SF 1583

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; modifying programs and
services for persons with disabilities; amending
Minnesota Statutes 2004, sections 252.27, subdivision
2a; 256B.04, by adding a subdivision; 256B.056,
subdivisions 3, 5c; 256B.057, subdivision 9;
256B.0575; 256B.0621, subdivisions 4, 6, by adding a
subdivision; 256B.0625, subdivision 9; 256B.0916, by
adding a subdivision; 256B.092, subdivisions 2a, 4b;
256B.35, subdivision 1; 256B.49, subdivisions 13, 16;
256B.5012, by adding a subdivision; 256B.69,
subdivision 23; 256B.765; 256D.03, subdivision 4;
256L.03, subdivisions 1, 5, by adding a subdivision;
proposing coding for new law in Minnesota Statutes,
chapter 256.

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

Section 1.

Minnesota Statutes 2004, section 252.27,
subdivision 2a, is amended to read:

Subd. 2a.

Contribution amount.

(a) The natural or
adoptive parents of a minor child, including a child determined
eligible for medical assistance without consideration of
parental income, must contribute to the cost of services used by
making monthly payments on a sliding scale based on income,
unless the child is married or has been married, parental rights
have been terminated, or the child's adoption is subsidized
according to section 259.67 or through title IV-E of the Social
Security Act.

(b) For households with adjusted gross income equal to or
greater than 100 percent of federal poverty guidelines, the
parental contribution shall be computed by applying the
following schedule of rates to the adjusted gross income of the
natural or adoptive parents:

(1) if the adjusted gross income is equal to or greater
than 100 percent of federal poverty guidelines and less than 175
percent of federal poverty guidelines, the parental contribution
is $4 per month;

(2) if the adjusted gross income is equal to or greater
than 175 percent of federal poverty guidelines and less than or
equal to deleted text begin 375 deleted text end new text begin 545 new text end percent of federal poverty guidelines, the
parental contribution shall be determined using a sliding fee
scale established by the commissioner of human services which
begins at one percent of adjusted gross income at 175 percent of
federal poverty guidelines and increases to 7.5 percent of
adjusted gross income for those with adjusted gross income up to
deleted text begin 375 deleted text end new text begin 545 new text end percent of federal poverty guidelines;

(3) if the adjusted gross income is greater than deleted text begin 375 deleted text end new text begin 545
new text end percent of federal poverty guidelines and less than 675 percent
of federal poverty guidelines, the parental contribution shall
be 7.5 percent of adjusted gross income;

(4) if the adjusted gross income is equal to or greater
than 675 percent of federal poverty guidelines and less than 975
percent of federal poverty guidelines, the parental contribution
shall be new text begin determined using a sliding fee scale established by the
commissioner of human services which begins at 7.5 percent of
adjusted gross income at 675 percent of federal poverty
guidelines and increases to new text end ten percent of adjusted gross income
new text begin for those with adjusted gross income up to 975 percent of
federal poverty guidelines new text end ; and

(5) if the adjusted gross income is equal to or greater
than 975 percent of federal poverty guidelines, the parental
contribution shall be 12.5 percent of adjusted gross income.

If the child lives with the parent, the annual adjusted
gross income is reduced by $2,400 prior to calculating the
parental contribution. If the child resides in an institution
specified in section 256B.35, the parent is responsible for the
personal needs allowance specified under that section in
addition to the parental contribution determined under this
section. The parental contribution is reduced by any amount
required to be paid directly to the child pursuant to a court
order, but only if actually paid.

(c) The household size to be used in determining the amount
of contribution under paragraph (b) includes natural and
adoptive parents and their dependents, including the child
receiving services. Adjustments in the contribution amount due
to annual changes in the federal poverty guidelines shall be
implemented on the first day of July following publication of
the changes.

(d) For purposes of paragraph (b), "income" means the
adjusted gross income of the natural or adoptive parents
determined according to the previous year's federal tax form,
except, effective retroactive to July 1, 2003, taxable capital
gains to the extent the funds have been used to purchase a home
shall not be counted as income.

(e) The contribution shall be explained in writing to the
parents at the time eligibility for services is being
determined. The contribution shall be made on a monthly basis
effective with the first month in which the child receives
services. Annually upon redetermination or at termination of
eligibility, if the contribution exceeded the cost of services
provided, the local agency or the state shall reimburse that
excess amount to the parents, either by direct reimbursement if
the parent is no longer required to pay a contribution, or by a
reduction in or waiver of parental fees until the excess amount
is exhausted.

(f) The monthly contribution amount must be reviewed at
least every 12 months; when there is a change in household size;
and when there is a loss of or gain in income from one month to
another in excess of ten percent. The local agency shall mail a
written notice 30 days in advance of the effective date of a
change in the contribution amount. A decrease in the
contribution amount is effective in the month that the parent
verifies a reduction in income or change in household size.

(g) Parents of a minor child who do not live with each
other shall each pay the contribution required under paragraph
(a). An amount equal to the annual court-ordered child support
payment actually paid on behalf of the child receiving services
shall be deducted from the adjusted gross income of the parent
making the payment prior to calculating the parental
contribution under paragraph (b).

(h) The contribution under paragraph (b) shall be increased
by an additional five percent if the local agency determines
that insurance coverage is available but not obtained for the
child. For purposes of this section, "available" means the
insurance is a benefit of employment for a family member at an
annual cost of no more than five percent of the family's annual
income. For purposes of this section, "insurance" means health
and accident insurance coverage, enrollment in a nonprofit
health service plan, health maintenance organization,
self-insured plan, or preferred provider organization.

Parents who have more than one child receiving services
shall not be required to pay more than the amount for the child
with the highest expenditures. There shall be no resource
contribution from the parents. The parent shall not be required
to pay a contribution in excess of the cost of the services
provided to the child, not counting payments made to school
districts for education-related services. Notice of an increase
in fee payment must be given at least 30 days before the
increased fee is due.

(i) The contribution under paragraph (b) shall be reduced
by $300 per fiscal year if, in the 12 months prior to July 1:

(1) the parent applied for insurance for the child;

(2) the insurer denied insurance;

(3) the parents submitted a complaint or appeal, in writing
to the insurer, submitted a complaint or appeal, in writing, to
the commissioner of health or the commissioner of commerce, or
litigated the complaint or appeal; and

(4) as a result of the dispute, the insurer reversed its
decision and granted insurance.

For purposes of this section, "insurance" has the meaning
given in paragraph (h).

A parent who has requested a reduction in the contribution
amount under this paragraph shall submit proof in the form and
manner prescribed by the commissioner or county agency,
including, but not limited to, the insurer's denial of
insurance, the written letter or complaint of the parents, court
documents, and the written response of the insurer approving
insurance. The determinations of the commissioner or county
agency under this paragraph are not rules subject to chapter 14.

Sec. 2.

new text begin [256.4825] DISABILITY SERVICES COORDINATION
COMMISSION.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The Disability Services
Coordination Commission is established for the purposes of
obtaining stakeholder input for planning and monitoring the
services, programs, and funding aimed at helping people with
disabilities to live in more independent settings. The
commission's objectives include, but are not limited to:
new text end

new text begin (1) promoting development of affordable and accessible
housing;
new text end

new text begin (2) improving the recruitment and retention of direct care
support staff;
new text end

new text begin (3) providing information and referral as well as
person-centered assessments;
new text end

new text begin (4) allowing funding to follow the individual, rather than
the providers;
new text end

new text begin (5) reducing the waiting lists for home and community-based
services;
new text end

new text begin (6) increasing employment opportunities for people with
disabilities;
new text end

new text begin (7) enhancing data collection activities and systems;
new text end

new text begin (8) improving transportation that complies with the
Americans with Disabilities Act; and
new text end

new text begin (9) assuring quality of services based on outcomes.
new text end

new text begin Subd. 2. new text end

new text begin Membership. new text end

new text begin The governor must appoint ten
members to the Disability Services Coordination Commission. The
speaker of the house of representatives must appoint three
members of the house of representatives to the commission. The
president of the senate must appoint three members of the senate
to the commission. The commission membership appointed by the
governor must include the following individuals:
new text end

new text begin (1) the commissioner of the Department of Human Services;
new text end

new text begin (2) the commissioner of the Department of Health;
new text end

new text begin (3) the commissioner of the Department of Corrections;
new text end

new text begin (4) the commissioner of the Department of Finance;
new text end

new text begin (5) the commissioner of the Department of Employment and
Economic Development;
new text end

new text begin (6) the commissioner of the Department of Education;
new text end

new text begin (7) the commissioner of the Minnesota Housing Finance
Agency;
new text end

new text begin (8) the Metropolitan Council housing planner;
new text end

new text begin (9) a representative of a public housing authority; and
new text end

new text begin (10) a representative of the counties.
new text end

new text begin Subd. 3. new text end

new text begin Commission duties. new text end

new text begin The duties of the Disability
Services Coordination commission include, but are not limited to:
new text end

new text begin (1) developing Minnesota's statewide vision and goals,
including specific timelines and targets for community
placement, related to the number of individuals who will receive
nursing home relocation services and transition into community
settings;
new text end

new text begin (2) assessing, coordinating, and tracking current
activities and outcomes as proposed under the various federal
grants provided to support Minnesota's efforts to support
persons with disabilities living more independently in community
settings;
new text end

new text begin (3) ensuring the state budget reflects the planning and
coordination goals;
new text end

new text begin (4) establishing a planning mechanism to ensure ongoing
annual review of disability services plans and goals;
new text end

new text begin (5) appointing individuals within various state agencies to
continue ongoing coordination efforts and annual reports to the
legislature and the Disability Services Coordination Commission;
new text end

new text begin (6) developing a forum for integrating state agency work
plans to implement Minnesota's coordinated plan and ensure open,
regular, public discussion of the plans; and
new text end

new text begin (7) identifying and advocating for integrated strategies to
provide more supportive housing, services, and employment
options to individuals transitioning into community settings.
new text end

new text begin Subd. 4. new text end

new text begin Meetings. new text end

new text begin At a minimum, meetings of the
commission must be conducted in accordance with chapter 13D.
During the 2006-2007 biennium, the commission must meet at least
quarterly.
new text end

new text begin Subd. 5. new text end

new text begin Commission staff. new text end

new text begin Staff support must be
provided by the Minnesota Council on Disability under section
256.482.
new text end

new text begin Subd. 6. new text end

new text begin Report. new text end

new text begin The commission must report to the
legislature on recommended law and policy changes necessary to
meet the objectives under subdivision 1 by November 1, 2007.
new text end

Sec. 3.

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

new text begin Subd. 20. new text end

new text begin Incentive for wellness visits. new text end

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

Sec. 4.

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

Subd. 3.

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

To be eligible for
medical assistance, a person new text begin eligible under section 256B.055,
subdivision 7, 7a, or 12 new text end must not individually own more
than deleted text begin $3,000 deleted text end new text begin $10,000 new text end in assets, or if a member of a household
with two deleted text begin family members, husband and wife, or parent and
child deleted text end new text begin or more persons new text end , the household must not own more
than deleted text begin $6,000 deleted text end new text begin $18,000 new text end in assets deleted text begin , plus $200 for each additional
legal dependent deleted text end . In addition to these maximum amounts, an
eligible individual or family may accrue interest on these
amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the
clothing and personal needs allowance according to section
256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not
considered in determining eligibility for medical assistance is
the value of those assets excluded under the supplemental
security income program for aged, blind, and disabled persons,
with the following exceptions:

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

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

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

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

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

Sec. 5.

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

Subd. 5c.

Excess income standard.

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

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

Sec. 6.

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

Subd. 9.

Employed persons with disabilities.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 7.

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

256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
PERSONS.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(3) if one of the following circumstances apply:

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

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

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

Sec. 8.

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

Subd. 4.

Relocation targeted case management provider
qualifications.

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

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

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

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

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

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

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

(b) new text begin The commissioner shall ensure that each eligible person
is given a choice of county and private agency relocation
targeted case management service providers.
new text end

new text begin (c) new text end A provider of targeted case management under section
256B.0625, subdivision 20, may be deemed a certified provider of
relocation targeted case management.

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

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

Subd. 6.

Eligible services.

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

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

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

deleted text begin (3) deleted text end new text begin (2) new text end routine contact or communication with the
recipient, recipient's family, primary caregiver, legal
representative, substitute care provider, service providers, or
other relevant persons identified as necessary to the
development or implementation of the goals of the individual
service plan;

deleted text begin (4) deleted text end new text begin (3) new text end coordinating referrals for, and the provision of,
case management services for the recipient with appropriate
service providers, consistent with section 1902(a)(23) of the
Social Security Act;

deleted text begin (5) deleted text end new text begin (4) new text end coordinating and monitoring the overall service
delivery to ensure quality of services, appropriateness, and
continued need;

deleted text begin (6) deleted text end new text begin (5) new text end completing and maintaining necessary documentation
that supports and verifies the activities in this subdivision;

deleted text begin (7) deleted text end new text begin (6) new text end traveling to conduct a visit with the recipient or
other relevant person necessary to develop or implement the
goals of the individual service plan; and

deleted text begin (8) deleted text end new text begin (7) new text end coordinating with the institution discharge planner
in the 180-day period before the recipient's discharge.

new text begin (b) Targeted relocation case management administrative
activities are the responsibility of the county or the agency
under contract. Targeted relocation case management
administrative activities include:
new text end

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

new text begin (2) eligibility determination;
new text end

new text begin (3) providing information and assistance to the recipient
or their legal representative sufficient to allow the recipient
to choose a provider of targeted case management services;
new text end

new text begin (4) approval of service plans and necessary contracts; and
new text end

new text begin (5) monitoring spending and evaluating health, safety,
welfare, and service outcomes.
new text end

Sec. 10.

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

new text begin Subd. 11. new text end

new text begin Notice of relocation targeted case management
availability. new text end

new text begin Upon admission and annually thereafter, the
commissioner shall provide notification to medical assistance
eligible persons who are residing in institutions of the
availability of relocation targeted case management services.
new text end

Sec. 11.

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

Subd. 9.

Dental services.

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

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

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

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

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

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

Sec. 12.

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

new text begin Subd. 10. new text end

new text begin Transitional supports allowance. new text end

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2004, section 256B.092,
subdivision 2a, is amended to read:

Subd. 2a.

Medical assistance for case management
activities under the state plan medicaid option.

new text begin (a) new text end Upon
receipt of federal approval, the commissioner shall make
payments to approved vendors of case management services
participating in the medical assistance program to reimburse
costs for providing case management service activities to
medical assistance eligible persons with mental retardation or a
related condition, in accordance with the state Medicaid plan
and federal requirements and limitations.

new text begin (b) The commissioner shall ensure that each eligible person
is given a choice of county and private agency case management
service coordination vendors.
new text end

new text begin (c) The commissioner shall, with consumer input, develop
standards, notice requirements, and basic consumer rights so
that full disclosure is provided in cases in which a case
manager may be providing relocation services, housing, or other
support services to the same individual.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

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

Subd. 4b.

Case management for persons receiving home and
community-based services.

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

new text begin (b) The commissioner shall ensure that each eligible person
is given a choice of county and private agency case management
service coordination vendors.
new text end

new text begin (c) The commissioner shall, with consumer input, develop
standards, notice requirements, and basic consumer rights so
that full disclosure is provided in cases in which a case
manager may be providing relocation services, housing, or other
support services to the same individual.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

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

Subdivision 1.

Personal needs allowance.

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

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

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

Sec. 16.

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

Subd. 13.

Case management new text begin service coordination and
administrative activities new text end .

(a) Each recipient of a home and
community-based waiver shall deleted text begin be provided deleted text end new text begin choose a vendor of new text end case
management deleted text begin services by deleted text end new text begin service coordination from among new text end qualified
new text begin public and private new text end vendors as described in the federally
approved waiver application. The case management
service new text begin coordination new text end activities provided will include:

(1) assessing the needs of the individual deleted text begin within 20 working
days of a recipient's request deleted text end new text begin as changes occur, but at least
annually new text end ;

(2) developing the written individual service plan within
ten working days after the assessment is completed;

(3) informing the recipient or the recipient's legal
guardian or conservator of service options;

(4) assisting the recipient in the identification of
potential service providers;

(5) assisting the recipient to access services;

(6) coordinating, evaluating, and monitoring of the
services identified in the service plan;

(7) completing the annual reviews of the service plan; and

(8) informing the recipient or legal representative of the
right to have assessments completed and service plans developed
within specified time periods, and to appeal county action or
inaction under section 256.045, subdivision 3.

(b) new text begin Case management administrative activities are the
responsibility of the county or agency under contract. Case
management administrative functions include:
new text end

new text begin (1) screening;
new text end

new text begin (2) assistance with obtaining diagnoses and necessary
medical or health reports;
new text end

new text begin (3) eligibility determination;
new text end

new text begin (4) initial assessment within 20 days of a request for
waiver services;
new text end

new text begin (5) providing information and assistance to the person or
their legal representative sufficient to allow the person to
choose a vendor of case management service coordination;
new text end

new text begin (6) determination of resources needed to meet assessed
needs;
new text end

new text begin (7) approval of service plans and necessary contracts; and
new text end

new text begin (8) monitoring spending and evaluating health, safety,
welfare, and service outcomes.
new text end

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 17.

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

Subd. 16.

Services and supports.

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

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

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

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

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

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

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

new text begin Subd. 6. new text end

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

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

Sec. 19.

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

Subd. 23.

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

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

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

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

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

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

Sec. 20.

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

256B.765 PROVIDER RATE INCREASES.

new text begin Subdivision 1. new text end

new text begin Annual inflation adjustments. new text end

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

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

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

new text begin Subd. 3. new text end

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

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

Sec. 21.

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

Subd. 4.

General assistance medical care; services.

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

(1) inpatient hospital services;

(2) outpatient hospital services;

(3) services provided by Medicare certified rehabilitation
agencies;

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

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

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

(7) hearing aids;

(8) prosthetic devices;

(9) laboratory and X-ray services;

(10) physician's services;

(11) medical transportation except special transportation;

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

(13) podiatric services;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(2) $25 for eyeglasses;

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 22.

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

Subdivision 1.

Covered health services.

For individuals
under section 256L.04, subdivision 7, with income no greater
than 75 percent of the federal poverty guidelines or for
families with children under section 256L.04, subdivision 1, all
subdivisions of this section apply. "Covered health services"
means the health services reimbursed under chapter 256B, with
the exception of inpatient hospital services, special education
services, private duty nursing services, adult dental care
services deleted text begin other than services deleted text end new text begin except as new text end covered under deleted text begin section
256B.0625, deleted text end subdivision deleted text begin 9, paragraph (b), orthodontic services
deleted text end new text begin 3b new text end , nonemergency medical transportation services, personal care
assistant and case management services, nursing home or
intermediate care facilities services, inpatient mental health
services, and chemical dependency services. Outpatient mental
health services covered under the MinnesotaCare program are
limited to diagnostic assessments, psychological testing,
explanation of findings, medication management by a physician,
day treatment, partial hospitalization, and individual, family,
and group psychotherapy.

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

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

Sec. 23.

Minnesota Statutes 2004, section 256L.03, is
amended by adding a subdivision to read:

new text begin Subd. 3b. new text end

new text begin Dental services effective july 1, 2005. new text end

new text begin (a)
Effective July 1, 2005, the provisions in paragraphs (b) and (c)
apply.
new text end

new text begin (b) For parents, grandparents, foster parents, relative
caretakers, and legal guardians eligible under section 256L.04,
subdivision 1, with incomes not exceeding 75 percent of the
federal poverty guidelines, dental services are covered as
provided under section 256B.0625, subdivision 9, except that no
coverage is provided for orthodontic services.
new text end

new text begin (c) For pregnant women and children under age 21, dental
services are covered as provided under section 256B.0625,
subdivision 9.
new text end

Sec. 24.

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

Subd. 5.

Co-payments and coinsurance.

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

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

(2) $3 per prescription for adult enrollees;

(3) $25 for eyeglasses for adult enrollees; and

(4) 50 percent of the fee-for-service rate for adult dental
care services other than preventive care services for persons
eligible under deleted text begin section 256L.04, subdivisions 1 to 7, with income
equal to or less than 175 percent of the federal poverty
guidelines deleted text end new text begin subdivision 3b, paragraph (b) new text end .

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

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

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

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

Sec. 25. new text begin FEDERAL APPROVAL.
new text end

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