years after that, 508.23 the commissioner of human services shall submit a report to the 508.24 legislature that identifies the following information relevant 508.25 to the implementation of this section: 508.26 (1) the number of child support obligors notified of an 508.27 intent to suspend a driver's license; 508.28 (2) the amount collected in payments from the child support 508.29 obligors notified of an intent to suspend a driver's license; 508.30 (3) the number of cases paid in full and payment agreements 508.31 executed in response to notification of an intent to suspend a 508.32 driver's license; 508.33 (4) the number of cases in which there has been 508.34 notification and no payments or payment agreements; 508.35 (5) the number of driver's licenses suspended; 508.36 (6) the cost of implementation and operation of the 509.1 requirements of this section; and 509.2 (7) the number of limited licenses issued and number of 509.3 cases in which payment agreements are executed and cases are 509.4 paid in full following issuance of a limited license. 509.5 (g) In addition to the criteria established under this 509.6 section for the suspension of an obligor's driver's license, a 509.7 court, a child support magistrate, or the public authority may 509.8 direct the commissioner of public safety to suspend the license 509.9 of a party who has failed, after receiving notice, to comply 509.10 with a subpoena relating to a paternity or child support 509.11 proceeding. Notice to an obligor of intent to suspend must be 509.12 served by first class mail at the obligor's last known address. 509.13 The notice must inform the obligor of the right to request a 509.14 hearing. If the obligor makes a written request within ten days 509.15 of the date of the hearing, a hearing must be held. At the 509.16 hearing, the only issues to be considered are mistake of fact 509.17 and whether the obligor received the subpoena. 509.18 (h) The license of an obligor who fails to remain in 509.19 compliance with an approved written payment agreement may be 509.20 suspended.Notice to the obligor of an intent to suspend under509.21this paragraph must be served by first class mail at the509.22obligor's last known address and must include a notice of509.23hearing. The notice must be served upon the obligor not less509.24than ten days before the date of the hearing.Prior to 509.25 suspending a license for noncompliance with an approved written 509.26 payment agreement, the public authority must mail to the 509.27 obligor's last known address a written notice that (1) the 509.28 public authority intends to seek suspension of the obligor's 509.29 driver's license under this paragraph, and (2) the obligor must 509.30 request a hearing, within 30 days of the date of the notice, to 509.31 contest the suspension. If, within 30 days of the date of the 509.32 notice, the public authority does not receive a written request 509.33 for a hearing and the obligor does not comply with an approved 509.34 written payment agreement, the public authority must direct the 509.35 department of public safety to suspend the obligor's license 509.36 under paragraph (b). If the obligor makes a written request for 510.1 a hearing within 30 days of the date of the notice, a court 510.2 hearing must be held. Notwithstanding any law to the contrary, 510.3 the obligor must be served with 14 days' notice in writing 510.4 specifying the time and place of the hearing and the allegations 510.5 against the obligor. The notice may be served personally or by 510.6 mail at the obligor's last known address. If the obligor 510.7 appears at the hearing and thejudgecourt determines that the 510.8 obligor has failed to comply with an approved written payment 510.9 agreement, thejudgecourt or public authority shall notify the 510.10 department of public safety to suspend the obligor's license 510.11 under paragraph(c)(b). If the obligor fails to appear at the 510.12 hearing, thepublic authority maycourt or public authority must 510.13 notify the department of public safety to suspend the obligor's 510.14 license under paragraph(c)(b). 510.15 Sec. 7. Laws 1997, chapter 245, article 2, section 11, is 510.16 amended to read: 510.17 Sec. 11. [FEDERAL FUNDS FOR VISITATION AND ACCESS.] 510.18 The commissioner of human services may accept on behalf of 510.19 the state any federal funding received under Public Law Number 510.20 104-193 for access and visitation programs, andshall transfer510.21these funds to the state court administrator for the cooperation510.22for the children pilot project and the parent education program510.23under Minnesota Statutes, section 518.571must administer the 510.24 funds for the activities allowed under federal law. The 510.25 commissioner may distribute the funds on a competitive basis and 510.26 must monitor, evaluate, and report on the access and visitation 510.27 programs in accordance with any applicable regulations. 510.28 ARTICLE 16 510.29 CRIMINAL JUSTICE APPROPRIATIONS AND POLICY PROVISIONS 510.30 Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.] 510.31 The sums shown in the columns marked "APPROPRIATIONS" are 510.32 appropriated from the general fund, or another named fund, to 510.33 the agencies and for the purposes specified in this act, to be 510.34 available for the fiscal years indicated for each purpose. The 510.35 figures "2004" and "2005," where used in this act, mean that the 510.36 appropriation or appropriations listed under them are available 511.1 for the year ending June 30, 2004, or June 30, 2005, 511.2 respectively. The term "first year" means the fiscal year 511.3 ending June 30, 2004, and the term "second year" means the 511.4 fiscal year ending June 30, 2005. 511.5 SUMMARY BY FUND 511.6 2004 2005 TOTAL 511.7 General $ 421,397,000 $ 426,702,000 $ 848,099,000 511.8 Special Revenue 511.9 Fund 1,000,000 1,000,000 2,000,000 511.10 TOTAL $ 422,397,000 $ 427,702,000 $ 850,099,000 511.11 APPROPRIATIONS 511.12 Available for the Year 511.13 Ending June 30 511.14 2004 2005 511.15 Sec. 2. CORRECTIONS 511.16 Subdivision 1. Total 511.17 Appropriation $368,202,000 $373,507,000 511.18 Summary by Fund 511.19 General Fund 367,202,000 372,507,000 511.20 Special Revenue 1,000,000 1,000,000 511.21 The amounts that may be spent from this 511.22 appropriation for each program are 511.23 specified in the following subdivisions. 511.24 Subd. 2. Correctional 511.25 Institutions 511.26 Summary by Fund 511.27 General Fund 236,579,000 239,697,000 511.28 Special Revenue 630,000 630,000 511.29 If the commissioner contracts with 511.30 other states, local units of 511.31 government, or the federal government 511.32 to rent beds in the Rush City 511.33 correctional facility, the commissioner 511.34 shall charge a per diem under the 511.35 contract, to the extent possible, that 511.36 is equal to or greater than the per 511.37 diem cost of housing Minnesota inmates 511.38 in the facility. The per diem cost for 511.39 housing inmates of other states, local 511.40 units of government, or the federal 511.41 government at this facility shall be 511.42 based on the assumption that the 511.43 facility is at or near capacity. 511.44 Notwithstanding any laws to the 511.45 contrary, the commissioner may use the 511.46 per diem appropriation to operate the 511.47 state correctional system. 511.48 No portion of this appropriation may be 511.49 used for the faith-based prerelease 511.50 program described in Laws 2001, First 512.1 Special Session chapter 9, article 18, 512.2 section 3, subdivision 2. 512.3 Subd. 3. Juvenile Services 512.4 13,035,000 13,035,000 512.5 Subd. 4. Community Services 512.6 Summary by Fund 512.7 General Fund 102,941,000 105,128,000 512.8 Special Revenue 120,000 120,000 512.9 Of the general fund appropriation, 512.10 $3,300,000 the first year and 512.11 $4,400,000 the second year are for 512.12 grants to counties to assist them to 512.13 incarcerate short-term offenders. The 512.14 commissioner shall make the grants in 512.15 an equitable manner based on the total 512.16 amount available for the grants, each 512.17 county's proportionate share of 512.18 offenders affected by the changes made 512.19 to Minnesota Statutes, section 609.105, 512.20 in this article, and the actual number 512.21 of bed days used by each county to 512.22 incarcerate these offenders. The 512.23 grants may not exceed the actual cost 512.24 per day incurred by a county. A county 512.25 seeking a grant shall report to the 512.26 commissioner on offenders affected by 512.27 the changes made to Minnesota Statutes, 512.28 section 609.105, in this article. The 512.29 report must include the number of these 512.30 offenders for the reporting period, the 512.31 actual number of bed days used for 512.32 these offenders, the costs associated 512.33 with this, and any other information 512.34 requested by the commissioner. These 512.35 reports are due on May 15, 2003, 512.36 September 15, 2003, December 15, 2003, 512.37 March 15, 2004, June 15, 2004, 512.38 September 15, 2004, December 15, 2004, 512.39 March 15, 2005, and June 15, 2005. The 512.40 commissioner shall make the grants 512.41 within a month of receiving the 512.42 required reports from counties. 512.43 Of the general fund appropriation, 512.44 $155,000 the first year and $155,000 512.45 the second year are for two agency 512.46 positions to administer the restorative 512.47 justice program. 512.48 Of the general fund appropriation, 512.49 $475,000 the first year and $475,000 512.50 the second year are for restorative 512.51 justice grants. 512.52 Subd. 5. Operations Support 512.53 Summary by Fund 512.54 General Fund 14,647,000 14,647,000 512.55 Special Revenue 250,000 250,000 512.56 Sec. 3. BOARD OF PUBLIC DEFENSE 53,759,000 53,759,000 513.1 Budget reductions must be allocated 513.2 proportionately between operating costs 513.3 and grant programs. 513.4 Sec. 4. SENTENCING GUIDELINES 513.5 COMMISSION 436,000 436,000 513.6 Sec. 5. Minnesota Statutes 2002, section 243.53, 513.7 subdivision 1, is amended to read: 513.8 Subdivision 1. [SEPARATE CELLS.] (a) When there are 513.9 sufficient cells available, each inmate shall be confined in a 513.10 separate cell. Each inmate shall be confined in a separate cell 513.11 in institutions classified by the commissioner as custody level 513.12five andsix institutions, except where the commissioner deems 513.13 necessary.This requirement does not apply to the following:513.14(1) geriatric dormitory-type facilities;513.15(2) honor dormitory-type facilities; and513.16(3) any other multiple occupancy facility at a custody513.17level five or six institution that confines inmates who could be513.18confined in an institution at custody level four or lower.513.19 (b) Correctional institutions classified by the 513.20 commissioner as custody level one, two, three, or four 513.21 institutions must permit multiple occupancy, except segregation 513.22 units, to the greatest extent possible. 513.23 (c) Correctional institutions classified by the 513.24 commissioner as custody level five must permit multiple 513.25 occupancy not to exceed the limits of facility infrastructure 513.26 and programming space. 513.27 Sec. 6. [243.557] [INMATE MEALS.] 513.28 Where inmates in a state correctional facility are not 513.29 routinely absent from the facility for work or other purposes, 513.30 the commissioner must make three meals available Monday through 513.31 Friday, excluding holidays, and at least two meals available on 513.32 Saturdays, Sundays, and holidays. 513.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 513.34 Sec. 7. Minnesota Statutes 2002, section 357.021, 513.35 subdivision 6, is amended to read: 513.36 Subd. 6. [SURCHARGES ON CRIMINAL AND TRAFFIC OFFENDERS.] 513.37 (a) The court shall impose and the court administrator shall 514.1 collect a$35$60 surcharge on every person convicted of any 514.2 felony, gross misdemeanor, misdemeanor, or petty misdemeanor 514.3 offense, other than a violation of a law or ordinance relating 514.4 to vehicle parking, for which there shall be a $3 surcharge. 514.5 The surcharge shall be imposed whether or not the person is 514.6 sentenced to imprisonment or the sentence is stayed. 514.7 (b) If the court fails to impose a surcharge as required by 514.8 this subdivision, the court administrator shall show the 514.9 imposition of the surcharge, collect the surcharge and correct 514.10 the record. 514.11 (c) The court may not waive payment of the surcharge 514.12 required under this subdivision. Upon a showing of indigency or 514.13 undue hardship upon the convicted person or the convicted 514.14 person's immediate family, the sentencing court may authorize 514.15 payment of the surcharge in installments. 514.16 (d) The court administrator or other entity collecting a 514.17 surcharge shall forward it to the state treasurer. 514.18 (e) If the convicted person is sentenced to imprisonment 514.19 and has not paid the surcharge before the term of imprisonment 514.20 begins, the chief executive officer of the correctional facility 514.21 in which the convicted person is incarcerated shall collect the 514.22 surcharge from any earnings the inmate accrues from work 514.23 performed in the facility or while on conditional release. The 514.24 chief executive officer shall forward the amount collected to 514.25 the state treasurer. 514.26 Sec. 8. Minnesota Statutes 2002, section 357.021, 514.27 subdivision 7, is amended to read: 514.28 Subd. 7. [DISBURSEMENT OF SURCHARGES BY STATE TREASURER.] 514.29 (a) Except as provided in paragraphs (b) and (c), the state 514.30 treasurer shall disburse surcharges received under subdivision 6 514.31 and section 97A.065, subdivision 2, as follows: 514.32 (1) one percent shall be credited to the game and fish fund 514.33 to provide peace officer training for employees of the 514.34 department of natural resources who are licensed under sections 514.35 626.84 to 626.863, and who possess peace officer authority for 514.36 the purpose of enforcing game and fish laws; 515.1 (2) 39 percent shall be credited to the peace officers 515.2 training account in the special revenue fund; and 515.3 (3) 60 percent shall be credited to the general fund. 515.4 (b) The state treasurer shall credit $3 of each surcharge 515.5 received under subdivision 6 and section 97A.065, subdivision 2, 515.6 to a criminal justice special projects account in the special 515.7 revenue fund. This account is available for appropriation to 515.8 the commissioner of public safety for grants to law enforcement 515.9 agencies and for other purposes authorized by the legislature. 515.10 (c) In addition to any amounts credited under paragraph 515.11 (a), the state treasurer shall credit$7$32 of each surcharge 515.12 received under subdivision 6 and section 97A.065, subdivision 2, 515.13 and the $3 parking surcharge, to the general fund. 515.14 Sec. 9. [481.011] [SURCHARGE.] 515.15 (a) The supreme court is requested to impose an annual 515.16 surcharge of $200 to be added to the fee set by the supreme 515.17 court under section 481.01 for attorney license renewals. Money 515.18 collected under the surcharge must be paid into the fund 515.19 established by section 481.01 and is appropriated annually to 515.20 the supreme court for the support of the public defender system 515.21 established by chapter 611. 515.22 (b) This section expires on June 30, 2007. 515.23 Sec. 10. Minnesota Statutes 2002, section 609.105, 515.24 subdivision 1, is amended to read: 515.25 Subdivision 1. In a felony sentence to imprisonment, when 515.26 the remaining term of imprisonment is formore than one year180 515.27 days or less, the defendant shallcommit the defendantbe 515.28 committed to the custody of the commissioner of corrections and 515.29 must serve the remaining term of imprisonment at a workhouse, 515.30 work farm, county jail, or other place authorized by law. 515.31 Sec. 11. Minnesota Statutes 2002, section 609.105, is 515.32 amended by adding a subdivision to read: 515.33 Subd. 1a. [DEFINITIONS.] (a) The terms in this subdivision 515.34 apply to this section. 515.35 (b) "Remaining term of imprisonment" as applied to inmates 515.36 whose crimes were committed before August 1, 1993, is the period 516.1 of time for which an inmate is committed to the custody of the 516.2 commissioner of corrections minus earned good time and jail 516.3 credit, if any. 516.4 (c) "Remaining term of imprisonment" as applied to inmates 516.5 whose crimes were committed on or after August 1, 1993, is the 516.6 period of time equal to two-thirds of the inmate's executed 516.7 sentence, minus jail credit, if any. 516.8 Sec. 12. Minnesota Statutes 2002, section 609.105, is 516.9 amended by adding a subdivision to read: 516.10 Subd. 1b. [SENTENCE TO MORE THAN 180 DAYS.] A felony 516.11 sentence to imprisonment when the warrant of commitment has a 516.12 remaining term of imprisonment for more than 180 days shall 516.13 commit the defendant to the custody of the commissioner of 516.14 corrections. 516.15 Sec. 13. Minnesota Statutes 2002, section 609.145, is 516.16 amended by adding a subdivision to read: 516.17 Subd. 3. [JAIL CREDIT DETERMINATION.] The appropriate 516.18 probation officer must provide to the court prior to the 516.19 sentencing hearing the amount of time the offender has credit 516.20 for prior imprisonment. The court must pronounce the amount of 516.21 credit for prior imprisonment at the time of sentencing. 516.22 Sec. 14. Minnesota Statutes 2002, section 609.2231, is 516.23 amended by adding a subdivision to read: 516.24 Subd. 7. [COMMUNITY CRIME PREVENTION GROUP MEMBERS.] (a) A 516.25 person is guilty of a gross misdemeanor who: 516.26 (1) assaults a community crime prevention group member 516.27 while the member is engaged in neighborhood patrol; 516.28 (2) should reasonably know that the victim is a community 516.29 crime prevention group member engaged in neighborhood patrol; 516.30 and 516.31 (3) inflicts demonstrable bodily harm. 516.32 (b) As used in this subdivision, "community crime 516.33 prevention group" means a community group focused on community 516.34 safety and crime prevention that: 516.35 (1) is organized for the purpose of discussing community 516.36 safety and patrolling community neighborhoods for criminal 517.1 activity; 517.2 (2) is designated and trained by the local law enforcement 517.3 agency as a community crime prevention group; or 517.4 (3) interacts with local law enforcement regarding 517.5 community safety issues. 517.6 Sec. 15. [611.254] [OVERSIGHT OF CORRECTIONAL FUNCTIONS.] 517.7 Subdivision 1. [DEFINITION.] As used in this section, 517.8 "administrative agency" or "agency" means any division, 517.9 official, or employee of the department of corrections, 517.10 including the commissioner of corrections, and any state 517.11 correctional facility licensed or inspected by the commissioner 517.12 of corrections, whether public or private, established and 517.13 operated for the detention and confinement of adults or 517.14 juveniles, but does not include: 517.15 (1) any court or judge; 517.16 (2) any member of the senate or house of representatives of 517.17 the state of Minnesota; 517.18 (3) the governor or the governor's personal staff; 517.19 (4) any instrumentality of the federal government of the 517.20 United States; or 517.21 (5) any interstate compact. 517.22 Subd. 2. [INVESTIGATION.] The state public defender has 517.23 the authority to investigate decisions, acts, and other matters 517.24 of the department of corrections to promote the highest 517.25 attainable standards of competence, efficiency, and justice in 517.26 the administration of corrections. The state public defender 517.27 may delegate any of this authority or these duties. 517.28 Subd. 3. [POWERS.] (a) The state public defender may: 517.29 (1) prescribe the methods by which complaints are to be 517.30 made, reviewed, and acted upon; provided, however, that the 517.31 state public defender may not levy a complaint fee; 517.32 (2) determine the scope and manner of investigations to be 517.33 made; 517.34 (3) except as otherwise provided, determine the form, 517.35 frequency, and distribution of conclusions, recommendations, and 517.36 proposals; 518.1 (4) investigate, upon a complaint, any action of an 518.2 administrative agency; 518.3 (5) request and be given access to information in the 518.4 possession of an administrative agency deemed necessary for the 518.5 discharge of responsibilities; 518.6 (6) examine the records and documents of an administrative 518.7 agency; 518.8 (7) enter and inspect, at any time, premises within the 518.9 control of an administrative agency; 518.10 (8) subpoena any person to appear, give testimony, or 518.11 produce documentary or other evidence that the state public 518.12 defender deems relevant to a matter under inquiry, and petition 518.13 the appropriate state court to enforce the subpoena; provided, 518.14 however, that any witness at a hearing or before an 518.15 investigation possesses the same privileges reserved to a 518.16 witness in the courts or under the laws of this state; and 518.17 (9) bring an action in an appropriate state court to 518.18 provide the operation of the powers provided in this subdivision. 518.19 (b) The provisions of this section are in addition to other 518.20 provisions of law under which any remedy or right of appeal or 518.21 objection is provided for any person, or any procedure provided 518.22 for inquiry or investigation concerning any matter. Nothing in 518.23 this section shall be construed to limit or affect any other 518.24 remedy or right of appeal or objection nor shall it be deemed 518.25 part of an exclusionary process. 518.26 Subd. 4. [ACTIONS AGAINST STATE PUBLIC DEFENDER.] No 518.27 proceeding or civil action shall be commenced against the state 518.28 public defender or staff members, or a person delegated the 518.29 state public defender's duties or authority under subdivision 2, 518.30 for actions taken pursuant to the provisions of this section. 518.31 Subd. 5. [MATTERS APPROPRIATE FOR INVESTIGATION.] In 518.32 selecting matters for attention, the state public defender 518.33 should address particularly actions of an administrative agency, 518.34 which might be: 518.35 (1) contrary to law or rule; 518.36 (2) unreasonable, unfair, oppressive, or inconsistent with 519.1 any policy or judgment of an administrative agency; or 519.2 (3) mistaken in law or arbitrary in the ascertainment of 519.3 facts. 519.4 Subd. 6. [COMPLAINTS.] (a) The state public defender may 519.5 receive a complaint from any source concerning an action of an 519.6 administrative agency. 519.7 (b) The state public defender may exercise powers without 519.8 regard to the finality of any action of an administrative 519.9 agency; however, the state public defender may require a 519.10 complainant to pursue other remedies or channels of complaint 519.11 open to the complainant before accepting or investigating the 519.12 complaint. 519.13 (c) After completing investigation of a complaint, the 519.14 state public defender shall inform the complainant, the 519.15 administrative agency, and the official or employee of the 519.16 action taken. 519.17 (d) A letter to the state public defender from a person in 519.18 an institution under the control of an administrative agency 519.19 must be forwarded immediately and unopened to the state public 519.20 defender's office. A reply from the state public defender to 519.21 the person must be delivered unopened to the person, promptly 519.22 after its receipt by the institution. No complainant shall be 519.23 punished nor shall the general condition of the complainant's 519.24 confinement or treatment be unfavorably altered as a result of 519.25 the complainant having made a complaint to the state public 519.26 defender. 519.27 Subd. 7. [RECOMMENDATIONS.] (a) If, after duly considering 519.28 a complaint and whatever material the state public defender 519.29 deems pertinent, the state public defender is of the opinion 519.30 that the complaint is valid, the state public defender may 519.31 recommend that an administrative agency should: 519.32 (1) consider the matter further; 519.33 (2) modify or cancel its actions; 519.34 (3) alter a ruling; 519.35 (4) explain more fully the action in question; or 519.36 (5) take any other step that the state public defender 520.1 recommends to the administrative agency involved. 520.2 (b) If the state public defender so requests, the agency 520.3 shall within the time the state public defender specifies, 520.4 inform the state public defender about the action taken on the 520.5 state public defender's recommendation or the reasons for not 520.6 complying with it. 520.7 Subd. 8. [ACCESS TO DATA.] Notwithstanding section 13.384 520.8 or 13.85, the state public defender has access to corrections 520.9 and detention data and medical data maintained by an agency and 520.10 classified as private data on individuals or confidential data 520.11 on individuals when access to the data is necessary for the 520.12 state public defender to perform the powers under this section. 520.13 Subd. 9. [PUBLICATION.] The state public defender may 520.14 publish conclusions and suggestions by transmitting them to the 520.15 office of the governor. Before announcing a conclusion or 520.16 recommendation that expressly or impliedly criticizes an 520.17 administrative agency, or any person, the state public defender 520.18 shall consult with that agency or person. When publishing an 520.19 opinion adverse to an administrative agency, or any person, the 520.20 state public defender shall include in such publication any 520.21 statement of reasonable length made to the state public defender 520.22 by that agency or person in defense or mitigation of the action. 520.23 Subd. 10. [COMPELLED TESTIMONY.] Neither the state public 520.24 defender nor any member of the state public defender's staff or 520.25 a person delegated the state public defender's duties or 520.26 authority under subdivision 2 shall be compelled to testify or 520.27 to produce evidence in any judicial or administrative proceeding 520.28 with respect to any matter involving the exercise of these 520.29 official duties except as may be necessary to enforce the 520.30 provisions of this section. 520.31 Sec. 16. [611A.0392] [NOTICE TO COMMUNITY CRIME PREVENTION 520.32 GROUP.] 520.33 Subdivision 1. [DEFINITIONS.] (a) As used in this section, 520.34 the following terms have the meanings given them. 520.35 (b) "Cities of the first class" has the meaning given in 520.36 section 410.01. 521.1 (c) "Community crime prevention group" means a community 521.2 group focused on community safety and crime prevention that: 521.3 (1) meets regularly for the purpose of discussing community 521.4 safety and patrolling community neighborhoods for criminal 521.5 activity; 521.6 (2) is previously designated by the local law enforcement 521.7 agency as a community crime prevention group; and 521.8 (3) interacts regularly with the police regarding community 521.9 safety issues. 521.10 Subd. 2. [NOTICE.] (a) A law enforcement agency that is 521.11 responsible for arresting individuals who commit crimes within 521.12 cities of the first class shall make reasonable efforts to 521.13 disclose certain information in a timely manner to the 521.14 designated leader of a community crime prevention group that has 521.15 reported criminal activity, excluding petty misdemeanors, to law 521.16 enforcement. The law enforcement agency shall make reasonable 521.17 efforts to disclose information on the final outcome of the 521.18 investigation into the criminal activity including, but not 521.19 limited to, where appropriate, the decision to arrest or not 521.20 arrest the person and whether the matter was referred to a 521.21 prosecuting authority. If the matter is referred to a 521.22 prosecuting authority, the law enforcement agency must notify 521.23 the prosecuting authority of the community crime prevention 521.24 group's request for notice under this subdivision. 521.25 (b) A prosecuting authority who is responsible for filing 521.26 charges against or prosecuting a person arrested for a criminal 521.27 offense in cities of the first class shall make reasonable 521.28 efforts to disclose certain information in a timely manner to 521.29 the designated leader of a community crime prevention group that 521.30 has reported specific criminal activity to law enforcement. The 521.31 prosecuting authority shall make reasonable efforts to disclose 521.32 information on the final outcome of the criminal proceeding that 521.33 resulted from the arrest including, but not limited to, where 521.34 appropriate, the decision to dismiss or not file charges against 521.35 the arrested person. 521.36 (c) A community crime prevention group that would like to 522.1 receive written or Internet notice under this subdivision must 522.2 request the law enforcement agency and the prosecuting authority 522.3 where the specific alleged criminal conduct occurred to provide 522.4 notice to the community crime prevention group leader. The 522.5 community crime prevention group must provide the law 522.6 enforcement agency with the name, address, and telephone number 522.7 of the community crime prevention group leader and the preferred 522.8 method of communication. 522.9 Sec. 17. [REPEALER.] 522.10 Minnesota Statutes 2002, sections 241.41; 241.42; 241.43; 522.11 241.44; 241.441; and 241.45, are repealed. 522.12 Sec. 18. [EFFECTIVE DATES.] 522.13 Sections 5 and 14 are effective the day following final 522.14 enactment, section 14 applies to crimes committed on or after 522.15 that date. Sections 7, 8, 13, and 16 are effective July 1, 522.16 2003, and apply to crimes committed on or after that date. 522.17 Sections 10 to 12 are effective July 1, 2003, and apply to 522.18 persons incarcerated or under correctional supervision and 522.19 crimes committed on or after that date.