SF 2171

1st Unofficial Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

1.1A bill for an act

1.2relating to state government; making changes to health and human services
1.3programs; changing children and family provisions; modifying licensing
1.4provisions; amending health care law; modifying continuing care provisions;
1.5amending mental health provisions; changing Department of Health provisions;
1.6establishing a children's health security program; changing public health
1.7provisions; amending MinnesotaCare, medical assistance, and general assistance
1.8medical care; instituting health care reform; establishing the Minnesota
1.9Health Insurance Exchange; requiring Section 125 Plans; modifying health
1.10insurance provisions; regulating anatomical gifts; establishing family supportive
1.11services; providing rate increases for certain providers; changing health
1.12records information provisions; making technical changes; providing civil and
1.13criminal penalties; establishing task forces; requiring reports; making forecast
1.14adjustments; appropriating money for human services and health;amending
1.15Minnesota Statutes 2006, sections 13.3806, by adding a subdivision; 13.46,
1.16subdivision 2; 16A.10, by adding a subdivision; 16A.724, subdivision 2; 16B.61,
1.17by adding a subdivision; 16D.13, subdivision 3; 43A.316; 62A.65, subdivision 3;
1.1862E.141; 62H.02; 62J.04, subdivision 3; 62J.17, subdivisions 2, 4a, 7; 62J.41,
1.19subdivision 1; 62J.495; 62J.52, subdivisions 1, 2; 62J.60, subdivisions 2, 3;
1.2062J.692, subdivisions 1, 4, 7a, 8, 10; 62J.81, subdivision 1; 62J.82; 62L.12,
1.21subdivisions 2, 4; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4, 13, 14,
1.22by adding a subdivision; 103I.101, subdivision 6; 103I.208, subdivisions 1, 2;
1.23103I.235, subdivision 1; 119B.05, subdivision 1; 119B.09, subdivisions 1, 7, by
1.24adding subdivisions; 119B.12; 119B.125, subdivision 2; 119B.13, subdivisions
1.251, 3a, 6, 7; 119B.21, subdivision 5; 144.05, by adding a subdivision; 144.123;
1.26144.125; 144.2215, subdivision 1; 144.3345; 144.565; 144.651, subdivision
1.2726; 144.672, subdivision 1; 144.698, subdivision 1; 144.699, by adding a
1.28subdivision; 144.9502, subdivision 3; 144.9504, subdivision 2; 144.9507,
1.29by adding a subdivision; 144.9512; 144A.071, subdivision 4c; 144E.101,
1.30subdivision 6; 144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07,
1.31by adding a subdivision; 148.235, by adding a subdivision; 151.37, subdivision
1.322; 152.11, by adding a subdivision; 156.001, by adding a subdivision; 156.02,
1.33subdivisions 1, 2; 156.04; 156.072, subdivision 2; 156.073; 156.12, subdivisions
1.342, 4, 6; 156.15, subdivision 2; 156.16, subdivisions 3, 10; 156.18, subdivisions
1.351, 2; 156.19; 157.16, subdivision 1; 179A.03, subdivision 7; 198.075; 245.462,
1.36subdivision 20; 245.465, by adding a subdivision; 245.4874; 245.50, subdivision
1.375; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision 2; 245A.16,
1.38subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04, subdivision 1;
1.39245C.05, subdivisions 1, 4, 5, 7, by adding subdivisions; 245C.08, subdivisions
2.11, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2; 245C.12;
2.2245C.16, subdivision 1; 245C.17, by adding subdivisions; 245C.21, by adding
2.3a subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54,
2.4subdivision 1; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding
2.5a subdivision; 253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16,
2.6subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06,
2.7subdivision 3; 256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions;
2.8256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.0471, subdivision 1;
2.9256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, by adding
2.10a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3,
2.114, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1;
2.12256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivisions 1a, 3,
2.135c, by adding a subdivision; 256B.057, subdivision 8; 256B.0621, subdivision
2.1411; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by adding
2.15subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by
2.16adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14;
2.17256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943,
2.18subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951,
2.19subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434,
2.20subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision;
2.21256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 1, 2,
2.225, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49,
2.23subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision;
2.24256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 256D.03,
2.25subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 256I.04,
2.26subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision;
2.27256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 65; 256J.21,
2.28subdivision 2; 256J.24, subdivision 10; 256J.42, subdivision 1; 256J.425,
2.29subdivisions 3, 4; 256J.46, by adding a subdivision; 256J.49, subdivision 13;
2.30256J.521, subdivisions 1, 2, by adding a subdivision; 256J.53, subdivision
2.312; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6; 256J.751,
2.32subdivisions 2, 5; 256J.95, subdivisions 3, 13; 256K.45, by adding a subdivision;
2.33256L.01, subdivision 4; 256L.03, subdivisions 1, 5; 256L.035; 256L.04,
2.34subdivisions 1, 12; 256L.11, subdivision 7; 256L.12, subdivision 9a; 259.20,
2.35subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41; 259.53,
2.36subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4, 7; 259.75,
2.37subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761, subdivision
2.387; 260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157, subdivision
2.391; 260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201, subdivision
2.4011; 260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317, subdivision 3;
2.41260C.331, subdivision 1; 270B.14, subdivision 1; 609.115, subdivision 9;
2.42626.556, subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000,
2.43chapter 340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005,
2.44First Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006,
2.45chapter 282, article 20, section 37; proposing coding for new law in Minnesota
2.46Statutes, chapters 16A; 62A; 62J; 62Q; 144; 145; 152; 156; 245A; 245C; 254A;
2.47256B; 256C; 256D; 256F; 256J; 260; 325E; proposing coding for new law as
2.48Minnesota Statutes, chapters 256N; 525A; repealing Minnesota Statutes 2006,
2.49sections 62J.052, subdivision 1; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08,
2.50subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
2.51252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085;
2.52254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
2.53254A.18; 256.969, subdivision 27; 256.9743; 256B.0913, subdivisions 5b, 5c,
2.545d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29;
2.55256J.37, subdivisions 3a, 3b; 256J.561, subdivision 1; 256J.62, subdivision 9;
2.56256J.626, subdivisions 7, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213;
2.57525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221;
2.58525.9222; 525.9223; 525.9224; Laws 1997, chapter 8, section 1; Laws 2004,
3.1chapter 288, article 6, section 27; Minnesota Rules, parts 9503.0035, subpart 2;
3.29560.0102, subpart 2, item C; 9585.0030.
3.3BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.4ARTICLE 1

3.5CHILDREN AND FAMILY

3.6    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:
3.7    Subd. 2. General. (a) Unless the data is summary data or a statute specifically
3.8provides a different classification, data on individuals collected, maintained, used, or
3.9disseminated by the welfare system is private data on individuals, and shall not be
3.10disclosed except:
3.11    (1) according to section 13.05;
3.12    (2) according to court order;
3.13    (3) according to a statute specifically authorizing access to the private data;
3.14    (4) to an agent of the welfare system, including a law enforcement person, attorney,
3.15or investigator acting for it in the investigation or prosecution of a criminal or civil
3.16proceeding relating to the administration of a program;
3.17    (5) to personnel of the welfare system who require the data to verify an individual's
3.18identity; determine eligibility, amount of assistance, and the need to provide services to
3.19an individual or family across programs; evaluate the effectiveness of programs; and
3.20investigate suspected fraud;
3.21    (6) to administer federal funds or programs;
3.22    (7) between personnel of the welfare system working in the same program;
3.23    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit
3.24programs and to identify individuals who may benefit from these programs. The following
3.25information may be disclosed under this paragraph: an individual's and their dependent's
3.26names, dates of birth, Social Security numbers, income, addresses, and other data as
3.27required, upon request by the Department of Revenue. Disclosures by the commissioner
3.28of revenue to the commissioner of human services for the purposes described in this clause
3.29are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
3.30but are not limited to, the dependent care credit under section 290.067, the Minnesota
3.31working family credit under section 290.0671, the property tax refund and rental credit
3.32under section 290A.04, and the Minnesota education credit under section 290.0674;
3.33    (9) between the Department of Human Services, the Department of Education, and
3.34the Department of Employment and Economic Development for the purpose of monitoring
3.35the eligibility of the data subject for unemployment benefits, for any employment or
4.1training program administered, supervised, or certified by that agency, for the purpose of
4.2administering any rehabilitation program or child care assistance program, whether alone
4.3or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
4.4family investment program or the child care assistance program by exchanging data on
4.5recipients and former recipients of food support, cash assistance under chapter 256, 256D,
4.6256J, or 256K, child care assistance under chapter 119B, or medical programs under
4.7chapter 256B, 256D, or 256L;
4.8    (10) to appropriate parties in connection with an emergency if knowledge of
4.9the information is necessary to protect the health or safety of the individual or other
4.10individuals or persons;
4.11    (11) data maintained by residential programs as defined in section 245A.02 may
4.12be disclosed to the protection and advocacy system established in this state according
4.13to Part C of Public Law 98-527 to protect the legal and human rights of persons with
4.14developmental disabilities or other related conditions who live in residential facilities for
4.15these persons if the protection and advocacy system receives a complaint by or on behalf
4.16of that person and the person does not have a legal guardian or the state or a designee of
4.17the state is the legal guardian of the person;
4.18    (12) to the county medical examiner or the county coroner for identifying or locating
4.19relatives or friends of a deceased person;
4.20    (13) data on a child support obligor who makes payments to the public agency
4.21may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
4.22determine eligibility under section 136A.121, subdivision 2, clause (5);
4.23    (14) participant Social Security numbers and names collected by the telephone
4.24assistance program may be disclosed to the Department of Revenue to conduct an
4.25electronic data match with the property tax refund database to determine eligibility under
4.26section 237.70, subdivision 4a;
4.27    (15) the current address of a Minnesota family investment program participant
4.28may be disclosed to law enforcement officers who provide the name of the participant
4.29and notify the agency that:
4.30    (i) the participant:
4.31    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
4.32conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
4.33jurisdiction from which the individual is fleeing; or
4.34    (B) is violating a condition of probation or parole imposed under state or federal law;
4.35    (ii) the location or apprehension of the felon is within the law enforcement officer's
4.36official duties; and
5.1    (iii) the request is made in writing and in the proper exercise of those duties;
5.2    (16) the current address of a recipient of general assistance or general assistance
5.3medical care may be disclosed to probation officers and corrections agents who are
5.4supervising the recipient and to law enforcement officers who are investigating the
5.5recipient in connection with a felony level offense;
5.6    (17) information obtained from food support applicant or recipient households may
5.7be disclosed to local, state, or federal law enforcement officials, upon their written request,
5.8for the purpose of investigating an alleged violation of the Food Stamp Act, according
5.9to Code of Federal Regulations, title 7, section 272.1(c);
5.10    (18) the address, Social Security number, and, if available, photograph of any
5.11member of a household receiving food support shall be made available, on request, to a
5.12local, state, or federal law enforcement officer if the officer furnishes the agency with the
5.13name of the member and notifies the agency that:
5.14    (i) the member:
5.15    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
5.16crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
5.17    (B) is violating a condition of probation or parole imposed under state or federal
5.18law; or
5.19    (C) has information that is necessary for the officer to conduct an official duty related
5.20to conduct described in subitem (A) or (B);
5.21    (ii) locating or apprehending the member is within the officer's official duties; and
5.22    (iii) the request is made in writing and in the proper exercise of the officer's official
5.23duty;
5.24    (19) the current address of a recipient of Minnesota family investment program,
5.25general assistance, general assistance medical care, or food support may be disclosed to
5.26law enforcement officers who, in writing, provide the name of the recipient and notify the
5.27agency that the recipient is a person required to register under section 243.166, but is not
5.28residing at the address at which the recipient is registered under section 243.166;
5.29    (20) certain information regarding child support obligors who are in arrears may be
5.30made public according to section 518A.74;
5.31    (21) data on child support payments made by a child support obligor and data on
5.32the distribution of those payments excluding identifying information on obligees may be
5.33disclosed to all obligees to whom the obligor owes support, and data on the enforcement
5.34actions undertaken by the public authority, the status of those actions, and data on the
5.35income of the obligor or obligee may be disclosed to the other party;
6.1    (22) data in the work reporting system may be disclosed under section 256.998,
6.2subdivision 7 ;
6.3    (23) to the Department of Education for the purpose of matching Department of
6.4Education student data with public assistance data to determine students eligible for free
6.5and reduced price meals, meal supplements, and free milk according to United States
6.6Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
6.7state funds that are distributed based on income of the student's family; and to verify
6.8receipt of energy assistance for the telephone assistance plan;
6.9    (24) the current address and telephone number of program recipients and emergency
6.10contacts may be released to the commissioner of health or a local board of health as
6.11defined in section 145A.02, subdivision 2, when the commissioner or local board of health
6.12has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
6.13risk of illness, and the data are necessary to locate the person;
6.14    (25) to other state agencies, statewide systems, and political subdivisions of this
6.15state, including the attorney general, and agencies of other states, interstate information
6.16networks, federal agencies, and other entities as required by federal regulation or law for
6.17the administration of the child support enforcement program;
6.18    (26) to personnel of public assistance programs as defined in section 256.741, for
6.19access to the child support system database for the purpose of administration, including
6.20monitoring and evaluation of those public assistance programs;
6.21    (27) to monitor and evaluate the Minnesota family investment program by
6.22exchanging data between the Departments of Human Services and Education, on
6.23recipients and former recipients of food support, cash assistance under chapter 256, 256D,
6.24256J, or 256K, child care assistance under chapter 119B, or medical programs under
6.25chapter 256B, 256D, or 256L;
6.26    (28) to evaluate child support program performance and to identify and prevent
6.27fraud in the child support program by exchanging data between the Department of Human
6.28Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
6.29and (b), without regard to the limitation of use in paragraph (c), Department of Health,
6.30Department of Employment and Economic Development, and other state agencies as is
6.31reasonably necessary to perform these functions; or
6.32    (29) counties operating child care assistance programs under chapter 119B may
6.33disseminate data on program participants, applicants, and providers to the commissioner
6.34of education.
7.1    (b) Information on persons who have been treated for drug or alcohol abuse may
7.2only be disclosed according to the requirements of Code of Federal Regulations, title
7.342, sections 2.1 to 2.67.
7.4    (c) Data provided to law enforcement agencies under paragraph (a), clause (15),
7.5(16), (17), or (18), or paragraph (b), are investigative data and are confidential or protected
7.6nonpublic while the investigation is active. The data are private after the investigation
7.7becomes inactive under section 13.82, subdivision 5, paragraph (a) or (b).
7.8    (d) Mental health data shall be treated as provided in subdivisions 7, 8, and 9, but is
7.9not subject to the access provisions of subdivision 10, paragraph (b).
7.10    For the purposes of this subdivision, a request will be deemed to be made in writing
7.11if made through a computer interface system.

7.12    Sec. 2. Minnesota Statutes 2006, section 16D.13, subdivision 3, is amended to read:
7.13    Subd. 3. Exclusion. A state agency may not charge interest under this section on
7.14overpayments of assistance benefits under the programs formerly codified in sections
7.15256.031 to 256.0361, 256.72 to 256.87, and under chapters 119B, 256D, and 256I, or the
7.16federal food stamp program. Notwithstanding this prohibition, any debts that have been
7.17reduced to judgment under these programs are subject to the interest charges provided
7.18under section 549.09.

7.19    Sec. 3. Minnesota Statutes 2006, section 119B.05, subdivision 1, is amended to read:
7.20    Subdivision 1. Eligible participants. Families eligible for child care assistance
7.21under the MFIP child care program are:
7.22    (1) MFIP participants who are employed or in job search and meet the requirements
7.23of section 119B.10;
7.24    (2) persons who are members of transition year families under section 119B.011,
7.25subdivision 20 , and meet the requirements of section 119B.10;
7.26    (3) families who are participating in employment orientation or job search, or
7.27other employment or training activities that are included in an approved employability
7.28development plan under section sections 256J.09 and 256J.95;
7.29    (4) MFIP families who are participating in work job search, job support,
7.30employment, or training activities as required in their employment plan, or in appeals,
7.31hearings, assessments, or orientations according to chapter 256J;
7.32    (5) MFIP families who are participating in social services activities under chapter
7.33256J as required in their employment plan approved according to chapter 256J;
8.1    (6) families who are participating in programs as required in tribal contracts under
8.2section 119B.02, subdivision 2, or 256.01, subdivision 2; and
8.3    (7) families who are participating in the transition year extension under section
8.4119B.011, subdivision 20a .

8.5    Sec. 4. Minnesota Statutes 2006, section 119B.09, subdivision 1, is amended to read:
8.6    Subdivision 1. General Eligibility requirements for all applicants for child
8.7care assistance. (a) Child care services must be available to families who need child
8.8care to find or keep employment or to obtain the training or education necessary to find
8.9employment and who:
8.10    (1) have household income less than or equal to 250 percent of the federal poverty
8.11guidelines, adjusted for family size, and meet the requirements of section 119B.05;
8.12receive MFIP assistance; and are participating in employment and training services under
8.13chapter 256J or 256K; or
8.14    (2) have household income less than or equal to 175 percent of the federal poverty
8.15guidelines, adjusted for family size, at program entry and less than 250 percent of the
8.16federal poverty guidelines, adjusted for family size, at program exit.; or
8.17    (3) have household income less than or equal to 250 percent of the federal poverty
8.18guidelines, adjusted for family size, and were a family whose child care assistance was
8.19terminated due to insufficient funds under Minnesota Rules, part 3400.0183.
8.20    (b) Child care services must be made available as in-kind services.
8.21    (c) All applicants for child care assistance and families currently receiving child care
8.22assistance must be assisted and required to cooperate in establishment of paternity and
8.23enforcement of child support obligations for all children in the family as a condition
8.24of program eligibility. For purposes of this section, a family is considered to meet the
8.25requirement for cooperation when the family complies with the requirements of section
8.26256.741 .
8.27EFFECTIVE DATE.This section is effective July 1, 2008.

8.28    Sec. 5. Minnesota Statutes 2006, section 119B.09, subdivision 7, is amended to read:
8.29    Subd. 7. Date of eligibility for assistance. (a) The date of eligibility for child
8.30care assistance under this chapter is the later of the date the application was signed; the
8.31beginning date of employment, education, or training; the date the infant is born for
8.32applicants to the at-home infant care program; or the date a determination has been made
8.33that the applicant is a participant in employment and training services under Minnesota
8.34Rules, part 3400.0080, subpart 2a, or chapter 256J.
9.1    (b) Payment ceases for a family under the at-home infant child care program when a
9.2family has used a total of 12 months of assistance as specified under section 119B.035.
9.3Payment of child care assistance for employed persons on MFIP is effective the date of
9.4employment or the date of MFIP eligibility, whichever is later. Payment of child care
9.5assistance for MFIP or DWP participants in employment and training services is effective
9.6the date of commencement of the services or the date of MFIP or DWP eligibility,
9.7whichever is later. Payment of child care assistance for transition year child care must be
9.8made retroactive to the date of eligibility for transition year child care.
9.9    (c) Notwithstanding paragraph (b), payment of child care assistance for participants
9.10eligible under section 119B.05, may only be made retroactively for a maximum of six
9.11months from the date of application for child care assistance.
9.12EFFECTIVE DATE.This section is effective July 1, 2008.

9.13    Sec. 6. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
9.14to read:
9.15    Subd. 11. Payment of other child care expenses. Payment by a source other
9.16than the family, of part or all of a family's child care expenses not payable under this
9.17chapter, does not affect the family's eligibility for child care assistance, and the amount
9.18paid is excluded from the family's income, if the funds are paid directly to the family's
9.19child care provider on behalf of the family. Child care providers who accept third-party
9.20payments must maintain family-specific documentation of payment source, amount, type
9.21of expenses, and time period covered by the payment.

9.22    Sec. 7. Minnesota Statutes 2006, section 119B.09, is amended by adding a subdivision
9.23to read:
9.24    Subd. 13. Sliding fee. Child care services to families must be made available on
9.25a sliding fee basis.
9.26    (a) The commissioner shall convert eligibility requirements in section 119B.09 and
9.27parent fee schedules in 119B.12 to state median income, based on a family size of three,
9.28adjusted for family size, Subd. 2(a) shall be implemented July 1, 2008. The commissioner
9.29shall report to the 2008 legislature with the necessary statutory changes to codify this
9.30conversion to state median income.

9.31    Sec. 8. Minnesota Statutes 2006, section 119B.12, is amended to read:
9.32119B.12 SLIDING FEE SCALE.
10.1    Subdivision 1. Fee schedule. In setting the sliding fee schedule, the commissioner
10.2shall exclude from the amount of income used to determine eligibility an amount for
10.3federal and state income and Social Security taxes attributable to that income level
10.4according to federal and state standardized tax tables. The commissioner shall base the
10.5parent fee on the ability of the family to pay for child care. The fee schedule must be
10.6designed to use any available tax credits.
10.7    PARENT FEE SCHEDULE. The parent fee schedule is as follows:

10.8 10.9	Income Range (as a percent of the federal poverty guidelines)	Co-payment (as a percentage of adjusted gross income)
10.10	0-74.99%	$0/month
10.11	75.00-99.99%	$5/month
10.12	100.00-104.99%	2.61%
10.13	105.00-109.99%	2.61%
10.14	110.00-114.99%	2.61%
10.15	115.00-119.99%	2.61%
10.16	120.00-124.99%	2.91%
10.17	125.00-129.99%	2.91%
10.18	130.00-134.99%	2.91%
10.19	135.00-139.99%	2.91%
10.20	140.00-144.99%	3.21%
10.21	145.00-149.99%	3.21%
10.22	150.00-154.99%	3.21%
10.23	155.00-159.99%	3.84%
10.24	160.00-164.99%	3.84%
10.25	165.00-169.99%	4.46%
10.26	170.00-174.99%	4.76%
10.27	175.00-179.99%	5.05%
10.28	180.00-184.99%	5.65%
10.29	185.00-189.99%	5.95%
10.30	190.00-194.99%	6.24%
10.31	195.00-199.99%	6.84%
10.32	200.00-204.99%	7.58%
10.33	205.00-209.99%	8.33%
10.34	210.00-214.99%	9.20%
10.35	215.00-219.99%	10.07%
10.36	220.00-224.99%	10.94%
10.37	225.00-229.99%	11.55%
10.38	230.00-234.99%	12.16%
10.39	235.00-239.99%	12.77%
10.40	240.00-244.99%	13.38%
10.41	245.00-249.99%	14.00%
10.42	250%	ineligible

11.1    A family's monthly co-payment fee is the fixed percentage established for the
11.2income range multiplied by the highest possible income within that income range.
11.3    Subd. 2. Parent fee. A family must be assessed a parent fee for each service period.
11.4A family's parent fee must be a fixed percentage of its annual gross income. Parent fees
11.5must apply to families eligible for child care assistance under sections 119B.03 and
11.6119B.05 . Income must be as defined in section 119B.011, subdivision 15. The fixed
11.7percent is based on the relationship of the family's annual gross income to 100 percent
11.8of the annual federal poverty guidelines. Parent fees must begin at 75 percent of the
11.9poverty level. The minimum parent fees for families between 75 percent and 100 percent
11.10of poverty level must be $10 $5 per month. Parent fees must provide for graduated
11.11movement to full payment. Payment of part or all of a family's parent fee directly to the
11.12family's child care provider on behalf of the family by a source other than the family shall
11.13not affect the family's eligibility for child care assistance, and the amount paid shall be
11.14excluded from the family's income. Child care providers who accept third-party payments
11.15must maintain family specific documentation of payment source, amount, and time period
11.16covered by the payment.
11.17EFFECTIVE DATE.(a) This section is effective July 1, 2007.
11.18    (b) Effective July 1, 2008, the parent fee scale for families with incomes greater than
11.19or equal to 100 percent of FPG shall be converted to state median income for a family size
11.20of three, adjusted for family size, as directed in section 119B.09, subdivision 2(a).

11.21    Sec. 9. Minnesota Statutes 2006, section 119B.125, subdivision 2, is amended to read:
11.22    Subd. 2. Persons who cannot be authorized. (a) A person who meets any of the
11.23conditions under paragraphs (b) to (n) must not be authorized as a legal nonlicensed
11.24family child care provider. To determine whether any of the listed conditions exist,
11.25the county must request information about the provider from the Bureau of Criminal
11.26Apprehension, the juvenile courts, and social service agencies. When one of the listed
11.27entities does not maintain information on a statewide basis, the county must contact the
11.28entity in the county where the provider resides and any other county in which the provider
11.29previously resided in the past year. For purposes of this subdivision, a finding that a
11.30delinquency petition is proven in juvenile court must be considered a conviction in state
11.31district court. If a county has determined that a provider is able to be authorized in that
11.32county, and a family in another county later selects that provider, the provider is able to
11.33be authorized in the second county without undergoing a new background investigation
11.34unless one of the following conditions exists:
11.35    (1) two years have passed since the first authorization;
12.1    (2) another person age 13 or older has joined the provider's household since the
12.2last authorization;
12.3    (3) a current household member has turned 13 since the last authorization; or
12.4    (4) there is reason to believe that a household member has a factor that prevents
12.5authorization.
12.6    (b) The person has been convicted of one of the following offenses or has admitted to
12.7committing or a preponderance of the evidence indicates that the person has committed an
12.8act that meets the definition of one of the following offenses: sections 609.185 to 609.195,
12.9murder in the first, second, or third degree; 609.2661 to 609.2663, murder of an unborn
12.10child in the first, second, or third degree; 609.322, solicitation, inducement, promotion
12.11of prostitution, or receiving profit from prostitution; 609.342 to 609.345, criminal sexual
12.12conduct in the first, second, third, or fourth degree; 609.352, solicitation of children to
12.13engage in sexual conduct; 609.365, incest; 609.377, felony malicious punishment of a
12.14child; 617.246, use of minors in sexual performance; 617.247, possession of pictorial
12.15representation of a minor; 609.2242 to 609.2243, felony domestic assault; a felony offense
12.16of spousal abuse; a felony offense of child abuse or neglect; a felony offense of a crime
12.17against children; or an attempt or conspiracy to commit any of these offenses as defined in
12.18Minnesota Statutes; or an offense in any other state or country where the elements are
12.19substantially similar to any of the offenses listed in this paragraph.
12.20    (c) Less than 15 years have passed since the discharge of the sentence imposed for
12.21the offense and the person has received a felony conviction for one of the following
12.22offenses, or the person has admitted to committing or a preponderance of the evidence
12.23indicates that the person has committed an act that meets the definition of a felony
12.24conviction for one of the following offenses: sections 609.20 to 609.205, manslaughter in
12.25the first or second degree; 609.21, criminal vehicular homicide; 609.215, aiding suicide
12.26or aiding attempted suicide; 609.221 to 609.2231, assault in the first, second, third, or
12.27fourth degree; 609.224, repeat offenses of fifth degree assault; 609.228, great bodily
12.28harm caused by distribution of drugs; 609.2325, criminal abuse of a vulnerable adult;
12.29609.2335 , financial exploitation of a vulnerable adult; 609.235, use of drugs to injure or
12.30facilitate a crime; 609.24, simple robbery; 617.241, repeat offenses of obscene materials
12.31and performances; 609.245, aggravated robbery; 609.25, kidnapping; 609.255, false
12.32imprisonment; 609.2664 to 609.2665, manslaughter of an unborn child in the first or
12.33second degree; 609.267 to 609.2672, assault of an unborn child in the first, second, or third
12.34degree; 609.268, injury or death of an unborn child in the commission of a crime; 609.27,
12.35coercion; 609.275, attempt to coerce; 609.324, subdivision 1, other prohibited acts, minor
12.36engaged in prostitution; 609.3451, repeat offenses of criminal sexual conduct in the fifth
13.1degree; 609.378, neglect or endangerment of a child; 609.52, theft; 609.521, possession of
13.2shoplifting gear; 609.561 to 609.563, arson in the first, second, or third degree; 609.582,
13.3burglary in the first, second, third, or fourth degree; 609.625, aggravated forgery; 609.63,
13.4forgery; 609.631, check forgery, offering a forged check; 609.635, obtaining signature
13.5by false pretenses; 609.66, dangerous weapon; 609.665, setting a spring gun; 609.67,
13.6unlawfully owning, possessing, or operating a machine gun; 609.687, adulteration; 609.71,
13.7riot; 609.713, terrorist threats; 609.749, harassment, stalking; 260C.301, termination of
13.8parental rights; 152.021 to 152.022 and 152.0262, controlled substance crime in the first
13.9or second degree; 152.023, subdivision 1, clause (3) or (4), or 152.023, subdivision 2,
13.10clause (4), controlled substance crime in third degree; 152.024, subdivision 1, clause
13.11(2), (3), or (4), controlled substance crime in fourth degree; 617.23, repeat offenses of
13.12indecent exposure; an attempt or conspiracy to commit any of these offenses as defined in
13.13Minnesota Statutes; or an offense in any other state or country where the elements are
13.14substantially similar to any of the offenses listed in this paragraph.
13.15    (d) Less than ten years have passed since the discharge of the sentence imposed for
13.16the offense and the person has received a gross misdemeanor conviction for one of the
13.17following offenses or the person has admitted to committing or a preponderance of the
13.18evidence indicates that the person has committed an act that meets the definition of a gross
13.19misdemeanor conviction for one of the following offenses: sections 609.224, fifth degree
13.20assault; 609.2242 to 609.2243, domestic assault; 518B.01, subdivision 14, violation of
13.21an order for protection; 609.3451, fifth degree criminal sexual conduct; 609.746, repeat
13.22offenses of interference with privacy; 617.23, repeat offenses of indecent exposure;
13.23617.241 , obscene materials and performances; 617.243, indecent literature, distribution;
13.24617.293 , disseminating or displaying harmful material to minors; 609.71, riot; 609.66,
13.25dangerous weapons; 609.749, harassment, stalking; 609.224, subdivision 2, paragraph
13.26(c), fifth degree assault against a vulnerable adult by a caregiver; 609.23, mistreatment
13.27of persons confined; 609.231, mistreatment of residents or patients; 609.2325, criminal
13.28abuse of a vulnerable adult; 609.2335, financial exploitation of a vulnerable adult;
13.29609.233 , criminal neglect of a vulnerable adult; 609.234, failure to report maltreatment of
13.30a vulnerable adult; 609.72, subdivision 3, disorderly conduct against a vulnerable adult;
13.31609.265 , abduction; 609.378, neglect or endangerment of a child; 609.377, malicious
13.32punishment of a child; 609.324, subdivision 1a, other prohibited acts, minor engaged
13.33in prostitution; 609.33, disorderly house; 609.52, theft; 609.582, burglary in the first,
13.34second, third, or fourth degree; 609.631, check forgery, offering a forged check; 609.275,
13.35attempt to coerce; an attempt or conspiracy to commit any of these offenses as defined in
14.1Minnesota Statutes; or an offense in any other state or country where the elements are
14.2substantially similar to any of the offenses listed in this paragraph.
14.3    (e) Less than seven years have passed since the discharge of the sentence imposed
14.4for the offense and the person has received a misdemeanor conviction for one of the
14.5following offenses or the person has admitted to committing or a preponderance of
14.6the evidence indicates that the person has committed an act that meets the definition
14.7of a misdemeanor conviction for one of the following offenses: sections 609.224, fifth
14.8degree assault; 609.2242, domestic assault; 518B.01, violation of an order for protection;
14.9609.3232 , violation of an order for protection; 609.746, interference with privacy; 609.79,
14.10obscene or harassing telephone calls; 609.795, letter, telegram, or package opening,
14.11harassment; 617.23, indecent exposure; 609.2672, assault of an unborn child, third degree;
14.12617.293 , dissemination and display of harmful materials to minors; 609.66, dangerous
14.13weapons; 609.665, spring guns; an attempt or conspiracy to commit any of these offenses
14.14as defined in Minnesota Statutes; or an offense in any other state or country where the
14.15elements are substantially similar to any of the offenses listed in this paragraph.
14.16    (f) The person has been identified by the child protection agency in the county where
14.17the provider resides or a county where the provider has resided or by the statewide child
14.18protection database as a person found by a preponderance of evidence under section
14.19626.556 to be responsible for physical or sexual abuse of a child within the last seven years.
14.20    (g) The person has been identified by the adult protection agency in the county
14.21where the provider resides or a county where the provider has resided or by the statewide
14.22adult protection database as the person responsible for abuse or neglect of a vulnerable
14.23adult within the last seven years.
14.24    (h) The person has refused to give written consent for disclosure of criminal history
14.25records.
14.26    (i) The person has been denied a family child care license or has received a fine or a
14.27sanction as a licensed child care provider that has not been reversed on appeal.
14.28    (j) The person has a family child care licensing disqualification that has not been
14.29set aside.
14.30    (k) The person has admitted or a county has found that there is a preponderance of
14.31evidence that fraudulent information was given to the county for child care assistance
14.32application purposes or was used in submitting child care assistance bills for payment.
14.33    (l) The person has been convicted of the crime of theft by wrongfully obtaining
14.34public assistance or has been found guilty of wrongfully obtaining public assistance by a
14.35federal court, state court, or an administrative hearing determination or waiver, through a
15.1disqualification consent agreement, as part of an approved diversion plan under section
15.2401.065, or a court-ordered stay with probationary or other conditions.
15.3    (m) The person has a household member age 13 or older who has access to children
15.4during the hours that care is provided and who meets one of the conditions listed in
15.5paragraphs (b) to (l).
15.6    (n) The person has a household member ages ten to 12 who has access to children
15.7during the hours that care is provided; information or circumstances exist which provide
15.8the county with articulable suspicion that further pertinent information may exist showing
15.9the household member meets one of the conditions listed in paragraphs (b) to (l); and the
15.10household member actually meets one of the conditions listed in paragraphs (b) to (l).

15.11    Sec. 10. Minnesota Statutes 2006, section 119B.13, subdivision 1, is amended to read:
15.12    Subdivision 1. Subsidy restrictions. (a) Beginning July 1, 2006 2007, the
15.13maximum rate paid for child care assistance in any county or multicounty region under the
15.14child care fund shall be the rate for like-care arrangements in the county effective January
15.15July 1, 2006, increased by six two percent.
15.16    (b) Rate changes shall be implemented for services provided in September 2006
15.172007 unless a participant eligibility redetermination or a new provider agreement is
15.18completed between July 1, 2006 2007, and August 31, 2006 2007.
15.19    As necessary, appropriate notice of adverse action must be made according to
15.20Minnesota Rules, part 3400.0185, subparts 3 and 4.
15.21    New cases approved on or after July 1, 2006 2007, shall have the maximum rates
15.22under paragraph (a), implemented immediately.
15.23    (c) Not less than once every two years year, the commissioner shall survey rates
15.24charged by child care providers in Minnesota to determine the 75th percentile for
15.25like-care arrangements in counties. When the commissioner determines that, using the
15.26commissioner's established protocol, the number of providers responding to the survey is
15.27too small to determine the 75th percentile rate for like-care arrangements in a county or
15.28multicounty region, the commissioner may establish the 75th percentile maximum rate
15.29based on like-care arrangements in a county, region, or category that the commissioner
15.30deems to be similar.
15.31    (d) A rate which includes a special needs rate paid under subdivision 3 or under
15.32a school readiness service agreement paid under section 30 may be in excess of the
15.33maximum rate allowed under this subdivision.
15.34    (e) The department shall monitor the effect of this paragraph on provider rates. The
15.35county shall pay the provider's full charges for every child in care up to the maximum
16.1established. The commissioner shall determine the maximum rate for each type of care
16.2on an hourly, full-day, and weekly basis, including special needs and disability care. The
16.3half-day rates are effective beginning July 1, 2008.
16.4    (f) When the provider charge is greater than the maximum provider rate allowed,
16.5the parent is responsible for payment of the difference in the rates in addition to any
16.6family co-payment fee.
16.7    (g) All maximum provider rate changes shall be implemented on the Monday
16.8following the effective date of the maximum provider rate.

16.9    Sec. 11. Minnesota Statutes 2006, section 119B.13, subdivision 3a, is amended to read:
16.10    Subd. 3a. Provider rate differential for accreditation. A family child care
16.11provider or child care center shall be paid a 15 percent differential above the maximum
16.12rate established in subdivision 1, up to the actual provider rate, if the provider or center
16.13holds a current early childhood development credential or is accredited. For a family
16.14child care provider, early childhood development credential and accreditation includes
16.15an individual who has earned a child development associate degree, a child development
16.16associate credential, a diploma in child development from a Minnesota state technical
16.17college, or a bachelor's or post baccalaureate degree in early childhood education from
16.18an accredited college or university, or who is accredited by the National Association for
16.19Family Child Care or the Competency Based Training and Assessment Program. For a
16.20child care center, accreditation includes accreditation by the National Association for the
16.21Education of Young Children, the Council on Accreditation, the National Early Childhood
16.22Program Accreditation, the National School-Age Care Association, or the National Head
16.23Start Association Program of Excellence. For Montessori programs, accreditation includes
16.24the American Montessori Society, Association of Montessori International-USA, or the
16.25National Center for Montessori Education.

16.26    Sec. 12. Minnesota Statutes 2006, section 119B.13, subdivision 6, is amended to read:
16.27    Subd. 6. Provider payments. (a) Counties or the state shall make vendor payments
16.28to the child care provider or pay the parent directly for eligible child care expenses.
16.29    (b) If payments for child care assistance are made to providers, the provider shall
16.30bill the county for services provided within ten days of the end of the service period. If
16.31bills are submitted within ten days of the end of the service period, a county or the state
16.32shall issue payment to the provider of child care under the child care fund within 30 days
16.33of receiving a bill from the provider. Counties or the state may establish policies that
16.34make payments on a more frequent basis.
17.1    (c) All bills If a provider has received an authorization of care and has been issued a
17.2billing form for an eligible family, the bill must be submitted within 60 days of the last
17.3date of service on the bill. A county may pay a bill submitted more than 60 days after
17.4the last date of service if the provider shows good cause why the bill was not submitted
17.5within 60 days. Good cause must be defined in the county's child care fund plan under
17.6section 119B.08, subdivision 3, and the definition of good cause must include county
17.7error. A county may not pay any bill submitted more than a year after the last date of
17.8service on the bill.
17.9    (d) If a provider provided care for a time period without receiving an authorization
17.10of care and a billing form for an eligible family, payment of child care assistance may only
17.11be made retroactively for a maximum of six months from the date the provider is issued an
17.12authorization of care and a billing form.
17.13    (d) (e) A county may stop payment issued to a provider or may refuse to pay a
17.14bill submitted by a provider if:
17.15    (1) the provider admits to intentionally giving the county materially false information
17.16on the provider's billing forms; or
17.17    (2) a county finds by a preponderance of the evidence that the provider intentionally
17.18gave the county materially false information on the provider's billing forms.
17.19    (e) (f) A county's payment policies must be included in the county's child care plan
17.20under section 119B.08, subdivision 3. If payments are made by the state, in addition to
17.21being in compliance with this subdivision, the payments must be made in compliance
17.22with section 16A.124.

17.23    Sec. 13. Minnesota Statutes 2006, section 119B.13, subdivision 7, is amended to read:
17.24    Subd. 7. Absent days. (a) Child care providers may not be reimbursed for more
17.25than 25 full-day absent days per child, excluding holidays, in a fiscal year, or for more
17.26than ten consecutive full-day absent days, unless the child has a documented medical
17.27condition that causes more frequent absences. Absences due to a documented medical
17.28condition of a parent or sibling who lives in the same residence as the child receiving
17.29child care assistance do not count against the 25-day absent day limit in a fiscal year.
17.30Documentation of medical conditions must be on the forms and submitted according to
17.31the timelines established by the commissioner. A public health nurse or school nurse
17.32may verify the illness in lieu of a medical practitioner. If a provider sends a child home
17.33early due to a medical reason including, but not limited to, fever or contagious illness,
17.34the child care center director or lead teacher may verify the illness in lieu of a medical
17.35practitioner. If a child attends for part of the time authorized to be in care in a day, but is
18.1absent for part of the time authorized to be in care in that same day, the absent time will be
18.2reimbursed but the time will not count toward the ten consecutive or 25 cumulative absent
18.3day limits. Children in families where at least one parent is under the age of 21, does not
18.4have a high school or general education development (GED) diploma, and is a student in a
18.5school district or another similar program that provides or arranges for child care, as well
18.6as parenting, social services, career and employment supports, and academic support to
18.7achieve high school graduation, may be exempt from the absent day limits upon request
18.8of the program and approval of the county. If a child attends part of an authorized day,
18.9payment to the provider must be for the full amount of care authorized for that day. Child
18.10care providers may only be reimbursed for absent days if the provider has a written policy
18.11for child absences and charges all other families in care for similar absences.
18.12    (b) Child care providers must be reimbursed for up to ten federal or state holidays
18.13or designated holidays per year when the provider charges all families for these days
18.14and the holiday or designated holiday falls on a day when the child is authorized to be
18.15in attendance. Parents may substitute other cultural or religious holidays for the ten
18.16recognized state and federal holidays. Holidays do not count toward the ten consecutive or
18.1725 cumulative absent day limits.
18.18    (c) A family or child care provider may not be assessed an overpayment for an
18.19absent day payment unless (1) there was an error in the amount of care authorized for the
18.20family, (2) all of the allowed full-day absent payments for the child have been paid, or (3)
18.21the family or provider did not timely report a change as required under law.
18.22    (d) The provider and family must receive notification of the number of absent days
18.23used upon initial provider authorization for a family and when the family has used 15
18.24cumulative absent days. Upon statewide implementation of the Minnesota Electronic
18.25Child Care System, the provider and family authorization for a family and ongoing
18.26notification of the number of absent days used as of the date of the notification.
18.27    (e) A county may pay for more absent days than the statewide absent day policy
18.28established under this subdivision, if current market practice in the county justifies
18.29payment for those additional days. County policies for payment of absent days in excess
18.30of the statewide absent day policy and justification for these county policies must be
18.31included in the county's child care fund plan under section 119B.08, subdivision 3. This
18.32paragraph may be implemented by counties on or after July 1, 2008.

18.33    Sec. 14. Minnesota Statutes 2006, section 119B.21, subdivision 5, is amended to read:
19.1    Subd. 5. Child care services grants. (a) A child care resource and referral program
19.2designated under section 119B.19, subdivision 1a, may award child care services grants
19.3for:
19.4    (1) creating new licensed child care facilities and expanding existing facilities,
19.5including, but not limited to, supplies, equipment, facility renovation, and remodeling;
19.6    (2) improving licensed child care facility programs;
19.7    (3) staff training and development services including, but not limited to, in-service
19.8training, curriculum development, accreditation, certification, consulting, resource centers,
19.9and program and resource materials, supporting effective teacher-child interactions,
19.10child-focused teaching, and content-driven classroom instruction;
19.11    (4) interim financing;
19.12    (5) capacity building through the purchase of appropriate technology to create,
19.13enhance, and maintain business management systems;
19.14    (6) emergency assistance for child care programs;
19.15    (7) new programs or projects for the creation, expansion, or improvement of
19.16programs that serve ethnic immigrant and refugee communities; and
19.17    (8) targeted recruitment initiatives to expand and build the capacity of the child
19.18care system and to improve the quality of care provided by legal nonlicensed child care
19.19providers.
19.20    (b) A child care resource and referral program designated under section 119B.19,
19.21subdivision 1a , may award child care services grants to:
19.22    (1) licensed providers;
19.23    (2) providers in the process of being licensed;
19.24    (3) corporations or public agencies that develop or provide child care services;
19.25    (4) school-age care programs; or
19.26    (5) any combination of clauses (1) to (4).
19.27Unlicensed providers are only eligible for grants under paragraph (a), clause (7).
19.28    (c) A recipient of a child care services grant for facility improvements, interim
19.29financing, or staff training and development must provide a 25 percent local match.

19.30    Sec. 15. Minnesota Statutes 2006, section 256.01, subdivision 2, is amended to read:
19.31    Subd. 2. Specific powers. Subject to the provisions of section 241.021, subdivision
19.322 , the commissioner of human services shall carry out the specific duties in paragraphs (a)
19.33through (cc):
19.34    (a) Administer and supervise all forms of public assistance provided for by state law
19.35and other welfare activities or services as are vested in the commissioner. Administration
20.1and supervision of human services activities or services includes, but is not limited to,
20.2assuring timely and accurate distribution of benefits, completeness of service, and quality
20.3program management. In addition to administering and supervising human services
20.4activities vested by law in the department, the commissioner shall have the authority to:
20.5    (1) require county agency participation in training and technical assistance programs
20.6to promote compliance with statutes, rules, federal laws, regulations, and policies
20.7governing human services;
20.8    (2) monitor, on an ongoing basis, the performance of county agencies in the
20.9operation and administration of human services, enforce compliance with statutes, rules,
20.10federal laws, regulations, and policies governing welfare services and promote excellence
20.11of administration and program operation;
20.12    (3) develop a quality control program or other monitoring program to review county
20.13performance and accuracy of benefit determinations;
20.14    (4) require county agencies to make an adjustment to the public assistance benefits
20.15issued to any individual consistent with federal law and regulation and state law and rule
20.16and to issue or recover benefits as appropriate;
20.17    (5) delay or deny payment of all or part of the state and federal share of benefits and
20.18administrative reimbursement according to the procedures set forth in section 256.017;
20.19    (6) make contracts with and grants to public and private agencies and organizations,
20.20both profit and nonprofit, and individuals, using appropriated funds; and
20.21    (7) enter into contractual agreements with federally recognized Indian tribes with
20.22a reservation in Minnesota to the extent necessary for the tribe to operate a federally
20.23approved family assistance program or any other program under the supervision of the
20.24commissioner. The commissioner shall consult with the affected county or counties in
20.25the contractual agreement negotiations, if the county or counties wish to be included,
20.26in order to avoid the duplication of county and tribal assistance program services. The
20.27commissioner may establish necessary accounts for the purposes of receiving and
20.28disbursing funds as necessary for the operation of the programs.
20.29    (b) Inform county agencies, on a timely basis, of changes in statute, rule, federal law,
20.30regulation, and policy necessary to county agency administration of the programs.
20.31    (c) Administer and supervise all child welfare activities; promote the enforcement of
20.32laws protecting disabled, dependent, neglected and delinquent children, and children born
20.33to mothers who were not married to the children's fathers at the times of the conception
20.34nor at the births of the children; license and supervise child-caring and child-placing
20.35agencies and institutions; supervise the care of children in boarding and foster homes or
21.1in private institutions; and generally perform all functions relating to the field of child
21.2welfare now vested in the State Board of Control.
21.3    (d) Administer and supervise all noninstitutional service to disabled persons,
21.4including those who are visually impaired, hearing impaired, or physically impaired
21.5or otherwise disabled. The commissioner may provide and contract for the care and
21.6treatment of qualified indigent children in facilities other than those located and available
21.7at state hospitals when it is not feasible to provide the service in state hospitals.
21.8    (e) Assist and actively cooperate with other departments, agencies and institutions,
21.9local, state, and federal, by performing services in conformity with the purposes of Laws
21.101939, chapter 431.
21.11    (f) Act as the agent of and cooperate with the federal government in matters of
21.12mutual concern relative to and in conformity with the provisions of Laws 1939, chapter
21.13431, including the administration of any federal funds granted to the state to aid in the
21.14performance of any functions of the commissioner as specified in Laws 1939, chapter 431,
21.15and including the promulgation of rules making uniformly available medical care benefits
21.16to all recipients of public assistance, at such times as the federal government increases its
21.17participation in assistance expenditures for medical care to recipients of public assistance,
21.18the cost thereof to be borne in the same proportion as are grants of aid to said recipients.
21.19    (g) Establish and maintain any administrative units reasonably necessary for the
21.20performance of administrative functions common to all divisions of the department.
21.21    (h) Act as designated guardian of both the estate and the person of all the wards of
21.22the state of Minnesota, whether by operation of law or by an order of court, without any
21.23further act or proceeding whatever, except as to persons committed as developmentally
21.24disabled. For children under the guardianship of the commissioner or a tribe in Minnesota
21.25recognized by the Secretary of the Interior whose interests would be best served by
21.26adoptive placement, the commissioner may contract with a licensed child-placing agency
21.27or a Minnesota tribal social services agency to provide adoption services. A contract
21.28with a licensed child-placing agency must be designed to supplement existing county
21.29efforts and may not replace existing county programs or tribal social services, unless the
21.30replacement is agreed to by the county board and the appropriate exclusive bargaining
21.31representative, tribal governing body, or the commissioner has evidence that child
21.32placements of the county continue to be substantially below that of other counties. Funds
21.33encumbered and obligated under an agreement for a specific child shall remain available
21.34until the terms of the agreement are fulfilled or the agreement is terminated.
21.35    (i) Act as coordinating referral and informational center on requests for service for
21.36newly arrived immigrants coming to Minnesota.
22.1    (j) The specific enumeration of powers and duties as hereinabove set forth shall in no
22.2way be construed to be a limitation upon the general transfer of powers herein contained.
22.3    (k) Establish county, regional, or statewide schedules of maximum fees and charges
22.4which may be paid by county agencies for medical, dental, surgical, hospital, nursing and
22.5nursing home care and medicine and medical supplies under all programs of medical
22.6care provided by the state and for congregate living care under the income maintenance
22.7programs.
22.8    (l) Have the authority to conduct and administer experimental projects to test
22.9methods and procedures of administering assistance and services to recipients or potential
22.10recipients of public welfare. To carry out such experimental projects, it is further provided
22.11that the commissioner of human services is authorized to waive the enforcement of
22.12existing specific statutory program requirements, rules, and standards in one or more
22.13counties. The order establishing the waiver shall provide alternative methods and
22.14procedures of administration, shall not be in conflict with the basic purposes, coverage, or
22.15benefits provided by law, and in no event shall the duration of a project exceed four years.
22.16It is further provided that no order establishing an experimental project as authorized by
22.17the provisions of this section shall become effective until the following conditions have
22.18been met:
22.19    (1) the secretary of health and human services of the United States has agreed, for
22.20the same project, to waive state plan requirements relative to statewide uniformity; and
22.21    (2) a comprehensive plan, including estimated project costs, shall be approved by
22.22the Legislative Advisory Commission and filed with the commissioner of administration.
22.23    (m) According to federal requirements, establish procedures to be followed by
22.24local welfare boards in creating citizen advisory committees, including procedures for
22.25selection of committee members.
22.26    (n) Allocate federal fiscal disallowances or sanctions which are based on quality
22.27control error rates for the aid to families with dependent children program formerly
22.28codified in sections 256.72 to 256.87, medical assistance, or food stamp program in the
22.29following manner:
22.30    (1) one-half of the total amount of the disallowance shall be borne by the county
22.31boards responsible for administering the programs. For the medical assistance and the
22.32AFDC program formerly codified in sections 256.72 to 256.87, disallowances shall be
22.33shared by each county board in the same proportion as that county's expenditures for the
22.34sanctioned program are to the total of all counties' expenditures for the AFDC program
22.35formerly codified in sections 256.72 to 256.87, and medical assistance programs. For the
22.36food stamp program, sanctions shall be shared by each county board, with 50 percent of
23.1the sanction being distributed to each county in the same proportion as that county's
23.2administrative costs for food stamps are to the total of all food stamp administrative costs
23.3for all counties, and 50 percent of the sanctions being distributed to each county in the
23.4same proportion as that county's value of food stamp benefits issued are to the total of
23.5all benefits issued for all counties. Each county shall pay its share of the disallowance
23.6to the state of Minnesota. When a county fails to pay the amount due hereunder, the
23.7commissioner may deduct the amount from reimbursement otherwise due the county, or
23.8the attorney general, upon the request of the commissioner, may institute civil action
23.9to recover the amount due; and
23.10    (2) notwithstanding the provisions of clause (1), if the disallowance results from
23.11knowing noncompliance by one or more counties with a specific program instruction, and
23.12that knowing noncompliance is a matter of official county board record, the commissioner
23.13may require payment or recover from the county or counties, in the manner prescribed in
23.14clause (1), an amount equal to the portion of the total disallowance which resulted from the
23.15noncompliance, and may distribute the balance of the disallowance according to clause (1).
23.16    (o) Develop and implement special projects that maximize reimbursements and
23.17result in the recovery of money to the state. For the purpose of recovering state money,
23.18the commissioner may enter into contracts with third parties. Any recoveries that result
23.19from projects or contracts entered into under this paragraph shall be deposited in the
23.20state treasury and credited to a special account until the balance in the account reaches
23.21$1,000,000. When the balance in the account exceeds $1,000,000, the excess shall be
23.22transferred and credited to the general fund. All money in the account is appropriated to
23.23the commissioner for the purposes of this paragraph.
23.24    (p) Have the authority to make direct payments to facilities providing shelter
23.25to women and their children according to section 256D.05, subdivision 3. Upon
23.26the written request of a shelter facility that has been denied payments under section
23.27256D.05, subdivision 3 , the commissioner shall review all relevant evidence and make
23.28a determination within 30 days of the request for review regarding issuance of direct
23.29payments to the shelter facility. Failure to act within 30 days shall be considered a
23.30determination not to issue direct payments.
23.31    (q) Have the authority to establish and enforce the following county reporting
23.32requirements:
23.33    (1) the commissioner shall establish fiscal and statistical reporting requirements
23.34necessary to account for the expenditure of funds allocated to counties for human
23.35services programs. When establishing financial and statistical reporting requirements, the
24.1commissioner shall evaluate all reports, in consultation with the counties, to determine if
24.2the reports can be simplified or the number of reports can be reduced;
24.3    (2) the county board shall submit monthly or quarterly reports to the department
24.4as required by the commissioner. Monthly reports are due no later than 15 working days
24.5after the end of the month. Quarterly reports are due no later than 30 calendar days after
24.6the end of the quarter, unless the commissioner determines that the deadline must be
24.7shortened to 20 calendar days to avoid jeopardizing compliance with federal deadlines
24.8or risking a loss of federal funding. Only reports that are complete, legible, and in the
24.9required format shall be accepted by the commissioner;
24.10    (3) if the required reports are not received by the deadlines established in clause (2),
24.11the commissioner may delay payments and withhold funds from the county board until
24.12the next reporting period. When the report is needed to account for the use of federal
24.13funds and the late report results in a reduction in federal funding, the commissioner shall
24.14withhold from the county boards with late reports an amount equal to the reduction in
24.15federal funding until full federal funding is received;
24.16    (4) a county board that submits reports that are late, illegible, incomplete, or not
24.17in the required format for two out of three consecutive reporting periods is considered
24.18noncompliant. When a county board is found to be noncompliant, the commissioner
24.19shall notify the county board of the reason the county board is considered noncompliant
24.20and request that the county board develop a corrective action plan stating how the
24.21county board plans to correct the problem. The corrective action plan must be submitted
24.22to the commissioner within 45 days after the date the county board received notice
24.23of noncompliance;
24.24    (5) the final deadline for fiscal reports or amendments to fiscal reports is one year
24.25after the date the report was originally due. If the commissioner does not receive a report
24.26by the final deadline, the county board forfeits the funding associated with the report for
24.27that reporting period and the county board must repay any funds associated with the
24.28report received for that reporting period;
24.29    (6) the commissioner may not delay payments, withhold funds, or require repayment
24.30under clause (3) or (5) if the county demonstrates that the commissioner failed to
24.31provide appropriate forms, guidelines, and technical assistance to enable the county to
24.32comply with the requirements. If the county board disagrees with an action taken by the
24.33commissioner under clause (3) or (5), the county board may appeal the action according
24.34to sections 14.57 to 14.69; and
24.35    (7) counties subject to withholding of funds under clause (3) or forfeiture or
24.36repayment of funds under clause (5) shall not reduce or withhold benefits or services to
25.1clients to cover costs incurred due to actions taken by the commissioner under clause
25.2(3) or (5).
25.3    (r) Allocate federal fiscal disallowances or sanctions for audit exceptions when
25.4federal fiscal disallowances or sanctions are based on a statewide random sample for
25.5the foster care program under title IV-E of the Social Security Act, United States Code,
25.6title 42, in direct proportion to each county's title IV-E foster care maintenance claim
25.7for that period.
25.8    (s) Be responsible for ensuring the detection, prevention, investigation, and
25.9resolution of fraudulent activities or behavior by applicants, recipients, and other
25.10participants in the human services programs administered by the department.
25.11    (t) Require county agencies to identify overpayments, establish claims, and utilize
25.12all available and cost-beneficial methodologies to collect and recover these overpayments
25.13in the human services programs administered by the department.
25.14    (u) Have the authority to administer a drug rebate program for drugs purchased
25.15pursuant to the prescription drug program established under section 256.955 after the
25.16beneficiary's satisfaction of any deductible established in the program. The commissioner
25.17shall require a rebate agreement from all manufacturers of covered drugs as defined in
25.18section 256B.0625, subdivision 13. Rebate agreements for prescription drugs delivered on
25.19or after July 1, 2002, must include rebates for individuals covered under the prescription
25.20drug program who are under 65 years of age. For each drug, the amount of the rebate shall
25.21be equal to the rebate as defined for purposes of the federal rebate program in United
25.22States Code, title 42, section 1396r-8. The manufacturers must provide full payment
25.23within 30 days of receipt of the state invoice for the rebate within the terms and conditions
25.24used for the federal rebate program established pursuant to section 1927 of title XIX of
25.25the Social Security Act. The manufacturers must provide the commissioner with any
25.26information necessary to verify the rebate determined per drug. The rebate program shall
25.27utilize the terms and conditions used for the federal rebate program established pursuant to
25.28section 1927 of title XIX of the Social Security Act.
25.29    (v) Have the authority to administer the federal drug rebate program for drugs
25.30purchased under the medical assistance program as allowed by section 1927 of title XIX
25.31of the Social Security Act and according to the terms and conditions of section 1927.
25.32Rebates shall be collected for all drugs that have been dispensed or administered in an
25.33outpatient setting and that are from manufacturers who have signed a rebate agreement
25.34with the United States Department of Health and Human Services.
25.35    (w) Have the authority to administer a supplemental drug rebate program for drugs
25.36purchased under the medical assistance program. The commissioner may enter into
26.1supplemental rebate contracts with pharmaceutical manufacturers and may require prior
26.2authorization for drugs that are from manufacturers that have not signed a supplemental
26.3rebate contract. Prior authorization of drugs shall be subject to the provisions of section
26.4256B.0625, subdivision 13 .
26.5    (x) Operate the department's communication systems account established in Laws
26.61993, First Special Session chapter 1, article 1, section 2, subdivision 2, to manage shared
26.7communication costs necessary for the operation of the programs the commissioner
26.8supervises. A communications account may also be established for each regional
26.9treatment center which operates communications systems. Each account must be used
26.10to manage shared communication costs necessary for the operations of the programs the
26.11commissioner supervises. The commissioner may distribute the costs of operating and
26.12maintaining communication systems to participants in a manner that reflects actual usage.
26.13Costs may include acquisition, licensing, insurance, maintenance, repair, staff time and
26.14other costs as determined by the commissioner. Nonprofit organizations and state, county,
26.15and local government agencies involved in the operation of programs the commissioner
26.16supervises may participate in the use of the department's communications technology and
26.17share in the cost of operation. The commissioner may accept on behalf of the state any
26.18gift, bequest, devise or personal property of any kind, or money tendered to the state for
26.19any lawful purpose pertaining to the communication activities of the department. Any
26.20money received for this purpose must be deposited in the department's communication
26.21systems accounts. Money collected by the commissioner for the use of communication
26.22systems must be deposited in the state communication systems account and is appropriated
26.23to the commissioner for purposes of this section.
26.24    (y) Receive any federal matching money that is made available through the medical
26.25assistance program for the consumer satisfaction survey. Any federal money received for
26.26the survey is appropriated to the commissioner for this purpose. The commissioner may
26.27expend the federal money received for the consumer satisfaction survey in either year of
26.28the biennium.
26.29    (z) Designate community information and referral call centers and incorporate
26.30cost reimbursement claims from the designated community information and referral
26.31call centers into the federal cost reimbursement claiming processes of the department
26.32according to federal law, rule, and regulations. Existing information and referral centers
26.33provided by Greater Twin Cities United Way or existing call centers for which Greater
26.34Twin Cities United Way has legal authority to represent, shall be included in these
26.35designations upon review by the commissioner and assurance that these services are
26.36accredited and in compliance with national standards. Any reimbursement is appropriated
27.1to the commissioner and all designated information and referral centers shall receive
27.2payments according to normal department schedules established by the commissioner
27.3upon final approval of allocation methodologies from the United States Department of
27.4Health and Human Services Division of Cost Allocation or other appropriate authorities.
27.5    (aa) Develop recommended standards for foster care homes that address the
27.6components of specialized therapeutic services to be provided by foster care homes with
27.7those services.
27.8    (bb) Authorize the method of payment to or from the department as part of the
27.9human services programs administered by the department. This authorization includes the
27.10receipt or disbursement of funds held by the department in a fiduciary capacity as part of
27.11the human services programs administered by the department.
27.12    (cc) Have the authority to administer a drug rebate program for drugs purchased for
27.13persons eligible for general assistance medical care under section 256D.03, subdivision 3.
27.14For manufacturers that agree to participate in the general assistance medical care rebate
27.15program, the commissioner shall enter into a rebate agreement for covered drugs as
27.16defined in section 256B.0625, subdivisions 13 and 13d. For each drug, the amount of the
27.17rebate shall be equal to the rebate as defined for purposes of the federal rebate program in
27.18United States Code, title 42, section 1396r-8. The manufacturers must provide payment
27.19within the terms and conditions used for the federal rebate program established under
27.20section 1927 of title XIX of the Social Security Act. The rebate program shall utilize
27.21the terms and conditions used for the federal rebate program established under section
27.221927 of title XIX of the Social Security Act.
27.23    Effective January 1, 2006, drug coverage under general assistance medical care shall
27.24be limited to those prescription drugs that:
27.25    (1) are covered under the medical assistance program as described in section
27.26256B.0625, subdivisions 13 and 13d ; and
27.27    (2) are provided by manufacturers that have fully executed general assistance
27.28medical care rebate agreements with the commissioner and comply with such agreements.
27.29Prescription drug coverage under general assistance medical care shall conform to
27.30coverage under the medical assistance program according to section 256B.0625,
27.31subdivisions 13 to 13g .
27.32    The rebate revenues collected under the drug rebate program are deposited in the
27.33general fund.

27.34    Sec. 16. Minnesota Statutes 2006, section 256.01, subdivision 4, is amended to read:
27.35    Subd. 4. Duties as state agency. (a) The state agency shall:
28.1    (1) supervise the administration of assistance to dependent children under Laws
28.21937, chapter 438, by the county agencies in an integrated program with other service for
28.3dependent children maintained under the direction of the state agency;
28.4    (2) may subpoena witnesses and administer oaths, make rules, and take such action
28.5as may be necessary, or desirable for carrying out the provisions of Laws 1937, chapter
28.6438. All rules made by the state agency shall be binding on the counties and shall be
28.7complied with by the respective county agencies;
28.8    (3) (2) establish adequate standards for personnel employed by the counties and the
28.9state agency in the administration of Laws 1937, chapter 438, and make the necessary
28.10rules to maintain such standards;
28.11    (4) (3) prescribe the form of and print and supply to the county agencies blanks
28.12for applications, reports, affidavits, and such other forms as it may deem necessary and
28.13advisable;
28.14    (5) (4) cooperate with the federal government and its public welfare agencies
28.15in any reasonable manner as may be necessary to qualify for federal aid for temporary
28.16assistance for needy families and in conformity with title I of Public Law 104-193, the
28.17Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and successor
28.18amendments, including the making of such reports and such forms and containing such
28.19information as the Federal Social Security Board may from time to time require, and
28.20comply with such provisions as such board may from time to time find necessary to assure
28.21the correctness and verification of such reports;
28.22    (6) may cooperate with other state agencies in establishing reciprocal agreements in
28.23instances where a child receiving Minnesota family investment program assistance moves
28.24or contemplates moving into or out of the state, in order that such child may continue to
28.25receive supervised aid from the state moved from until the child shall have resided for
28.26one year in the state moved to;
28.27    (7) (5) on or before October 1 in each even-numbered year make a biennial report
28.28to the governor concerning the activities of the agency;
28.29    (8) (6) enter into agreements with other departments of the state as necessary to meet
28.30all requirements of the federal government; and
28.31    (9) (7) cooperate with the commissioner of education to enforce the requirements
28.32for program integrity and fraud prevention for investigation for child care assistance
28.33under chapter 119B.
28.34    (b) The state agency may:
28.35    (1) subpoena witnesses and administer oaths, make rules, and take such action as
28.36may be necessary or desirable for carrying out the provisions of Laws 1937, chapter 438.
29.1All rules made by the state agency shall be binding on the counties and shall be complied
29.2with by the respective county agencies;
29.3    (2) cooperate with other state agencies in establishing reciprocal agreements in
29.4instances where a child receiving Minnesota family investment program assistance moves
29.5or contemplates moving into or out of the state, in order that the child may continue
29.6to receive supervised aid from the state moved from until the child has resided for one
29.7year in the state moved to; and
29.8    (3) administer oaths and affirmations, take depositions, certify to official acts, and
29.9issue subpoenas to compel the attendance of individuals and the production of documents
29.10and other personal property necessary in connection with the administration of programs
29.11administered by the Department of Human Services.
29.12    (c) The fees for service of a subpoena in paragraph (b), clause (3), must be paid in
29.13the same manner as prescribed by law for a service of process issued by a district court.
29.14Witnesses must receive the same fees and mileage as in civil actions.
29.15    (d) The subpoena in paragraph (b), clause (3), shall be enforceable through the
29.16district court in the district where the subpoena is issued.

29.17    Sec. 17. Minnesota Statutes 2006, section 256.01, subdivision 18, is amended to read:
29.18    Subd. 18. Immigration status verifications. (a) Notwithstanding any waiver of
29.19this requirement by the secretary of the United States Department of Health and Human
29.20Services, effective July 1, 2001, the commissioner shall utilize the Systematic Alien
29.21Verification for Entitlements (SAVE) program to conduct immigration status verifications:
29.22    (1) as required under United States Code, title 8, section 1642;
29.23    (2) for all applicants and recipients at recertification for food assistance benefits,
29.24whether under the federal food stamp program, the MFIP or work first program, or the
29.25Minnesota food assistance program;
29.26    (3) for all applicants and recipients at recertification for general assistance medical
29.27care, except assistance for an emergency medical condition, for immunization with respect
29.28to an immunizable disease, or for testing and treatment of symptoms of a communicable
29.29disease; and
29.30    (4) for all applicants and recipients at recertification for general assistance,
29.31Minnesota supplemental aid, MinnesotaCare, or group residential housing, when the
29.32benefits provided by these programs would fall under the definition of "federal public
29.33benefit" under United States Code, title 8, section 1642, if federal funds were used to
29.34pay for all or part of the benefits.
30.1    (b) The commissioner shall comply with the reporting requirements under United
30.2States Code, title 42, section 611a, and any federal regulation or guidance adopted under
30.3that law.

30.4    Sec. 18. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
30.5to read:
30.6    Subd. 23. Administrative simplification; county cost study. (a) The commissioner
30.7shall establish and convene the first meeting of an advisory committee to identify ways
30.8to simplify and streamline human services laws and administrative requirements. The
30.9advisory committee shall select its chair from its membership at the first meeting.
30.10    (b) The committee shall consist of three senators appointed by the senate Committee
30.11on Rules and Administration, three state representatives appointed by the speaker of the
30.12house of representatives, four department staff, and five county representatives appointed
30.13by the Association of Minnesota Counties after consultation with other relevant county
30.14organizations.
30.15    (c) The committee shall annually select up to two topics for review. The goals of
30.16the reviews are to discuss opportunities for administrative improvements and increased
30.17simplification and streamlining to improve consistency, efficiency, fairness, and to reduce
30.18the risk of recipient noncompliance. In reviewing the topics selected, consideration shall
30.19be given to:
30.20    (1) current challenges in administrative complexity and service delivery and whether
30.21the sharing of responsibilities between the state and the county should be altered in any
30.22way, including transferring responsibilities from one entity to the other;
30.23    (2) methods of reducing inconsistency with similar programs; and
30.24    (3) the current funding mechanism, whether funding formulas should be adjusted for
30.25special demographic or geographic factors that influence program costs, differences in
30.26county property tax contributions and maintenance of effort obligations, and whether the
30.27mix of state and county obligations for financial support of this service should be changed.
30.28    (d) The committee members shall assume responsibility for reporting progress to
30.29the appropriate leadership of the groups they represent. The commissioner, in partnership
30.30with the advisory committee, shall report to the legislative committees and divisions with
30.31jurisdiction over the Department of Human Services on the findings and recommendations
30.32of the advisory committee by December 15 of each year.
30.33    (e) This section expires June 30, 2012.

30.34    Sec. 19. Minnesota Statutes 2006, section 256.015, subdivision 7, is amended to read:
31.1    Subd. 7. Cooperation required. Upon the request of the Department of Human
31.2Services, any state agency or third party payer shall cooperate with the department in
31.3furnishing information to help establish a third party liability. Upon the request of the
31.4Department of Human Services or county child support or human service agencies, any
31.5employer or third party payer shall cooperate in furnishing information about group health
31.6insurance plans or medical benefit plans available to its employees. For purposes of
31.7section 176.191, subdivision 4, the Department of Labor and Industry may allow the
31.8Department of Human Services and county agencies direct access and data matching on
31.9information relating to workers' compensation claims in order to determine whether the
31.10claimant has reported the fact of a pending claim and the amount paid to or on behalf of
31.11the claimant to the Department of Human Services. The Department of Human Services
31.12and county agencies shall limit its use of information gained from agencies, third party
31.13payers, and employers to purposes directly connected with the administration of its public
31.14assistance and child support programs. The provision of information by agencies, third
31.15party payers, and employers to the department under this subdivision is not a violation of
31.16any right of confidentiality or data privacy.

31.17    Sec. 20. Minnesota Statutes 2006, section 256.017, subdivision 1, is amended to read:
31.18    Subdivision 1. Authority and purpose. The commissioner shall administer a
31.19compliance system for the Minnesota family investment program, the food stamp or food
31.20support program, emergency assistance, general assistance, medical assistance, general
31.21assistance medical care, emergency general assistance, Minnesota supplemental assistance,
31.22preadmission screening, and alternative care grants, and the child care assistance program
31.23under the powers and authorities named in section 256.01, subdivision 2. The purpose of
31.24the compliance system is to permit the commissioner to supervise the administration of
31.25public assistance programs and to enforce timely and accurate distribution of benefits,
31.26completeness of service and efficient and effective program management and operations,
31.27to increase uniformity and consistency in the administration and delivery of public
31.28assistance programs throughout the state, and to reduce the possibility of sanctions and
31.29fiscal disallowances for noncompliance with federal regulations and state statutes.
31.30    The commissioner shall utilize training, technical assistance, and monitoring
31.31activities, as specified in section 256.01, subdivision 2, to encourage county agency
31.32compliance with written policies and procedures.

31.33    Sec. 21. Minnesota Statutes 2006, section 256.017, subdivision 9, is amended to read:
32.1    Subd. 9. Timing and disposition of penalty and case disallowance funds. Quality
32.2control case penalty and administrative penalty amounts shall be disallowed or withheld
32.3from the next regular reimbursement made to the county agency for state and federal
32.4benefit reimbursements and federal administrative reimbursements for all programs
32.5covered in this section, according to procedures established in statute, but shall not be
32.6imposed sooner than 30 calendar days from the date of written notice of such penalties.
32.7Except for penalties withheld under the child care assistance program, all penalties
32.8must be deposited in the county incentive fund provided in section 256.018. Penalties
32.9withheld under the child care assistance program shall be reallocated to counties using the
32.10allocation formula under section 119B.03, subdivision 5. All penalties must be imposed
32.11according to this provision until a decision is made regarding the status of a written
32.12exception. Penalties must be returned to county agencies when a review of a written
32.13exception results in a decision in their favor.

32.14    Sec. 22. Minnesota Statutes 2006, section 256.0471, subdivision 1, is amended to read:
32.15    Subdivision 1. Qualifying overpayment. Any overpayment for assistance granted
32.16under chapter 119B, the MFIP program formerly codified under sections 256.031 to
32.17256.0361 , and the AFDC program formerly codified under sections 256.72 to 256.871;
32.18chapters 256B, 256D, 256I, 256J, and 256K, and 256L; and the food stamp or food support
32.19program, except agency error claims, become a judgment by operation of law 90 days
32.20after the notice of overpayment is personally served upon the recipient in a manner that
32.21is sufficient under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by
32.22certified mail, return receipt requested. This judgment shall be entitled to full faith and
32.23credit in this and any other state.

32.24    Sec. 23. Minnesota Statutes 2006, section 256.984, subdivision 1, is amended to read:
32.25    Subdivision 1. Declaration. Every application for public assistance under this
32.26chapter or chapters 256B, 256D, 256J, and 256L; child care programs under chapter 119B;
32.27and food stamps or food support under chapter 393 shall be in writing or reduced to
32.28writing as prescribed by the state agency and shall contain the following declaration which
32.29shall be signed by the applicant:
32.30"I declare under the penalties of perjury that this application has been examined
32.31by me and to the best of my knowledge is a true and correct statement of every
32.32material point. I understand that a person convicted of perjury may be sentenced
32.33to imprisonment of not more than five years or to payment of a fine of not more
32.34than $10,000, or both."

33.1    Sec. 24. [256D.0516] EXPIRATION OF FOOD SUPPORT BENEFITS AND
33.2REPORTING REQUIREMENTS.
33.3    Subdivision 1. Expiration of food support benefits. Food support benefits shall
33.4not be stored off line or expunged from a recipient's account unless the benefits have not
33.5been accessed for 12 months after the month they were issued.
33.6    Subd. 2. Food support reporting requirements. The Department of Human
33.7Services shall implement simplified reporting as permitted under the Food Stamp Act of
33.81977, as amended, and the food stamp regulations in Code of Federal Regulations, title
33.97, part 273. Food support recipient households required to report periodically shall not
33.10be required to report more often than one time every six months. This provision shall
33.11not apply to households receiving food benefits under the Minnesota family investment
33.12program waiver.
33.13EFFECTIVE DATE.Subdivision 1 is effective February 1, 2008, and subdivision
33.142 is effective May 1, 2008.

33.15    Sec. 25. [256F.15] GRANT PROGRAM FOR CRISIS NURSERIES.
33.16    Subdivision 1. Crisis nurseries. The commissioner of human services shall
33.17establish a grant program to assist private and public agencies and organizations to
33.18provide crisis nurseries to offer services and temporary care to families experiencing crisis
33.19situations including children who are at high risk of abuse and neglect, children who have
33.20been abused and neglected, and children who are in families receiving child protective
33.21services. This service shall be provided without a fee for a maximum of 30 days in any
33.22year. Crisis nurseries shall provide short-term case management, family support services,
33.23parent education, crisis intervention, referrals, and resources, as needed.
33.24    (a) The crisis nurseries must provide a spectrum of services that may include, but
33.25are not limited to:
33.26    (1) being available 24 hours a day, seven days a week;
33.27    (2) providing services for children up to 72 hours at any one time;
33.28    (3) providing short-term case management to bridge the gap between crisis and
33.29successful living;
33.30    (4) making referrals for parents to counseling services and other community
33.31resources to help alleviate the underlying cause of the precipitating stress or crisis;
33.32    (5) providing services without a fee for a maximum of 30 days in any year;
33.33    (6) providing services to families with children from birth through 12 years of age,
33.34as services are available;
34.1    (7) providing an immediate response to family needs and strengths with an initial
34.2assessment and intake interview, making referrals to appropriate agencies or programs,
34.3and providing temporary care of children, as needed;
34.4    (8) maintaining the clients' confidentiality to the extent required by law, and also
34.5complying with statutory reporting requirements which may mandate a report to child
34.6protective services;
34.7    (9) providing a volunteer component and support for volunteers;
34.8    (10) providing preservice training and ongoing training to providers and volunteers;
34.9    (11) evaluating the services provided by documenting use of services, the result of
34.10family referrals made to community resources, and how the services reduced the risk of
34.11maltreatment;
34.12    (12) providing developmental assessments;
34.13    (13) providing medical assessments as determined by using a risk screening tool;
34.14    (14) providing parent education classes or programs that include parent-child
34.15interaction either on site or in collaboration with other community agencies; and
34.16    (15) having a multidisciplinary advisory board which may include one or more
34.17parents who have used the crisis nursery services.
34.18    (b) The crisis nurseries are encouraged to provide opportunities for parents to
34.19volunteer, if appropriate.
34.20    (c) Parents shall retain custody of their children during placement in a crisis facility.
34.21    Subd. 2. Fund distribution. In distributing funds, the commissioner shall give
34.22priority consideration to agencies and organizations with experience in working with
34.23abused or neglected children and their families, and with children at high risk of abuse and
34.24neglect and their families, and serve communities which demonstrate the greatest need
34.25for these services. Funds shall be distributed to crisis nurseries according to a formula
34.26developed by the commissioner in consultation with the Minnesota Crisis Nursery
34.27Association. The formula shall include funding for all existing crisis nursery programs
34.28that have been previously funded through the Department of Human Services and that
34.29meet program requirements as specified in subdivision 1, paragraph (a), and consideration
34.30of factors reflecting the need for services in each service area, including but not limited to
34.31the number of children 18 years of age and under living in the service area, the percent
34.32of children 18 years of age and under living in poverty in the service area, and factors
34.33reflecting the cost of providing services, including but not limited to the number of hours
34.34of service provided in the previous year.

35.1    Sec. 26. Minnesota Statutes 2006, section 256J.01, is amended by adding a subdivision
35.2to read:
35.3    Subd. 6. Legislative approval to move programs or activities. The commissioner
35.4shall not move programs or activities funded with MFIP or TANF maintenance of effort
35.5funds to other funding sources without legislative approval.

35.6    Sec. 27. Minnesota Statutes 2006, section 256J.02, subdivision 1, is amended to read:
35.7    Subdivision 1. Commissioner's authority to administer block grant funds. The
35.8commissioner of human services is authorized to receive, administer, and expend funds
35.9available under the TANF block grant authorized under title I of Public Law 104-193, the
35.10Personal Responsibility and Work Opportunity Reconciliation Act of 1996, and under
35.11Public Law 109-171, the Deficit Reduction Act of 2005.

35.12    Sec. 28. Minnesota Statutes 2006, section 256J.02, subdivision 4, is amended to read:
35.13    Subd. 4. Authority to transfer. Subject to limitations of title I of Public Law
35.14104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996,
35.15as amended, and under Public Law 109-171, the Deficit Reduction Act of 2005, the
35.16legislature may transfer money from the TANF block grant to the child care fund under
35.17chapter 119B, or the Title XX block grant.

35.18    Sec. 29. Minnesota Statutes 2006, section 256J.021, is amended to read:
35.19256J.021 SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.
35.20    Families receiving assistance under this section must comply with all applicable
35.21requirements in this chapter.
35.22    (a) Until October 1, 2006, the commissioner of human services must treat MFIP
35.23expenditures made to or on behalf of any minor child under section 256J.02, subdivision
35.242 , clause (1), who is a resident of this state under section 256J.12, and who is part of a
35.25two-parent eligible household as expenditures under a separately funded state program
35.26and report those expenditures to the federal Department of Health and Human Services
35.27as separate state program expenditures under Code of Federal Regulations, title 45,
35.28section 263.5.
35.29    (b) Beginning October 1, 2006, and each year thereafter, the commissioner of human
35.30services must treat MFIP expenditures made to or on behalf of any minor child under
35.31section 256J.02, subdivision 2, clause (1), who is a resident of this state under section
35.32256J.12, and who is part of a two-parent eligible household, as expenditures under a
35.33separately funded state program. These expenditures shall not count toward the state's
36.1maintenance of effort (MOE) requirements under the federal Temporary Assistance to
36.2Needy Families (TANF) program except if counting certain families would allow the
36.3commissioner to avoid a federal penalty. Families receiving assistance under this section
36.4must comply with all applicable requirements in this chapter.

36.5    Sec. 30. Minnesota Statutes 2006, section 256J.08, subdivision 65, is amended to read:
36.6    Subd. 65. Participant. (a) "Participant" means includes any of the following:
36.7    (1) a person who is currently receiving cash assistance or the food portion available
36.8through MFIP. A person who fails to withdraw or access electronically any portion of the
36.9person's cash and food assistance payment by the end of the payment month, who makes a
36.10written request for closure before the first of a payment month and repays cash and food
36.11assistance electronically issued for that payment month within that payment month, or
36.12who returns any uncashed assistance check and food coupons and withdraws from the
36.13program is not a participant.;
36.14    (2) a person who withdraws a cash or food assistance payment by electronic transfer
36.15or receives and cashes an MFIP assistance check or food coupons and is subsequently
36.16determined to be ineligible for assistance for that period of time is a participant, regardless
36.17whether that assistance is repaid. The term "participant" includes;
36.18    (3) the caregiver relative and the minor child whose needs are included in the
36.19assistance payment.;
36.20    (4) a person in an assistance unit who does not receive a cash and food assistance
36.21payment because the case has been suspended from MFIP is a participant.;
36.22    (5) a person who receives cash payments under the diversionary work program
36.23under section 256J.95 is a participant.; and
36.24    (6) a person who receives cash payments under the family stabilization services
36.25program under section 256J.575.
36.26    (b) "Participant" does not include a person who fails to withdraw or access
36.27electronically any portion of the person's cash and food assistance payment by the end of
36.28the payment month, who makes a written request for closure before the first of a payment
36.29month and repays cash and food assistance electronically issued for that payment month
36.30within that payment month, or who returns any uncashed assistance check and food
36.31coupons and withdraws from the program.
36.32EFFECTIVE DATE.This section is effective the day following final enactment.

36.33    Sec. 31. Minnesota Statutes 2006, section 256J.21, subdivision 2, is amended to read:
37.1    Subd. 2. Income exclusions. The following must be excluded in determining a
37.2family's available income:
37.3    (1) payments for basic care, difficulty of care, and clothing allowances received for
37.4providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
37.5to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
37.6for care and maintenance of a third-party beneficiary who is not a household member;
37.7    (2) reimbursements for employment training received through the Workforce
37.8Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;
37.9    (3) reimbursement for out-of-pocket expenses incurred while performing volunteer
37.10services, jury duty, employment, or informal carpooling arrangements directly related to
37.11employment;
37.12    (4) all educational assistance, except the county agency must count graduate student
37.13teaching assistantships, fellowships, and other similar paid work as earned income and,
37.14after allowing deductions for any unmet and necessary educational expenses, shall
37.15count scholarships or grants awarded to graduate students that do not require teaching
37.16or research as unearned income;
37.17    (5) loans, regardless of purpose, from public or private lending institutions,
37.18governmental lending institutions, or governmental agencies;
37.19    (6) loans from private individuals, regardless of purpose, provided an applicant or
37.20participant documents that the lender expects repayment;
37.21    (7)(i) state income tax refunds; and
37.22    (ii) federal income tax refunds;
37.23    (8)(i) federal earned income credits;
37.24    (ii) Minnesota working family credits;
37.25    (iii) state homeowners and renters credits under chapter 290A; and
37.26    (iv) federal or state tax rebates;
37.27    (9) funds received for reimbursement, replacement, or rebate of personal or real
37.28property when these payments are made by public agencies, awarded by a court, solicited
37.29through public appeal, or made as a grant by a federal agency, state or local government,
37.30or disaster assistance organizations, subsequent to a presidential declaration of disaster;
37.31    (10) the portion of an insurance settlement that is used to pay medical, funeral, and
37.32burial expenses, or to repair or replace insured property;
37.33    (11) reimbursements for medical expenses that cannot be paid by medical assistance;
37.34    (12) payments by a vocational rehabilitation program administered by the state
37.35under chapter 268A, except those payments that are for current living expenses;
38.1    (13) in-kind income, including any payments directly made by a third party to a
38.2provider of goods and services;
38.3    (14) assistance payments to correct underpayments, but only for the month in which
38.4the payment is received;
38.5    (15) payments for short-term emergency needs under section 256J.626, subdivision
38.62 ;
38.7    (16) funeral and cemetery payments as provided by section 256.935;
38.8    (17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
38.9a calendar month;
38.10    (18) any form of energy assistance payment made through Public Law 97-35,
38.11Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
38.12providers by other public and private agencies, and any form of credit or rebate payment
38.13issued by energy providers;
38.14    (19) Supplemental Security Income (SSI), including retroactive SSI payments and
38.15other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;
38.16    (20) Minnesota supplemental aid, including retroactive payments;
38.17    (21) proceeds from the sale of real or personal property;
38.18    (22) state adoption assistance payments under section 259.67, and up to an equal
38.19amount of county adoption assistance payments;
38.20    (23) state-funded family subsidy program payments made under section 252.32
38.21to help families care for children with developmental disabilities, consumer support
38.22grant funds under section 256.476, and resources and services for a disabled household
38.23member under one of the home and community-based waiver services programs under
38.24chapter 256B;
38.25    (24) interest payments and dividends from property that is not excluded from and
38.26that does not exceed the asset limit;
38.27    (25) rent rebates;
38.28    (26) income earned by a minor caregiver, minor child through age 6, or a minor
38.29child who is at least a half-time student in an approved elementary or secondary education
38.30program;
38.31    (27) income earned by a caregiver under age 20 who is at least a half-time student in
38.32an approved elementary or secondary education program;
38.33    (28) MFIP child care payments under section 119B.05;
38.34    (29) all other payments made through MFIP to support a caregiver's pursuit of
38.35greater economic stability;
38.36    (30) income a participant receives related to shared living expenses;
39.1    (31) reverse mortgages;
39.2    (32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
39.342, chapter 13A, sections 1771 to 1790;
39.4    (33) benefits provided by the women, infants, and children (WIC) nutrition program,
39.5United States Code, title 42, chapter 13A, section 1786;
39.6    (34) benefits from the National School Lunch Act, United States Code, title 42,
39.7chapter 13, sections 1751 to 1769e;
39.8    (35) relocation assistance for displaced persons under the Uniform Relocation
39.9Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
39.1042, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
39.11Code, title 12, chapter 13, sections 1701 to 1750jj;
39.12    (36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
39.1312, part 2, sections 2271 to 2322;
39.14    (37) war reparations payments to Japanese Americans and Aleuts under United
39.15States Code, title 50, sections 1989 to 1989d;
39.16    (38) payments to veterans or their dependents as a result of legal settlements
39.17regarding Agent Orange or other chemical exposure under Public Law 101-239, section
39.1810405, paragraph (a)(2)(E);
39.19    (39) income that is otherwise specifically excluded from MFIP consideration in
39.20federal law, state law, or federal regulation;
39.21    (40) security and utility deposit refunds;
39.22    (41) American Indian tribal land settlements excluded under Public Laws 98-123,
39.2398-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
39.24Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
39.25under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;
39.26    (42) all income of the minor parent's parents and stepparents when determining the
39.27grant for the minor parent in households that include a minor parent living with parents or
39.28stepparents on MFIP with other children;
39.29    (43) income of the minor parent's parents and stepparents equal to 200 percent of the
39.30federal poverty guideline for a family size not including the minor parent and the minor
39.31parent's child in households that include a minor parent living with parents or stepparents
39.32not on MFIP when determining the grant for the minor parent. The remainder of income is
39.33deemed as specified in section 256J.37, subdivision 1b;
39.34    (44) payments made to children eligible for relative custody assistance under section
39.35257.85 ;
40.1    (45) vendor payments for goods and services made on behalf of a client unless the
40.2client has the option of receiving the payment in cash; and
40.3    (46) the principal portion of a contract for deed payment.; and
40.4    (47) cash payments to individuals enrolled for full-time service as a volunteer under
40.5AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
40.6National, and AmeriCorps NCCC.

40.7    Sec. 32. Minnesota Statutes 2006, section 256J.24, subdivision 10, is amended to read:
40.8    Subd. 10. MFIP exit level. The commissioner shall adjust the MFIP earned income
40.9disregard to ensure that most participants do not lose eligibility for MFIP until their
40.10income reaches at least 115 140 percent of the federal poverty guidelines in effect in
40.11October of each fiscal year. The adjustment to the disregard shall be based on a household
40.12size of three, and the resulting earned income disregard percentage must be applied to all
40.13household sizes. The adjustment under this subdivision must be implemented at the same
40.14time as the October food stamp or food support cost-of-living adjustment is reflected in
40.15the food portion of MFIP transitional standard as required under subdivision 5a.

40.16    Sec. 33. Minnesota Statutes 2006, section 256J.42, subdivision 1, is amended to read:
40.17    Subdivision 1. Time limit. (a) Except as otherwise provided for in this section, an
40.18assistance unit in which any adult caregiver has received 60 months of cash assistance
40.19funded in whole or in part by the TANF block grant in this or any other state or
40.20United States territory, or from a tribal TANF program, MFIP, the AFDC program
40.21formerly codified in sections 256.72 to 256.87, or the family general assistance program
40.22formerly codified in sections 256D.01 to 256D.23, funded in whole or in part by state
40.23appropriations, is ineligible to receive MFIP. Any cash assistance funded with TANF
40.24dollars in this or any other state or United States territory, or from a tribal TANF program,
40.25or MFIP assistance funded in whole or in part by state appropriations, that was received
40.26by the unit on or after the date TANF was implemented, including any assistance received
40.27in states or United States territories of prior residence, counts toward the 60-month
40.28limitation. Months during which any cash assistance is received by an assistance unit
40.29with a mandatory member who is disqualified for wrongfully obtaining public assistance
40.30under section 256.98, subdivision 8, counts toward the time limit for the disqualified
40.31member. The 60-month limit applies to a minor caregiver except under subdivision 5. The
40.3260-month time period does not need to be consecutive months for this provision to apply.
41.1    (b) The months before July 1998 in which individuals received assistance as part of
41.2the field trials as an MFIP, MFIP-R, or MFIP or MFIP-R comparison group family are
41.3not included in the 60-month time limit.
41.4EFFECTIVE DATE.This section is effective October 1, 2007.

41.5    Sec. 34. Minnesota Statutes 2006, section 256J.425, subdivision 3, is amended to read:
41.6    Subd. 3. Hard-to-employ participants. An assistance unit subject to the time
41.7limit in section 256J.42, subdivision 1, is eligible to receive months of assistance under
41.8a hardship extension if the participant who reached the time limit belongs to any of the
41.9following groups:
41.10    (1) a person who is diagnosed by a licensed physician, psychological practitioner,
41.11or other qualified professional, as developmentally disabled or mentally ill, and that
41.12condition prevents the person from obtaining or retaining unsubsidized employment;
41.13    (2) a person who:
41.14    (i) has been assessed by a vocational specialist or the county agency to be
41.15unemployable for purposes of this subdivision; or
41.16    (ii) has an IQ below 80 who has been assessed by a vocational specialist or a county
41.17agency to be employable, but not at a level that makes the participant eligible for an
41.18extension under subdivision 4. The determination of IQ level must be made by a qualified
41.19professional. In the case of a non-English-speaking person: (A) the determination must
41.20be made by a qualified professional with experience conducting culturally appropriate
41.21assessments, whenever possible; (B) the county may accept reports that identify an
41.22IQ range as opposed to a specific score; (C) these reports must include a statement of
41.23confidence in the results;
41.24    (3) a person who is determined by a qualified professional to be learning disabled,
41.25and the disability severely limits the person's ability to obtain, perform, or maintain
41.26suitable employment. For purposes of the initial approval of a learning disability
41.27extension, the determination must have been made or confirmed within the previous 12
41.28months. In the case of a non-English-speaking person: (i) the determination must be made
41.29by a qualified professional with experience conducting culturally appropriate assessments,
41.30whenever possible; and (ii) these reports must include a statement of confidence in the
41.31results. If a rehabilitation plan for a participant extended as learning disabled is developed
41.32or approved by the county agency, the plan must be incorporated into the employment
41.33plan. However, a rehabilitation plan does not replace the requirement to develop and
41.34comply with an employment plan under section 256J.521; or
42.1    (4) a person who has been granted a family violence waiver, and who is complying
42.2with an employment plan under section 256J.521, subdivision 3; or
42.3    (5) a participant under section 256J.561, subdivision 2, paragraph (d), who is
42.4complying with an employment plan tailored to recognize the special circumstances of
42.5the caregivers and family, including limitations due to illness or disability, and caregiving
42.6needs.

42.7    Sec. 35. Minnesota Statutes 2006, section 256J.425, subdivision 4, is amended to read:
42.8    Subd. 4. Employed participants. (a) An assistance unit subject to the time limit
42.9under section 256J.42, subdivision 1, is eligible to receive assistance under a hardship
42.10extension if the participant who reached the time limit belongs to:
42.11    (1) a one-parent assistance unit in which the participant is participating in work
42.12activities for at least 30 hours per week, of which an average of at least 25 hours per week
42.13every month are spent participating in employment;
42.14    (2) a two-parent assistance unit in which the participants are participating in work
42.15activities for at least 55 hours per week, of which an average of at least 45 hours per week
42.16every month are spent participating in employment; or
42.17    (3) an assistance unit in which a participant is participating in employment for fewer
42.18hours than those specified in clause (1) or (2), and the participant submits verification from
42.19a qualified professional, in a form acceptable to the commissioner, stating that the number
42.20of hours the participant may work is limited due to illness or disability, as long as the
42.21participant is participating in employment for at least the number of hours specified by the
42.22qualified professional. The participant must be following the treatment recommendations
42.23of the qualified professional providing the verification. The commissioner shall develop a
42.24form to be completed and signed by the qualified professional, documenting the diagnosis
42.25and any additional information necessary to document the functional limitations of the
42.26participant that limit work hours. If the participant is part of a two-parent assistance unit,
42.27the other parent must be treated as a one-parent assistance unit for purposes of meeting the
42.28work requirements under this subdivision.
42.29    (b) For purposes of this section, employment means:
42.30    (1) unsubsidized employment under section 256J.49, subdivision 13, clause (1);
42.31    (2) subsidized employment under section 256J.49, subdivision 13, clause (2);
42.32    (3) on-the-job training under section 256J.49, subdivision 13, clause (2);
42.33    (4) an apprenticeship under section 256J.49, subdivision 13, clause (1);
42.34    (5) supported work under section 256J.49, subdivision 13, clause (2);
42.35    (6) a combination of clauses (1) to (5); or
43.1    (7) child care under section 256J.49, subdivision 13, clause (7), if it is in combination
43.2with paid employment.
43.3    (c) If a participant is complying with a child protection plan under chapter 260C,
43.4the number of hours required under the child protection plan count toward the number
43.5of hours required under this subdivision.
43.6    (d) (c) The county shall provide the opportunity for subsidized employment to
43.7participants needing that type of employment within available appropriations.
43.8    (e) (d) To be eligible for a hardship extension for employed participants under this
43.9subdivision, a participant must be in compliance for at least ten out of the 12 months
43.10the participant received MFIP immediately preceding the participant's 61st month on
43.11assistance. If ten or fewer months of eligibility for TANF assistance remain at the time the
43.12participant from another state applies for assistance, the participant must be in compliance
43.13every month.
43.14    (f) (e) The employment plan developed under section 256J.521, subdivision 2, for
43.15participants under this subdivision must contain at least the minimum number of hours
43.16specified in paragraph (a) for the purpose of meeting the requirements for an extension
43.17under this subdivision. The job counselor and the participant must sign the employment
43.18plan to indicate agreement between the job counselor and the participant on the contents
43.19of the plan.
43.20    (g) (f) Participants who fail to meet the requirements in paragraph (a), without
43.21good cause under section 256J.57, shall be sanctioned or permanently disqualified under
43.22subdivision 6. Good cause may only be granted for that portion of the month for which
43.23the good cause reason applies. Participants must meet all remaining requirements in the
43.24approved employment plan or be subject to sanction or permanent disqualification.
43.25    (h) (g) If the noncompliance with an employment plan is due to the involuntary loss
43.26of employment, the participant is exempt from the hourly employment requirement under
43.27this subdivision for one month. Participants must meet all remaining requirements in the
43.28approved employment plan or be subject to sanction or permanent disqualification. This
43.29exemption is available to each participant two times in a 12-month period.

43.30    Sec. 36. Minnesota Statutes 2006, section 256J.46, is amended by adding a subdivision
43.31to read:
43.32    Subd. 3. Restrictions on sanctions. A participant shall not be sanctioned for failure
43.33to meet the agreed upon hours in a participant's employment plan under section 256J.521,
43.34subdivision 2, when the participant:
44.1    (1) fails to meet the agreed upon hours of participation in paid employment because
44.2the participant is not eligible for holiday pay and the participant's place of employment is
44.3closed for a holiday; or
44.4    (2) is otherwise meeting or exceeding the federal TANF work participation rate
44.5hourly requirements.

44.6    Sec. 37. Minnesota Statutes 2006, section 256J.49, subdivision 13, is amended to read:
44.7    Subd. 13. Work activity. "Work activity" means any activity in a participant's
44.8approved employment plan that leads to employment. For purposes of the MFIP program,
44.9this includes activities that meet the definition of work activity under the participation
44.10requirements of TANF. Work activity includes:
44.11    (1) unsubsidized employment, including work study and paid apprenticeships or
44.12internships;
44.13    (2) subsidized private sector or public sector employment, including grant diversion
44.14as specified in section 256J.69, on-the-job training as specified in section 256J.66,
44.15the self-employment investment demonstration program (SEID) as specified in section
44.16256J.65 , paid work experience, and supported work when a wage subsidy is provided;
44.17    (3) unpaid work experience, including community service, volunteer work,
44.18the community work experience program as specified in section 256J.67, unpaid
44.19apprenticeships or internships, and supported work when a wage subsidy is not provided.
44.20Unpaid work performed in return for cash assistance is prohibited and does not count
44.21as a work activity, unless the participant voluntarily agrees, in writing, to engage in
44.22unpaid work in return for cash assistance. The participant may terminate the unpaid
44.23work arrangement, in writing, at any time;
44.24    (4) job search including job readiness assistance, job clubs, job placement,
44.25job-related counseling, and job retention services;
44.26    (5) job readiness education, including English as a second language (ESL) or
44.27functional work literacy classes as limited by the provisions of section 256J.531,
44.28subdivision 2 , general educational development (GED) course work, high school
44.29completion, and adult basic education as limited by the provisions of section 256J.531,
44.30subdivision 1 ;
44.31    (6) job skills training directly related to employment, including education and
44.32training that can reasonably be expected to lead to employment, as limited by the
44.33provisions of section 256J.53;
44.34    (7) providing child care services to a participant who is working in a community
44.35service program;
45.1    (8) activities included in the employment plan that is developed under section
45.2256J.521, subdivision 3 ; and
45.3    (9) preemployment activities including chemical and mental health assessments,
45.4treatment, and services; learning disabilities services; child protective services; family
45.5stabilization services; or other programs designed to enhance employability.

45.6    Sec. 38. Minnesota Statutes 2006, section 256J.521, subdivision 1, is amended to read:
45.7    Subdivision 1. Assessments. (a) For purposes of MFIP employment services,
45.8assessment is a continuing process of gathering information related to employability
45.9for the purpose of identifying both participant's strengths and strategies for coping with
45.10issues that interfere with employment. The job counselor must use information from the
45.11assessment process to develop and update the employment plan under subdivision 2 or 3,
45.12as appropriate, and to determine whether the participant qualifies for a family violence
45.13waiver including an employment plan under subdivision 3, and to determine whether the
45.14participant should be referred to the family stabilization services program under section
45.15256J.575.
45.16    (b) The scope of assessment must cover at least the following areas:
45.17    (1) basic information about the participant's ability to obtain and retain employment,
45.18including: a review of the participant's education level; interests, skills, and abilities; prior
45.19employment or work experience; transferable work skills; child care and transportation
45.20needs;
45.21    (2) identification of personal and family circumstances that impact the participant's
45.22ability to obtain and retain employment, including: any special needs of the children, the
45.23level of English proficiency, family violence issues, and any involvement with social
45.24services or the legal system;
45.25    (3) the results of a mental and chemical health screening tool designed by the
45.26commissioner and results of the brief screening tool for special learning needs. Screening
45.27tools for mental and chemical health and special learning needs must be approved by the
45.28commissioner and may only be administered by job counselors or county staff trained in
45.29using such screening tools. The commissioner shall work with county agencies to develop
45.30protocols for referrals and follow-up actions after screens are administered to participants,
45.31including guidance on how employment plans may be modified based upon outcomes
45.32of certain screens. Participants must be told of the purpose of the screens and how the
45.33information will be used to assist the participant in identifying and overcoming barriers to
45.34employment. Screening for mental and chemical health and special learning needs must
45.35be completed by participants who are unable to find suitable employment after six weeks
46.1of job search under subdivision 2, paragraph (b), and participants who are determined to
46.2have barriers to employment under subdivision 2, paragraph (d). Failure to complete the
46.3screens will result in sanction under section 256J.46; and
46.4    (4) a comprehensive review of participation and progress for participants who have
46.5received MFIP assistance and have not worked in unsubsidized employment during the
46.6past 12 months. The purpose of the review is to determine the need for additional services
46.7and supports, including placement in subsidized employment or unpaid work experience
46.8under section 256J.49, subdivision 13, or referral to the family stabilization services
46.9program under section 256J.575 .
46.10    (c) Information gathered during a caregiver's participation in the diversionary work
46.11program under section 256J.95 must be incorporated into the assessment process.
46.12    (d) The job counselor may require the participant to complete a professional chemical
46.13use assessment to be performed according to the rules adopted under section 254A.03,
46.14subdivision 3 , including provisions in the administrative rules which recognize the cultural
46.15background of the participant, or a professional psychological assessment as a component
46.16of the assessment process, when the job counselor has a reasonable belief, based on
46.17objective evidence, that a participant's ability to obtain and retain suitable employment
46.18is impaired by a medical condition. The job counselor may assist the participant with
46.19arranging services, including child care assistance and transportation, necessary to meet
46.20needs identified by the assessment. Data gathered as part of a professional assessment
46.21must be classified and disclosed according to the provisions in section 13.46.

46.22    Sec. 39. Minnesota Statutes 2006, section 256J.521, subdivision 2, is amended to read:
46.23    Subd. 2. Employment plan; contents. (a) Based on the assessment under
46.24subdivision 1, the job counselor and the participant must develop an employment plan
46.25that includes participation in activities and hours that meet the requirements of section
46.26256J.55, subdivision 1 . The purpose of the employment plan is to identify for each
46.27participant the most direct path to unsubsidized employment and any subsequent steps that
46.28support long-term economic stability. The employment plan should be developed using
46.29the highest level of activity appropriate for the participant. Activities must be chosen from
46.30clauses (1) to (6), which are listed in order of preference. Notwithstanding this order of
46.31preference for activities, priority must be given for activities related to a family violence
46.32waiver when developing the employment plan. The employment plan must also list the
46.33specific steps the participant will take to obtain employment, including steps necessary
46.34for the participant to progress from one level of activity to another, and a timetable for
46.35completion of each step. Levels of activity include:
47.1    (1) unsubsidized employment;
47.2    (2) job search;
47.3    (3) subsidized employment or unpaid work experience;
47.4    (4) unsubsidized employment and job readiness education or job skills training;
47.5    (5) unsubsidized employment or unpaid work experience and activities related to
47.6a family violence waiver or preemployment needs; and
47.7    (6) activities related to a family violence waiver or preemployment needs.
47.8    (b) Participants who are determined to possess sufficient skills such that the
47.9participant is likely to succeed in obtaining unsubsidized employment must job search at
47.10least 30 hours per week for up to six weeks and accept any offer of suitable employment.
47.11The remaining hours necessary to meet the requirements of section 256J.55, subdivision
47.121 , may be met through participation in other work activities under section 256J.49,
47.13subdivision 13 . The participant's employment plan must specify, at a minimum: (1)
47.14whether the job search is supervised or unsupervised; (2) support services that will
47.15be provided; and (3) how frequently the participant must report to the job counselor.
47.16Participants who are unable to find suitable employment after six weeks must meet
47.17with the job counselor to determine whether other activities in paragraph (a) should be
47.18incorporated into the employment plan. Job search activities which are continued after six
47.19weeks must be structured and supervised.
47.20    (c) Beginning July 1, 2004, activities and hourly requirements in the employment
47.21plan may be adjusted as necessary to accommodate the personal and family circumstances
47.22of participants identified under section 256J.561, subdivision 2, paragraph (d). Participants
47.23who no longer meet the provisions of section 256J.561, subdivision 2, paragraph (d),
47.24must meet with the job counselor within ten days of the determination to revise the
47.25employment plan.
47.26    (d) Participants who are determined to have barriers to obtaining or retaining
47.27employment that will not be overcome during six weeks of job search under paragraph (b)
47.28must work with the job counselor to develop an employment plan that addresses those
47.29barriers by incorporating appropriate activities from paragraph (a), clauses (1) to (6).
47.30The employment plan must include enough hours to meet the participation requirements
47.31in section 256J.55, subdivision 1, unless a compelling reason to require fewer hours
47.32is noted in the participant's file.
47.33    (e) The job counselor and the participant must sign the employment plan to indicate
47.34agreement on the contents.
47.35    (f) Except as provided under paragraphs (g) and (h), failure to develop or comply
47.36with activities in the plan, or voluntarily quitting suitable employment without good
48.1cause, will result in the imposition of a sanction under section 256J.46. The job counselor
48.2is encouraged to allow participants who are participating in at least 20 hours of work
48.3activities to also participate in employment and training activities in order to meet the
48.4federal hourly participation rates.
48.5    (g) When a participant fails to meet the agreed upon hours of participation in paid
48.6employment because the participant is not eligible for holiday pay and the participant's
48.7place of employment is closed for a holiday, the job counselor shall not impose a sanction
48.8or increase the hours of participation in any other activity, including paid employment, to
48.9offset the hours that were missed due to the holiday.
48.10    (h) The job counselor shall not impose a sanction for failure to meet the agreed upon
48.11hours in a participant's employment plan under this subdivision when the participant
48.12is otherwise meeting or exceeding the federal TANF work participation rate hourly
48.13requirements.
48.14    (f) (i) Employment plans must be reviewed at least every three months to determine
48.15whether activities and hourly requirements should be revised.

48.16    Sec. 40. Minnesota Statutes 2006, section 256J.521, is amended by adding a
48.17subdivision to read:
48.18    Subd. 7. Employment plan; nonmaintenance of effort; single caregivers. (a)
48.19When a single caregiver is moved to the nonmaintenance of effort state-funded program
48.20under section 256J.021, paragraphs (a) and (b), the single caregiver shall develop or revise
48.21the employment plan as specified in this subdivision with a job counselor or county. The
48.22plan must address issues interfering with employment, including physical and mental
48.23health, substance use, and social service issues of the caregiver and the caregiver's family.
48.24Job search and employment must also be included in the plan to the extent possible.
48.25    (b) Counties must coordinate services by ensuring that all workers involved with
48.26the family communicate on a regular basis, and that expectations for the family across
48.27service areas lead to common goals.
48.28    (c) Activities and hourly requirements in the employment plan may be adjusted as
48.29necessary to accommodate the personal and family circumstances of the participant.
48.30Participants who no longer meet the criteria for the nonmaintenance of effort state-funded
48.31program shall meet with the job counselor or county within ten days of the determination
48.32to revise the employment plan.

48.33    Sec. 41. Minnesota Statutes 2006, section 256J.53, subdivision 2, is amended to read:
49.1    Subd. 2. Approval of postsecondary education or training. (a) In order for a
49.2postsecondary education or training program to be an approved activity in an employment
49.3plan, the participant must be working in unsubsidized employment at least 20 hours per
49.4week.
49.5    (b) Participants seeking approval of a postsecondary education or training plan
49.6must provide documentation that:
49.7    (1) the employment goal can only be met with the additional education or training;
49.8    (2) there are suitable employment opportunities that require the specific education or
49.9training in the area in which the participant resides or is willing to reside;
49.10    (3) the education or training will result in significantly higher wages for the
49.11participant than the participant could earn without the education or training;
49.12    (4) the participant can meet the requirements for admission into the program; and
49.13    (5) there is a reasonable expectation that the participant will complete the training
49.14program based on such factors as the participant's MFIP assessment, previous education,
49.15training, and work history; current motivation; and changes in previous circumstances.
49.16    (c) The hourly unsubsidized employment requirement does not apply for intensive
49.17education or training programs lasting 12 weeks or less when full-time attendance is
49.18required.
49.19    (d) (b) Participants with an approved employment plan in place on July 1, 2003,
49.20which includes more than 12 months of postsecondary education or training shall be
49.21allowed to complete that plan provided that hourly requirements in section 256J.55,
49.22subdivision 1 , and conditions specified in paragraph (b) (a), and subdivisions 3 and 5 are
49.23met. A participant whose case is subsequently closed for three months or less for reasons
49.24other than noncompliance with program requirements and who returns to MFIP shall
49.25be allowed to complete that plan provided that hourly requirements in section 256J.55,
49.26subdivision 1 , and conditions specified in paragraph (b) (a) and subdivisions 3 and 5 are
49.27met.

49.28    Sec. 42. Minnesota Statutes 2006, section 256J.55, subdivision 1, is amended to read:
49.29    Subdivision 1. Participation requirements. (a) All caregivers must participate
49.30in employment services under sections 256J.515 to 256J.57 concurrent with receipt of
49.31MFIP assistance.
49.32    (b) Until July 1, 2004, participants who meet the requirements of section 256J.56 are
49.33exempt from participation requirements.
50.1    (c) Participants under paragraph (a) must develop and comply with an employment
50.2plan under section 256J.521 or section 256J.54 in the case of a participant under the age of
50.320 who has not obtained a high school diploma or its equivalent.
50.4    (d) With the exception of participants under the age of 20 who must meet the
50.5education requirements of section 256J.54, all participants must meet the hourly
50.6participation requirements of TANF or the hourly requirements listed in clauses (1) to
50.7(3), whichever is higher.
50.8    (1) In single-parent families with no children under six years of age, the job
50.9counselor and the caregiver must develop an employment plan that includes 30 to 35 hours
50.10per week of work activities 130 hours per month of work activities.
50.11    (2) In single-parent families with a child under six years of age, the job counselor
50.12and the caregiver must develop an employment plan that includes 20 to 35 hours per week
50.13of work activities 87 hours per month of work activities.
50.14    (3) In two-parent families, the job counselor and the caregivers must develop
50.15employment plans which result in a combined total of at least 55 hours per week of work
50.16activities.
50.17    (e) Failure to participate in employment services, including the requirement to
50.18develop and comply with an employment plan, including hourly requirements, without
50.19good cause under section 256J.57, shall result in the imposition of a sanction under section
50.20256J.46 .

50.21    Sec. 43. [256J.575] FAMILY STABILIZATION SERVICES.
50.22    Subdivision 1. Purpose. (a) The family stabilization services serve families who are
50.23not making significant progress within the Minnesota family investment program (MFIP)
50.24due to a variety of barriers to employment.
50.25    (b) The goal of the services is to stabilize and improve the lives of families at risk
50.26of long-term welfare dependency or family instability due to employment barriers such
50.27as physical disability, mental disability, age, or providing care for a disabled household
50.28member. These services promote and support families to achieve the greatest possible
50.29degree of self-sufficiency.
50.30    Subd. 2. Definitions. The terms used in this section have the meanings given them
50.31in paragraphs (a) to (e).
50.32    (a) "Family stabilization services" means the services established under this section.
50.33    (b) "Case management" means the services provided by or through the county
50.34agency or through the employment services agency to participating families, including
51.1assessment, information, referrals, and assistance in the preparation and implementation
51.2of a family stabilization plan under subdivision 5.
51.3    (c) "Family stabilization plan" means a plan developed by a case manager and
51.4the participant, which identifies the participant's most appropriate path to unsubsidized
51.5employment, family stability, and barrier reduction, taking into account the family's
51.6circumstances.
51.7    (d) "Family stabilization services" means programs, activities, and services in this
51.8section that provide participants and their family members with assistance regarding,
51.9but not limited to:
51.10    (1) obtaining and retaining unsubsidized employment;
51.11    (2) family stability;
51.12    (3) economic stability; and
51.13    (4) barrier reduction.
51.14    The goal of the services is to achieve the greatest degree of economic self-sufficiency
51.15and family well-being possible for the family under the circumstances.
51.16    (e) "Case manager" means the county-designated staff person or employment
51.17services counselor.
51.18    Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP)
51.19participants are eligible for the services under this section:
51.20    (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who
51.21has or is eligible for an employment plan developed under section 256J.521, subdivision
51.222, paragraph (c);
51.23    (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as
51.24unlikely to benefit from the DWP;
51.25    (3) a participant who meets the requirements for or has been granted a hardship
51.26extension under section 256J.425, subdivision 2 or 3;
51.27    (4) a participant who is applying for supplemental security income or Social Security
51.28disability insurance;
51.29    (5) a participant who is a noncitizen who has been in the United States for 12 or
51.30fewer months; and
51.31    (6) a new MFIP participant, for the first 30 days the participant receives assistance or
51.32when the participant's employment plan is completed, whichever is sooner.
51.33    (b) Families must meet all other eligibility requirements for MFIP established in
51.34this chapter. Families are eligible for financial assistance to the same extent as if they
51.35were participating in MFIP.
52.1    (c) A participant under paragraph (a), clause (5), must be provided with English as a
52.2second language opportunities and skills training for up to 12 months. After 12 months,
52.3the case manager and participant must determine whether the participant should continue
52.4with English as a second language classes or skills training, or both, or if the participant
52.5should become an MFIP participant.
52.6    Subd. 4. Universal participation. All caregivers must participate in family
52.7stabilization services as defined in subdivision 2.
52.8    Subd. 5. Case management; family stabilization plans; coordinated services. (a)
52.9The county agency shall provide family stabilization services to families through a case
52.10management model. A case manager shall be assigned to each participating family within
52.1130 days after the family begins to receive financial assistance as a participant of the family
52.12stabilization services. The case manager, with the full involvement of the participant, shall
52.13recommend, and the county agency shall establish and modify as necessary, a family
52.14stabilization plan for each participating family. If a participant is already assigned to a
52.15county case manager or a county-designated case manager in social services, disability
52.16services, or housing services that case manager already assigned may be the case manager
52.17for purposes of these services.
52.18    (b) The family stabilization plan must include:
52.19    (1) each participant's plan for long-term self-sufficiency, including an employment
52.20goal where applicable;
52.21    (2) an assessment of each participant's strengths and barriers, and any special
52.22circumstances of the participant's family that impact, or are likely to impact, the
52.23participant's progress towards the goals in the plan; and
52.24    (3) an identification of the services, supports, education, training, and
52.25accommodations needed to reduce or overcome any barriers to enable the family to
52.26achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
52.27    (c) The case manager and the participant shall meet within 30 days of the family's
52.28referral to the case manager. The initial family stabilization plan must be completed within
52.2930 days of the first meeting with the case manager. The case manager shall establish a
52.30schedule for periodic review of the family stabilization plan that includes personal contact
52.31with the participant at least once per month. In addition, the case manager shall review
52.32and, if necessary, modify the plan under the following circumstances:
52.33    (1) there is a lack of satisfactory progress in achieving the goals of the plan;
52.34    (2) the participant has lost unsubsidized or subsidized employment;
52.35    (3) a family member has failed or is unable to comply with a family stabilization
52.36plan requirement;
53.1    (4) services, supports, or other activities required by the plan are unavailable;
53.2    (5) changes to the plan are needed to promote the well-being of the children; or
53.3    (6) the participant and case manager determine that the plan is no longer appropriate
53.4for any other reason.
53.5    Subd. 6. Cooperation with services requirements. (a) To be eligible, a participant
53.6shall comply with paragraphs (b) to (e).
53.7    (b) Participants shall engage in family stabilization plan services for the appropriate
53.8number of hours per week that the activities are scheduled and available, unless good
53.9cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
53.10number of hours must be based on the participant's plan.
53.11    (c) The case manager shall review the participant's progress toward the goals in the
53.12family stabilization plan every six months to determine whether conditions have changed,
53.13including whether revisions to the plan are needed.
53.14    (d) When the participant has increased participation in work-related activities
53.15sufficient to meet the federal participation requirements of TANF, the county agency shall
53.16refer the participant to the MFIP program and assign the participant to a job counselor.
53.17The participant and the job counselor shall meet within 15 days of referral to the MFIP
53.18program to develop an employment plan under section 256J.521. No reapplication is
53.19necessary and financial assistance continues without interruption.
53.20    (e) A participant's requirement to comply with any or all family stabilization plan
53.21requirements under this subdivision is excused when the case management services,
53.22training and educational services, and family support services identified in the participant's
53.23family stabilization plan are unavailable for reasons beyond the control of the participant,
53.24including when money appropriated is not sufficient to provide the services.
53.25    Subd. 7. Sanctions. (a) The financial assistance grant of a participating family is
53.26reduced according to section 256J.46, if a participating adult fails without good cause to
53.27comply or continue to comply with the family stabilization plan requirements in this
53.28subdivision, unless compliance has been excused under subdivision 6, paragraph (e).
53.29    (b) Given the purpose of the family stabilization services in this section and the
53.30nature of the underlying family circumstances that act as barriers to both employment and
53.31full compliance with program requirements, sanctions are appropriate only when it is clear
53.32that there is both the ability to comply and willful noncompliance by the participant, as
53.33confirmed by a behavioral health or medical professional.
53.34    (c) Prior to the imposition of a sanction, the county agency shall review the
53.35participant's case to determine if the family stabilization plan is still appropriate and
54.1meet with the participant face-to-face. The participant may bring an advocate to the
54.2face-to-face meeting.
54.3    During the face-to-face meeting, the county agency must:
54.4    (1) determine whether the continued noncompliance can be explained and mitigated
54.5by providing a needed family stabilization service, as defined in subdivision 2, paragraph
54.6(d);
54.7    (2) determine whether the participant qualifies for a good cause exemption under
54.8section 256J.57, or if the sanction is for noncooperation with child support requirements,
54.9determine if the participant qualifies for a good cause exemption under section 256.741,
54.10subdivision 10;
54.11    (3) determine whether activities in the family stabilization plan are appropriate
54.12based on the family's circumstances;
54.13    (4) explain the consequences of continuing noncompliance;
54.14    (5) identify other resources that may be available to the participant to meet the
54.15needs of the family; and
54.16    (6) inform the participant of the right to appeal under section 256J.40.
54.17    If the lack of an identified activity or service can explain the noncompliance, the
54.18county shall work with the participant to provide the identified activity.
54.19    (d) If the participant fails to come to the face-to-face meeting, the case manager or a
54.20designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
54.21the county agency shall send the participant a written notice that includes the information
54.22under paragraph (c).
54.23    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
54.24of a sanction, the county agency shall provide a notice of intent to sanction under section
54.25256J.57, subdivision 2, and, when applicable, a notice of adverse action under section
54.26256J.31.
54.27    (f) Section 256J.57 applies to this section except to the extent that it is modified
54.28by this subdivision.
54.29    Subd. 8. Funding. (a) The commissioner of human services must treat MFIP
54.30expenditures made to or on behalf of any minor child under this section, who is part of a
54.31household that meets criteria in subdivision 3, as expenditures under a separately funded
54.32state program. These expenditures shall not count toward the state's maintenance of effort
54.33requirements under the federal TANF program.
54.34    (b) A family is no longer part of a separately funded program under this section, if
54.35the caregiver no longer meets the criteria for family stabilization services in subdivision
55.13 or if it is determined at recertification that the caregiver is meeting the federal work
55.2participation rate, whichever occurs sooner.

55.3    Sec. 44. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:
55.4    Subdivision 1. Consolidated fund. The consolidated fund is established to support
55.5counties and tribes in meeting their duties under this chapter. Counties and tribes must use
55.6funds from the consolidated fund to develop programs and services that are designed to
55.7improve participant outcomes as measured in section 256J.751, subdivision 2. Counties
55.8may use the funds for any allowable expenditures under subdivision 2, and to provide case
55.9management services to participants of the family stabilization services program. Tribes
55.10may use the funds for any allowable expenditures under subdivision 2, except those in
55.11subdivision 2, paragraph (a), clauses (1) and (6).

55.12    Sec. 45. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:
55.13    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures
55.14under the consolidated fund to benefits and services allowed under title IV-A of the federal
55.15Social Security Act. Allowable expenditures under the consolidated fund may include, but
55.16are not limited to:
55.17    (1) short-term, nonrecurring shelter and utility needs that are excluded from the
55.18definition of assistance under Code of Federal Regulations, title 45, section 260.31, for
55.19families who meet the residency requirement in section 256J.12, subdivisions 1 and 1a.
55.20Payments under this subdivision are not considered TANF cash assistance and are not
55.21counted towards the 60-month time limit;
55.22    (2) transportation needed to obtain or retain employment or to participate in other
55.23approved work activities or activities under a family stabilization plan;
55.24    (3) direct and administrative costs of staff to deliver employment services for
55.25MFIP or, the diversionary work program, or the family stabilization services program;
55.26 to administer financial assistance,; and to provide specialized services intended to assist
55.27hard-to-employ participants to transition to work or transition from the family stabilization
55.28services program to MFIP;
55.29    (4) costs of education and training including functional work literacy and English as
55.30a second language;
55.31    (5) cost of work supports including tools, clothing, boots, telephone service, and
55.32other work-related expenses;
55.33    (6) county administrative expenses as defined in Code of Federal Regulations, title
55.3445, section 260(b);
56.1    (7) services to parenting and pregnant teens;
56.2    (8) supported work;
56.3    (9) wage subsidies;
56.4    (10) child care needed for MFIP or, the diversionary work program, or the family
56.5stabilization services program participants to participate in social services;
56.6    (11) child care to ensure that families leaving MFIP or diversionary work program
56.7will continue to receive child care assistance from the time the family no longer qualifies
56.8for transition year child care until an opening occurs under the basic sliding fee child
56.9care program; and
56.10    (12) services to help noncustodial parents who live in Minnesota and have minor
56.11children receiving MFIP or DWP assistance, but do not live in the same household as the
56.12child, obtain or retain employment; and
56.13    (13) services to help families participating in the family stabilization services
56.14program achieve the greatest possible degree of self-sufficiency.
56.15    (b) Administrative costs that are not matched with county funds as provided in
56.16subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation
56.17under this section. The commissioner shall define administrative costs for purposes of
56.18this subdivision.
56.19    (c) The commissioner may waive the cap on administrative costs for a county or tribe
56.20that elects to provide an approved supported employment, unpaid work, or community
56.21work experience program for a major segment of the county's or tribe's MFIP population.
56.22The county or tribe must apply for the waiver on forms provided by the commissioner. In
56.23no case shall total administrative costs exceed the TANF limits.

56.24    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:
56.25    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman,
56.26or a noncustodial parent of a minor child receiving assistance, with incomes below 200
56.27percent of the federal poverty guideline for a family of the applicable size, are eligible
56.28for services funded under the consolidated fund. Counties and tribes must give priority
56.29to families currently receiving MFIP or, the diversionary work program, or the family
56.30stabilization services program, and families at risk of receiving MFIP or diversionary
56.31work program.

56.32    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:
56.33    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1,
56.342004, and each two-year period thereafter, each county and tribe must have in place an
57.1approved biennial service agreement related to the services and programs in this chapter.
57.2In counties with a city of the first class with a population over 300,000, the county must
57.3consider a service agreement that includes a jointly developed plan for the delivery of
57.4employment services with the city. Counties may collaborate to develop multicounty,
57.5multitribal, or regional service agreements.
57.6    (b) The service agreements will be completed in a form prescribed by the
57.7commissioner. The agreement must include:
57.8    (1) a statement of the needs of the service population and strengths and resources
57.9in the community;
57.10    (2) numerical goals for participant outcomes measures to be accomplished during
57.11the biennial period. The commissioner may identify outcomes from section 256J.751,
57.12subdivision 2 , as core outcomes for all counties and tribes;
57.13    (3) strategies the county or tribe will pursue to achieve the outcome targets.
57.14Strategies must include specification of how funds under this section will be used and may
57.15include community partnerships that will be established or strengthened; and
57.16    (4) strategies the county or tribe will pursue under the family stabilization services
57.17program; and
57.18    (5) other items prescribed by the commissioner in consultation with counties and
57.19tribes.
57.20    (c) The commissioner shall provide each county and tribe with information needed
57.21to complete an agreement, including: (1) information on MFIP cases in the county or
57.22tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome
57.23measures; and (4) promising program practices.
57.24    (d) The service agreement must be submitted to the commissioner by October 15,
57.252003, and October 15 of each second year thereafter. The county or tribe must allow
57.26a period of not less than 30 days prior to the submission of the agreement to solicit
57.27comments from the public on the contents of the agreement.
57.28    (e) The commissioner must, within 60 days of receiving each county or tribal service
57.29agreement, inform the county or tribe if the service agreement is approved. If the service
57.30agreement is not approved, the commissioner must inform the county or tribe of any
57.31revisions needed prior to approval.
57.32    (f) The service agreement in this subdivision supersedes the plan requirements
57.33of section 116L.88.

57.34    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:
58.1    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000
58.2of the funds annually appropriated to the commissioner for use in the consolidated
58.3fund shall be available to the commissioner for projects testing innovative approaches
58.4to improving outcomes for MFIP participants, family stabilization services program
58.5participants, and persons at risk of receiving MFIP as detailed in subdivision 3, and
58.6for providing incentives to counties and tribes that exceed performance. Projects shall
58.7be targeted to geographic areas with poor outcomes as specified in section 256J.751,
58.8subdivision 5 , or to subgroups within the MFIP case load who are experiencing poor
58.9outcomes. For purposes of an incentive, a county or tribe exceeds performance if the
58.10county or tribe is above the top of the county's or tribe's annualized range of expected
58.11performance on the three-year self-support index under section 256J.751, subdivision 2,
58.12clause (7), and achieves a 50 percent TANF participation rate under section 256J.751,
58.13subdivision 2, clause (7), as averaged across the four quarterly measurements for the most
58.14recent year for which the measurements are available.

58.15    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:
58.16    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of
58.17this section, the following terms have the meanings given.
58.18    (1) "2002 historic spending base" means the commissioner's determination of
58.19the sum of the reimbursement related to fiscal year 2002 of county or tribal agency
58.20expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings
58.21related to calendar year 2002 in the base program listed in clause (6), item (v), and the
58.22amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi),
58.23issued to or on behalf of persons residing in the county or tribal service delivery area.
58.24    (2) "Adjusted caseload factor" means a factor weighted:
58.25    (i) 47 percent on the MFIP cases in each county at four points in time in the most
58.26recent 12-month period for which data is available multiplied by the county's caseload
58.27difficulty factor; and
58.28    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points
58.29in time in the most recent 12-month period for which data is available multiplied by the
58.30county or tribe's caseload difficulty factor.
58.31    (3) "Caseload difficulty factor" means a factor determined by the commissioner for
58.32each county and tribe based upon the self-support index described in section 256J.751,
58.33subdivision 2 , clause (7).
58.34    (4) "Initial allocation" means the amount potentially available to each county or tribe
58.35based on the formula in paragraphs (b) through (h).
59.1    (5) "Final allocation" means the amount available to each county or tribe based on
59.2the formula in paragraphs (b) through (h), after adjustment by subdivision 7.
59.3    (6) "Base programs" means the:
59.4    (i) MFIP employment and training services under Minnesota Statutes 2002, section
59.5256J.62, subdivision 1 , in effect June 30, 2002;
59.6    (ii) bilingual employment and training services to refugees under Minnesota Statutes
59.72002, section 256J.62, subdivision 6, in effect June 30, 2002;
59.8    (iii) work literacy language programs under Minnesota Statutes 2002, section
59.9256J.62, subdivision 7 , in effect June 30, 2002;
59.10    (iv) supported work program authorized in Laws 2001, First Special Session chapter
59.119, article 17, section 2, in effect June 30, 2002;
59.12    (v) administrative aid program under section 256J.76 in effect December 31, 2002;
59.13and
59.14    (vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48,
59.15in effect June 30, 2002.
59.16    (b) The commissioner shall:
59.17    (1) beginning July 1, 2003, determine the initial allocation of funds available under
59.18this section according to clause (2);
59.19    (2) allocate all of the funds available for the period beginning July 1, 2003, and
59.20ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's
59.21share of the statewide 2002 historic spending base;
59.22    (3) determine for calendar year 2005 the initial allocation of funds to be made
59.23available under this section in proportion to the county or tribe's initial allocation for the
59.24period of July 1, 2003, to December 31, 2004;
59.25    (4) determine for calendar year 2006 the initial allocation of funds to be made
59.26available under this section based 90 percent on the proportion of the county or tribe's
59.27share of the statewide 2002 historic spending base and ten percent on the proportion of
59.28the county or tribe's share of the adjusted caseload factor;
59.29    (5) determine for calendar year 2007 the initial allocation of funds to be made
59.30available under this section based 70 percent on the proportion of the county or tribe's
59.31share of the statewide 2002 historic spending base and 30 percent on the proportion of the
59.32county or tribe's share of the adjusted caseload factor; and
59.33    (6) determine for calendar year 2008 and subsequent years the initial allocation of
59.34funds to be made available under this section based 50 percent on the proportion of the
59.35county or tribe's share of the statewide 2002 historic spending base and 50 percent on the
59.36proportion of the county or tribe's share of the adjusted caseload factor.
60.1    (c) With the commencement of a new or expanded tribal TANF program or an
60.2agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of
60.3the responsibilities of particular counties under this section are transferred to a tribe,
60.4the commissioner shall:
60.5    (1) in the case where all responsibilities under this section are transferred to a tribal
60.6program, determine the percentage of the county's current caseload that is transferring to a
60.7tribal program and adjust the affected county's allocation accordingly; and
60.8    (2) in the case where a portion of the responsibilities under this section are
60.9transferred to a tribal program, the commissioner shall consult with the affected county or
60.10counties to determine an appropriate adjustment to the allocation.
60.11    (d) Effective January 1, 2005, counties and tribes will have their final allocations
60.12adjusted based on the performance provisions of subdivision 7.

60.13    Sec. 50. Minnesota Statutes 2006, section 256J.751, subdivision 2, is amended to read:
60.14    Subd. 2. Quarterly comparison report. The commissioner shall report quarterly to
60.15all counties on each county's performance on the following measures:
60.16    (1) percent of MFIP caseload working in paid employment;
60.17    (2) percent of MFIP caseload receiving only the food portion of assistance;
60.18    (3) number of MFIP cases that have left assistance;
60.19    (4) median placement wage rate;
60.20    (5) caseload by months of TANF assistance;
60.21    (6) percent of MFIP and diversionary work program (DWP) cases off cash assistance
60.22or working 30 or more hours per week at one-year, two-year, and three-year follow-up
60.23points from a baseline quarter. This measure is called the self-support index. The
60.24commissioner shall report quarterly an expected range of performance for each county,
60.25county grouping, and tribe on the self-support index. The expected range shall be derived
60.26by a statistical methodology developed by the commissioner in consultation with the
60.27counties and tribes. The statistical methodology shall control differences across counties
60.28in economic conditions and demographics of the MFIP and DWP case load; and
60.29    (7) the MFIP TANF work participation rate, defined as the participation requirements
60.30specified in title 1 of Public Law 104-193 applied to all MFIP cases except child only
60.31cases under Public Law 109-171, the Deficit Reduction Act of 2005.

60.32    Sec. 51. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:
60.33    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur
60.34for failure to meet the performance standards specified in title 1 of Public Law 104-193
61.1of the Personal Responsibility and Work Opportunity Act of 1996, and under Public
61.2Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the
61.3sanction. The remaining 12 percent of the sanction will be paid by the counties. The
61.4county portion of the sanction will be distributed across all counties in proportion to each
61.5county's percentage of the MFIP average monthly caseload during the period for which
61.6the sanction was applied.
61.7    (b) If a county fails to meet the performance standards specified in title 1 of Public
61.8Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and
61.9Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner
61.10shall work with counties to organize a joint state-county technical assistance team to work
61.11with the county. The commissioner shall coordinate any technical assistance with other
61.12departments and agencies including the Departments of Employment and Economic
61.13Development and Education as necessary to achieve the purpose of this paragraph.
61.14    (c) For state performance measures, a low-performing county is one that:
61.15    (1) performs below the bottom of their expected range for the measure in subdivision
61.162, clause (7) (6), in an annualized measurement reported in October of each year; or
61.17    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as
61.18averaged across the four quarterly measurements for the year, or the ten counties with the
61.19lowest rates if more than ten are below 40 percent.
61.20    (d) Low-performing counties under paragraph (c) must engage in corrective action
61.21planning as defined by the commissioner. The commissioner may coordinate technical
61.22assistance as specified in paragraph (b) for low-performing counties under paragraph (c).

61.23    Sec. 52. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:
61.24    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
61.25of family units listed below, all family units who apply for cash benefits and who
61.26meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must
61.27participate in the diversionary work program. Family units that are not eligible for the
61.28diversionary work program include:
61.29    (1) child only cases;
61.30    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent
61.31is eligible for this exception once in a parent's lifetime and is not eligible if the parent
61.32has already used the previously allowed child under age one exemption from MFIP
61.33employment services;
61.34    (3) a minor parent without a high school diploma or its equivalent;
62.1    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
62.2who chooses to have an employment plan with an education option;
62.3    (5) a caregiver age 60 or over;
62.4    (6) family units with a caregiver who received DWP benefits in the 12 months prior
62.5to the month the family applied for DWP, except as provided in paragraph (c);
62.6    (7) family units with a caregiver who received MFIP within the 12 months prior to
62.7the month the family unit applied for DWP;
62.8    (8) a family unit with a caregiver who received 60 or more months of TANF
62.9assistance; and
62.10    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
62.11fraud.; and
62.12    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section
62.13444.43, who arrived in the United States in the 12 months prior to the date of application
62.14for family cash assistance.
62.15    (b) A two-parent family must participate in DWP unless both caregivers meet the
62.16criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
62.17includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).
62.18    (c) Once DWP eligibility is determined, the four months run consecutively. If a
62.19participant leaves the program for any reason and reapplies during the four-month period,
62.20the county must redetermine eligibility for DWP.
62.21EFFECTIVE DATE.This section is effective the day following final enactment.

62.22    Sec. 53. Minnesota Statutes 2006, section 256J.95, subdivision 13, is amended to read:
62.23    Subd. 13. Immediate referral to employment services. Within one working day of
62.24determination that the applicant is eligible for the diversionary work program, but before
62.25benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to
62.26employment services. The referral to the DWP employment services must be in writing
62.27and must contain the following information:
62.28    (1) notification that, as part of the application process, applicants are required to
62.29develop an employment plan or the DWP application will be denied;
62.30    (2) the employment services provider name and phone number;
62.31    (3) the date, time, and location of the scheduled employment services interview;
62.32    (4) (3) the immediate availability of supportive services, including, but not limited
62.33to, child care, transportation, and other work-related aid; and
63.1    (5) (4) the rights, responsibilities, and obligations of participants in the program,
63.2including, but not limited to, the grounds for good cause, the consequences of refusing or
63.3failing to participate fully with program requirements, and the appeal process.

63.4    Sec. 54. Minnesota Statutes 2006, section 256K.45, is amended by adding a
63.5subdivision to read:
63.6    Subd. 6. Funding. Any funds appropriated for this section may be expended
63.7on programs described under subdivisions 3 to 5, technical assistance, and capacity
63.8building. In addition, up to five percent of funds appropriated may be used for program
63.9administration and up to eight percent of funds appropriated may be used for the purpose
63.10of monitoring and evaluating runaway and homeless youth programs receiving funding
63.11under this section. Funding shall be directed to meet the greatest need, with a significant
63.12share of the funding focused on homeless youth providers in greater Minnesota.

63.13    Sec. 55. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:
63.14    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's
63.15written consent to adoption by a particular person is also shall be necessary. A child
63.16of any age who is under the guardianship of the commissioner and is legally available
63.17for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to
63.18recruit, identify, and place the child in an adoptive home required under section 260C.317,
63.19subdivision 3, paragraph (b), or sign a document relieving county social services agencies
63.20of all recruitment efforts on the child's behalf.

63.21    Sec. 56. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:
63.22    Subdivision 1. Notice to commissioner; referral for postplacement assessment.
63.23    (a) Upon the filing of a petition for adoption of a child who is:
63.24    (1) under the guardianship of the commissioner or a licensed child-placing agency
63.25according to section 260C.201, subdivision 11, or 260C.317;
63.26    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
63.27agency after a consent to adopt according to section 259.24 or under an agreement
63.28conferring authority to place for adoption according to section 259.25; or
63.29    (3) placed by preadoptive custody order for a direct adoptive placement ordered
63.30by the district court under section 259.47,
63.31the court administrator shall immediately transmit a copy of the petition to the
63.32commissioner of human services.
64.1    (b) The court shall immediately refer the petition to the agency specified below for
64.2completion of a postplacement assessment and report as required by subdivision 2.
64.3    (1) If the child to be adopted has been committed to the guardianship of the
64.4commissioner or an agency under section 260C.317 or an agency has been given authority
64.5to place the child under section 259.25, the court shall refer the petition to that agency,
64.6unless another agency is supervising the placement, in which case the court shall refer the
64.7petition to the supervising agency.
64.8    (2) If the child to be adopted has been placed in the petitioner's home by a direct
64.9adoptive placement, the court shall refer the petition to the agency supervising the
64.10placement under section 259.47, subdivision 3, paragraph (a), clause (6).
64.11    (3) If the child is to be adopted by an individual who is related to the child as defined
64.12by section 245A.02, subdivision 13, and in all other instances not described in clause (1)
64.13or (2), the court shall refer the petition to the local social services agency of the county in
64.14which the prospective adoptive parent lives.

64.15    Sec. 57. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:
64.16    Subdivision 1. Findings; orders. Upon the hearing,
64.17    (a) if the court finds that it is in the best interests of the child that the petition
64.18be granted, a decree of adoption shall be made and recorded in the office of the court
64.19administrator, ordering that henceforth the child shall be the child of the petitioner. In the
64.20decree the court may change the name of the child if desired. After the decree is granted
64.21for a child who is:
64.22    (1) under the guardianship of the commissioner or a licensed child-placing agency
64.23according to section 260C.201, subdivision 11, or 260C.317;
64.24    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
64.25agency after a consent to adopt according to section 259.24 or under an agreement
64.26conferring authority to place for adoption according to section 259.25; or
64.27    (3) adopted after a direct adoptive placement ordered by the district court under
64.28section 259.47,
64.29the court administrator shall immediately mail a copy of the recorded decree to the
64.30commissioner of human services;
64.31    (b) if the court is not satisfied that the proposed adoption is in the best interests
64.32of the child, the court shall deny the petition, and shall order the child returned to the
64.33custody of the person or agency legally vested with permanent custody or certify the
64.34case for appropriate action and disposition to the court having jurisdiction to determine
64.35the custody and guardianship of the child.

65.1    Sec. 58. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:
65.2    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC
65.3requirements as specified in federal law as of July 16, 1996, when determining the child's
65.4eligibility for adoption assistance under title IV-E of the Social Security Act. If the child
65.5does not qualify, the placing agency shall certify a child as eligible for state funded
65.6adoption assistance only if the following criteria are met:
65.7    (1) Due to the child's characteristics or circumstances it would be difficult to provide
65.8the child an adoptive home without adoption assistance.
65.9    (2)(i) A placement agency has made reasonable efforts to place the child for adoption
65.10without adoption assistance, but has been unsuccessful; or
65.11    (ii) the child's licensed foster parents desire to adopt the child and it is determined by
65.12the placing agency that the adoption is in the best interest of the child.
65.13    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed
65.14child-placing agency, or a tribal social service agency of Minnesota recognized by the
65.15Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a
65.16termination of parental rights or relinquishment, provided that the tribe has documented
65.17the valid reason why the child cannot or should not be returned to the home of the child's
65.18parent. The placing agency shall not certify a child who remains under the jurisdiction
65.19of the sending agency pursuant to section 260.851, article 5, for state-funded adoption
65.20assistance when Minnesota is the receiving state.
65.21    (b) For purposes of this subdivision, the characteristics or circumstances that may
65.22be considered in determining whether a child is a child with special needs under United
65.23States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of
65.24paragraph (a), clause (1), are the following:
65.25    (1) The child is a member of a sibling group to be placed as one unit in which at
65.26least one sibling is older than 15 months of age or is described in clause (2) or (3).
65.27    (2) The child has documented physical, mental, emotional, or behavioral disabilities.
65.28    (3) The child has a high risk of developing physical, mental, emotional, or behavioral
65.29disabilities.
65.30    (4) The child is adopted according to tribal law without a termination of parental
65.31rights or relinquishment, provided that the tribe has documented the valid reason why the
65.32child cannot or should not be returned to the home of the child's parent.
65.33    (4) The child is five years of age or older.
65.34    (c) When a child's eligibility for adoption assistance is based upon the high risk of
65.35developing physical, mental, emotional, or behavioral disabilities, payments shall not be
66.1made under the adoption assistance agreement unless and until the potential disability
66.2manifests itself as documented by an appropriate health care professional.

66.3    Sec. 59. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:
66.4    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and
66.5the provisions of this subdivision a child-placing agency licensed in Minnesota or any
66.6other state, or local or tribal social services agency shall receive a reimbursement from the
66.7commissioner equal to 100 percent of the reasonable and appropriate cost of providing
66.8adoption services for a child certified as eligible for adoption assistance under subdivision
66.94. Such assistance. Adoption services under this subdivision may include adoptive family
66.10recruitment, counseling, and special training when needed.
66.11    (b) An eligible child must have a goal of adoption, which may include an adoption
66.12in accordance with tribal law, and meet one of the following criteria:
66.13    (1) is a ward of the commissioner of human services or a ward of tribal court
66.14pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision
66.154, paragraph (b), clause (1), (2), or (3); or
66.16    (2) is under the guardianship of a Minnesota-licensed child-placing agency who
66.17meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).
66.18    (c) A child-placing agency licensed in Minnesota or any other state shall receive
66.19reimbursement for adoption services it purchases for or directly provides to an eligible
66.20child. Tribal social services shall receive reimbursement for adoption services it purchases
66.21for or directly provides to an eligible child. A local or tribal social services agency shall
66.22receive such reimbursement only for adoption services it purchases for an eligible child.
66.23    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal
66.24social services agency seeking reimbursement under this subdivision shall enter into
66.25Before providing adoption services for which reimbursement will be sought under this
66.26subdivision, a reimbursement agreement, on the designated format, must be entered into
66.27with the commissioner before providing adoption services for which reimbursement
66.28is sought. No reimbursement under this subdivision shall be made to an agency for
66.29services provided prior to entering a reimbursement agreement. Separate reimbursement
66.30agreements shall be made for each child and separate records shall be kept on each child
66.31for whom a reimbursement agreement is made. The commissioner of human services shall
66.32agree that the reimbursement costs are reasonable and appropriate. The commissioner
66.33may spend up to $16,000 for each purchase of service agreement. Only one agreement per
66.34child is allowed, unless an exception is granted by the commissioner. Funds encumbered
67.1and obligated under such an agreement for the child remain available until the terms of
67.2the agreement are fulfilled or the agreement is terminated.
67.3    (c) When a local or tribal social services agency uses a purchase of service agreement
67.4to provide services reimbursable under a reimbursement agreement, The commissioner
67.5may shall make reimbursement payments directly to the agency providing the service if
67.6direct reimbursement is specified by the purchase of service agreement, and if the request
67.7for reimbursement is submitted by the local or tribal social services agency along with a
67.8verification that the service was provided.

67.9    Sec. 60. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:
67.10    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state
67.11adoption exchange shall be only for one or more of the following reasons:
67.12    (a) the child is in an adoptive placement but is not legally adopted;
67.13    (b) the child's foster parents or other individuals are now considering adoption;
67.14    (c) diagnostic study or testing is required to clarify the child's problem and provide
67.15an adequate description; or
67.16    (d) the child is currently in a hospital and continuing need for daily professional care
67.17will not permit placement in a family setting; or.
67.18    (e) the child is 14 years of age or older and will not consent to an adoption plan.
67.19Approval of a request to defer listing for any of the reasons specified in paragraph (b) or
67.20(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for
67.21those reasons.

67.22    Sec. 61. Minnesota Statutes 2006, section 260.012, is amended to read:
67.23260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
67.24REUNIFICATION; REASONABLE EFFORTS.
67.25    (a) Once a child alleged to be in need of protection or services is under the court's
67.26jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
67.27services, by the social services agency are made to prevent placement or to eliminate the
67.28need for removal and to reunite the child with the child's family at the earliest possible
67.29time, and when a child cannot be reunified with the parent or guardian from whom the
67.30child was removed, the court must ensure that the responsible social services agency
67.31makes reasonable efforts to finalize an alternative permanent plan for the child as provided
67.32in paragraph (e). In determining reasonable efforts to be made with respect to a child and
67.33in making those reasonable efforts, the child's best interests, health, and safety must be of
67.34paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
68.1reunification are always required except upon a determination by the court that a petition
68.2has been filed stating a prima facie case that:
68.3    (1) the parent has subjected a child to egregious harm as defined in section
68.4260C.007, subdivision 14 ;
68.5    (2) the parental rights of the parent to another child have been terminated
68.6involuntarily;
68.7    (3) the child is an abandoned infant under section 260C.301, subdivision 2,
68.8paragraph (a), clause (2);
68.9    (4) the parent's custodial rights to another child have been involuntarily transferred
68.10to a relative under section 260C.201, subdivision 11, paragraph (e), clause (1), or a similar
68.11law of another jurisdiction; or
68.12    (5) the provision of services or further services for the purpose of reunification is
68.13futile and therefore unreasonable under the circumstances.
68.14    (b) When the court makes one of the prima facie determinations under paragraph (a),
68.15either permanency pleadings under section 260C.201, subdivision 11, or a termination
68.16of parental rights petition under sections 260C.141 and 260C.301 must be filed. A
68.17permanency hearing under section 260C.201, subdivision 11, must be held within 30
68.18days of this determination.
68.19    (c) In the case of an Indian child, in proceedings under sections 260B.178 or
68.20260C.178 , 260C.201, and 260C.301 the juvenile court must make findings and conclusions
68.21consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section
68.221901 et seq., as to the provision of active efforts. In cases governed by the Indian Child
68.23Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social
68.24services agency must provide active efforts as required under United States Code, title
68.2525, section 1911(d).
68.26    (d) "Reasonable efforts to prevent placement" means:
68.27    (1) the agency has made reasonable efforts to prevent the placement of the child in
68.28foster care; or
68.29    (2) given the particular circumstances of the child and family at the time of the
68.30child's removal, there are no services or efforts available which could allow the child to
68.31safely remain in the home.
68.32    (e) "Reasonable efforts to finalize a permanent plan for the child" means due
68.33diligence by the responsible social services agency to:
68.34    (1) reunify the child with the parent or guardian from whom the child was removed;
69.1    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
69.2where appropriate, provide services necessary to enable the noncustodial parent to safely
69.3provide the care, as required by section 260C.212, subdivision 4;
69.4    (3) conduct a relative search as required under section 260C.212, subdivision 5; and
69.5    (4) when the child cannot return to the parent or guardian from whom the child was
69.6removed, to plan for and finalize a safe and legally permanent alternative home for the
69.7child, and considers permanent alternative homes for the child inside or outside of the
69.8state, preferably through adoption or transfer of permanent legal and physical custody of
69.9the child.
69.10    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible
69.11social services agency to use culturally appropriate and available services to meet the
69.12needs of the child and the child's family. Services may include those provided by the
69.13responsible social services agency and other culturally appropriate services available in
69.14the community. At each stage of the proceedings where the court is required to review
69.15the appropriateness of the responsible social services agency's reasonable efforts as
69.16described in paragraphs (a), (d), and (e), the social services agency has the burden of
69.17demonstrating that:
69.18    (1) it has made reasonable efforts to prevent placement of the child in foster care;
69.19    (2) it has made reasonable efforts to eliminate the need for removal of the child from
69.20the child's home and to reunify the child with the child's family at the earliest possible time;
69.21    (3) it has made reasonable efforts to finalize an alternative permanent home for
69.22the child, and considers permanent alternative homes for the child inside or outside of
69.23the state; or
69.24    (4) reasonable efforts to prevent placement and to reunify the child with the parent
69.25or guardian are not required. The agency may meet this burden by stating facts in a sworn
69.26petition filed under section 260C.141, by filing an affidavit summarizing the agency's
69.27reasonable efforts or facts the agency believes demonstrate there is no need for reasonable
69.28efforts to reunify the parent and child, or through testimony or a certified report required
69.29under juvenile court rules.
69.30    (g) Once the court determines that reasonable efforts for reunification are not
69.31required because the court has made one of the prima facie determinations under paragraph
69.32(a), the court may only require reasonable efforts for reunification after a hearing according
69.33to section 260C.163, where the court finds there is not clear and convincing evidence of
69.34the facts upon which the court based its prima facie determination. In this case when there
69.35is clear and convincing evidence that the child is in need of protection or services, the
69.36court may find the child in need of protection or services and order any of the dispositions
70.1available under section 260C.201, subdivision 1. Reunification of a surviving child with a
70.2parent is not required if the parent has been convicted of:
70.3    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections
70.4609.185 to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the
70.5parent;
70.6    (2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the
70.7surviving child; or
70.8    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States
70.9Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.
70.10    (h) The juvenile court, in proceedings under sections 260B.178 or 260C.178,
70.11260C.201 , and 260C.301 shall make findings and conclusions as to the provision of
70.12reasonable efforts. When determining whether reasonable efforts have been made, the
70.13court shall consider whether services to the child and family were:
70.14    (1) relevant to the safety and protection of the child;
70.15    (2) adequate to meet the needs of the child and family;
70.16    (3) culturally appropriate;
70.17    (4) available and accessible;
70.18    (5) consistent and timely; and
70.19    (6) realistic under the circumstances.
70.20    In the alternative, the court may determine that provision of services or further
70.21services for the purpose of rehabilitation is futile and therefore unreasonable under the
70.22circumstances or that reasonable efforts are not required as provided in paragraph (a).
70.23    (i) This section does not prevent out-of-home placement for treatment of a child with
70.24a mental disability when the child's diagnostic assessment or individual treatment plan
70.25indicates that appropriate and necessary treatment cannot be effectively provided outside
70.26of a residential or inpatient treatment program.
70.27    (j) If continuation of reasonable efforts to prevent placement or reunify the child
70.28with the parent or guardian from whom the child was removed is determined by the court
70.29to be inconsistent with the permanent plan for the child or upon the court making one of
70.30the prima facie determinations under paragraph (a), reasonable efforts must be made to
70.31place the child in a timely manner in a safe and permanent home and to complete whatever
70.32steps are necessary to legally finalize the permanent placement of the child.
70.33    (k) Reasonable efforts to place a child for adoption or in another permanent
70.34placement may be made concurrently with reasonable efforts to prevent placement or to
70.35reunify the child with the parent or guardian from whom the child was removed. When
70.36the responsible social services agency decides to concurrently make reasonable efforts for
71.1both reunification and permanent placement away from the parent under paragraph (a), the
71.2agency shall disclose its decision and both plans for concurrent reasonable efforts to all
71.3parties and the court. When the agency discloses its decision to proceed on both plans for
71.4reunification and permanent placement away from the parent, the court's review of the
71.5agency's reasonable efforts shall include the agency's efforts under both plans.

71.6    Sec. 62. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:
71.7    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or
71.8other organized group or community of Indians recognized as eligible for the services
71.9provided to Indians by the secretary because of their status as Indians, including any band
71.10Native group under the Alaska Native Claims Settlement Act, United States Code, title 43,
71.11section 1602, and exercising tribal governmental powers.

71.12    Sec. 63. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:
71.13    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized
71.14jurisdiction over child custody proceedings and which is either a court of Indian offenses,
71.15or a court established and operated under the code or custom of an Indian tribe, or the
71.16any other administrative body of a tribe which is vested with authority over child custody
71.17proceedings. Except as provided in section 260.771, subdivision 5, nothing in this chapter
71.18shall be construed as conferring jurisdiction on an Indian tribe.

71.19    Sec. 64. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:
71.20    Subd. 7. Identification of extended family members. Any agency considering
71.21placement of an Indian child shall make reasonable active efforts to identify and locate
71.22extended family members.

71.23    Sec. 65. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:
71.24    Subd. 5. Identification of extended family members. Any agency considering
71.25placement of an Indian child shall make reasonable active efforts to identify and locate
71.26extended family members.

71.27    Sec. 66. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:
71.28    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has
71.29exclusive jurisdiction over a child placement proceeding involving an Indian child who
71.30resides or is domiciled within the reservation of such the tribe at the commencement of
71.31the proceedings, except where jurisdiction is otherwise vested in the state by existing
72.1federal law. When an Indian child is in the legal custody of a person or agency pursuant
72.2to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction,
72.3notwithstanding the residence or domicile of the child.

72.4    Sec. 67. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:
72.5    Subd. 2. Court determination of tribal affiliation of child. In any child placement
72.6proceeding, the court shall establish whether an Indian child is involved and the identity
72.7of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are
72.8applicable without exception in any child custody proceeding, as defined in the federal act,
72.9involving an Indian child. This chapter applies to child custody proceedings involving
72.10an Indian child whether the child is in the physical or legal custody of an Indian parent,
72.11Indian custodian, Indian extended family member, or other person at the commencement
72.12of the proceedings. A court shall not determine the applicability of this chapter or the
72.13federal Indian Child Welfare Act to a child custody proceeding based upon whether an
72.14Indian child is part of an existing Indian family or based upon the level of contact a child
72.15has with the child's Indian tribe, reservation, society, or off-reservation community.

72.16    Sec. 68. [260.852] PLACEMENT PROCEDURES.
72.17    Subdivision 1. Home study. The state must have procedures for the orderly and
72.18timely interstate placement of children that are implemented in accordance with an
72.19interstate compact and that, within 60 days after the state receives from another state a
72.20request to conduct a study of a home environment for purposes of assessing the safety
72.21and suitability of placing a child in the home, the state shall, directly or by contract,
72.22conduct and complete a home study and return to the other state a report on the results of
72.23the study, which shall address the extent to which placement in the home would meet the
72.24needs of the child; except in the case of a home study begun before October 1, 2008, if the
72.25state fails to comply with conducting and completing the home study within the 60-day
72.26period and this is as a result of circumstances beyond the control of the state, the state has
72.2775 days to comply if the state documents the circumstances involved and certifies that
72.28completing the home study is in the best interests of the child.
72.29    This subdivision does not require the completion within the applicable period of
72.30the parts of the home study involving the education and training of the prospective foster
72.31or adoptive parents.
72.32    Subd. 2. Effect of received report. The state shall treat any report described in
72.33subdivision 1 that is received from another state, an Indian tribe, or a private agency
72.34under contract with another state or Indian tribe as meeting any requirements imposed by
73.1the state for the completion of a home study before placing a child in the home, unless,
73.2within 14 days after receipt of the report, the state determines, based on grounds that
73.3are specific to the content of the report, that making a decision in reliance on the report
73.4would be contrary to the welfare of the child.
73.5    Subd. 3. Resources. The state shall make effective use of cross-jurisdictional
73.6resources, including through contract for the purchase of services, and shall eliminate
73.7legal barriers to facilitate timely adoptive or permanent placements for waiting children.
73.8The state shall not impose any restriction on the use of private agencies for the purpose of
73.9conducting a home study to meet the 60-day requirement.
73.10    Subd. 4. Incentive eligibility. Minnesota is an incentive-eligible state and must:
73.11    (1) have an approved plan as required by the United States Secretary of Health
73.12and Human Services;
73.13    (2) be in compliance with the data requirements of the United States Department of
73.14Health and Human Services; and
73.15    (3) have data that verify that a home study is completed within 30 days.
73.16    Subd. 5. Data requirements. The state shall provide to the United States Secretary
73.17of Health and Human Services a written report, covering the preceding fiscal year, that
73.18specifies:
73.19    (1) the total number of interstate home studies requested by the state with respect
73.20to children in foster care under the responsibility of the state, and with respect to each
73.21study, the identity of the other state involved;
73.22    (2) the total number of timely interstate home studies completed by the state with
73.23respect to children in foster care under the responsibility of other states and, with respect
73.24to each study, the identity of the other state involved; and
73.25    (3) other information the United States Secretary of Health and Human Services
73.26requires in order to determine whether Minnesota is a home study incentive-eligible state.
73.27    Subd. 6. Definitions. (a) The definitions in this subdivision apply to this section.
73.28    (b) "Home study" means an evaluation of a home environment conducted in
73.29accordance with applicable requirements of the state in which the home is located, to
73.30determine whether a proposed placement of a child would meet the individual needs of the
73.31child, including the child's safety; permanency; health; well-being; and mental, emotional,
73.32and physical development.
73.33    (c) "Interstate home study" means a home study conducted by a state at the request
73.34of another state to facilitate an adoptive or foster placement in the state of a child in foster
73.35care under the responsibility of the state.
74.1    (d) "Timely interstate home study" means an interstate home study completed by a
74.2state if the state provides to the state that requested the study, within 30 days after receipt
74.3of the request, a report on the results of the study, except that there is no requirement
74.4for completion within the 30-day period of the parts of the home study involving the
74.5education and training of the prospective foster or adoptive parents.
74.6    Subd. 7. Background study requirements for adoption and foster care. (a)
74.7Background study requirements for an adoption home study must be completed consistent
74.8with section 259.41, subdivisions 1, 2, and 3.
74.9    (b) Background study requirements for a foster care license must be completed
74.10consistent with section 245C.08.
74.11    Subd. 8. Home visits. If a child has been placed in foster care outside the state in
74.12which the home of the parents of the child is located, periodically, but at least every six
74.13months, a caseworker on the staff of the agency of the state in which the home of the
74.14parents of the child is located or the state in which the child has been placed, or a private
74.15agency under contract with either state, must visit the child in the home or institution and
74.16submit a report on each visit to the agency of the state in which the home of the parents of
74.17the child is located.

74.18    Sec. 69. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:
74.19    Subdivision 1. Investigation. Upon request of the court the local social services
74.20agency or probation officer shall investigate the personal and family history and
74.21environment of any minor coming within the jurisdiction of the court under section
74.22260B.101 and shall report its findings to the court. The court may order any minor coming
74.23within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or
74.24psychologist appointed by the court.
74.25    The court shall have order a chemical use assessment conducted when a child is
74.26(1) found to be delinquent for violating a provision of chapter 152, or for committing a
74.27felony-level violation of a provision of chapter 609 if the probation officer determines
74.28that alcohol or drug use was a contributing factor in the commission of the offense, or
74.29(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being
74.30held in custody under a detention order. The assessor's qualifications and the assessment
74.31criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under
74.32chapter 254B are to be used to pay for the recommended treatment, the assessment and
74.33placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to
74.349530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall
74.35reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.
75.1    The court shall have order a children's mental health screening conducted when
75.2a child is found to be delinquent. The screening shall be conducted with a screening
75.3instrument approved by the commissioner of human services and shall be conducted by a
75.4mental health practitioner as defined in section 245.4871, subdivision 26, or a probation
75.5officer who is trained in the use of the screening instrument. If the screening indicates
75.6a need for assessment, the local social services agency, in consultation with the child's
75.7family, shall have a diagnostic assessment conducted, including a functional assessment,
75.8as defined in section 245.4871.
75.9    With the consent of the commissioner of corrections and agreement of the county to
75.10pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction
75.11in an institution maintained by the commissioner for the detention, diagnosis, custody and
75.12treatment of persons adjudicated to be delinquent, in order that the condition of the minor
75.13be given due consideration in the disposition of the case. Any funds received under the
75.14provisions of this subdivision shall not cancel until the end of the fiscal year immediately
75.15following the fiscal year in which the funds were received. The funds are available for
75.16use by the commissioner of corrections during that period and are hereby appropriated
75.17annually to the commissioner of corrections as reimbursement of the costs of providing
75.18these services to the juvenile courts.

75.19    Sec. 70. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:
75.20    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The
75.21foster parents, if any, of a child and any preadoptive parent or relative providing care
75.22for the child must be provided notice of and an opportunity a right to be heard in any
75.23review or hearing to be held with respect to the child. Any other relative may also request,
75.24and must be granted, a notice and the opportunity to be heard under this section. This
75.25subdivision does not require that a foster parent, preadoptive parent, or relative providing
75.26care for the child be made a party to a review or hearing solely on the basis of the notice
75.27and opportunity right to be heard.

75.28    Sec. 71. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:
75.29    Subdivision 1. General. (a) Except for hearings arising under section 260C.425,
75.30hearings on any matter shall be without a jury and may be conducted in an informal
75.31manner. In all adjudicatory proceedings involving a child alleged to be in need of
75.32protection or services, the court shall admit only evidence that would be admissible in a
75.33civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of
75.34protection or services must be proved by clear and convincing evidence.
76.1    (b) Except for proceedings involving a child alleged to be in need of protection or
76.2services and petitions for the termination of parental rights, hearings may be continued or
76.3adjourned from time to time. In proceedings involving a child alleged to be in need of
76.4protection or services and petitions for the termination of parental rights, hearings may not
76.5be continued or adjourned for more than one week unless the court makes specific findings
76.6that the continuance or adjournment is in the best interests of the child. If a hearing is held
76.7on a petition involving physical or sexual abuse of a child who is alleged to be in need of
76.8protection or services or neglected and in foster care, the court shall file the decision with
76.9the court administrator as soon as possible but no later than 15 days after the matter is
76.10submitted to the court. When a continuance or adjournment is ordered in any proceeding,
76.11the court may make any interim orders as it deems in the best interests of the minor in
76.12accordance with the provisions of sections 260C.001 to 260C.421.
76.13    (c) Except as otherwise provided in this paragraph, the court shall exclude the
76.14general public from hearings under this chapter and shall admit only those persons who, in
76.15the discretion of the court, have a direct interest in the case or in the work of the court.
76.16    (d) Adoption hearings shall be conducted in accordance with the provisions of
76.17laws relating to adoptions.
76.18    (e) In any permanency hearing, including the transition of a child from foster care
76.19to independent living, the court shall ensure that any consult with the child is in an
76.20age-appropriate manner.

76.21    Sec. 72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to
76.22read:
76.23    Subd. 11. Review of court-ordered placements; permanent placement
76.24determination. (a) This subdivision and subdivision 11a do not apply in cases where
76.25the child is in placement due solely to the child's developmental disability or emotional
76.26disturbance, where legal custody has not been transferred to the responsible social services
76.27agency, and where the court finds compelling reasons under section 260C.007, subdivision
76.288 , to continue the child in foster care past the time periods specified in this subdivision.
76.29Foster care placements of children due solely to their disability are governed by section
76.30260C.141, subdivision 2a . In all other cases where the child is in foster care or in the care
76.31of a noncustodial parent under subdivision 1, the court shall commence proceedings
76.32to determine the permanent status of a child not later than 12 months after the child is
76.33placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing
76.34commencing such proceedings, the court shall determine whether there is a prima facie
76.35basis for finding that the agency made reasonable efforts, or in the case of an Indian
77.1child active efforts, required under section 260.012 and proceed according to the rules of
77.2juvenile court.
77.3    For purposes of this subdivision, the date of the child's placement in foster care is
77.4the earlier of the first court-ordered placement or 60 days after the date on which the
77.5child has been voluntarily placed in foster care by the child's parent or guardian. For
77.6purposes of this subdivision, time spent by a child under the protective supervision of
77.7the responsible social services agency in the home of a noncustodial parent pursuant to
77.8an order under subdivision 1 counts towards the requirement of a permanency hearing
77.9under this subdivision or subdivision 11a. Time spent on a trial home visit does not count
77.10counts towards the requirement of a permanency hearing under this subdivision or and a
77.11permanency review for a child under eight years of age under subdivision 11a.
77.12    For purposes of this subdivision, 12 months is calculated as follows:
77.13    (1) during the pendency of a petition alleging that a child is in need of protection
77.14or services, all time periods when a child is placed in foster care or in the home of a
77.15noncustodial parent are cumulated;
77.16    (2) if a child has been placed in foster care within the previous five years under one
77.17or more previous petitions, the lengths of all prior time periods when the child was placed
77.18in foster care within the previous five years are cumulated. If a child under this clause
77.19has been in foster care for 12 months or more, the court, if it is in the best interests of the
77.20child and for compelling reasons, may extend the total time the child may continue out
77.21of the home under the current petition up to an additional six months before making a
77.22permanency determination.
77.23    (b) Unless the responsible social services agency recommends return of the child
77.24to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing
77.25required under paragraph (a) and the rules of juvenile court, the responsible social services
77.26agency shall file pleadings in juvenile court to establish the basis for the juvenile court to
77.27order permanent placement of the child, including a termination of parental rights petition,
77.28according to paragraph (d). Notice of the hearing and copies of the pleadings must be
77.29provided pursuant to section 260C.152.
77.30    (c) The permanency proceedings shall be conducted in a timely fashion including
77.31that any trial required under section 260C.163 shall be commenced within 60 days of the
77.32admit-deny hearing required under paragraph (a). At the conclusion of the permanency
77.33proceedings, the court shall:
77.34    (1) order the child returned to the care of the parent or guardian from whom the
77.35child was removed; or
78.1    (2) order a permanent placement or termination of parental rights if permanent
78.2placement or termination of parental rights is in the child's best interests. The "best
78.3interests of the child" means all relevant factors to be considered and evaluated. Transfer
78.4of permanent legal and physical custody, termination of parental rights, or guardianship
78.5and legal custody to the commissioner through a consent to adopt are preferred
78.6permanency options for a child who cannot return home.
78.7    (d) If the child is not returned to the home, the court must order one of the following
78.8dispositions:
78.9    (1) permanent legal and physical custody to a relative in the best interests of the
78.10child according to the following conditions:
78.11    (i) an order for transfer of permanent legal and physical custody to a relative shall
78.12only be made after the court has reviewed the suitability of the prospective legal and
78.13physical custodian;
78.14    (ii) in transferring permanent legal and physical custody to a relative, the juvenile
78.15court shall follow the standards applicable under this chapter and chapter 260, and the
78.16procedures set out in the juvenile court rules;
78.17    (iii) an order establishing permanent legal and physical custody under this
78.18subdivision must be filed with the family court;
78.19    (iv) a transfer of legal and physical custody includes responsibility for the protection,
78.20education, care, and control of the child and decision making on behalf of the child;
78.21    (v) the social services agency may bring a petition or motion naming a fit and
78.22willing relative as a proposed permanent legal and physical custodian. The commissioner
78.23of human services shall annually prepare for counties information that must be given to
78.24proposed custodians about their legal rights and obligations as custodians together with
78.25information on financial and medical benefits for which the child is eligible; and
78.26    (vi) the juvenile court may maintain jurisdiction over the responsible social services
78.27agency, the parents or guardian of the child, the child, and the permanent legal and
78.28physical custodian for purposes of ensuring appropriate services are delivered to the child
78.29and permanent legal custodian or for the purpose of ensuring conditions ordered by the
78.30court related to the care and custody of the child are met;
78.31    (2) termination of parental rights when the requirements of sections 260C.301 to
78.32260C.328 are met or according to the following conditions:
78.33    (i) order the social services agency to file a petition for termination of parental
78.34rights in which case all the requirements of sections 260C.301 to 260C.328 remain
78.35applicable; and
79.1    (ii) an adoption completed subsequent to a determination under this subdivision may
79.2include an agreement for communication or contact under section 259.58;
79.3    (3) long-term foster care according to the following conditions:
79.4    (i) the court may order a child into long-term foster care only if it approves the
79.5responsible social service agency's compelling reasons that neither an award of permanent
79.6legal and physical custody to a relative, nor termination of parental rights is in the child's
79.7best interests;
79.8    (ii) further, the court may only order long-term foster care for the child under this
79.9section if it finds the following:
79.10    (A) the child has reached age 12 and the responsible social services agency has made
79.11reasonable efforts to locate and place the child with an adoptive family or with a fit and
79.12willing relative who will agree to a transfer of permanent legal and physical custody of
79.13the child, but such efforts have not proven successful; or
79.14    (B) the child is a sibling of a child described in subitem (A) and the siblings have
79.15a significant positive relationship and are ordered into the same long-term foster care
79.16home; and
79.17    (iii) at least annually, the responsible social services agency reconsiders its provision
79.18of services to the child and the child's placement in long-term foster care to ensure that:
79.19    (A) long-term foster care continues to be the most appropriate legal arrangement
79.20for meeting the child's need for permanency and stability, including whether there is
79.21another permanent placement option under this chapter that would better serve the child's
79.22needs and best interests;
79.23    (B) whenever possible, there is an identified long-term foster care family that is
79.24committed to being the foster family for the child as long as the child is a minor or under
79.25the jurisdiction of the court;
79.26    (C) the child is receiving appropriate services or assistance to maintain or build
79.27connections with the child's family and community;
79.28    (D) the child's physical and mental health needs are being appropriately provided
79.29for; and
79.30    (E) the child's educational needs are being met;
79.31    (4) foster care for a specified period of time according to the following conditions:
79.32    (i) foster care for a specified period of time may be ordered only if:
79.33    (A) the sole basis for an adjudication that the child is in need of protection or
79.34services is the child's behavior;
79.35    (B) the court finds that foster care for a specified period of time is in the best
79.36interests of the child; and
80.1    (C) the court approves the responsible social services agency's compelling reasons
80.2that neither an award of permanent legal and physical custody to a relative, nor termination
80.3of parental rights is in the child's best interests;
80.4    (ii) the order does not specify that the child continue in foster care for any period
80.5exceeding one year; or
80.6    (5) guardianship and legal custody to the commissioner of human services under
80.7the following procedures and conditions:
80.8    (i) there is an identified prospective adoptive home agreed to by the responsible
80.9social services agency having legal custody of the child pursuant to court order under this
80.10section that has agreed to adopt the child and the court accepts the parent's voluntary
80.11consent to adopt under section 259.24, except that such consent executed by a parent under
80.12this item, following proper notice that consent given under this provision is irrevocable
80.13upon acceptance by the court, shall be irrevocable unless fraud is established and an order
80.14issues permitting revocation as stated in item (vii);
80.15    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other
80.16enumerated permanency dispositions, the court must review the matter at least every 90
80.17days. The review will address the reasonable efforts of the agency to achieve a finalized
80.18adoption;
80.19    (iii) a consent to adopt under this clause vests all legal authority regarding the child,
80.20including guardianship and legal custody of the child, with the commissioner of human
80.21services as if the child were a state ward after termination of parental rights;
80.22    (iv) the court must forward a copy of the consent to adopt, together with a certified
80.23copy of the order transferring guardianship and legal custody to the commissioner, to
80.24the commissioner;
80.25    (v) if an adoption is not finalized by the identified prospective adoptive parent within
80.2612 months of the execution of the consent to adopt under this clause, the commissioner of
80.27human services or the commissioner's delegate shall pursue adoptive placement in another
80.28home unless the commissioner certifies that the failure to finalize is not due to either an
80.29action or a failure to act by the prospective adoptive parent;
80.30    (vi) notwithstanding item (v), the commissioner of human services or the
80.31commissioner's designee must pursue adoptive placement in another home as soon as the
80.32commissioner or commissioner's designee determines that finalization of the adoption with
80.33the identified prospective adoptive parent is not possible, that the identified prospective
80.34adoptive parent is not willing to adopt the child, that the identified prospective adoptive
80.35parent is not cooperative in completing the steps necessary to finalize the adoption, or
80.36upon the commissioner's determination to withhold consent to the adoption.
81.1    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code,
81.2title 25, section 1913, a consent to adopt executed under this section, following proper
81.3notice that consent given under this provision is irrevocable upon acceptance by the court,
81.4shall be irrevocable upon acceptance by the court except upon order permitting revocation
81.5issued by the same court after written findings that consent was obtained by fraud.
81.6    (e) In ordering a permanent placement of a child, the court must be governed by the
81.7best interests of the child, including a review of the relationship between the child and
81.8relatives and the child and other important persons with whom the child has resided or
81.9had significant contact. When the court has determined that permanent placement of the
81.10child away from the parent is necessary, the court shall consider permanent alternative
81.11homes that are available both inside and outside the state.
81.12    (f) Once a permanent placement determination has been made and permanent
81.13placement has been established, further court reviews are necessary if:
81.14    (1) the placement is long-term foster care or foster care for a specified period of time;
81.15    (2) the court orders further hearings because it has retained jurisdiction of a transfer
81.16of permanent legal and physical custody matter;
81.17    (3) an adoption has not yet been finalized; or
81.18    (4) there is a disruption of the permanent or long-term placement.
81.19    (g) Court reviews of an order for long-term foster care, whether under this section
81.20or section 260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and
81.21must review the child's out-of-home placement plan and the reasonable efforts of the
81.22agency to finalize the permanent plan for the child including the agency's efforts to:
81.23    (1) ensure that long-term foster care continues to be the most appropriate legal
81.24arrangement for meeting the child's need for permanency and stability or, if not, to identify
81.25and attempt to finalize another permanent placement option under this chapter that would
81.26better serve the child's needs and best interests;
81.27    (2) identify a specific long-term foster home for the child, if one has not already
81.28been identified;
81.29    (3) support continued placement of the child in the identified home, if one has been
81.30identified;
81.31    (4) ensure appropriate services are provided to address the physical health, mental
81.32health, and educational needs of the child during the period of long-term foster care and
81.33also ensure appropriate services or assistance to maintain relationships with appropriate
81.34family members and the child's community; and
81.35    (5) plan for the child's independence upon the child's leaving long-term foster care
81.36living as required under section 260C.212, subdivision 1.
82.1    (h) In the event it is necessary for a child that has been ordered into foster care for a
82.2specified period of time to be in foster care longer than one year after the permanency
82.3hearing held under this section, not later than 12 months after the time the child was
82.4ordered into foster care for a specified period of time, the matter must be returned to
82.5court for a review of the appropriateness of continuing the child in foster care and of the
82.6responsible social services agency's reasonable efforts to finalize a permanent plan for
82.7the child; if it is in the child's best interests to continue the order for foster care for a
82.8specified period of time past a total of 12 months, the court shall set objectives for the
82.9child's continuation in foster care, specify any further amount of time the child may be in
82.10foster care, and review the plan for the safe return of the child to the parent.
82.11    (i) An order permanently placing a child out of the home of the parent or guardian
82.12must include the following detailed findings:
82.13    (1) how the child's best interests are served by the order;
82.14    (2) the nature and extent of the responsible social service agency's reasonable efforts,
82.15or, in the case of an Indian child, active efforts to reunify the child with the parent or
82.16guardian where reasonable efforts are required;
82.17    (3) the parent's or parents' efforts and ability to use services to correct the conditions
82.18which led to the out-of-home placement; and
82.19    (4) that the conditions which led to the out-of-home placement have not been
82.20corrected so that the child can safely return home.
82.21    (j) An order for permanent legal and physical custody of a child may be modified
82.22under sections 518.18 and 518.185. The social services agency is a party to the proceeding
82.23and must receive notice. A parent may only seek modification of an order for long-term
82.24foster care upon motion and a showing by the parent of a substantial change in the parent's
82.25circumstances such that the parent could provide appropriate care for the child and that
82.26removal of the child from the child's permanent placement and the return to the parent's
82.27care would be in the best interest of the child. The responsible social services agency may
82.28ask the court to vacate an order for long-term foster care upon a prima facie showing
82.29that there is a factual basis for the court to order another permanency option under this
82.30chapter and that such an option is in the child's best interests. Upon a hearing where
82.31the court determines that there is a factual basis for vacating the order for long-term
82.32foster care and that another permanent order regarding the placement of the child is in
82.33the child's best interests, the court may vacate the order for long-term foster care and
82.34enter a different order for permanent placement that is in the child's best interests. The
82.35court shall not require further reasonable efforts to reunify the child with the parent or
82.36guardian as a basis for vacating the order for long-term foster care and ordering a different
83.1permanent placement in the child's best interests. The county attorney must file pleadings
83.2and give notice as required under the rules of juvenile court in order to modify an order for
83.3long-term foster care under this paragraph.
83.4    (k) The court shall issue an order required under this section within 15 days of the
83.5close of the proceedings. The court may extend issuing the order an additional 15 days
83.6when necessary in the interests of justice and the best interests of the child.
83.7    (l) This paragraph applies to proceedings required under this subdivision when
83.8the child is on a trial home visit:
83.9    (1) if the child is on a trial home visit 12 months after the child was placed in
83.10foster care or in the care of a noncustodial parent as calculated in this subdivision, the
83.11responsible social services agency may file a report with the court regarding the child's and
83.12parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe
83.13and permanent return to the care of the parent in lieu of filing the pleadings required under
83.14paragraph (b). The court shall make findings regarding reasonableness of the responsible
83.15social services efforts to finalize the child's return home as the permanent order in the best
83.16interests of the child. The court may continue the trial home visit to a total time not to
83.17exceed six months as provided in subdivision 1. If the court finds the responsible social
83.18services agency has not made reasonable efforts to finalize the child's return home as the
83.19permanent order in the best interests of the child, the court may order other or additional
83.20efforts to support the child remaining in the care of the parent; and
83.21    (2) if a trial home visit ordered or continued at proceedings under this subdivision
83.22terminates, the court shall re-commence proceedings under this subdivision to determine
83.23the permanent status of the child not later than 30 days after the child is returned to foster
83.24care.

83.25    Sec. 73. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:
83.26    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan
83.27shall be prepared within 30 days after any child is placed in a residential facility by court
83.28order or by the voluntary release of the child by the parent or parents.
83.29    For purposes of this section, a residential facility means any group home, family
83.30foster home or other publicly supported out-of-home residential facility, including any
83.31out-of-home residential facility under contract with the state, county or other political
83.32subdivision, or any agency thereof, to provide those services or foster care as defined in
83.33section 260C.007, subdivision 18.
83.34    (b) An out-of-home placement plan means a written document which is prepared by
83.35the responsible social services agency jointly with the parent or parents or guardian of the
84.1child and in consultation with the child's guardian ad litem, the child's tribe, if the child is
84.2an Indian child, the child's foster parent or representative of the residential facility, and,
84.3where appropriate, the child. For a child in placement due solely or in part to the child's
84.4emotional disturbance, preparation of the out-of-home placement plan shall additionally
84.5include the child's mental health treatment provider. As appropriate, the plan shall be:
84.6    (1) submitted to the court for approval under section 260C.178, subdivision 7;
84.7    (2) ordered by the court, either as presented or modified after hearing, under section
84.8260C.178, subdivision 7 , or 260C.201, subdivision 6; and
84.9    (3) signed by the parent or parents or guardian of the child, the child's guardian ad
84.10litem, a representative of the child's tribe, the responsible social services agency, and, if
84.11possible, the child.
84.12    (c) The out-of-home placement plan shall be explained to all persons involved in its
84.13implementation, including the child who has signed the plan, and shall set forth:
84.14    (1) a description of the residential facility including how the out-of-home placement
84.15plan is designed to achieve a safe placement for the child in the least restrictive, most
84.16family-like, setting available which is in close proximity to the home of the parent or
84.17parents or guardian of the child when the case plan goal is reunification, and how the
84.18placement is consistent with the best interests and special needs of the child according to
84.19the factors under subdivision 2, paragraph (b);
84.20    (2) the specific reasons for the placement of the child in a residential facility, and
84.21when reunification is the plan, a description of the problems or conditions in the home of
84.22the parent or parents which necessitated removal of the child from home and the changes
84.23the parent or parents must make in order for the child to safely return home;
84.24    (3) a description of the services offered and provided to prevent removal of the child
84.25from the home and to reunify the family including:
84.26    (i) the specific actions to be taken by the parent or parents of the child to eliminate
84.27or correct the problems or conditions identified in clause (2), and the time period during
84.28which the actions are to be taken; and
84.29    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
84.30to achieve a safe and stable home for the child including social and other supportive
84.31services to be provided or offered to the parent or parents or guardian of the child, the
84.32child, and the residential facility during the period the child is in the residential facility;
84.33    (4) a description of any services or resources that were requested by the child or the
84.34child's parent, guardian, foster parent, or custodian since the date of the child's placement
84.35in the residential facility, and whether those services or resources were provided and if
84.36not, the basis for the denial of the services or resources;
85.1    (5) the visitation plan for the parent or parents or guardian, other relatives as defined
85.2in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
85.3together in the residential facility, and whether visitation is consistent with the best interest
85.4of the child, during the period the child is in the residential facility;
85.5    (6) documentation of steps to finalize the adoption or legal guardianship of the child
85.6if the court has issued an order terminating the rights of both parents of the child or of
85.7the only known, living parent of the child, and. At a minimum, the documentation must
85.8include child-specific recruitment efforts such as relative search and the use of state,
85.9regional, and national adoption exchanges to facilitate orderly and timely placements in
85.10and outside of the state. A copy of this documentation shall be provided to the court in the
85.11review required under section 260C.317, subdivision 3, paragraph (b);
85.12    (7) to the extent available and accessible, the health and educational records of the
85.13child including the most recent information available regarding:
85.14    (i) the names and addresses of the child's health and educational providers;
85.15    (ii) the child's grade level performance;
85.16    (iii) the child's school record;
85.17    (iv) assurances that the child's placement in foster care takes into account proximity
85.18to the school in which the child is enrolled at the time of placement;
85.19    (v) a record of the child's immunizations;
85.20    (vi) the child's known medical problems, including any known communicable
85.21diseases, as defined in section 144.4172, subdivision 2;
85.22    (vii) the child's medications; and
85.23    (viii) any other relevant health and education information;
85.24    (8) an independent living plan for a child age 16 or older who is in placement as
85.25a result of a permanency disposition. The plan should include, but not be limited to,
85.26the following objectives:
85.27    (i) educational, vocational, or employment planning;
85.28    (ii) health care planning and medical coverage;
85.29    (iii) transportation including, where appropriate, assisting the child in obtaining a
85.30driver's license;
85.31    (iv) money management;
85.32    (v) planning for housing;
85.33    (vi) social and recreational skills; and
85.34    (vii) establishing and maintaining connections with the child's family and
85.35community; and
86.1    (9) for a child in placement due solely or in part to the child's emotional disturbance,
86.2diagnostic and assessment information, specific services relating to meeting the mental
86.3health care needs of the child, and treatment outcomes.
86.4    (d) The parent or parents or guardian and the child each shall have the right to legal
86.5counsel in the preparation of the case plan and shall be informed of the right at the time
86.6of placement of the child. The child shall also have the right to a guardian ad litem.
86.7If unable to employ counsel from their own resources, the court shall appoint counsel
86.8upon the request of the parent or parents or the child or the child's legal guardian. The
86.9parent or parents may also receive assistance from any person or social services agency
86.10in preparation of the case plan.
86.11    After the plan has been agreed upon by the parties involved or approved or ordered
86.12by the court, the foster parents shall be fully informed of the provisions of the case plan
86.13and shall be provided a copy of the plan.
86.14    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
86.15physical custodian, as appropriate, and the child, if appropriate, must be provided with
86.16a current copy of the child's health and education record.

86.17    Sec. 74. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:
86.18    Subd. 4. Responsible social service agency's duties for children in placement. (a)
86.19When a child is in placement, the responsible social services agency shall make diligent
86.20efforts to identify, locate, and, where appropriate, offer services to both parents of the child.
86.21    (1) The responsible social services agency shall assess whether a noncustodial or
86.22nonadjudicated parent is willing and capable of providing for the day-to-day care of the
86.23child temporarily or permanently. An assessment under this clause may include, but
86.24is not limited to, obtaining information under section 260C.209. If after assessment,
86.25the responsible social services agency determines that a noncustodial or nonadjudicated
86.26parent is willing and capable of providing day-to-day care of the child, the responsible
86.27social services agency may seek authority from the custodial parent or the court to have
86.28that parent assume day-to-day care of the child. If a parent is not an adjudicated parent,
86.29the responsible social services agency shall require the nonadjudicated parent to cooperate
86.30with paternity establishment procedures as part of the case plan.
86.31    (2) If, after assessment, the responsible social services agency determines that the
86.32child cannot be in the day-to-day care of either parent, the agency shall:
86.33    (i) prepare an out-of-home placement plan addressing the conditions that each parent
86.34must meet before the child can be in that parent's day-to-day care; and
87.1    (ii) provide a parent who is the subject of a background study under section
87.2260C.209 15 days' notice that it intends to use the study to recommend against putting the
87.3child with that parent, as well as the notice provided in section 260C.209, subdivision 4,
87.4and the court shall afford the parent an opportunity to be heard concerning the study.
87.5    The results of a background study of a noncustodial parent shall not be used by the
87.6agency to determine that the parent is incapable of providing day-to-day care of the child
87.7unless the agency reasonably believes that placement of the child into the home of that
87.8parent would endanger the child's health, safety, or welfare.
87.9    (3) If, after the provision of services following an out-of-home placement plan under
87.10this section, the child cannot return to the care of the parent from whom the child was
87.11removed or who had legal custody at the time the child was placed in foster care, the
87.12agency may petition on behalf of a noncustodial parent to establish legal custody with
87.13that parent under section 260C.201, subdivision 11. If paternity has not already been
87.14established, it may be established in the same proceeding in the manner provided for
87.15under chapter 257.
87.16    (4) The responsible social services agency may be relieved of the requirement to
87.17locate and offer services to both parents by the juvenile court upon a finding of good cause
87.18after the filing of a petition under section 260C.141.
87.19    (b) The responsible social services agency shall give notice to the parent or parents
87.20or guardian of each child in a residential facility, other than a child in placement due
87.21solely to that child's developmental disability or emotional disturbance, of the following
87.22information:
87.23    (1) that residential care of the child may result in termination of parental rights or an
87.24order permanently placing the child out of the custody of the parent, but only after notice
87.25and a hearing as required under chapter 260C and the juvenile court rules;
87.26    (2) time limits on the length of placement and of reunification services, including
87.27the date on which the child is expected to be returned to and safely maintained in the
87.28home of the parent or parents or placed for adoption or otherwise permanently removed
87.29from the care of the parent by court order;
87.30    (3) the nature of the services available to the parent;
87.31    (4) the consequences to the parent and the child if the parent fails or is unable to use
87.32services to correct the circumstances that led to the child's placement;
87.33    (5) the first consideration for placement with relatives;
87.34    (6) the benefit to the child in getting the child out of residential care as soon as
87.35possible, preferably by returning the child home, but if that is not possible, through a
87.36permanent legal placement of the child away from the parent;
88.1    (7) when safe for the child, the benefits to the child and the parent of maintaining
88.2visitation with the child as soon as possible in the course of the case and, in any event,
88.3according to the visitation plan under this section; and
88.4    (8) the financial responsibilities and obligations, if any, of the parent or parents for
88.5the support of the child during the period the child is in the residential facility.
88.6    (c) The responsible social services agency shall inform a parent considering
88.7voluntary placement of a child who is not developmentally disabled or emotionally
88.8disturbed of the following information:
88.9    (1) the parent and the child each has a right to separate legal counsel before signing a
88.10voluntary placement agreement, but not to counsel appointed at public expense;
88.11    (2) the parent is not required to agree to the voluntary placement, and a parent
88.12who enters a voluntary placement agreement may at any time request that the agency
88.13return the child. If the parent so requests, the child must be returned within 24 hours of
88.14the receipt of the request;
88.15    (3) evidence gathered during the time the child is voluntarily placed may be used
88.16at a later time as the basis for a petition alleging that the child is in need of protection
88.17or services or as the basis for a petition seeking termination of parental rights or other
88.18permanent placement of the child away from the parent;
88.19    (4) if the responsible social services agency files a petition alleging that the child is
88.20in need of protection or services or a petition seeking the termination of parental rights
88.21or other permanent placement of the child away from the parent, the parent would have
88.22the right to appointment of separate legal counsel and the child would have a right to the
88.23appointment of counsel and a guardian ad litem as provided by law, and that counsel will
88.24be appointed at public expense if they are unable to afford counsel; and
88.25    (5) the timelines and procedures for review of voluntary placements under
88.26subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a
88.27permanent placement determination hearing under section 260C.201, subdivision 11.
88.28    (d) When an agency accepts a child for placement, the agency shall determine
88.29whether the child has had a physical examination by or under the direction of a licensed
88.30physician within the 12 months immediately preceding the date when the child came into
88.31the agency's care. If there is documentation that the child has had an examination within
88.32the last 12 months, the agency is responsible for seeing that the child has another physical
88.33examination within one year of the documented examination and annually in subsequent
88.34years. If the agency determines that the child has not had a physical examination within
88.35the 12 months immediately preceding placement, the agency shall ensure that the child
89.1has an examination within 30 days of coming into the agency's care and once a year
89.2in subsequent years.
89.3    (e) If a child leaves foster care by reason of having attained the age of majority
89.4under state law, the child must be given at no cost a copy of the child's health and
89.5education report.

89.6    Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:
89.7    Subd. 9. Review of certain child placements. (a) When a developmentally
89.8disabled child or emotionally disturbed child needs placement in a residential facility for
89.9the sole reason of accessing services or a level of skilled care that cannot be provided in
89.10the parent's home, the child must be placed pursuant to a voluntary placement agreement
89.11between the responsible social services agency and the child's parent. The voluntary
89.12placement agreement must give the responsible social services agency legal responsibility
89.13for the child's physical care, custody, and control, but must not transfer legal custody of
89.14the child to the agency. The voluntary placement agreement must be executed in a form
89.15developed and promulgated by the commissioner of human services. The responsible
89.16social services agency shall report to the commissioner the number of children who are the
89.17subject of a voluntary placement agreement under this subdivision and other information
89.18regarding these children as the commissioner may require.
89.19    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed
89.20has been placed in a residential facility pursuant to a voluntary release by the child's parent
89.21or parents because of the child's disabling conditions or need for long-term residential
89.22treatment or supervision, the social services agency responsible for the placement shall
89.23report to the court and bring a petition for review of the child's foster care status as
89.24required in section 260C.141, subdivision 2a.
89.25    (b) (c) If a child is in placement due solely to the child's developmental disability or
89.26emotional disturbance, and the court finds compelling reasons not to proceed under section
89.27260C.201, subdivision 11 , and custody of the child is not transferred to the responsible
89.28social services agency under section 260C.201, subdivision 1, paragraph (a), clause (2),
89.29and no petition is required by section 260C.201, subdivision 11.
89.30    (c) (d) Whenever a petition for review is brought pursuant to this subdivision, a
89.31guardian ad litem shall be appointed for the child.

89.32    Sec. 76. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:
89.33    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and
89.34the order terminating parental rights, and a summary of the court's information concerning
90.1the child shall be furnished by the court to the commissioner or the agency to which
90.2guardianship is transferred. The orders shall be on a document separate from the findings.
90.3The court shall furnish the individual to whom guardianship is transferred a copy of the
90.4order terminating parental rights.
90.5    (b) The court shall retain jurisdiction in a case where adoption is the intended
90.6permanent placement disposition until the child's adoption is finalized, the child is 18 years
90.7of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The
90.8guardian ad litem and counsel for the child shall continue on the case until an adoption
90.9decree is entered. A hearing must be held every 90 days following termination of parental
90.10rights for the court to review progress toward an adoptive placement and the specific
90.11recruitment efforts the agency has taken to find an adoptive family or other placement
90.12living arrangement for the child and to finalize the adoption or other permanency plan.
90.13    (c) The responsible social services agency may make a determination of compelling
90.14reasons for a child to be in long-term foster care when the agency has made exhaustive
90.15efforts to recruit, identify, and place the child in an adoptive home, and the child continues
90.16in foster care for at least 24 months after the court has issued the order terminating
90.17parental rights. A child of any age who is under the guardianship of the commissioner of
90.18the Department of Human Services and is legally available for adoption may not refuse
90.19or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the
90.20child in an adoptive home required under paragraph (b) or sign a document relieving
90.21county social services agencies of all recruitment efforts on the child's behalf. Upon
90.22approving the agency's determination of compelling reasons, the court may order the
90.23child placed in long-term foster care. At least every 12 months thereafter as long as the
90.24child continues in out-of-home placement, the court shall conduct a permanency review
90.25hearing to determine the future status of the child using the review requirements of section
90.26260C.201, subdivision 11 , paragraph (g).
90.27    (d) The court shall retain jurisdiction through the child's minority in a case where
90.28long-term foster care is the permanent disposition whether under paragraph (c) or section
90.29260C.201, subdivision 11 .

90.30    Sec. 77. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:
90.31    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights
90.32are terminated,
90.33    (1) whenever legal custody of a child is transferred by the court to a responsible
90.34social services agency,
91.1    (2) whenever legal custody is transferred to a person other than the responsible social
91.2services agency, but under the supervision of the responsible social services agency, or
91.3    (3) whenever a child is given physical or mental examinations or treatment under
91.4order of the court, and no provision is otherwise made by law for payment for the care,
91.5examination, or treatment of the child, these costs are a charge upon the welfare funds of
91.6the county in which proceedings are held upon certification of the judge of juvenile court.
91.7    (b) The court shall order, and the responsible social services agency shall require,
91.8the parents or custodian of a child, while the child is under the age of 18, to use the
91.9total income and resources attributable to the child for the period of care, examination,
91.10or treatment, except for clothing and personal needs allowance as provided in section
91.11256B.35 , to reimburse the county for the cost of care, examination, or treatment. Income
91.12and resources attributable to the child include, but are not limited to, Social Security
91.13benefits, supplemental security income (SSI), veterans benefits, railroad retirement
91.14benefits and child support. When the child is over the age of 18, and continues to receive
91.15care, examination, or treatment, the court shall order, and the responsible social services
91.16agency shall require, reimbursement from the child for the cost of care, examination, or
91.17treatment from the income and resources attributable to the child less the clothing and
91.18personal needs allowance. Income does not include earnings from a child over the age of
91.1918 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
91.20clause (8), to transition from foster care.
91.21    (c) If the income and resources attributable to the child are not enough to reimburse
91.22the county for the full cost of the care, examination, or treatment, the court shall inquire
91.23into the ability of the parents to support the child and, after giving the parents a reasonable
91.24opportunity to be heard, the court shall order, and the responsible social services agency
91.25shall require, the parents to contribute to the cost of care, examination, or treatment of
91.26the child. When determining the amount to be contributed by the parents, the court shall
91.27use a fee schedule based upon ability to pay that is established by the responsible social
91.28services agency and approved by the commissioner of human services. The income of
91.29a stepparent who has not adopted a child shall be excluded in calculating the parental
91.30contribution under this section.
91.31    (d) The court shall order the amount of reimbursement attributable to the parents
91.32or custodian, or attributable to the child, or attributable to both sources, withheld under
91.33chapter 518A from the income of the parents or the custodian of the child. A parent or
91.34custodian who fails to pay without good reason may be proceeded against for contempt, or
91.35the court may inform the county attorney, who shall proceed to collect the unpaid sums,
91.36or both procedures may be used.
92.1    (e) If the court orders a physical or mental examination for a child, the examination
92.2is a medically necessary service for purposes of determining whether the service is
92.3covered by a health insurance policy, health maintenance contract, or other health
92.4coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
92.5requirements for medical necessity. Nothing in this paragraph changes or eliminates
92.6benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
92.7or other requirements in the policy, contract, or plan that relate to coverage of other
92.8medically necessary services.

92.9    Sec. 78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:
92.10    Subdivision 1. Disclosure to commissioner of human services. (a) On the request
92.11of the commissioner of human services, the commissioner shall disclose return information
92.12regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to
92.13the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).
92.14    (b) Data that may be disclosed are limited to data relating to the identity,
92.15whereabouts, employment, income, and property of a person owing or alleged to be owing
92.16an obligation of child support.
92.17    (c) The commissioner of human services may request data only for the purposes of
92.18carrying out the child support enforcement program and to assist in the location of parents
92.19who have, or appear to have, deserted their children. Data received may be used only
92.20as set forth in section 256.978.
92.21    (d) The commissioner shall provide the records and information necessary to
92.22administer the supplemental housing allowance to the commissioner of human services.
92.23    (e) At the request of the commissioner of human services, the commissioner of
92.24revenue shall electronically match the Social Security numbers and names of participants
92.25in the telephone assistance plan operated under sections 237.69 to 237.711, with those of
92.26property tax refund filers, and determine whether each participant's household income is
92.27within the eligibility standards for the telephone assistance plan.
92.28    (f) The commissioner may provide records and information collected under sections
92.29295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid
92.30Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law
92.31102-234. Upon the written agreement by the United States Department of Health and
92.32Human Services to maintain the confidentiality of the data, the commissioner may provide
92.33records and information collected under sections 295.50 to 295.59 to the Centers for
92.34Medicare and Medicaid Services section of the United States Department of Health and
92.35Human Services for purposes of meeting federal reporting requirements.
93.1    (g) The commissioner may provide records and information to the commissioner of
93.2human services as necessary to administer the early refund of refundable tax credits.
93.3    (h) The commissioner may disclose information to the commissioner of human
93.4services necessary to verify income for eligibility and premium payment under the
93.5MinnesotaCare program, under section 256L.05, subdivision 2.
93.6    (i) The commissioner may disclose information to the commissioner of human
93.7services necessary to verify whether applicants or recipients for the Minnesota family
93.8investment program, general assistance, food support, and Minnesota supplemental aid
93.9program, and child care assistance have claimed refundable tax credits under chapter 290
93.10and the property tax refund under chapter 290A, and the amounts of the credits.

93.11    Sec. 79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:
93.12    Subd. 2. Definitions. As used in this section, the following terms have the meanings
93.13given them unless the specific content indicates otherwise:
93.14    (a) "Family assessment" means a comprehensive assessment of child safety, risk
93.15of subsequent child maltreatment, and family strengths and needs that is applied to a
93.16child maltreatment report that does not allege substantial child endangerment. Family
93.17assessment does not include a determination as to whether child maltreatment occurred
93.18but does determine the need for services to address the safety of family members and the
93.19risk of subsequent maltreatment.
93.20    (b) "Investigation" means fact gathering related to the current safety of a child
93.21and the risk of subsequent maltreatment that determines whether child maltreatment
93.22occurred and whether child protective services are needed. An investigation must be used
93.23when reports involve substantial child endangerment, and for reports of maltreatment in
93.24facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
93.25144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
93.2613, and 124D.10; or in a nonlicensed personal care provider association as defined in
93.27sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
93.28    (c) "Substantial child endangerment" means a person responsible for a child's care,
93.29and in the case of sexual abuse includes a person who has a significant relationship to the
93.30child as defined in section 609.341, or a person in a position of authority as defined in
93.31section 609.341, who by act or omission commits or attempts to commit an act against a
93.32child under their care that constitutes any of the following:
93.33    (1) egregious harm as defined in section 260C.007, subdivision 14;
93.34    (2) sexual abuse as defined in paragraph (d);
93.35    (3) abandonment under section 260C.301, subdivision 2;
94.1    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
94.2child's physical or mental health, including a growth delay, which may be referred to as
94.3failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
94.4    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
94.5609.195;
94.6    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
94.7    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
94.8609.223;
94.9    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
94.10    (9) criminal sexual conduct under sections 609.342 to 609.3451;
94.11    (10) solicitation of children to engage in sexual conduct under section 609.352;
94.12    (11) malicious punishment or neglect or endangerment of a child under section
94.13609.377 or 609.378;
94.14    (12) use of a minor in sexual performance under section 617.246; or
94.15    (13) parental behavior, status, or condition which mandates that the county attorney
94.16file a termination of parental rights petition under section 260C.301, subdivision 3,
94.17paragraph (a).
94.18    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
94.19child's care, by a person who has a significant relationship to the child, as defined in
94.20section 609.341, or by a person in a position of authority, as defined in section 609.341,
94.21subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
94.22conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
94.23609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
94.24in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
94.25abuse also includes any act which involves a minor which constitutes a violation of
94.26prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
94.27threatened sexual abuse.
94.28    (e) "Person responsible for the child's care" means (1) an individual functioning
94.29within the family unit and having responsibilities for the care of the child such as a
94.30parent, guardian, or other person having similar care responsibilities, or (2) an individual
94.31functioning outside the family unit and having responsibilities for the care of the child
94.32such as a teacher, school administrator, other school employees or agents, or other lawful
94.33custodian of a child having either full-time or short-term care responsibilities including,
94.34but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
94.35and coaching.
94.36    (f) "Neglect" means:
95.1    (1) failure by a person responsible for a child's care to supply a child with necessary
95.2food, clothing, shelter, health, medical, or other care required for the child's physical or
95.3mental health when reasonably able to do so;
95.4    (2) failure to protect a child from conditions or actions that seriously endanger the
95.5child's physical or mental health when reasonably able to do so, including a growth delay,
95.6which may be referred to as a failure to thrive, that has been diagnosed by a physician and
95.7is due to parental neglect;
95.8    (3) failure to provide for necessary supervision or child care arrangements
95.9appropriate for a child after considering factors as the child's age, mental ability, physical
95.10condition, length of absence, or environment, when the child is unable to care for the
95.11child's own basic needs or safety, or the basic needs or safety of another child in their care;
95.12    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
95.13260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
95.14child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
95.15    (5) nothing in this section shall be construed to mean that a child is neglected solely
95.16because the child's parent, guardian, or other person responsible for the child's care in
95.17good faith selects and depends upon spiritual means or prayer for treatment or care of
95.18disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
95.19or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
95.20if a lack of medical care may cause serious danger to the child's health. This section does
95.21not impose upon persons, not otherwise legally responsible for providing a child with
95.22necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
95.23    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
95.24subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
95.25symptoms in the child at birth, results of a toxicology test performed on the mother at
95.26delivery or the child at birth, or medical effects or developmental delays during the child's
95.27first year of life that medically indicate prenatal exposure to a controlled substance;
95.28    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
95.29    (8) chronic and severe use of alcohol or a controlled substance by a parent or
95.30person responsible for the care of the child that adversely affects the child's basic needs
95.31and safety; or
95.32    (9) emotional harm from a pattern of behavior which contributes to impaired
95.33emotional functioning of the child which may be demonstrated by a substantial and
95.34observable effect in the child's behavior, emotional response, or cognition that is not
95.35within the normal range for the child's age and stage of development, with due regard to
95.36the child's culture.
96.1    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
96.2inflicted by a person responsible for the child's care on a child other than by accidental
96.3means, or any physical or mental injury that cannot reasonably be explained by the child's
96.4history of injuries, or any aversive or deprivation procedures, or regulated interventions,
96.5that have not been authorized under section 121A.67 or 245.825. Abuse does not include
96.6reasonable and moderate physical discipline of a child administered by a parent or legal
96.7guardian which does not result in an injury. Abuse does not include the use of reasonable
96.8force by a teacher, principal, or school employee as allowed by section 121A.582. Actions
96.9which are not reasonable and moderate include, but are not limited to, any of the following
96.10that are done in anger or without regard to the safety of the child:
96.11    (1) throwing, kicking, burning, biting, or cutting a child;
96.12    (2) striking a child with a closed fist;
96.13    (3) shaking a child under age three;
96.14    (4) striking or other actions which result in any nonaccidental injury to a child
96.15under 18 months of age;
96.16    (5) unreasonable interference with a child's breathing;
96.17    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
96.18    (7) striking a child under age one on the face or head;
96.19    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
96.20substances which were not prescribed for the child by a practitioner, in order to control or
96.21punish the child; or other substances that substantially affect the child's behavior, motor
96.22coordination, or judgment or that results in sickness or internal injury, or subjects the
96.23child to medical procedures that would be unnecessary if the child were not exposed
96.24to the substances;
96.25    (9) unreasonable physical confinement or restraint not permitted under section
96.26609.379, including but not limited to tying, caging, or chaining; or
96.27    (10) in a school facility or school zone, an act by a person responsible for the child's
96.28care that is a violation under section 121A.58.
96.29    (h) "Report" means any report received by the local welfare agency, police
96.30department, county sheriff, or agency responsible for assessing or investigating
96.31maltreatment pursuant to this section.
96.32    (i) "Facility" means:
96.33    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
96.34sanitarium, or other facility or institution required to be licensed under sections 144.50 to
96.35144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;
97.1    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
97.2124D.10; or
97.3    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
97.4subdivision 16, and 256B.0625, subdivision 19a.
97.5    (j) "Operator" means an operator or agency as defined in section 245A.02.
97.6    (k) "Commissioner" means the commissioner of human services.
97.7    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
97.8not limited to employee assistance counseling and the provision of guardian ad litem and
97.9parenting time expeditor services.
97.10    (m) "Mental injury" means an injury to the psychological capacity or emotional
97.11stability of a child as evidenced by an observable or substantial impairment in the child's
97.12ability to function within a normal range of performance and behavior with due regard to
97.13the child's culture.
97.14    (n) "Threatened injury" means a statement, overt act, condition, or status that
97.15represents a substantial risk of physical or sexual abuse or mental injury. Threatened
97.16injury includes, but is not limited to, exposing a child to a person responsible for the
97.17child's care, as defined in paragraph (e), clause (1), who has:
97.18    (1) subjected a child to, or failed to protect a child from, an overt act or condition
97.19that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
97.20similar law of another jurisdiction;
97.21    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
97.22(4), or a similar law of another jurisdiction;
97.23    (3) committed an act that has resulted in an involuntary termination of parental rights
97.24under section 260C.301, or a similar law of another jurisdiction; or
97.25    (4) committed an act that has resulted in the involuntary transfer of permanent legal
97.26and physical custody of a child to a relative under section 260C.201, subdivision 11,
97.27paragraph (d), clause (1), or a similar law of another jurisdiction.
97.28    (o) Persons who conduct assessments or investigations under this section shall take
97.29into account accepted child-rearing practices of the culture in which a child participates
97.30and accepted teacher discipline practices, which are not injurious to the child's health,
97.31welfare, and safety.

97.32    Sec. 80. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:
97.33    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
97.34to believe a child is being neglected or physically or sexually abused, as defined in
97.35subdivision 2, or has been neglected or physically or sexually abused within the preceding
98.1three years, shall immediately report the information to the local welfare agency, agency
98.2responsible for assessing or investigating the report, police department, or the county
98.3sheriff if the person is:
98.4    (1) a professional or professional's delegate who is engaged in the practice of
98.5the healing arts, social services, hospital administration, psychological or psychiatric
98.6treatment, child care, education, correctional supervision, probation and correctional
98.7services, or law enforcement; or
98.8    (2) employed as a member of the clergy and received the information while
98.9engaged in ministerial duties, provided that a member of the clergy is not required by
98.10this subdivision to report information that is otherwise privileged under section 595.02,
98.11subdivision 1 , paragraph (c).
98.12    The police department or the county sheriff, upon receiving a report, shall
98.13immediately notify the local welfare agency or agency responsible for assessing or
98.14investigating the report, orally and in writing. The local welfare agency, or agency
98.15responsible for assessing or investigating the report, upon receiving a report, shall
98.16immediately notify the local police department or the county sheriff orally and in writing.
98.17The county sheriff and the head of every local welfare agency, agency responsible
98.18for assessing or investigating reports, and police department shall each designate a
98.19person within their agency, department, or office who is responsible for ensuring that
98.20the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
98.21this subdivision shall be construed to require more than one report from any institution,
98.22facility, school, or agency.
98.23    (b) Any person may voluntarily report to the local welfare agency, agency
98.24responsible for assessing or investigating the report, police department, or the county
98.25sheriff if the person knows, has reason to believe, or suspects a child is being or has been
98.26neglected or subjected to physical or sexual abuse. The police department or the county
98.27sheriff, upon receiving a report, shall immediately notify the local welfare agency or
98.28agency responsible for assessing or investigating the report, orally and in writing. The
98.29local welfare agency or agency responsible for assessing or investigating the report, upon
98.30receiving a report, shall immediately notify the local police department or the county
98.31sheriff orally and in writing.
98.32    (c) A person mandated to report physical or sexual child abuse or neglect occurring
98.33within a licensed facility shall report the information to the agency responsible for
98.34licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
98.35chapter 245B; or a nonlicensed personal care provider organization as defined in sections
98.36256B.04, subdivision 16 ; and 256B.0625, subdivision 19. A health or corrections agency
99.1receiving a report may request the local welfare agency to provide assistance pursuant
99.2to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work
99.3within a school facility, upon receiving a complaint of alleged maltreatment, shall provide
99.4information about the circumstances of the alleged maltreatment to the commissioner of
99.5education. Section 13.03, subdivision 4, applies to data received by the commissioner of
99.6education from a licensing entity.
99.7    (d) Any person mandated to report shall receive a summary of the disposition of
99.8any report made by that reporter, including whether the case has been opened for child
99.9protection or other services, or if a referral has been made to a community organization,
99.10unless release would be detrimental to the best interests of the child. Any person who is
99.11not mandated to report shall, upon request to the local welfare agency, receive a concise
99.12summary of the disposition of any report made by that reporter, unless release would be
99.13detrimental to the best interests of the child.
99.14    (e) For purposes of this subdivision section, "immediately" means as soon as
99.15possible but in no event longer than 24 hours.

99.16    Sec. 81. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
99.17to read:
99.18    Subd. 3e. Agency responsibility for assessing or investigating reports of sexual
99.19abuse. The local welfare agency is the agency responsible for investigating allegations
99.20of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual
99.21functioning within the family unit as a person responsible for the child's care, or a person
99.22with a significant relationship to the child if that person resides in the child's household.

99.23    Sec. 82. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
99.24to read:
99.25    Subd. 3f. Law enforcement agency responsibility for investigating
99.26maltreatment. The local law enforcement agency has responsibility for investigating any
99.27report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement
99.28and the responsible agency must coordinate their investigations or assessments as required
99.29under subdivision 10.

99.30    Sec. 83. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:
99.31    Subd. 10. Duties of local welfare agency and local law enforcement agency upon
99.32receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine
100.1whether to conduct a family assessment or an investigation as appropriate to prevent or
100.2provide a remedy for child maltreatment. The local welfare agency:
100.3    (1) shall conduct an investigation on reports involving substantial child
100.4endangerment;
100.5    (2) shall begin an immediate investigation if, at any time when it is using a family
100.6assessment response, it determines that there is reason to believe that substantial child
100.7endangerment or a serious threat to the child's safety exists;
100.8    (3) may conduct a family assessment for reports that do not allege substantial child
100.9endangerment. In determining that a family assessment is appropriate, the local welfare
100.10agency may consider issues of child safety, parental cooperation, and the need for an
100.11immediate response; and
100.12    (4) may conduct a family assessment on a report that was initially screened and
100.13assigned for an investigation. In determining that a complete investigation is not required,
100.14the local welfare agency must document the reason for terminating the investigation and
100.15notify the local law enforcement agency if the local law enforcement agency is conducting
100.16a joint investigation.
100.17    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
100.18or individual functioning within the family unit as a person responsible for the child's
100.19care, or sexual abuse by a person with a significant relationship to the child when that
100.20person resides in the child's household or by a sibling, the local welfare agency shall
100.21immediately conduct a family assessment or investigation as identified in clauses (1) to
100.22(4). In conducting a family assessment or investigation, the local welfare agency shall
100.23gather information on the existence of substance abuse and domestic violence and offer
100.24services for purposes of preventing future child maltreatment, safeguarding and enhancing
100.25the welfare of the abused or neglected minor, and supporting and preserving family
100.26life whenever possible. If the report alleges a violation of a criminal statute involving
100.27sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the
100.28local law enforcement agency and local welfare agency shall coordinate the planning and
100.29execution of their respective investigation and assessment efforts to avoid a duplication of
100.30fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of
100.31the results of its investigation. In cases of alleged child maltreatment resulting in death,
100.32the local agency may rely on the fact-finding efforts of a law enforcement investigation
100.33to make a determination of whether or not maltreatment occurred. When necessary the
100.34local welfare agency shall seek authority to remove the child from the custody of a parent,
100.35guardian, or adult with whom the child is living. In performing any of these duties, the
100.36local welfare agency shall maintain appropriate records.
101.1    If the family assessment or investigation indicates there is a potential for abuse of
101.2alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
101.3the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
101.4Rules, part 9530.6615. The local welfare agency shall report the determination of the
101.5chemical use assessment, and the recommendations and referrals for alcohol and other
101.6drug treatment services to the state authority on alcohol and drug abuse.
101.7    (b) When a local agency receives a report or otherwise has information indicating
101.8that a child who is a client, as defined in section 245.91, has been the subject of physical
101.9abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
101.10245.91 , it shall, in addition to its other duties under this section, immediately inform the
101.11ombudsman established under sections 245.91 to 245.97. The commissioner of education
101.12shall inform the ombudsman established under sections 245.91 to 245.97 of reports
101.13regarding a child defined as a client in section 245.91 that maltreatment occurred at a
101.14school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
101.15    (c) Authority of the local welfare agency responsible for assessing or investigating
101.16the child abuse or neglect report, the agency responsible for assessing or investigating
101.17the report, and of the local law enforcement agency for investigating the alleged abuse or
101.18neglect includes, but is not limited to, authority to interview, without parental consent,
101.19the alleged victim and any other minors who currently reside with or who have resided
101.20with the alleged offender. The interview may take place at school or at any facility or
101.21other place where the alleged victim or other minors might be found or the child may be
101.22transported to, and the interview conducted at, a place appropriate for the interview of a
101.23child designated by the local welfare agency or law enforcement agency. The interview
101.24may take place outside the presence of the alleged offender or parent, legal custodian,
101.25guardian, or school official. For family assessments, it is the preferred practice to request
101.26a parent or guardian's permission to interview the child prior to conducting the child
101.27interview, unless doing so would compromise the safety assessment. Except as provided in
101.28this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible
101.29local welfare or law enforcement agency no later than the conclusion of the investigation
101.30or assessment that this interview has occurred. Notwithstanding rule 49.02 32 of the
101.31Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on
101.32an ex parte motion by the local welfare agency, order that, where reasonable cause exists,
101.33the agency withhold notification of this interview from the parent, legal custodian, or
101.34guardian. If the interview took place or is to take place on school property, the order shall
101.35specify that school officials may not disclose to the parent, legal custodian, or guardian the
101.36contents of the notification of intent to interview the child on school property, as provided
102.1under this paragraph, and any other related information regarding the interview that may
102.2be a part of the child's school record. A copy of the order shall be sent by the local welfare
102.3or law enforcement agency to the appropriate school official.
102.4    (d) When the local welfare, local law enforcement agency, or the agency responsible
102.5for assessing or investigating a report of maltreatment determines that an interview should
102.6take place on school property, written notification of intent to interview the child on school
102.7property must be received by school officials prior to the interview. The notification
102.8shall include the name of the child to be interviewed, the purpose of the interview, and
102.9a reference to the statutory authority to conduct an interview on school property. For
102.10interviews conducted by the local welfare agency, the notification shall be signed by the
102.11chair of the local social services agency or the chair's designee. The notification shall be
102.12private data on individuals subject to the provisions of this paragraph. School officials
102.13may not disclose to the parent, legal custodian, or guardian the contents of the notification
102.14or any other related information regarding the interview until notified in writing by the
102.15local welfare or law enforcement agency that the investigation or assessment has been
102.16concluded, unless a school employee or agent is alleged to have maltreated the child.
102.17Until that time, the local welfare or law enforcement agency or the agency responsible
102.18for assessing or investigating a report of maltreatment shall be solely responsible for any
102.19disclosures regarding the nature of the assessment or investigation.
102.20    Except where the alleged offender is believed to be a school official or employee,
102.21the time and place, and manner of the interview on school premises shall be within the
102.22discretion of school officials, but the local welfare or law enforcement agency shall have
102.23the exclusive authority to determine who may attend the interview. The conditions as to
102.24time, place, and manner of the interview set by the school officials shall be reasonable and
102.25the interview shall be conducted not more than 24 hours after the receipt of the notification
102.26unless another time is considered necessary by agreement between the school officials and
102.27the local welfare or law enforcement agency. Where the school fails to comply with the
102.28provisions of this paragraph, the juvenile court may order the school to comply. Every
102.29effort must be made to reduce the disruption of the educational program of the child, other
102.30students, or school staff when an interview is conducted on school premises.
102.31    (e) Where the alleged offender or a person responsible for the care of the alleged
102.32victim or other minor prevents access to the victim or other minor by the local welfare
102.33agency, the juvenile court may order the parents, legal custodian, or guardian to produce
102.34the alleged victim or other minor for questioning by the local welfare agency or the local
102.35law enforcement agency outside the presence of the alleged offender or any person
102.36responsible for the child's care at reasonable places and times as specified by court order.
103.1    (f) Before making an order under paragraph (e), the court shall issue an order to
103.2show cause, either upon its own motion or upon a verified petition, specifying the basis for
103.3the requested interviews and fixing the time and place of the hearing. The order to show
103.4cause shall be served personally and shall be heard in the same manner as provided in
103.5other cases in the juvenile court. The court shall consider the need for appointment of a
103.6guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
103.7litem shall be present at the hearing on the order to show cause.
103.8    (g) The commissioner of human services, the ombudsman for mental health and
103.9developmental disabilities, the local welfare agencies responsible for investigating reports,
103.10the commissioner of education, and the local law enforcement agencies have the right to
103.11enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
103.12including medical records, as part of the investigation. Notwithstanding the provisions of
103.13chapter 13, they also have the right to inform the facility under investigation that they are
103.14conducting an investigation, to disclose to the facility the names of the individuals under
103.15investigation for abusing or neglecting a child, and to provide the facility with a copy of
103.16the report and the investigative findings.
103.17    (h) The local welfare agency responsible for conducting a family assessment or
103.18investigation shall collect available and relevant information to determine child safety,
103.19risk of subsequent child maltreatment, and family strengths and needs and share not public
103.20information with an Indian's tribal social services agency without violating any law of the
103.21state that may otherwise impose duties of confidentiality on the local welfare agency in
103.22order to implement the tribal state agreement. The local welfare agency or the agency
103.23responsible for investigating the report shall collect available and relevant information
103.24to ascertain whether maltreatment occurred and whether protective services are needed.
103.25Information collected includes, when relevant, information with regard to the person
103.26reporting the alleged maltreatment, including the nature of the reporter's relationship to the
103.27child and to the alleged offender, and the basis of the reporter's knowledge for the report;
103.28the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
103.29collateral sources having relevant information related to the alleged maltreatment. The
103.30local welfare agency or the agency responsible for assessing or investigating the report
103.31may make a determination of no maltreatment early in an assessment, and close the case
103.32and retain immunity, if the collected information shows no basis for a full assessment or
103.33investigation.
103.34    Information relevant to the assessment or investigation must be asked for, and
103.35may include:
104.1    (1) the child's sex and age, prior reports of maltreatment, information relating
104.2to developmental functioning, credibility of the child's statement, and whether the
104.3information provided under this clause is consistent with other information collected
104.4during the course of the assessment or investigation;
104.5    (2) the alleged offender's age, a record check for prior reports of maltreatment, and
104.6criminal charges and convictions. The local welfare agency or the agency responsible for
104.7assessing or investigating the report must provide the alleged offender with an opportunity
104.8to make a statement. The alleged offender may submit supporting documentation relevant
104.9to the assessment or investigation;
104.10    (3) collateral source information regarding the alleged maltreatment and care of the
104.11child. Collateral information includes, when relevant: (i) a medical examination of the
104.12child; (ii) prior medical records relating to the alleged maltreatment or the care of the
104.13child maintained by any facility, clinic, or health care professional and an interview with
104.14the treating professionals; and (iii) interviews with the child's caretakers, including the
104.15child's parent, guardian, foster parent, child care provider, teachers, counselors, family
104.16members, relatives, and other persons who may have knowledge regarding the alleged
104.17maltreatment and the care of the child; and
104.18    (4) information on the existence of domestic abuse and violence in the home of
104.19the child, and substance abuse.
104.20    Nothing in this paragraph precludes the local welfare agency, the local law
104.21enforcement agency, or the agency responsible for assessing or investigating the report
104.22from collecting other relevant information necessary to conduct the assessment or
104.23investigation. Notwithstanding section 13.384 or 144.335, the local welfare agency has
104.24access to medical data and records for purposes of clause (3). Notwithstanding the data's
104.25classification in the possession of any other agency, data acquired by the local welfare
104.26agency or the agency responsible for assessing or investigating the report during the course
104.27of the assessment or investigation are private data on individuals and must be maintained
104.28in accordance with subdivision 11. Data of the commissioner of education collected
104.29or maintained during and for the purpose of an investigation of alleged maltreatment
104.30in a school are governed by this section, notwithstanding the data's classification as
104.31educational, licensing, or personnel data under chapter 13.
104.32    In conducting an assessment or investigation involving a school facility as defined
104.33in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
104.34reports and data that are relevant to a report of maltreatment and are from local law
104.35enforcement and the school facility.
105.1    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face
105.2contact with the child reported to be maltreated and with the child's primary caregiver
105.3sufficient to complete a safety assessment and ensure the immediate safety of the child.
105.4The face-to-face contact with the child and primary caregiver shall occur immediately
105.5if substantial child endangerment is alleged and within five calendar days for all other
105.6reports. If the alleged offender was not already interviewed as the primary caregiver, the
105.7local welfare agency shall also conduct a face-to-face interview with the alleged offender
105.8in the early stages of the assessment or investigation. At the initial contact, the local child
105.9welfare agency or the agency responsible for assessing or investigating the report must
105.10inform the alleged offender of the complaints or allegations made against the individual in
105.11a manner consistent with laws protecting the rights of the person who made the report.
105.12The interview with the alleged offender may be postponed if it would jeopardize an active
105.13law enforcement investigation.
105.14    (j) When conducting an investigation, the local welfare agency shall use a question
105.15and answer interviewing format with questioning as nondirective as possible to elicit
105.16spontaneous responses. For investigations only, the following interviewing methods and
105.17procedures must be used whenever possible when collecting information:
105.18    (1) audio recordings of all interviews with witnesses and collateral sources; and
105.19    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with
105.20the alleged victim and child witnesses.
105.21    (k) In conducting an assessment or investigation involving a school facility as
105.22defined in subdivision 2, paragraph (i), the commissioner of education shall collect
105.23available and relevant information and use the procedures in paragraphs (i), (k), and
105.24subdivision 3d, except that the requirement for face-to-face observation of the child
105.25and face-to-face interview of the alleged offender is to occur in the initial stages of the
105.26assessment or investigation provided that the commissioner may also base the assessment
105.27or investigation on investigative reports and data received from the school facility and
105.28local law enforcement, to the extent those investigations satisfy the requirements of
105.29paragraphs (i) and (k), and subdivision 3d.

105.30    Sec. 84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to
105.31read:
105.32    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility
105.33for investigation; welfare agency reliance on law enforcement fact-finding; welfare
105.34agency offer of services. (a) If the report alleges neglect, physical abuse, or sexual abuse
105.35by a person who is not a parent, guardian, sibling, person responsible for the child's care
106.1functioning outside within the family unit, or a person who lives in the child's household
106.2and who has a significant relationship to the child, in a setting other than a facility as
106.3defined in subdivision 2, the local welfare agency shall immediately notify the appropriate
106.4law enforcement agency, which shall conduct an investigation of the alleged abuse or
106.5neglect if a violation of a criminal statute is alleged.
106.6    (b) The local agency may rely on the fact-finding efforts of the law enforcement
106.7investigation conducted under this subdivision to make a determination whether or not
106.8threatened harm or other maltreatment has occurred under subdivision 2 if an alleged
106.9offender has minor children or lives with minors.
106.10    (c) The local welfare agency shall offer appropriate social services for the purpose of
106.11safeguarding and enhancing the welfare of the abused or neglected minor.

106.12    Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to
106.13read:
106.14    Subd. 10c. Duties of local social service agency upon receipt of a report of
106.15medical neglect. If the report alleges medical neglect as defined in section 260C.007,
106.16subdivision 4 6 , clause (5), the local welfare agency shall, in addition to its other duties
106.17under this section, immediately consult with designated hospital staff and with the parents
106.18of the infant to verify that appropriate nutrition, hydration, and medication are being
106.19provided; and shall immediately secure an independent medical review of the infant's
106.20medical charts and records and, if necessary, seek a court order for an independent medical
106.21examination of the infant. If the review or examination leads to a conclusion of medical
106.22neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings
106.23under section 260C.141 and by filing an expedited motion to prevent the withholding
106.24of medically indicated treatment.

106.25    Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:
106.26    Subd. 10f. Notice of determinations. Within ten working days of the conclusion
106.27of a family assessment, the local welfare agency shall notify the parent or guardian of
106.28the child of the need for services to address child safety concerns or significant risk of
106.29subsequent child maltreatment. The local welfare agency and the family may also jointly
106.30agree that family support and family preservation services are needed. Within ten working
106.31days of the conclusion of an investigation, the local welfare agency or agency responsible
106.32for assessing or investigating the report shall notify the parent or guardian of the child, the
106.33person determined to be maltreating the child, and if applicable, the director of the facility,
106.34of the determination and a summary of the specific reasons for the determination. The
107.1notice must also include a certification that the information collection procedures under
107.2subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a
107.3data subject to obtain access to other private data on the subject collected, created, or
107.4maintained under this section. In addition, the notice shall include the length of time that
107.5the records will be kept under subdivision 11c. The investigating agency shall notify the
107.6parent or guardian of the child who is the subject of the report, and any person or facility
107.7determined to have maltreated a child, of their appeal or review rights under this section
107.8or section 256.022. The notice must also state that a finding of maltreatment may result
107.9in denial of a license application or background study disqualification under chapter
107.10245C related to employment or services that are licensed by the Department of Human
107.11Services under chapter 245A, the Department of Health under chapter 144 or 144A, the
107.12Department of Corrections under section 241.021, and from providing services related to
107.13an unlicensed personal care provider organization under chapter 256B.

107.14    Sec. 87. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.
107.15    (a) The commissioner of human services shall fund a two-year demonstration grant
107.16to be transferred to a nonprofit organization experienced in kinship advocacy and policy
107.17that has:
107.18    (1) experience working with grandparents and relatives who are raising kinship
107.19children;
107.20    (2) an established statewide outreach network;
107.21    (3) established kinship support groups;
107.22    (4) an intergenerational approach to programming; and
107.23    (5) a board of directors consisting of 50 percent grandparents and relatives raising
107.24kinship children.
107.25    (b) The purpose of the grant is to provide support to grandparents or relatives raising
107.26kinship children. One site must be in the metropolitan area, and the other in the Bemidji
107.27region. One-stop services may include, but are not limited to, legal services, education,
107.28information, family activities, support groups, mental health access, advocacy, mentors,
107.29and information related to foster care licensing. Funds may also be used for a media
107.30campaign to inform kinship families about available information and services, support
107.31sites, and other program development.

107.32    Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.
108.1    Subdivision 1. Establishment. A pilot program is established in Stearns and
108.2Benton Counties to expand the Workforce U program administered by the Stearns-Benton
108.3Employment and Training Council.
108.4    Subd. 2. Evaluation. The Workforce U pilot program must be evaluated by a
108.5research and evaluation organization with experience evaluating welfare programs. The
108.6evaluation must include information on the total number of persons served, percentage
108.7of participants exiting the program, percentage of former participants reentering the
108.8program, average wages of program participants, and recommendations to the legislature
108.9for possible statewide implementation of the program. The evaluation must be presented
108.10to the legislature by February 15, 2011.
108.11    Subd. 3. Expiration. The Workforce U pilot program expires on June 30, 2011.

108.12    Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.
108.13    (a) The commissioner of human services shall provide a planning grant to address
108.14the unmet need for local, effective, culturally relevant alcohol and drug treatment for
108.15American Indian youth, and develop a plan for a family-based youth treatment center in
108.16the Leech Lake area. The planning grant must be provided to a volunteer board consisting
108.17of at least four members appointed by the commissioner, to include at least the following:
108.18    (1) two members of the Leech Lake Tribal Council or their designees;
108.19    (2) one member appointed by the Cass County Social Services administrator; and
108.20    (3) one member appointed by the Cass Lake-Bena Public School superintendent.
108.21    (b) The plan must include:
108.22    (1) an interest, feasibility, and suitability of location study;
108.23    (2) defining scope of programs and services to be offered;
108.24    (3) defining site use limitations and restrictions, including physical and capacity;
108.25    (4) defining facilities required for programs and services offered;
108.26    (5) identifying partners, partnership roles, and partner resources;
108.27    (6) developing proposed operating and maintenance budgets;
108.28    (7) identifying funding sources;
108.29    (8) developing a long-term funding plan; and
108.30    (9) developing a formal steering committee, structure, and bylaws.
108.31    (c) The plan is due to the legislative committees having jurisdiction over chemical
108.32health issues no later than September 2008 in order to provide the 12 months necessary to
108.33complete the plan.

109.1    Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED
109.2APPLICATION.
109.3    The Department of Human Services shall create a simplified application for the
109.4Minnesota food support program for persons over the age of 60 and persons with
109.5disabilities. The application must be no longer than three pages in length.
109.6EFFECTIVE DATE.This section is effective January 1, 2008.

109.7    Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.
109.8    The commissioner of human services, in consultation with the commissioners of
109.9health and education and the counties, shall develop and present recommendations to
109.10the legislature in January 2008 in order for each legally unlicensed child care provider
109.11receiving child care assistance funds to receive a onetime home visit to receive information
109.12on health and safety, and school readiness.

109.13    Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY
109.14CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT
109.15TRAINING.
109.16    Subdivision 1. Development and implementation of an early childhood and
109.17school-age professional development system. (a) The commissioner of human services,
109.18in cooperation with the commissioners of education and health, shall develop and phase-in
109.19the implementation of a professional development system for practitioners serving
109.20children in early childhood and school-age programs. The system shall provide training
109.21options and supports for practitioners to voluntarily choose, as they complete or exceed
109.22existing licensing requirements.
109.23    The system must, at a minimum, include the following features:
109.24    (1) a continuum of training content based on the early childhood and school-age
109.25care practitioner core competencies that translates knowledge into improved practice to
109.26support children's school success;
109.27    (2) training strategies that provide direct feedback about practice to practitioners
109.28through ongoing consultation, mentoring, or coaching with special emphasis on early
109.29literacy and early mathematics;
109.30    (3) an approval process for trainers;
109.31    (4) a professional development registry for early childhood and school-age care
109.32practitioners that will provide tracking and recognition of practitioner training/career
109.33development progress;
110.1    (5) a career lattice that includes a range of professional development and educational
110.2opportunities that provide appropriate coursework and degree pathways;
110.3    (6) development of a plan with public higher education institutions for an articulated
110.4system of education, training, and professional development that includes credit for prior
110.5learning and development of equivalences to two- and four-year degrees;
110.6    (7) incentives and supports for early childhood and school-age care practitioners
110.7to seek additional training and education, including TEACH, other scholarships, and
110.8career guidance; and
110.9    (8) coordinated and accessible delivery of training to early childhood and school-age
110.10care practitioners.
110.11    (b) By January 1, 2008, the commissioner, in consultation with the organizations
110.12named in subdivision 2 shall develop additional opportunities in order to qualify more
110.13licensed family child care providers under section 119B.13, subdivision 3a.
110.14    (c) The commissioner of human services must evaluate the professional development
110.15system and make continuous improvements.
110.16    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall
110.17phase-in the professional development system.
110.18    Subd. 2. Two-hour early childhood training. By January 15, 2008, the
110.19commissioner of human services, with input from the Minnesota Licensed Family Child
110.20Care Association and the Minnesota Professional Development Council, shall identify
110.21trainings that qualify for the two-hour early childhood development training requirement
110.22for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision
110.239a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also
110.24seek the input of labor unions that serve licensed family child care providers, if the union
110.25has been recognized by a county to serve licensed family child care providers.

110.26    Sec. 93. SCHOOL READINESS SERVICE AGREEMENTS.
110.27    Subdivision 1. Overview. (a) Effective July 1, 2007, funds must be made available
110.28to allow the commissioner to pay higher rates to up to 50 child care providers who are
110.29deemed by the commissioner to meet the requirements of a school readiness service
110.30agreement (SRSA) provider and perform services that support school readiness for
110.31children and economic stability for parents.
110.32    (b) A provider may be paid a rate above that currently allowed under Minnesota
110.33Statutes, section 119B.13, if:
110.34    (1) the provider has entered into an SRSA with the commissioner;
111.1    (2) a family using that provider receives child care assistance under any provision in
111.2Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
111.3    (3) the family using that provider meets the criteria in this section; and
111.4    (4) funding is available under this section.
111.5    Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
111.6apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:
111.7    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter
111.8119B;
111.9    (2) have at least 25 percent of the children enrolled with the provider subsidized
111.10through the child care assistance program;
111.11    (3) provide full-time, full-year child care services; and
111.12    (4) serve at least one child who is subsidized through the child care assistance
111.13program and who is expected to enter kindergarten within the following 30 months.
111.14    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause
111.15(2), if necessary to achieve geographic distribution of SRSA providers and diversity of
111.16types of care provided by SRSA providers.
111.17    (c) An eligible provider who would like to enter into an SRSA with the commissioner
111.18shall submit an SRSA application. To determine whether to enter into an SRSA with a
111.19provider, the commissioner shall evaluate the following factors:
111.20    (1) the qualifications of the provider and the provider's staff;
111.21    (2) the provider's staff-child ratios;
111.22    (3) the provider's curriculum;
111.23    (4) the provider's current or planned parent education activities;
111.24    (5) the provider's current or planned social service and employment linkages;
111.25    (6) the provider's child development assessment plan;
111.26    (7) the geographic distribution needed for SRSA providers;
111.27    (8) the inclusion of a variety of child care delivery models; and
111.28    (9) other related factors determined by the commissioner.
111.29    Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
111.30provider for their children shall:
111.31    (1) be eligible to receive child care assistance under any provision in Minnesota
111.32Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
111.33    (2) be in an authorized activity for an average of at least 35 hours per week when
111.34initial eligibility is determined; and
111.35    (3) include a child who has not yet entered kindergarten.
112.1    (b) A family who is determined to be eligible to choose an SRSA provider remains
112.2eligible to be paid at a higher rate through the SRSA provider when the following
112.3conditions exist:
112.4    (1) the child attends child care with the SRSA provider a minimum of 25 hours per
112.5week, on average;
112.6    (2) the family has a child who has not yet entered kindergarten; and
112.7    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except
112.8Minnesota Statutes, section 119B.035.
112.9    (c) For the 12 months after initial eligibility has been determined, a decrease in
112.10the family's authorized activities to an average of less than 35 hours per week does not
112.11result in ineligibility for the SRSA rate.
112.12    (d) A family that moves between counties but continues to use the same SRSA
112.13provider shall continue to receive SRSA funding for the increased payments.
112.14    Subd. 4. Requirements of providers. An SRSA must include assessment,
112.15evaluation, and reporting requirements that promote the goals of improved school
112.16readiness and movement toward appropriate child development milestones. A provider
112.17who enters into an SRSA shall comply with the assessment, evaluation, and reporting
112.18requirements in the SRSA.
112.19    Subd. 5. Relationship to current law. (a) The following provisions in Minnesota
112.20Statutes, chapter 119B, must be waived or modified for families receiving services under
112.21this section.
112.22    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a,
112.23maximum weekly rates under this section are 125 percent of the existing maximum
112.24weekly rate for like-care. Providers eligible for a differential rate under Minnesota
112.25Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the
112.26rate identified in this section. Only care for children who have not yet entered kindergarten
112.27may be paid at the maximum rate under this section. The provider's charge for service
112.28provided through an SRSA may not exceed the rate that the provider charges a private-pay
112.29family for like-care arrangements.
112.30    (c) A family or child care provider may not be assessed an overpayment for care
112.31provided through an SRSA unless:
112.32    (1) there was an error in the amount of care authorized for the family; or
112.33    (2) the family or provider did not timely report a change as required under the law.
112.34    (d) Care provided through an SRSA is authorized on a weekly basis.
112.35    (e) Funds appropriated under this section to serve families eligible under Minnesota
112.36Statutes, section 119B.03, are not allocated through the basic sliding fee formula under
113.1Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to
113.2offset increased costs when payments are made under SRSA's.
113.3    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the
113.4maximum amount of child care assistance that may be authorized for a child receiving
113.5care through an SRSA in a two-week period is 160 hours per child.
113.6    Subd. 6. Establishment of service agreements. (a) The commissioner shall
113.7approve SRSA's for up to 50 providers that represent diverse parts of the state and a
113.8variety of child care delivery models. Entering into a service agreement does not guarantee
113.9that a provider will receive payment at a higher rate for families receiving child care
113.10assistance. A family eligible under this section shall choose a provider participating in an
113.11SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by
113.12the availability of SRSA funds.
113.13    (b) Nothing in this section shall be construed to limit parent choice as defined in
113.14Minnesota Statutes, section 119B.09, subdivision 5.
113.15    (c) The commissioner may allow for startup time for some providers if failing to
113.16do so would limit geographic diversity of SRSA providers or a variety of child care
113.17delivery models.

113.18    Sec. 94. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.
113.19    Subdivision 1. Establishment. A family, friend, and neighbor (FFN) grant program
113.20is established to promote children's early literacy, healthy development, and school
113.21readiness, and to foster community partnerships to promote children's school readiness.
113.22The commissioner shall attempt to ensure that grants are made in all areas of the state. The
113.23commissioner of human services shall make grants available to fund: community-based
113.24organizations, nonprofit organizations, and Indian tribes working with FFN caregivers
113.25under subdivision 2, paragraph (a); and community-based partnerships to implement early
113.26literacy programs under subdivision 2, paragraph (b).
113.27    Subd. 2. Program components. (a)(1) Grants that the commissioner awards under
113.28this section must be used by community-based organizations, nonprofit organizations, and
113.29Indian tribes working with FFN caregivers in local communities, cultural communities,
113.30and Indian tribes to:
113.31    (i) provide training, support, and resources to FFN caregivers in order to improve
113.32and promote children's health, safety, nutrition, and school readiness;
113.33    (ii) connect FFN caregivers and children's families with appropriate community
113.34resources that support the families' health, mental health, economic, and developmental
113.35needs;
114.1    (iii) connect FFN caregivers and children's families to early childhood screening
114.2programs and facilitate referrals where appropriate;
114.3    (iv) provide FFN caregivers and children's families with information about early
114.4learning guidelines from the Departments of Human Services and Education;
114.5    (v) provide FFN caregivers and children's families with information about becoming
114.6a licensed family child care provider; and
114.7    (vi) provide FFN caregivers and children's families with information about early
114.8learning allowances and enrollment opportunities in high quality community-based
114.9child-care and preschool programs.
114.10    (2) Grants that the commissioner awards under this paragraph also may be used for:
114.11    (i) health and safety and early learning kits for FFN caregivers;
114.12    (ii) play-and-learn groups with FFN caregivers;
114.13    (iii) culturally appropriate early childhood training for FFN caregivers;
114.14    (iv) transportation for FFN caregivers and children's families to school readiness and
114.15other early childhood training activities;
114.16    (v) other activities that promote school readiness;
114.17    (vi) data collection and evaluation;
114.18    (vii) staff outreach and outreach activities;
114.19    (viii) translation needs; or
114.20    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.
114.21    (b) Grants that the commissioner awards under this section also must be used to fund
114.22partnerships among Minnesota public and regional library systems, community-based
114.23organizations, nonprofit organizations, and Indian tribes to implement early literacy
114.24programs in low-income communities, including tribal communities, to:
114.25    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers
114.26and children's families with books, training, and early literacy activities;
114.27    (2) provide FFN caregivers and children's families with translations of early
114.28childhood books, training, and early literacy activities in native languages; or
114.29    (3) provide FFN caregivers and children's families with early literacy activities in
114.30local libraries.
114.31    Subd. 3. Grant awards. Interested entities eligible to receive a grant under
114.32this section may apply to the commissioner in the form and manner the commissioner
114.33determines. The commissioner shall awards grants to eligible entities consistent with
114.34the requirements of this section.
114.35    Subd. 4. Evaluation. The commissioner, in consultation with early childhood
114.36care and education experts at the University of Minnesota, must evaluate the impact of
115.1the grants under subdivision 2 on children's school readiness and submit a written report
115.2to the human services and education finance and policy committees of the legislature by
115.3February 15, 2010.
115.4EFFECTIVE DATE.This section is effective the day following final enactment.

115.5    Sec. 95. CHILD CARE PROVIDER STUDY.
115.6    The commissioner of human services is directed to study the implications of
115.7restricting the use of state subsidies in center-based child care to centers meeting state
115.8quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to
115.9publish the results no later than January 1, 2010. The study must include:
115.10    (1) the likelihood of there being sufficient child care providers meeting the standards;
115.11    (2) the cost to bring providers up to the standards and how this cost would be funded;
115.12    (3) how the standards and the ratings would be communicated to both parents and
115.13the general public; and
115.14    (4) a determination whether a similar system could be implemented for
115.15non-center-based care.

115.16    Sec. 96. DIRECTION TO COMMISSIONER.
115.17    (a) The commissioner of human services shall offer a request for proposals to
115.18identify a research and evaluation firm with experience working with:
115.19    (1) homeless youth providers;
115.20    (2) data; and
115.21    (3) the topics of housing, homelessness, and a continuum of care for youth.
115.22    (b) The research and evaluation firm identified under paragraph (a) shall monitor and
115.23evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.

115.24    Sec. 97. REVISOR'S INSTRUCTION.
115.25    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
115.26as Minnesota Statutes, section 626.556, subdivision 3g.
115.27    (b) The revisor shall change references to Minnesota Statutes, section 260.851,
115.28to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to
115.29section 260.853, article 4, wherever those references appear in Minnesota Statutes and
115.30Minnesota Rules.

115.31    Sec. 98. REPEALER.
116.1(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37,
116.2subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.
116.3(b) Laws 1997, chapter 8, section 1, is repealed.
116.4(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.

116.5ARTICLE 2

116.6LICENSING

116.7    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:
116.8245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY
116.9LICENSE RELATIVE PLACEMENT.
116.10    Subdivision 1. Grant of Emergency license placement. Notwithstanding section
116.11245A.03, subdivision 2a , or 245C.13, subdivision 2, a county agency may place a child
116.12for foster care with a relative who is not licensed to provide foster care, provided the
116.13requirements of subdivision 2 this section are met. As used in this section, the term
116.14"relative" has the meaning given it under section 260C.007, subdivision 27.
116.15    Subd. 2. Cooperation with emergency licensing placement process. (a) A county
116.16agency that places a child with a relative who is not licensed to provide foster care must
116.17begin the process of securing an emergency license for the relative as soon as possible
116.18and must conduct the initial inspection required by subdivision 3, clause (1), whenever
116.19possible, prior to placing the child in the relative's home, but no later than three working
116.20days after placing the child in the home. A child placed in the home of a relative who is
116.21not licensed to provide foster care must be removed from that home if the relative fails
116.22to cooperate with the county agency in securing an emergency foster care license. The
116.23commissioner may issue an emergency foster care license to a relative with whom the
116.24county agency wishes to place or has placed a child for foster care, or to a relative with
116.25whom a child has been placed by court order.
116.26    (b) If a child is to be placed in the home of a relative not licensed to provide foster
116.27care, either the placing agency or the county agency in the county in which the relative
116.28lives shall conduct the emergency licensing placement process as required in this section.
116.29    Subd. 3. Requirements for emergency license placement. Before an emergency
116.30license placement may be issued made, the following requirements must be met:
116.31    (1) the county agency must conduct an initial inspection of the premises where
116.32the foster care placement is to be provided made to ensure the health and safety of any
116.33child placed in the home. The county agency shall conduct the inspection using a form
116.34developed by the commissioner;
117.1    (2) at the time of the inspection or placement, whichever is earlier, the county
117.2agency must provide the relative being considered for an emergency license shall receive
117.3placement an application form for a child foster care license;
117.4    (3) whenever possible, prior to placing the child in the relative's home, the relative
117.5being considered for an emergency license placement shall provide the information
117.6required by section 245C.05; and
117.7    (4) if the county determines, prior to the issuance of an emergency license
117.8placement, that anyone requiring a background study may be prior to licensure of the
117.9home is disqualified under section 245C.14 and chapter 245C, and the disqualification
117.10is one which the commissioner cannot set aside, an emergency license shall placement
117.11must not be issued made.
117.12    Subd. 4. Applicant study. When the county agency has received the information
117.13required by section 245C.05, the county agency shall begin an applicant study according to
117.14the procedures in chapter 245C. The commissioner may issue an emergency license upon
117.15recommendation of the county agency once the initial inspection has been successfully
117.16completed and the information necessary to begin the applicant background study has been
117.17provided. If the county agency does not recommend that the emergency license be granted,
117.18the agency shall notify the relative in writing that the agency is recommending denial to the
117.19commissioner; shall remove any child who has been placed in the home prior to licensure;
117.20and shall inform the relative in writing of the procedure to request review pursuant to
117.21subdivision 6. An emergency license shall be effective until a child foster care license is
117.22granted or denied, but shall in no case remain in effect more than 120 days from the date
117.23of placement submit the information to the commissioner according to section 245C.05.
117.24    Subd. 5. Child foster care license application. (a) The relatives with whom the
117.25emergency license holder placement has been made shall complete the child foster care
117.26license application and necessary paperwork within ten days of the placement. The county
117.27agency shall assist the emergency license holder applicant to complete the application.
117.28The granting of a child foster care license to a relative shall be under the procedures in this
117.29chapter and according to the standards set forth by foster care rule in Minnesota Rules,
117.30chapter 2960. In licensing a relative, the commissioner shall consider the importance of
117.31maintaining the child's relationship with relatives as an additional significant factor in
117.32determining whether to a background study disqualification should be set aside a licensing
117.33disqualifier under section 245C.22, or to grant a variance of licensing requirements should
117.34be granted under sections 245C.21 to 245C.27 section 245C.30.
117.35    (b) When the county or private child-placing agency is processing an application
117.36for child foster care licensure of a relative as defined in section 260B.007, subdivision
118.112 , or 260C.007, subdivision 27, the county agency or child-placing agency must explain
118.2the licensing process to the prospective licensee, including the background study process
118.3and the procedure for reconsideration of an initial disqualification for licensure. The
118.4county or private child-placing agency must also provide the prospective relative licensee
118.5with information regarding appropriate options for legal representation in the pertinent
118.6geographic area. If a relative is initially disqualified under section 245C.14, the county
118.7or child-placing agency commissioner must provide written notice of the reasons for the
118.8disqualification and the right to request a reconsideration by the commissioner as required
118.9under section 245C.17.
118.10    (c) The commissioner shall maintain licensing data so that activities related to
118.11applications and licensing actions for relative foster care providers may be distinguished
118.12from other child foster care settings.
118.13    Subd. 6. Denial of emergency license. If the commissioner denies an application
118.14for an emergency foster care license under this section, that denial must be in writing and
118.15must include reasons for the denial. Denial of an emergency license is not subject to
118.16appeal under chapter 14. The relative may request a review of the denial by submitting
118.17to the commissioner a written statement of the reasons an emergency license should be
118.18granted. The commissioner shall evaluate the request for review and determine whether
118.19to grant the emergency license. The commissioner's review shall be based on a review
118.20of the records submitted by the county agency and the relative. Within 15 working
118.21days of the receipt of the request for review, the commissioner shall notify the relative
118.22requesting review in written form whether the emergency license will be granted. The
118.23commissioner's review shall be based on a review of the records submitted by the county
118.24agency and the relative. A child shall not be placed or remain placed in the relative's home
118.25while the request for review is pending. Denial of an emergency license shall not preclude
118.26an individual from reapplying for an emergency license or from applying for a child foster
118.27care license. The decision of the commissioner is the final administrative agency action.

118.28    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:
118.29    Subd. 2. County fees for background studies and licensing inspections. (a) For
118.30purposes of family and group family child care licensing under this chapter, a county
118.31agency may charge a fee to an applicant or license holder to recover the actual cost of
118.32background studies, but in any case not to exceed $100 annually. A county agency may
118.33also charge a license fee to an applicant or license holder to recover the actual cost of
118.34licensing inspections, but in any case not to exceed $150 annually $50 for a one-year
118.35license or $100 for a two-year license.
119.1    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
119.2applicant for authorization to recover the actual cost of background studies completed
119.3under section 119B.125, but in any case not to exceed $100 annually.
119.4    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
119.5    (1) in cases of financial hardship;
119.6    (2) if the county has a shortage of providers in the county's area;
119.7    (3) for new providers; or
119.8    (4) for providers who have attained at least 16 hours of training before seeking
119.9initial licensure.
119.10    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
119.11an installment basis for up to one year. If the provider is receiving child care assistance
119.12payments from the state, the provider may have the fees under paragraph (a) or (b)
119.13deducted from the child care assistance payments for up to one year and the state shall
119.14reimburse the county for the county fees collected in this manner.
119.15EFFECTIVE DATE.This section is effective the day following final enactment.

119.16    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:
119.17    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
119.18private agencies that have been designated or licensed by the commissioner to perform
119.19licensing functions and activities under section 245A.04 and background studies for adult
119.20foster care, family adult day services, family child care, and child foster care under chapter
119.21245C,; to recommend denial of applicants under section 245A.05,; to issue correction
119.22orders, to issue variances, and recommend a conditional license under section 245A.06, or
119.23to recommend suspending or revoking a license or issuing a fine under section 245A.07,
119.24shall comply with rules and directives of the commissioner governing those functions and
119.25with this section. The following variances are excluded from the delegation of variance
119.26authority and may be issued only by the commissioner:
119.27    (1) dual licensure of family child care and child foster care, dual licensure of child
119.28and adult foster care, and adult foster care and family child care;
119.29    (2) adult foster care maximum capacity;
119.30    (3) adult foster care minimum age requirement;
119.31    (4) child foster care maximum age requirement;
119.32    (5) variances regarding disqualified individuals except that county agencies may
119.33issue variances under section 245C.30 regarding disqualified individuals when the county
119.34is responsible for conducting a consolidated reconsideration according to sections 245C.25
120.1and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
120.2and a disqualification based on serious or recurring maltreatment; and
120.3    (6) the required presence of a caregiver in the adult foster care residence during
120.4normal sleeping hours.
120.5    (b) County agencies must report:
120.6    (1) information about disqualification reconsiderations under sections 245C.25 and
120.7245C.27, subdivision 2 , clauses paragraphs (a) and (b), and variances granted under
120.8paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by
120.9the commissioner; and.
120.10    (2) for relative child foster care applicants and license holders, the number of
120.11relatives, as defined in section 260C.007, subdivision 27, and household members of
120.12relatives who are disqualified under section 245C.14; the disqualifying characteristics
120.13under section 245C.15; the number of these individuals who requested reconsideration
120.14under section 245C.21; the number of set-asides under section 245C.22; and variances
120.15under section 245C.30 issued. This information shall be reported to the commissioner
120.16annually by January 15 of each year in a format prescribed by the commissioner.
120.17    (c) For family day care programs, the commissioner may authorize licensing reviews
120.18every two years after a licensee has had at least one annual review.
120.19    (d) For family adult day services programs, the commissioner may authorize
120.20licensing reviews every two years after a licensee has had at least one annual review.
120.21    (e) A license issued under this section may be issued for up to two years.
120.22    (f) The commissioner shall work with counties to determine the cost and propose
120.23an ongoing funding allocation from the general fund to cover the cost to counties
120.24to implement an annual license review for licensed family child care providers.
120.25The commissioner shall solicit input from counties to determine the outcome. The
120.26commissioner shall report to the committees of the house of representatives and senate
120.27having jurisdiction over early childhood programs by January 15, 2008, as to the costs
120.28and the funding allocation recommended for future use.
120.29EFFECTIVE DATE.This section is effective January 1, 2008.

120.30    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:
120.31    Subd. 3. Recommendations to the commissioner. The county or private agency
120.32shall not make recommendations to the commissioner regarding licensure without first
120.33conducting an inspection, and for adult foster care, family adult day services, family child
120.34care, and child foster care, a background study of the applicant, and evaluation pursuant to
120.35under chapter 245C. The county or private agency must forward its recommendation to
121.1the commissioner regarding the appropriate licensing action within 20 working days of
121.2receipt of a completed application.
121.3EFFECTIVE DATE.This section is effective January 1, 2008.

121.4    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision
121.5to read:
121.6    Subd. 14a. Private agency. "Private agency" has the meaning given in section
121.7245A.02, subdivision 12.

121.8    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
121.9    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
121.10background study of an individual required to be studied under section 245C.03,
121.11subdivision 1 , at least upon application for initial license for all license types.
121.12    (b) The commissioner shall conduct a background study of an individual required to
121.13be studied under section 245C.03, subdivision 1, at reapplication for a license for family
121.14child care, child foster care, and adult foster care, and family adult day services.
121.15    (c) The commissioner is not required to conduct a study of an individual at the time
121.16of reapplication for a license if the individual's background study was completed by the
121.17commissioner of human services for an adult foster care license holder that is also:
121.18    (1) registered under chapter 144D; or
121.19    (2) licensed to provide home and community-based services to people with
121.20disabilities at the foster care location and the license holder does not reside in the foster
121.21care residence; and
121.22    (3) the following conditions are met:
121.23    (i) a study of the individual was conducted either at the time of initial licensure or
121.24when the individual became affiliated with the license holder;
121.25    (ii) the individual has been continuously affiliated with the license holder since
121.26the last study was conducted; and
121.27    (iii) the last study of the individual was conducted on or after October 1, 1995.
121.28    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services
121.29shall conduct a study of an individual required to be studied under section 245C.03, at
121.30the time of reapplication for a child foster care license. The county or private agency
121.31shall collect and forward to the commissioner the information required under section
121.32245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The
121.33background study conducted by the commissioner of human services under this paragraph
122.1must include a review of the information required under section 245C.08, subdivisions
122.21, paragraph (a), clauses (1) to (4), and 3.
122.3    (e) The commissioner of human services shall conduct a background study of an
122.4individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
122.5to (6), who is newly affiliated with a child foster care license holder. The county or
122.6private agency shall collect and forward to the commissioner the information required
122.7under section 245C.05, subdivisions 1 and 5. The background study conducted by the
122.8commissioner of human services under this paragraph must include a review of the
122.9information required under section 245C.08, subdivisions 1, paragraph (a), and 3.
122.10    (f) Applicants for licensure, license holders, and other entities as provided in this
122.11chapter must submit completed background study forms to the commissioner before
122.12individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
122.13contact in any licensed program.
122.14    (e) (g) For purposes of this section, a physician licensed under chapter 147 is
122.15considered to be continuously affiliated upon the license holder's receipt from the
122.16commissioner of health or human services of the physician's background study results.

122.17    Sec. 7. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
122.18    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
122.19background study of an individual required to be studied under section 245C.03,
122.20subdivision 1 , at least upon application for initial license for all license types.
122.21    (b) The commissioner shall conduct a background study of an individual required
122.22to be studied under section 245C.03, subdivision 1, at reapplication for a license for
122.23family child care, child foster care, and adult foster care.
122.24    (c) The commissioner is not required to conduct a study of an individual at the time
122.25of reapplication for a license if the individual's background study was completed by the
122.26commissioner of human services for an adult foster care license holder that is also:
122.27    (1) registered under chapter 144D; or
122.28    (2) licensed to provide home and community-based services to people with
122.29disabilities at the foster care location and the license holder does not reside in the foster
122.30care residence; and
122.31    (3) the following conditions are met:
122.32    (i) a study of the individual was conducted either at the time of initial licensure or
122.33when the individual became affiliated with the license holder;
122.34    (ii) the individual has been continuously affiliated with the license holder since
122.35the last study was conducted; and
123.1    (iii) the last study of the individual was conducted on or after October 1, 1995.
123.2    (d) From January 1, 2008, to December 31, 2009, the commissioner shall conduct
123.3a study of an individual required to be studied under section 245C.03, at the time of
123.4reapplication for a family child care license. The county shall collect and forward to the
123.5commissioner the information required under section 245C.05, subdivisions 1 and 5. The
123.6background study conducted by the commissioner under this paragraph must include a
123.7review of the information required under section 245C.08, subdivisions 1, paragraph
123.8(a), and 3.
123.9    (e) The commissioner shall conduct a background study of an individual specified
123.10under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly
123.11affiliated with a family child care license holder. The county shall collect and forward
123.12to the commissioner the information required under section 245C.05, subdivisions 1
123.13and 5. The background study conducted by the commissioner under this paragraph
123.14must include a review of the information required under section 245C.08, subdivisions
123.151, paragraph (a), and 3.
123.16    (f) Applicants for licensure, license holders, and other entities as provided in this
123.17chapter must submit completed background study forms to the commissioner before
123.18individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
123.19contact in any licensed program.
123.20    (e) (g) For purposes of this section, a physician licensed under chapter 147 is
123.21considered to be continuously affiliated upon the license holder's receipt from the
123.22commissioner of health or human services of the physician's background study results.
123.23EFFECTIVE DATE.This section is effective January 1, 2008.

123.24    Sec. 8. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:
123.25    Subdivision 1. Individual studied. (a) The individual who is the subject of the
123.26background study must provide the applicant, license holder, or other entity under section
123.27245C.04 with sufficient information to ensure an accurate study, including:
123.28    (1) the individual's first, middle, and last name and all other names by which the
123.29individual has been known;
123.30    (2) home address, city, and state of residence;
123.31    (3) zip code;
123.32    (4) sex;
123.33    (5) date of birth; and
123.34    (6) Minnesota driver's license number or state identification number.
124.1    (b) Every subject of a background study conducted or initiated by counties or private
124.2agencies under this chapter must also provide the home address, city, county, and state of
124.3residence for the past five years.
124.4    (c) Every subject of a background study related to child foster care licensed through
124.5a private agency shall also provide the commissioner a signed consent for the release of
124.6any information received from national crime information databases to the private agency
124.7that initiated the background study.
124.8    (d) The subject of a background study shall provide fingerprints as required in
124.9subdivision 5, paragraph (c).

124.10    Sec. 9. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision
124.11to read:
124.12    Subd. 2a. County or private agency. For background studies related to child foster
124.13care, county and private agencies must collect the information under subdivision 1 and
124.14forward it to the commissioner.

124.15    Sec. 10. Minnesota Statutes 2006, section 245C.05, is amended by adding a
124.16subdivision to read:
124.17    Subd. 2b. County agency. For background studies related to family child care,
124.18county agencies must collect the information under subdivision 1 and forward it to the
124.19commissioner.
124.20EFFECTIVE DATE.This section is effective January 1, 2008.

124.21    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:
124.22    Subd. 4. Electronic transmission. For background studies conducted by the
124.23Department of Human Services, the commissioner shall implement a system for the
124.24electronic transmission of:
124.25    (1) background study information to the commissioner; and
124.26    (2) background study results to the license holder; and
124.27    (3) background study results to county and private agencies for background studies
124.28conducted by the commissioner for family child care and child foster care.
124.29EFFECTIVE DATE.This section is effective January 1, 2008.

124.30    Sec. 12. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:
125.1    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background
125.2study completed under this chapter, when the commissioner has reasonable cause to
125.3believe that further pertinent information may exist on the subject of the background
125.4study, the subject shall provide the commissioner with a set of classifiable fingerprints
125.5obtained from an authorized law enforcement agency.
125.6    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause
125.7when, but not limited to, the:
125.8    (1) information from the Bureau of Criminal Apprehension indicates that the subject
125.9is a multistate offender;
125.10    (2) information from the Bureau of Criminal Apprehension indicates that multistate
125.11offender status is undetermined; or
125.12    (3) commissioner has received a report from the subject or a third party indicating
125.13that the subject has a criminal history in a jurisdiction other than Minnesota.
125.14    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for
125.15background studies conducted by the commissioner for child foster care, the subject of the
125.16background study shall provide the commissioner with a set of classifiable fingerprints
125.17obtained from an authorized agency.

125.18    Sec. 13. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
125.19    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
125.20corrections agent shall notify the commissioner of an individual's conviction if the
125.21individual is:
125.22    (1) affiliated with a program or facility regulated by the Department of Human
125.23Services or Department of Health, a facility serving children or youth licensed by the
125.24Department of Corrections, or any type of home care agency or provider of personal care
125.25assistance services; and
125.26    (2) convicted of a crime constituting a disqualification under section 245C.14.
125.27    (b) For the purpose of this subdivision, "conviction" has the meaning given it
125.28in section 609.02, subdivision 5.
125.29    (c) The commissioner, in consultation with the commissioner of corrections, shall
125.30develop forms and information necessary to implement this subdivision and shall provide
125.31the forms and information to the commissioner of corrections for distribution to local
125.32probation officers and corrections agents.
125.33    (d) The commissioner shall inform individuals subject to a background study that
125.34criminal convictions for disqualifying crimes will be reported to the commissioner by the
125.35corrections system.
126.1    (e) A probation officer, corrections agent, or corrections agency is not civilly or
126.2criminally liable for disclosing or failing to disclose the information required by this
126.3subdivision.
126.4    (f) Upon receipt of disqualifying information, the commissioner shall provide the
126.5notice required under section 245C.17, as appropriate, to agencies on record as having
126.6initiated a background study or making a request for documentation of the background
126.7study status of the individual.
126.8    (g) This subdivision does not apply to family child care and child foster care
126.9programs.

126.10    Sec. 14. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
126.11    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
126.12corrections agent shall notify the commissioner of an individual's conviction if the
126.13individual is:
126.14    (1) affiliated with a program or facility regulated by the Department of Human
126.15Services or Department of Health, a facility serving children or youth licensed by the
126.16Department of Corrections, or any type of home care agency or provider of personal care
126.17assistance services; and
126.18    (2) convicted of a crime constituting a disqualification under section 245C.14.
126.19    (b) For the purpose of this subdivision, "conviction" has the meaning given it
126.20in section 609.02, subdivision 5.
126.21    (c) The commissioner, in consultation with the commissioner of corrections, shall
126.22develop forms and information necessary to implement this subdivision and shall provide
126.23the forms and information to the commissioner of corrections for distribution to local
126.24probation officers and corrections agents.
126.25    (d) The commissioner shall inform individuals subject to a background study that
126.26criminal convictions for disqualifying crimes will be reported to the commissioner by the
126.27corrections system.
126.28    (e) A probation officer, corrections agent, or corrections agency is not civilly or
126.29criminally liable for disclosing or failing to disclose the information required by this
126.30subdivision.
126.31    (f) Upon receipt of disqualifying information, the commissioner shall provide the
126.32notice required under section 245C.17, as appropriate, to agencies on record as having
126.33initiated a background study or making a request for documentation of the background
126.34study status of the individual.
127.1    (g) This subdivision does not apply to family child care and child foster care
127.2programs.
127.3EFFECTIVE DATE.This section is effective January 1, 2008.

127.4    Sec. 15. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:
127.5    Subdivision 1. Background studies conducted by commissioner of human
127.6services. (a) For a background study conducted by the commissioner, the commissioner
127.7shall review:
127.8    (1) information related to names of substantiated perpetrators of maltreatment of
127.9vulnerable adults that has been received by the commissioner as required under section
127.10626.557, subdivision 9c , paragraph (i);
127.11    (2) the commissioner's records relating to the maltreatment of minors in licensed
127.12programs, and from county agency findings of maltreatment of minors as indicated
127.13through the social service information system;
127.14    (3) information from juvenile courts as required in subdivision 4 for individuals
127.15listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
127.16    (4) information from the Bureau of Criminal Apprehension.;
127.17    (5) except as provided in clause (6), information from the national crime information
127.18system when the commissioner has reasonable cause as defined under section 245C.05,
127.19subdivision 5; and
127.20    (6) for a background study related to a child foster care application for licensure, the
127.21commissioner shall also review:
127.22    (i) information from the child abuse and neglect registry for any state in which the
127.23background study subject has resided in for the past five years; and
127.24    (ii) information from national crime information databases.
127.25    (b) Notwithstanding expungement by a court, the commissioner may consider
127.26information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
127.27received notice of the petition for expungement and the court order for expungement is
127.28directed specifically to the commissioner.

127.29    Sec. 16. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:
127.30    Subd. 2. Background studies conducted by a county or private agency. (a) For
127.31a background study conducted by a county or private agency for child foster care, adult
127.32foster care, family adult day services, and family child care homes, the commissioner
127.33shall review:
128.1    (1) information from the county agency's record of substantiated maltreatment
128.2of adults and the maltreatment of minors;
128.3    (2) information from juvenile courts as required in subdivision 4 for individuals
128.4listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);
128.5    (3) information from the Bureau of Criminal Apprehension; and
128.6    (4) arrest and investigative records maintained by the Bureau of Criminal
128.7Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the
128.8National Criminal Records Repository, and criminal records from other states.
128.9    (b) If the individual has resided in the county for less than five years, the study shall
128.10include the records specified under paragraph (a) for the previous county or counties of
128.11residence for the past five years.
128.12    (c) Notwithstanding expungement by a court, the county or private agency may
128.13consider information obtained under paragraph (a), clauses (3) and (4), unless the
128.14commissioner received notice of the petition for expungement and the court order for
128.15expungement is directed specifically to the commissioner.

128.16    Sec. 17. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:
128.17    Subd. 2. Background studies conducted by a county or private agency. (a) For a
128.18background study conducted by a county or private agency for child foster care, and adult
128.19foster care, and family child care homes, the commissioner shall review:
128.20    (1) information from the county agency's record of substantiated maltreatment
128.21of adults and the maltreatment of minors;
128.22    (2) information from juvenile courts as required in subdivision 4 for individuals
128.23listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);
128.24    (3) information from the Bureau of Criminal Apprehension; and
128.25    (4) arrest and investigative records maintained by the Bureau of Criminal
128.26Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the
128.27National Criminal Records Repository, and criminal records from other states.
128.28    (b) If the individual has resided in the county for less than five years, the study shall
128.29include the records specified under paragraph (a) for the previous county or counties of
128.30residence for the past five years.
128.31    (c) Notwithstanding expungement by a court, the county or private agency may
128.32consider information obtained under paragraph (a), clauses (3) and (4), unless the
128.33commissioner received notice of the petition for expungement and the court order for
128.34expungement is directed specifically to the commissioner.
128.35EFFECTIVE DATE.This section is effective January 1, 2008.

129.1    Sec. 18. Minnesota Statutes 2006, section 245C.10, is amended by adding a
129.2subdivision to read:
129.3    Subd. 4. Temporary personnel agencies, educational programs, and professional
129.4services agencies. The commissioner shall recover the cost of the background studies
129.5initiated by temporary personnel agencies, educational programs, and professional
129.6services agencies that initiate background studies under section 245C.03, subdivision 4,
129.7through a fee of no more than $20 per study charged to the agency. In fiscal years 2008
129.8and 2009, the fees collected under this subdivision are appropriated to the commissioner
129.9for the purpose of conducting background studies.

129.10    Sec. 19. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:
129.11    Subdivision 1. Adult foster care; criminal conviction data. For individuals who
129.12are required to have background studies under section 245C.03, subdivisions 1 and 2, and
129.13who have been continuously affiliated with a an adult foster care provider that is licensed
129.14in more than one county, criminal conviction data may be shared among those counties in
129.15which the adult foster care programs are licensed. A county agency's receipt of criminal
129.16conviction data from another county agency shall meet the criminal data background
129.17study requirements of this chapter.

129.18    Sec. 20. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:
129.19    Subd. 2. Jointly licensed programs. A county agency may accept a background
129.20study completed by the commissioner under this chapter in place of the background study
129.21required under section 245A.16, subdivision 3, in programs with joint licensure as home
129.22and community-based services and adult foster care for people with developmental
129.23disabilities when the license holder does not reside in the adult foster care residence and
129.24the subject of the study has been continuously affiliated with the license holder since the
129.25date of the commissioner's study.

129.26    Sec. 21. Minnesota Statutes 2006, section 245C.12, is amended to read:
129.27245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
129.28    (a) For the purposes of background studies completed by tribal organizations
129.29performing licensing activities otherwise required of the commissioner under this chapter,
129.30after obtaining consent from the background study subject, tribal licensing agencies shall
129.31have access to criminal history data in the same manner as county licensing agencies and
129.32private licensing agencies under this chapter.
130.1    (b) Tribal organizations may contract with the commissioner to obtain background
130.2study data on individuals under tribal jurisdiction related to adoptions according to
130.3section 245C.34. Tribal organizations may also contract with the commissioner to obtain
130.4background study data on individuals under tribal jurisdiction related to child foster care
130.5according to section 245C.34.

130.6    Sec. 22. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:
130.7    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner
130.8determines that the individual studied has a disqualifying characteristic, the commissioner
130.9shall review the information immediately available and make a determination as to the
130.10subject's immediate risk of harm to persons served by the program where the individual
130.11studied will have direct contact.
130.12    (b) The commissioner shall consider all relevant information available, including the
130.13following factors in determining the immediate risk of harm:
130.14    (1) the recency of the disqualifying characteristic;
130.15    (2) the recency of discharge from probation for the crimes;
130.16    (3) the number of disqualifying characteristics;
130.17    (4) the intrusiveness or violence of the disqualifying characteristic;
130.18    (5) the vulnerability of the victim involved in the disqualifying characteristic;
130.19    (6) the similarity of the victim to the persons served by the program where the
130.20individual studied will have direct contact; and
130.21    (7) whether the individual has a disqualification from a previous background study
130.22that has not been set aside.
130.23    (c) This section does not apply when the subject of a background study is regulated
130.24by a health-related licensing board as defined in chapter 214, and the subject is determined
130.25to be responsible for substantiated maltreatment under section 626.556 or 626.557.
130.26    (d) This section does not apply to a background study related to an initial application
130.27for a child foster care license.
130.28    (e) If the commissioner has reason to believe, based on arrest information or an
130.29active maltreatment investigation, that an individual poses an imminent risk of harm to
130.30persons receiving services, the commissioner may order that the person be continuously
130.31supervised or immediately removed pending the conclusion of the maltreatment
130.32investigation or criminal proceedings.

130.33    Sec. 23. Minnesota Statutes 2006, section 245C.17, is amended by adding a
130.34subdivision to read:
131.1    Subd. 5. Notice to county or private agency. For studies on individuals related to a
131.2license to provide child foster care, the commissioner shall also provide a notice of the
131.3background study results to the county or private agency that initiated the background
131.4study.

131.5    Sec. 24. Minnesota Statutes 2006, section 245C.17, is amended by adding a
131.6subdivision to read:
131.7    Subd. 5a. Notice to county agency. For studies on individuals related to a license to
131.8provide family child care, the commissioner shall also provide a notice of the background
131.9study results to the county or private agency that initiated the background study.
131.10EFFECTIVE DATE.This section is effective January 1, 2008.

131.11    Sec. 25. Minnesota Statutes 2006, section 245C.21, is amended by adding a
131.12subdivision to read:
131.13    Subd. 1a. Submission of reconsideration request to county or private agency.
131.14    (a) For disqualifications related to studies conducted by county agencies, and for
131.15disqualifications related to studies conducted by the commissioner for child foster care,
131.16the individual shall submit the request for reconsideration to the county or private agency
131.17that initiated the background study.
131.18    (b) A reconsideration request shall be submitted within the time frames specified in
131.19subdivision 2.
131.20    (c) The county or private agency shall forward the individual's request for
131.21reconsideration and provide the commissioner with a recommendation whether to set aside
131.22the individual's disqualification.

131.23    Sec. 26. Minnesota Statutes 2006, section 245C.21, is amended by adding a
131.24subdivision to read:
131.25    Subd. 1a. Submission of reconsideration request to county agency. (a) For
131.26disqualifications related to studies conducted by county agencies, and for disqualifications
131.27related to studies conducted by the commissioner for family child care, the individual shall
131.28submit the request for reconsideration to the county that initiated the background study.
131.29    (b) A reconsideration request shall be submitted within the time frames specified in
131.30subdivision 2.
131.31    (c) The county agency shall forward the individual's request for reconsideration and
131.32provide the commissioner with a recommendation whether to set aside the individual's
131.33disqualification.
132.1EFFECTIVE DATE.This section is effective January 1, 2008.

132.2    Sec. 27. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:
132.3    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
132.4commissioner shall notify the license holder of the disqualification and order the license
132.5holder to immediately remove the individual from any position allowing direct contact
132.6with persons receiving services from the license holder if:
132.7    (1) the individual studied does not submit a timely request for reconsideration
132.8under section 245C.21;
132.9    (2) the individual submits a timely request for reconsideration, but the commissioner
132.10does not set aside the disqualification for that license holder under section 245C.22;
132.11    (3) an individual who has a right to request a hearing under sections 245C.27 and
132.12256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
132.13not request a hearing within the specified time; or
132.14    (4) an individual submitted a timely request for a hearing under sections 245C.27
132.15and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
132.16disqualification under section 245A.08, subdivision 5, or 256.045.
132.17    (b) If the commissioner does not set aside the disqualification under section 245C.22,
132.18and the license holder was previously ordered under section 245C.17 to immediately
132.19remove the disqualified individual from direct contact with persons receiving services or
132.20to ensure that the individual is under continuous, direct supervision when providing direct
132.21contact services, the order remains in effect pending the outcome of a hearing under
132.22sections 245C.27 and 256.045, or 245C.28 and chapter 14.
132.23    (c) For background studies related to child foster care, the commissioner shall
132.24also notify the county or private agency that initiated the study of the results of the
132.25reconsideration.

132.26    Sec. 28. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:
132.27    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
132.28commissioner shall notify the license holder of the disqualification and order the license
132.29holder to immediately remove the individual from any position allowing direct contact
132.30with persons receiving services from the license holder if:
132.31    (1) the individual studied does not submit a timely request for reconsideration
132.32under section 245C.21;
132.33    (2) the individual submits a timely request for reconsideration, but the commissioner
132.34does not set aside the disqualification for that license holder under section 245C.22;
133.1    (3) an individual who has a right to request a hearing under sections 245C.27 and
133.2256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
133.3not request a hearing within the specified time; or
133.4    (4) an individual submitted a timely request for a hearing under sections 245C.27
133.5and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
133.6disqualification under section 245A.08, subdivision 5, or 256.045.
133.7    (b) If the commissioner does not set aside the disqualification under section 245C.22,
133.8and the license holder was previously ordered under section 245C.17 to immediately
133.9remove the disqualified individual from direct contact with persons receiving services or
133.10to ensure that the individual is under continuous, direct supervision when providing direct
133.11contact services, the order remains in effect pending the outcome of a hearing under
133.12sections 245C.27 and 256.045, or 245C.28 and chapter 14.
133.13    (c) For background studies related to family child care, the commissioner shall also
133.14notify the county that initiated the study of the results of the reconsideration.
133.15EFFECTIVE DATE.This section is effective January 1, 2008.

133.16    Sec. 29. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:
133.17    Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in
133.18paragraph (b), the commissioner may not set aside the disqualification of any individual
133.19disqualified pursuant to this chapter, in connection with a license to provide family child
133.20care for children, foster care for children in the provider's home, or foster care or day care
133.21services for adults in the provider's home regardless of how much time has passed, if the
133.22individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 1.
133.23    (b) For an individual in the chemical dependency field who was disqualified for a
133.24crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification
133.25was set aside prior to July 1, 2005, the commissioner must consider granting a variance
133.26pursuant to section 245C.30 for the license holder for a program dealing primarily with
133.27adults. A request for reconsideration evaluated under this paragraph must include a
133.28letter of recommendation from the license holder that was subject to the prior set-aside
133.29decision addressing the individual's quality of care to children or vulnerable adults and the
133.30circumstances of the individual's departure from that service.

133.31    Sec. 30. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.
133.32    Subdivision 1. Background studies conducted by commissioner. Before
133.33placement of a child for purposes of adoption, the commissioner shall conduct a
134.1background study on individuals listed in section 259.41, subdivision 3, for county
134.2agencies and private agencies licensed to place children for adoption.
134.3    Subd. 2. Information and data provided to county or private agency. The
134.4subject of the background study shall provide the following information to the county
134.5or private agency:
134.6    (1) the information specified in section 245C.05;
134.7    (2) a set of classifiable fingerprints obtained from an authorized agency; and
134.8    (3) for studies initiated by a private agency, a signed consent for the release of
134.9information received from national crime information databases to the private agency.
134.10    Subd. 3. Information and data provided to commissioner. The county or private
134.11agency shall forward the data collected under subdivision 2 to the commissioner.
134.12    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
134.13the following information regarding the background study subject:
134.14    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
134.15    (2) information from the child abuse and neglect registry for any state in which the
134.16subject has resided for the past five years; and
134.17    (3) information from national crime information databases.
134.18    (b) The commissioner shall provide any information collected under this subdivision
134.19to the county or private agency that initiated the background study. The commissioner
134.20shall indicate if the information collected shows that the subject of the background study
134.21has a conviction listed in United States Code, title 42, section 671(a)(20)(A).

134.22    Sec. 31. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND
134.23STUDIES; TRIBAL ORGANIZATIONS.
134.24    Subdivision 1. Background studies may be conducted by commissioner. (a)
134.25Tribal organizations may contract with the commissioner under section 245C.12 to obtain
134.26background study data on individuals under tribal jurisdiction related to adoptions.
134.27    (b) Tribal organizations may contract with the commissioner under section 245C.12
134.28to obtain background study data on individuals under tribal jurisdiction related to child
134.29foster care.
134.30    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b)
134.31must be conducted as provided in subdivisions 2 and 3.
134.32    Subd. 2. Information and data provided to tribal organization. The background
134.33study subject must provide the following information to the tribal organization:
134.34    (1) for background studies related to adoptions, the information under section
134.35245C.05;
135.1    (2) for background studies related to child foster care, the information under section
135.2245C.05;
135.3    (3) a set of classifiable fingerprints obtained from an authorized agency; and
135.4    (4) a signed consent for the release of information received from national crime
135.5information databases to the tribal organization.
135.6    Subd. 3. Information and data provided to commissioner. The tribal organization
135.7shall forward the data collected under subdivision 2 to the commissioner.
135.8    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
135.9the following information regarding the background study subject:
135.10    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
135.11    (2) information from the child abuse and neglect registry for any state in which the
135.12subject has resided for the past five years; and
135.13    (3) information from national crime information databases.
135.14    (b) The commissioner shall provide any information collected under this subdivision
135.15to the tribal organization that initiated the background study. The commissioner shall
135.16indicate if the information collected shows that the subject of the background study has a
135.17conviction listed in United States Code, title 42, section 671(a)(20)(A).

135.18    Sec. 32. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:
135.19    Subd. 2. Other applicable law. (a) Portions of chapters 245A, 245C, 257, 260, and
135.20317A may also affect the adoption of a particular child.
135.21    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter
135.2221, sections 1901-1923, may also apply in the adoption of an Indian child, and may
135.23preempt specific provisions of this chapter.
135.24    (c) Consistent with section 245C.33 and Public Law 109-248, a completed
135.25background study is required before the approval of any foster or adoptive placement in
135.26a related or an unrelated home.

135.27    Sec. 33. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:
135.28    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota
135.29is to ensure that the best interests of the child are met by requiring individualized
135.30determination of the needs of the child and of how the adoptive placement will serve the
135.31needs of the child.
135.32    (b) Among the factors the agency shall consider in determining the needs of the child
135.33are those specified under section 260C.193, subdivision 3, paragraph (b).
136.1    (c) Except for emergency placements provided for in section 245A.035, a completed
136.2background study is required under section 245C.33 before the approval of an adoptive
136.3placement in a home.

136.4    Sec. 34. Minnesota Statutes 2006, section 259.41, is amended to read:
136.5259.41 ADOPTION STUDY.
136.6    Subdivision 1. Study required before placement; certain relatives excepted. (a)
136.7An approved adoption study; completed background study, as required under section
136.8245C.33; and written report must be completed before the child is placed in a prospective
136.9adoptive home under this chapter, except as allowed by section 259.47, subdivision 6.
136.10In an agency placement, the report must be filed with the court at the time the adoption
136.11petition is filed. In a direct adoptive placement, the report must be filed with the court in
136.12support of a motion for temporary preadoptive custody under section 259.47, subdivision
136.133 , or, if the study and report are complete, in support of an emergency order under section
136.14259.47, subdivision 6 . The study and report shall be completed by a licensed child-placing
136.15agency and must be thorough and comprehensive. The study and report shall be paid for
136.16by the prospective adoptive parent, except as otherwise required under section 259.67
136.17or 259.73.
136.18    (b) A placement for adoption with an individual who is related to the child, as
136.19defined by section 245A.02, subdivision 13, is not subject to this section except as required
136.20by section sections 245C.33 and 259.53, subdivision 2, paragraph (c).
136.21    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster
136.22parent's care, any portions of the foster care licensing process that duplicate requirements
136.23of the home study may be submitted in satisfaction of the relevant requirements of this
136.24section.
136.25    Subd. 2. Form of study. (a) The adoption study must include at least one in-home
136.26visit with the prospective adoptive parent. At a minimum, the study must include
136.27document the following information about the prospective adoptive parent:
136.28    (1) a background check study as required by subdivision 3 and section 245C.33,
136.29and including:
136.30    (i) an evaluation assessment of the data and information provided by section
136.31245C.33, subdivision 4, to determine if the prospective adoptive parent and any other
136.32person over the age of 13 living in the home has a felony conviction consistent with
136.33subdivision 3 and section 471(a)(2) of the Social Security Act; and
137.1    (ii) an assessment of the effect of a any conviction or finding of substantiated
137.2maltreatment on the ability to capacity of the prospective adoptive parent to safely care
137.3for and parent a child;
137.4    (2) a medical and social history and assessment of current health;
137.5    (3) an assessment of potential parenting skills;
137.6    (4) an assessment of ability to provide adequate financial support for a child; and
137.7    (5) an assessment of the level of knowledge and awareness of adoption issues
137.8including, where appropriate, matters relating to interracial, cross-cultural, and special
137.9needs adoptions.
137.10    (b) The adoption study is the basis for completion of a written report. The report
137.11must be in a format specified by the commissioner and must contain recommendations
137.12regarding the suitability of the subject of the study to be an adoptive parent.
137.13    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption
137.14study is commenced, each prospective adoptive parent must:
137.15    (1) authorize access by the agency to any private data needed to complete the study;
137.16    (2) provide all addresses at which the prospective adoptive parent and anyone in the
137.17household over the age of 13 has resided in the previous five years; and
137.18    (3) disclose any names used previously other than the name used at the time of
137.19the study.
137.20    (b) When the requirements of paragraph (a) have been met, the agency shall
137.21immediately begin initiate a background check, study under section 245C.33 to be
137.22completed by the commissioner on each person over the age of 13 living in the home,
137.23consisting, at a minimum, of the following:. As required under section 245C.33 and Public
137.24Law 109-248, a completed background study is required before the approval of any foster
137.25or adoptive placement in a related or an unrelated home. The required background study
137.26must be completed as part of the home study.
137.27    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension
137.28and local law enforcement authorities;
137.29    (2) a check for data on substantiated maltreatment of a child or vulnerable adult
137.30and domestic violence data with local law enforcement and social services agencies and
137.31district courts; and
137.32    (3) for those persons under the age of 25, a check of juvenile court records.
137.33    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of
137.34Criminal Apprehension, local law enforcement and social services agencies, district courts,
137.35and juvenile courts shall release the requested information to the agency completing
137.36the adoption study.
138.1    (c) When paragraph (b) requires checking the data or records of local law
138.2enforcement and social services agencies and district and juvenile courts, the agency
138.3shall check with the law enforcement and social services agencies and courts whose
138.4jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the
138.5agency is unable to complete any of the record checks required by paragraph (b), the
138.6agency shall document the fact and the agency's efforts to obtain the information.
138.7    (d) For a study completed under this section, when the agency has reasonable
138.8cause to believe that further information may exist on the prospective adoptive parent or
138.9household member over the age of 13 that may relate to the health, safety, or welfare of
138.10the child, the prospective adoptive parent or household member over the age of 13 shall
138.11provide the agency with a set of classifiable fingerprints obtained from an authorized law
138.12enforcement agency and the agency may obtain criminal history data from the National
138.13Criminal Records Repository by submitting fingerprints to the Bureau of Criminal
138.14Apprehension. The agency has reasonable cause when, but not limited to, the:
138.15    (1) information from the Bureau of Criminal Apprehension indicates that the
138.16prospective adoptive parent or household member over the age of 13 is a multistate
138.17offender;
138.18    (2) information from the Bureau of Criminal Apprehension indicates that multistate
138.19offender status is undetermined;
138.20    (3) the agency has received a report from the prospective adoptive parent or
138.21household member over the age of 13 or a third party indicating that the prospective
138.22adoptive parent or household member over the age of 13 has a criminal history in a
138.23jurisdiction other than Minnesota; or
138.24    (4) the prospective adoptive parent or household member over the age of 13 is or has
138.25been a resident of a state other than Minnesota in the prior five years.
138.26    (e) At any time prior to completion of the background check required under
138.27paragraph (b), a prospective adoptive parent may submit to the agency conducting the
138.28study a sworn affidavit stating whether they or any person residing in the household have
138.29been convicted of a crime. The affidavit shall also state whether the adoptive parent or any
138.30other person residing in the household is the subject of an open investigation of, or have
138.31been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment
138.32within the past ten years. A complete description of the crime, open investigation, or
138.33substantiated abuse, and a complete description of any sentence, treatment, or disposition
138.34must be included. The affidavit must contain an acknowledgment that if, at any time
138.35before the adoption is final, a court receives evidence leading to a conclusion that a
138.36prospective adoptive parent knowingly gave false information in the affidavit, it shall be
139.1determined that the adoption of the child by the prospective adoptive parent is not in the
139.2best interests of the child.
139.3    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an
139.4adoption study is complete for placement, even though the background checks required by
139.5paragraph (b) have not been completed, if each prospective adoptive parent has completed
139.6the affidavit allowed by paragraph (e) and the other requirements of this section have been
139.7met. The background checks required by paragraph (b) must be completed before an
139.8adoption petition is filed. If an adoption study has been submitted to the court under section
139.9259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were
139.10complete, an updated adoption study report which includes the results of the background
139.11check must be filed with the adoption petition. In the event that an agency is unable to
139.12complete any of the records checks required by paragraph (b), the agency shall submit with
139.13the petition to adopt an affidavit documenting the agency's efforts to complete the checks.
139.14    (c) A home study under paragraph (b) used to consider placement of any child
139.15on whose behalf Title IV-E adoption assistance payments are to be made must not be
139.16approved if a background study reveals a felony conviction at any time for:
139.17    (1) child abuse or neglect;
139.18    (2) spousal abuse;
139.19    (3) a crime against children, including child pornography; or
139.20    (4) a crime involving violence, including rape, sexual assault, or homicide, but not
139.21including other physical assault or battery.
139.22    (d) A home study under paragraph (b) used to consider placement of any child
139.23on whose behalf Title IV-E adoption assistance payments are to be made must not be
139.24approved if a background study reveals a felony conviction within the past five years for:
139.25    (1) physical assault or battery; or
139.26    (2) a drug-related offense.
139.27    Subd. 4. Updates to adoption study; period of validity. An agency may update
139.28an adoption study and report as needed, regardless of when the original study and report
139.29or most recent update was completed. An update must be in a format specified by the
139.30commissioner and must verify the continuing accuracy of the elements of the original
139.31report and document any changes to elements of the original report. An update to a study
139.32and report not originally completed under this section must ensure that the study and
139.33report, as updated, meet the requirements of this section. An adoption study is valid if the
139.34report has been completed or updated within the previous 12 months.

139.35    Sec. 35. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:
140.1    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The
140.2agency to which the petition has been referred under subdivision 1 shall conduct a
140.3postplacement assessment and file a report with the court within 90 days of receipt
140.4of a copy of the adoption petition. The agency shall send a copy of the report to the
140.5commissioner at the time it files the report with the court. The assessment and report
140.6must evaluate the environment and antecedents of the child to be adopted, the home of
140.7the petitioners, whether placement with the petitioners meets the needs of the child as
140.8described in section 259.57, subdivision 2. The report must include a recommendation to
140.9the court as to whether the petition should or should not be granted.
140.10    In making evaluations and recommendations, the postplacement assessment and
140.11report must, at a minimum, address the following:
140.12    (1) the level of adaptation by the prospective adoptive parents to parenting the child;
140.13    (2) the health and well-being of the child in the prospective adoptive parents' home;
140.14    (3) the level of incorporation by the child into the prospective adoptive parents'
140.15home, extended family, and community; and
140.16    (4) the level of inclusion of the child's previous history into the prospective adoptive
140.17home, such as cultural or ethnic practices, or contact with former foster parents or
140.18biological relatives.
140.19    (b) A postplacement adoption report is valid for 12 months following its date
140.20of completion.
140.21    (c) If the petitioner is an individual who is related to the child, as defined by section
140.22245A.02, subdivision 13, the agency, as part of its postplacement assessment and report
140.23under paragraph (a), shall conduct a background check meeting the requirements of
140.24section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall
140.25cooperate in the completion of the background check by supplying the information and
140.26authorizations described in section 259.41, subdivision 3, paragraph (a).
140.27    (d) (c) If the report recommends that the court not grant the petition to adopt the
140.28child, the provisions of this paragraph apply. Unless the assessment and report were
140.29completed by the local social services agency, the agency completing the report, at the
140.30time it files the report with the court under paragraph (a), must provide a copy of the report
140.31to the local social services agency in the county where the prospective adoptive parent
140.32lives. The agency or local social services agency may recommend that the court dismiss
140.33the petition. If the local social services agency determines that continued placement in the
140.34home endangers the child's physical or emotional health, the agency shall seek a court
140.35order to remove the child from the home.
141.1    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was
141.2referred under subdivision 1, paragraph (b), fails to complete the assessment and file the
141.3report within 90 days of the date it received a copy of the adoption petition, the court may
141.4hear the petition upon giving the agency and the local social services agency, if different,
141.5five days' notice by mail of the time and place of the hearing.

141.6    Sec. 36. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:
141.7    Subd. 2. Protection of child's best interests. (a) The policy of the state of
141.8Minnesota is to ensure that the best interests of children are met by requiring an
141.9individualized determination of the needs of the child and how the adoptive placement
141.10will serve the needs of the child.
141.11    (b) Among the factors the court shall consider in determining the needs of the child
141.12are those specified under section 260C.193, subdivision 3, paragraph (b). Consistent with
141.13section 245C.33 and Public Law 109-248, a complete background study is required before
141.14the approval of an adoptive placement in a home.
141.15    (c) In reviewing adoptive placement and in determining appropriate adoption,
141.16the court shall consider placement, consistent with the child's best interests and in the
141.17following order, with (1) a relative or relatives of the child, or (2) an important friend with
141.18whom the child has resided or had significant contact. Placement of a child cannot be
141.19delayed or denied based on race, color, or national origin of the adoptive parent or the
141.20child. Whenever possible, siblings should be placed together unless it is determined
141.21not to be in the best interests of a sibling.
141.22    (d) If the child's birth parent or parents explicitly request that relatives and important
141.23friends not be considered, the court shall honor that request consistent with the best
141.24interests of the child.
141.25    If the child's birth parent or parents express a preference for placing the child in an
141.26adoptive home of the same or a similar religious background to that of the birth parent
141.27or parents, the court shall place the child with a family that also meets the birth parent's
141.28religious preference. Only if no family is available as described in clause (a) or (b)
141.29may the court give preference to a family described in clause (c) that meets the parent's
141.30religious preference.
141.31    (e) This subdivision does not affect the Indian Child Welfare Act, United States
141.32Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation
141.33Act, sections 260.751 to 260.835.

142.1    Sec. 37. Minnesota Statutes 2006, section 260C.209, is amended to read:
142.2260C.209 BACKGROUND CHECKS.
142.3    Subdivision 1. Subjects. The responsible social services agency must conduct
142.4initiate a background check study to be completed by the commissioner under this section
142.5of chapter 245C on the following individuals:
142.6    (1) a noncustodial parent or nonadjudicated parent who is being assessed for
142.7purposes of providing day-to-day care of a child temporarily or permanently under section
142.8260C.212, subdivision 4 , and any member of the parent's household who is over the age of
142.913 when there is a reasonable cause to believe that the parent or household member over
142.10age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult
142.11which would endanger the child's health, safety, or welfare;
142.12    (2) an individual whose suitability for relative placement under section 260C.212,
142.13subdivision 5 , is being determined and any member of the relative's household who is
142.14over the age of 13 when:
142.15    (i) the relative must be licensed for foster care; or
142.16    (ii) the agency must conduct a background study is required under section 259.53,
142.17subdivision 2 ; or
142.18    (iii) the agency or the commissioner has reasonable cause to believe the relative
142.19or household member over the age of 13 has a criminal history which would not make
142.20transfer of permanent legal and physical custody to the relative under section 260C.201,
142.21subdivision 11 , in the child's best interest; and
142.22    (3) a parent, following an out-of-home placement, when the responsible social
142.23services agency has reasonable cause to believe that the parent has been convicted of a
142.24crime directly related to the parent's capacity to maintain the child's health, safety, or
142.25welfare or the parent is the subject of an open investigation of, or has been the subject
142.26of a substantiated allegation of, child or vulnerable-adult maltreatment within the past
142.27ten years.
142.28"Reasonable cause" means that the agency has received information or a report from the
142.29subject or a third person that creates an articulable suspicion that the individual has a
142.30history that may pose a risk to the health, safety, or welfare of the child. The information
142.31or report must be specific to the potential subject of the background check and shall not
142.32be based on the race, religion, ethnic background, age, class, or lifestyle of the potential
142.33subject.
142.34    Subd. 2. General procedures. (a) When conducting initiating a background check
142.35under subdivision 1, the agency may shall require the individual being assessed to provide
142.36sufficient information to ensure an accurate assessment under this section, including:
143.1    (1) the individual's first, middle, and last name and all other names by which the
143.2individual has been known;
143.3    (2) home address, zip code, city, county, and state of residence for the past ten five
143.4years;
143.5    (3) sex;
143.6    (4) date of birth; and
143.7    (5) driver's license number or state identification number.
143.8    (b) When notified by the commissioner or the responsible social services agency that
143.9it is conducting an assessment under this section, the Bureau of Criminal Apprehension,
143.10commissioners of health and human services, law enforcement, and county agencies must
143.11provide the commissioner or the responsible social services agency or county attorney
143.12with the following information on the individual being assessed: criminal history data,
143.13reports about the maltreatment of adults substantiated under section 626.557, and reports
143.14of maltreatment of minors substantiated under section 626.556.
143.15    Subd. 3. Multistate information. (a) For any assessment every background study
143.16completed under this section, if the responsible social services agency has reasonable
143.17cause to believe that the individual is a multistate offender, the individual must the subject
143.18of the background study shall provide the responsible social services agency or the
143.19county attorney with a set of classifiable fingerprints obtained from an authorized law
143.20enforcement agency. The responsible social services agency or county attorney may shall
143.21provide the fingerprints to the commissioner, and the commissioner shall obtain criminal
143.22history data from the National Criminal Records Repository by submitting the fingerprints
143.23to the Bureau of Criminal Apprehension.
143.24    (b) For purposes of this subdivision, the responsible social services agency has
143.25reasonable cause when, but not limited to:
143.26    (1) information from the Bureau of Criminal Apprehension indicates that the
143.27individual is a multistate offender;
143.28    (2) information from the Bureau of Criminal Apprehension indicates that multistate
143.29offender status is undetermined;
143.30    (3) the social services agency has received a report from the individual or a third
143.31party indicating that the individual has a criminal history in a jurisdiction other than
143.32Minnesota; or
143.33    (4) the individual is or has been a resident of a state other than Minnesota at any
143.34time during the prior ten years.
143.35    Subd. 4. Notice upon receipt. The responsible social services agency commissioner
143.36must provide the subject of the background study with the results of the study as required
144.1under this section within 15 business days of receipt or at least 15 days prior to the hearing
144.2at which the results will be presented, whichever comes first. The subject may provide
144.3written information to the agency that the results are incorrect and may provide additional
144.4or clarifying information to the agency and to the court through a party to the proceeding.
144.5This provision does not apply to any background study conducted under chapters 245A
144.6and chapter 245C.

144.7    Sec. 38. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:
144.8    Subd. 2. Placement decisions based on best interest of the child. (a) The policy
144.9of the state of Minnesota is to ensure that the child's best interests are met by requiring an
144.10individualized determination of the needs of the child and of how the selected placement
144.11will serve the needs of the child being placed. The authorized child-placing agency shall
144.12place a child, released by court order or by voluntary release by the parent or parents, in
144.13a family foster home selected by considering placement with relatives and important
144.14friends in the following order:
144.15    (1) with an individual who is related to the child by blood, marriage, or adoption; or
144.16    (2) with an individual who is an important friend with whom the child has resided or
144.17had significant contact.
144.18    (b) Among the factors the agency shall consider in determining the needs of the
144.19child are the following:
144.20    (1) the child's current functioning and behaviors;
144.21    (2) the medical, educational, and developmental needs of the child;
144.22    (3) the child's history and past experience;
144.23    (4) the child's religious and cultural needs;
144.24    (5) the child's connection with a community, school, and church;
144.25    (6) the child's interests and talents;
144.26    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and
144.27    (8) the reasonable preference of the child, if the court, or the child-placing agency
144.28in the case of a voluntary placement, deems the child to be of sufficient age to express
144.29preferences.
144.30    (c) Placement of a child cannot be delayed or denied based on race, color, or national
144.31origin of the foster parent or the child.
144.32    (d) Siblings should be placed together for foster care and adoption at the earliest
144.33possible time unless it is determined not to be in the best interests of a sibling or unless it
144.34is not possible after appropriate efforts by the responsible social services agency.
145.1    (e) Except for emergency placement as provided for in section 245A.035, a
145.2completed background study is required under section 245C.08 before the approval of a
145.3foster placement in a related or unrelated home.

145.4ARTICLE 3

145.5HEALTH CARE

145.6    Section 1. Minnesota Statutes 2006, section 16A.724, subdivision 2, is amended to
145.7read:
145.8    Subd. 2. Transfers. (a) Notwithstanding section 295.581, to the extent available
145.9resources in the health care access fund exceed expenditures in that fund, effective with
145.10the biennium beginning July 1, 2007, the commissioner shall transfer funds from the
145.11health care access fund to the general fund to offset the costs of MinnesotaCare enrollees
145.12shifting to medical assistance due to the implementation of an automated eligibility
145.13determination system. The medical assistance costs shall be identified and updated in the
145.14November and February forecasts.
145.15    (b) In addition to the amounts in paragraph (a), the commissioner of finance shall
145.16transfer the excess funds from the health care access fund to the general fund on June
145.1730 of each year, provided that the amount transferred in any fiscal biennium shall not
145.18exceed $96,000,000. For the biennium ending June 30, 2011, the transfer shall not exceed
145.19$48,000,000.
145.20    (b) (c) For fiscal years 2006 to 2009, MinnesotaCare shall be a forecasted program,
145.21and, if necessary, the commissioner shall reduce these transfers from the health care access
145.22fund to the general fund to meet annual MinnesotaCare expenditures or, if necessary,
145.23transfer sufficient funds from the general fund to the health care access fund to meet
145.24annual MinnesotaCare expenditures.

145.25    Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to read:
145.26    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
145.27assistance program must not be submitted until the recipient is discharged. However,
145.28the commissioner shall establish monthly interim payments for inpatient hospitals that
145.29have individual patient lengths of stay over 30 days regardless of diagnostic category.
145.30Except as provided in section 256.9693, medical assistance reimbursement for treatment
145.31of mental illness shall be reimbursed based on diagnostic classifications. Individual
145.32hospital payments established under this section and sections 256.9685, 256.9686, and
145.33256.9695 , in addition to third party and recipient liability, for discharges occurring during
145.34the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
146.1inpatient services paid for the same period of time to the hospital. This payment limitation
146.2shall be calculated separately for medical assistance and general assistance medical
146.3care services. The limitation on general assistance medical care shall be effective for
146.4admissions occurring on or after July 1, 1991. Services that have rates established under
146.5subdivision 11 or 12, must be limited separately from other services. After consulting with
146.6the affected hospitals, the commissioner may consider related hospitals one entity and
146.7may merge the payment rates while maintaining separate provider numbers. The operating
146.8and property base rates per admission or per day shall be derived from the best Medicare
146.9and claims data available when rates are established. The commissioner shall determine
146.10the best Medicare and claims data, taking into consideration variables of recency of the
146.11data, audit disposition, settlement status, and the ability to set rates in a timely manner.
146.12The commissioner shall notify hospitals of payment rates by December 1 of the year
146.13preceding the rate year. The rate setting data must reflect the admissions data used to
146.14establish relative values. Base year changes from 1981 to the base year established for the
146.15rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
146.16to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
146.171. The commissioner may adjust base year cost, relative value, and case mix index data
146.18to exclude the costs of services that have been discontinued by the October 1 of the year
146.19preceding the rate year or that are paid separately from inpatient services. Inpatient stays
146.20that encompass portions of two or more rate years shall have payments established based
146.21on payment rates in effect at the time of admission unless the date of admission preceded
146.22the rate year in effect by six months or more. In this case, operating payment rates for
146.23services rendered during the rate year in effect and established based on the date of
146.24admission shall be adjusted to the rate year in effect by the hospital cost index.
146.25    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
146.26payment, before third-party liability and spenddown, made to hospitals for inpatient
146.27services is reduced by .5 percent from the current statutory rates.
146.28    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
146.29admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
146.30before third-party liability and spenddown, is reduced five percent from the current
146.31statutory rates. Mental health services within diagnosis related groups 424 to 432, and
146.32facilities defined under subdivision 16, and, effective for admissions occurring on or after
146.33July 1, 2007, a long-term hospital as designated by the Medicare program that is located in
146.34a city of the first class as defined in section 410.01, are excluded from this paragraph.
146.35    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
146.36fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
147.1inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
147.2the current statutory rates. Mental health services within diagnosis related groups 424 to
147.3432 and, facilities defined under subdivision 16, and, effective for admissions occurring
147.4on or after July 1, 2007, a long-term hospital as designated by the Medicare program
147.5that is located in a city of the first class as defined in section 410.01, are excluded from
147.6this paragraph. Notwithstanding section 256.9686, subdivision 7, for purposes of this
147.7paragraph, medical assistance does not include general assistance medical care. Payments
147.8made to managed care plans shall be reduced for services provided on or after January
147.91, 2006, to reflect this reduction.

147.10    Sec. 3. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:
147.11    Subd. 9. Disproportionate numbers of low-income patients served. (a) For
147.12admissions occurring on or after October 1, 1992, through December 31, 1992, the
147.13medical assistance disproportionate population adjustment shall comply with federal law
147.14and shall be paid to a hospital, excluding regional treatment centers and facilities of the
147.15federal Indian Health Service, with a medical assistance inpatient utilization rate in excess
147.16of the arithmetic mean. The adjustment must be determined as follows:
147.17    (1) for a hospital with a medical assistance inpatient utilization rate above the
147.18arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
147.19federal Indian Health Service but less than or equal to one standard deviation above the
147.20mean, the adjustment must be determined by multiplying the total of the operating and
147.21property payment rates by the difference between the hospital's actual medical assistance
147.22inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
147.23treatment centers and facilities of the federal Indian Health Service; and
147.24    (2) for a hospital with a medical assistance inpatient utilization rate above one
147.25standard deviation above the mean, the adjustment must be determined by multiplying
147.26the adjustment that would be determined under clause (1) for that hospital by 1.1. If
147.27federal matching funds are not available for all adjustments under this subdivision, the
147.28commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for
147.29federal match. The commissioner may establish a separate disproportionate population
147.30operating payment rate adjustment under the general assistance medical care program.
147.31For purposes of this subdivision medical assistance does not include general assistance
147.32medical care. The commissioner shall report annually on the number of hospitals likely to
147.33receive the adjustment authorized by this paragraph. The commissioner shall specifically
147.34report on the adjustments received by public hospitals and public hospital corporations
147.35located in cities of the first class.
148.1    (b) For admissions occurring on or after July 1, 1993, the medical assistance
148.2disproportionate population adjustment shall comply with federal law and shall be paid to
148.3a hospital, excluding regional treatment centers and facilities of the federal Indian Health
148.4Service, with a medical assistance inpatient utilization rate in excess of the arithmetic
148.5mean. The adjustment must be determined as follows:
148.6    (1) for a hospital with a medical assistance inpatient utilization rate above the
148.7arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
148.8federal Indian Health Service but less than or equal to one standard deviation above the
148.9mean, the adjustment must be determined by multiplying the total of the operating and
148.10property payment rates by the difference between the hospital's actual medical assistance
148.11inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
148.12treatment centers and facilities of the federal Indian Health Service;
148.13    (2) for a hospital with a medical assistance inpatient utilization rate above one
148.14standard deviation above the mean, the adjustment must be determined by multiplying
148.15the adjustment that would be determined under clause (1) for that hospital by 1.1. The
148.16commissioner may establish a separate disproportionate population operating payment
148.17rate adjustment under the general assistance medical care program. For purposes of this
148.18subdivision, medical assistance does not include general assistance medical care. The
148.19commissioner shall report annually on the number of hospitals likely to receive the
148.20adjustment authorized by this paragraph. The commissioner shall specifically report on
148.21the adjustments received by public hospitals and public hospital corporations located
148.22in cities of the first class;
148.23    (3) for a hospital that had medical assistance fee-for-service payment volume during
148.24calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service
148.25payment volume, a medical assistance disproportionate population adjustment shall be
148.26paid in addition to any other disproportionate payment due under this subdivision as
148.27follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995.
148.28For a hospital that had medical assistance fee-for-service payment volume during calendar
148.29year 1991 in excess of eight percent of total medical assistance fee-for-service payment
148.30volume and was the primary hospital affiliated with the University of Minnesota, a
148.31medical assistance disproportionate population adjustment shall be paid in addition to any
148.32other disproportionate payment due under this subdivision as follows: $505,000 due on
148.33the 15th of each month after noon, beginning July 15, 1995; and
148.34    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be
148.35reduced to zero.
149.1    (c) The commissioner shall adjust rates paid to a health maintenance organization
149.2under contract with the commissioner to reflect rate increases provided in paragraph (b),
149.3clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those
149.4rates to reflect payments provided in clause (3).
149.5    (d) If federal matching funds are not available for all adjustments under paragraph
149.6(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a
149.7pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
149.8    (e) For purposes of this subdivision, medical assistance does not include general
149.9assistance medical care.
149.10    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general
149.11assistance medical care expenditures for fee-for-service inpatient and outpatient hospital
149.12services made by the department and by prepaid health plans participating in general
149.13assistance medical care effective July 1, 2007, payments under section 256B.199 shall be
149.14considered Medicaid disproportionate share hospital payments, except as limited below:
149.15by clauses (1) to (5);
149.16    (1) only the portion of Minnesota's disproportionate share hospital allotment under
149.17section 1923(f) of the Social Security Act that is not spent on the disproportionate
149.18population adjustments in paragraph (b), clauses (1) and (2), may be used for general
149.19assistance medical care expenditures;
149.20    (2) only those general assistance medical care expenditures made to hospitals that
149.21qualify for disproportionate share payments under section 1923 of the Social Security Act
149.22and the Medicaid state plan may be considered disproportionate share hospital payments;
149.23    (3) only those general assistance medical care expenditures made to an individual
149.24hospital that would not cause the hospital to exceed its individual hospital limits under
149.25section 1923 of the Social Security Act may be considered; and
149.26    (4) general assistance medical care expenditures may be considered only to the
149.27extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
149.28All hospitals and prepaid health plans participating in general assistance medical care
149.29must provide any necessary expenditure, cost, and revenue information required by
149.30the commissioner as necessary for purposes of obtaining federal Medicaid matching
149.31funds for general assistance medical care expenditures. Medicaid disproportionate share
149.32payments; and
149.33    (5) expenditures under general assistance medical care shall be used to the fullest
149.34extent before payments under section 256B.199.
150.1    (g) Upon federal approval of the related state plan amendment, paragraph (f) is
150.2effective retroactively from July 1, 2005, or the earliest effective date approved by the
150.3Centers for Medicare and Medicaid Services.

150.4    Sec. 4. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision
150.5to read:
150.6    Subd. 28. Long-term hospital payment adjustment. For admissions occurring on
150.7or after July 1, 2009, the commissioner shall increase the medical assistance payments
150.8to a long-term hospital with a medical assistance inpatient utilization rate of 17.95
150.9percent of total patient days as of the base year in effect on July 1, 2005, by an amount
150.10equal to 13 percent of the total of the operating and property payment rates. Payments
150.11made to managed care plans shall not reflect this payment increase. For purposes of
150.12this subdivision, medical assistance does not include general assistance medical care.
150.13Payments to a hospital under this subdivision shall be reduced by the amount of any
150.14payments made under subdivision 27.

150.15    Sec. 5. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:
150.16    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
150.17and feasible, the commissioner may utilize volume purchase through competitive bidding
150.18and negotiation under the provisions of chapter 16C, to provide items under the medical
150.19assistance program including but not limited to the following:
150.20    (1) eyeglasses;
150.21    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
150.22situation on a short-term basis, until the vendor can obtain the necessary supply from
150.23the contract dealer;
150.24    (3) hearing aids and supplies; and
150.25    (4) durable medical equipment, including but not limited to:
150.26    (i) hospital beds;
150.27    (ii) commodes;
150.28    (iii) glide-about chairs;
150.29    (iv) patient lift apparatus;
150.30    (v) wheelchairs and accessories;
150.31    (vi) oxygen administration equipment;
150.32    (vii) respiratory therapy equipment;
150.33    (viii) electronic diagnostic, therapeutic and life support systems;
151.1    (5) special nonemergency transportation services level of need determinations,
151.2disbursement of public transportation passes and tokens, and volunteer and recipient
151.3mileage and parking reimbursements; and
151.4    (6) drugs.
151.5    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
151.6contract payments under this subdivision unless specifically identified.

151.7    Sec. 6. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision
151.8to read:
151.9    Subd. 14a. Level of need determination. Nonemergency medical transportation
151.10level of need determinations must be performed by a physician, a registered nurse working
151.11under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
151.12licensed practical nurse, or a discharge planner. Nonemergency medical transportation
151.13level of need determinations must not be performed more than semiannually on any
151.14individual, unless the individual's circumstances have sufficiently changed so as to
151.15require a new level of need determination. Individuals residing in licensed nursing
151.16facilities and individuals requiring stretcher transportation are exempt from a level of need
151.17determination and are eligible for special transportation services until the individual no
151.18longer resides in a licensed nursing facility or no longer requires stretcher transportation.

151.19    Sec. 7. Minnesota Statutes 2006, section 256B.056, is amended by adding a
151.20subdivision to read:
151.21    Subd. 1d. Treatment of certain monetary gifts. The commissioner shall disregard
151.22as income any portion of a monetary gift received by an applicant or enrollee that is
151.23designated to purchase a prosthetic device not covered by insurance, other third-party
151.24payers, or medical assistance.

151.25    Sec. 8. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to
151.26read:
151.27    Subd. 3f. Circumcision for newborns. Newborn Circumcision is not covered,
151.28unless the procedure is medically necessary or required because of a well-established
151.29religious practice.

151.30    Sec. 9. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
151.31subdivision to read:
152.1    Subd. 8d. Chiropractic services. Medical assistance covers the following
152.2medically necessary chiropractic services: one initial or progress exam per year, manual
152.3manipulation of the spine, and x-rays.
152.4EFFECTIVE DATE.This section is effective July 1, 2007.

152.5    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to
152.6read:
152.7    Subd. 13c. Formulary committee. The commissioner, after receiving
152.8recommendations from professional medical associations and professional pharmacy
152.9associations, and consumer groups shall designate a Formulary Committee to carry
152.10out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be
152.11comprised of four licensed physicians actively engaged in the practice of medicine in
152.12Minnesota one of whom must be actively engaged in the treatment of persons with mental
152.13illness; at least three licensed pharmacists actively engaged in the practice of pharmacy
152.14in Minnesota; and one consumer representative; the remainder to be made up of health
152.15care professionals who are licensed in their field and have recognized knowledge in the
152.16clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs.
152.17Members of the Formulary Committee shall not be employed by the Department of
152.18Human Services, but the committee shall be staffed by an employee of the department
152.19who shall serve as an ex officio, nonvoting member of the board committee. The
152.20department's medical director shall also serve as an ex officio, nonvoting member for the
152.21committee. Committee members shall serve three-year terms and may be reappointed
152.22by the commissioner. The Formulary Committee shall meet at least quarterly. The
152.23commissioner may require more frequent Formulary Committee meetings as needed. An
152.24honorarium of $100 per meeting and reimbursement for mileage shall be paid to each
152.25committee member in attendance.

152.26    Sec. 11. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to
152.27read:
152.28    Subd. 13d. Drug formulary. (a) The commissioner shall establish a drug
152.29formulary. Its establishment and publication shall not be subject to the requirements of the
152.30Administrative Procedure Act, but the Formulary Committee shall review and comment
152.31on the formulary contents.
152.32    (b) The formulary shall not include:
152.33    (1) drugs or products for which there is no federal funding;
152.34    (2) over-the-counter drugs, except as provided in subdivision 13;
153.1    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may
153.2be covered for a recipient with type II diabetes;
153.3    (4) drugs when used for the treatment of impotence or erectile dysfunction;
153.4    (5) drugs for which medical value has not been established; and
153.5    (6) drugs from manufacturers who have not signed a rebate agreement with the
153.6Department of Health and Human Services pursuant to section 1927 of title XIX of the
153.7Social Security Act.
153.8    (c) If a single-source drug used by at least two percent of the fee-for-service
153.9medical assistance recipients is removed from the formulary due to the failure of the
153.10manufacturer to sign a rebate agreement with the Department of Health and Human
153.11Services, the commissioner shall notify prescribing practitioners within 30 days of
153.12receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a
153.13rebate agreement was not signed.
153.14EFFECTIVE DATE.This section is effective the day following final enactment.

153.15    Sec. 12. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
153.16subdivision to read:
153.17    Subd. 13i. Medicare Part D. Notwithstanding subdivision 13, paragraph (d), for
153.18recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare
153.19Advantage special needs plan, medical assistance covers co-payments which the recipient
153.20is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage
153.21special needs plan, once the recipient has paid $12 per month in prescription drug
153.22co-payments, and according to the requirements of the plan.

153.23    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to
153.24read:
153.25    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs
153.26incurred solely for obtaining emergency medical care or transportation costs incurred
153.27by eligible persons in obtaining emergency or nonemergency medical care when paid
153.28directly to an ambulance company, common carrier, or other recognized providers of
153.29transportation services.
153.30    (b) Medical assistance covers special transportation, as defined in Minnesota Rules,
153.31part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
153.32would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
153.33transportation, or private automobile.
154.1The commissioner may use an order by the recipient's attending physician to certify that
154.2the recipient requires special transportation services. Special transportation includes
154.3driver-assisted service to eligible individuals. Driver-assisted service includes passenger
154.4pickup at and return to the individual's residence or place of business, assistance with
154.5admittance of the individual to the medical facility, and assistance in passenger securement
154.6or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers
154.7must obtain written documentation from the health care service provider who is serving
154.8the recipient being transported, identifying the time that the recipient arrived. Special
154.9transportation providers may not bill for separate base rates for the continuation of a trip
154.10beyond the original destination. Special transportation providers must take recipients
154.11to the nearest appropriate health care provider, using the most direct quickest route
154.12available as determined by a commercially available mileage software program approved
154.13by the commissioner. The maximum medical assistance reimbursement rates for special
154.14transportation services are:
154.15    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons
154.16who need a wheelchair-accessible van;
154.17    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who
154.18do not need a wheelchair-accessible van; and
154.19    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
154.20services to eligible persons who need a stretcher-accessible vehicle.

154.21    Sec. 14. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
154.22read:
154.23    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
154.24meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
154.25$6.50 for lunch, or $8 for dinner.
154.26    (b) Medical assistance reimbursement for lodging for persons traveling to receive
154.27medical care may not exceed $50 per day unless prior authorized by the local agency.
154.28    (c) Medical assistance direct mileage reimbursement to the an eligible person or the
154.29an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative
154.30that is providing direct transportation to a covered service shall be at 15 cents below the
154.31current Internal Revenue Service mileage reimbursement for business purposes.
154.32    (d) Medical assistance covers oral language interpreter services when provided by
154.33an enrolled health care provider during the course of providing a direct, person-to-person
154.34covered health care service to an enrolled recipient with limited English proficiency.

155.1    Sec. 15. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
155.2subdivision to read:
155.3    Subd. 49. Community health worker. (a) Medical assistance covers the care
155.4coordination and patient education services provided by a community health worker if
155.5the community health worker has:
155.6    (1) received a certificate from the Minnesota State Colleges and Universities System
155.7approved community health worker curriculum; or
155.8    (2) at least five years of supervised experience with an enrolled physician or
155.9advanced practice registered nurse.
155.10Community health workers eligible for payment under clause (2) must complete the
155.11certification program by January 1, 2010, to continue to be eligible for payment.
155.12    (b) Community health workers must work under the supervision of a medical
155.13assistance enrolled physician or advanced practice registered nurse.

155.14    Sec. 16. Minnesota Statutes 2006, section 256B.0644, is amended to read:
155.15256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
155.16PROGRAMS.
155.17    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
155.18health maintenance organization, as defined in chapter 62D, must participate as a provider
155.19or contractor in the medical assistance program, general assistance medical care program,
155.20and MinnesotaCare as a condition of participating as a provider in health insurance plans
155.21and programs or contractor for state employees established under section 43A.18, the
155.22public employees insurance program under section 43A.316, for health insurance plans
155.23offered to local statutory or home rule charter city, county, and school district employees,
155.24the workers' compensation system under section 176.135, and insurance plans provided
155.25through the Minnesota Comprehensive Health Association under sections 62E.01 to
155.2662E.19 . The limitations on insurance plans offered to local government employees shall
155.27not be applicable in geographic areas where provider participation is limited by managed
155.28care contracts with the Department of Human Services.
155.29    (b) For providers other than health maintenance organizations, participation in the
155.30medical assistance program means that:
155.31     (1) the provider accepts new medical assistance, general assistance medical care,
155.32and MinnesotaCare patients or;
155.33    (2) for providers other than dental service providers, at least 20 percent of the
155.34provider's patients are covered by medical assistance, general assistance medical care, and
155.35MinnesotaCare as their primary source of coverage, or; or
156.1    (3) for dental service providers, at least ten percent of the provider's patients are
156.2covered by medical assistance, general assistance medical care, and MinnesotaCare as
156.3their primary source of coverage, or the provider accepts new medical assistance and
156.4MinnesotaCare patients who are children with special health care needs. For purposes
156.5of this section, "children with special health care needs" means children up to age 18
156.6who: (i) require health and related services beyond that required by children generally;
156.7and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
156.8condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
156.9cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
156.10neurological diseases; visual impairment or deafness; Down syndrome and other genetic
156.11disorders; autism; fetal alcohol syndrome; and other conditions designated by the
156.12commissioner after consultation with representatives of pediatric dental providers and
156.13consumers.
156.14    (c) Patients seen on a volunteer basis by the provider at a location other than the
156.15provider's usual place of practice may be considered in meeting this the participation
156.16requirement in this section. The commissioner shall establish participation requirements
156.17for health maintenance organizations. The commissioner shall provide lists of
156.18participating medical assistance providers on a quarterly basis to the commissioner of
156.19employee relations, the commissioner of labor and industry, and the commissioner of
156.20commerce. Each of the commissioners shall develop and implement procedures to exclude
156.21as participating providers in the program or programs under their jurisdiction those
156.22providers who do not participate in the medical assistance program. The commissioner
156.23of employee relations shall implement this section through contracts with participating
156.24health and dental carriers.

156.25    Sec. 17. [256B.0751] CARE COORDINATION FOR CHILDREN WITH
156.26HIGH-COST MEDICAL CONDITIONS.
156.27    Subdivision 1. Care coordination required. (a) The commissioner of human
156.28services shall contract with the U special kids program to provide care coordination,
156.29beginning October 1, 2007, for medical assistance enrollees who are children with
156.30high-cost medical conditions, and to perform the other duties specified in this section.
156.31    (b) For purposes of this section, "care coordination" means collaboration with
156.32primary care physicians and specialists to manage care, development of medical
156.33management plans for recurrent acute illnesses, oversight and coordination of all aspects
156.34of care in partnership with families, organization of medical information into a summary
156.35of critical information, coordination and appropriate sequencing of tests and multiple
157.1appointments, information and assistance with accessing resources, and telephone triage
157.2for acute illnesses or problems.
157.3    Subd. 2. Referrals. The commissioner shall develop a mechanism to refer
157.4children to the U special kids program for care coordination. Beginning October 1, 2007,
157.5and subject to the limits on total program enrollment specified in subdivision 3, the
157.6commissioner shall refer to the U special kids program children who:
157.7    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;
157.8    (2) have medical conditions that involve four or more major systems; require
157.9multiple specialists; require use of technology such as G-tube, trach, central line, or
157.10oxygen; and require multiple medications;
157.11    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy,
157.12or bone marrow replacement; and
157.13    (4) voluntarily agree to participate in the program.
157.14    Subd. 3. Qualifying level of medical expenses. (a) For the period October 1, 2007,
157.15through September 30, 2008, the commissioner shall refer children for care coordination
157.16under this section if they incurred medical expenses of $500,000 or more during the
157.17fiscal year ending June 30, 2007.
157.18    (b) For the period October 1, 2008, through September 30, 2009, the commissioner
157.19shall refer children for care coordination under this section if they incurred medical
157.20expenses of $400,000 or more during the fiscal year ending June 30, 2008.
157.21    (c) For the period October 1, 2009, through September 30, 2010, the commissioner
157.22shall refer children for care coordination under this section if they incurred medical
157.23expenses of $300,000 or more during the fiscal year ending June 30, 2009.
157.24    (d) Beginning October 1, 2010, the commissioner shall refer children for care
157.25coordination under this section if they incurred medical expenses of $250,000 or more
157.26during the previous fiscal year.
157.27    (e) The commissioner shall limit referrals to the extent necessary to ensure that
157.28total enrollment in the U special kids program does not exceed 100 children for the
157.29period October 1, 2007, through September 30, 2008, and does not exceed 150 children
157.30beginning October 1, 2008.
157.31    Subd. 4. Case management. Beginning October 1, 2007, the U special kids
157.32program shall coordinate all nonmedical case management services provided to children
157.33who are required to receive care coordination under this section. The program may
157.34require all nonmedical case managers, including, but not limited to, county case managers
157.35and case managers for children served under a home and community-based waiver,
157.36to submit care plans for approval, and to document client compliance with the care
158.1plans. The U special kids program, beginning October 1, 2008, may employ or contract
158.2with nonmedical case managers to provide all nonmedical case management services to
158.3children required to receive care coordination under this section. The commissioner shall
158.4reimburse the U special kids program for case management services through the medical
158.5assistance program.
158.6    Subd. 5. Statewide availability of care coordination. The U special kids program
158.7may contract with other entities to provide care coordination services as defined in
158.8subdivision 1, in order to ensure the availability of these services in all regions of the state.
158.9    Subd. 6. Advance practice nurse telephone triage system. The U special kids
158.10program shall establish and operate an advance practice nurse telephone triage system that
158.11is available statewide, 24 hours a day, seven days per week. The system must provide
158.12advance practice nurses with access to a Web-based information system to appropriately
158.13triage medical problems, manage care, and reduce unnecessary hospitalizations.
158.14    Subd. 7. Monitoring and evaluation. The commissioner shall monitor program
158.15outcomes and evaluate the extent to which referrals to the U special kids program have
158.16improved the quality and coordination of care and provided financial savings to the
158.17medical assistance program. The U special kids program shall submit to the commissioner,
158.18in the form and manner specified by the commissioner, all data and information necessary
158.19to monitor program outcomes and evaluate the program. The commissioner shall present a
158.20preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
158.21legislature by January 15, 2010.
158.22EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal
158.23approval, whichever is later.

158.24    Sec. 18. [256B.0752] CARE COORDINATION FOR CHILDREN WITH
158.25HIGH-COST MENTAL HEALTH CONDITIONS.
158.26    Subdivision 1. Care coordination required. (a) The commissioner of human
158.27services shall contract with the U special kids program to provide care coordination,
158.28beginning October 1, 2007, for medical assistance enrollees who are children with
158.29high-cost mental health conditions and behavioral problems, and to perform the other
158.30duties specified in this section.
158.31    (b) For purposes of this section, "care coordination" means: collaboration with
158.32primary care physicians and specialists to manage care; development of mental health
158.33management plans for recurrent mental health issues; oversight and coordination of all
158.34aspects of care in partnership with families; organization of medical, treatment, and
158.35therapy information into a summary of critical information; coordination and appropriate
159.1sequencing of evaluations and multiple appointments; information and assistance with
159.2accessing resources; and telephone triage for behavior or other problems.
159.3    Subd. 2. Referrals. The commissioner shall develop a mechanism to refer children
159.4to the program for care coordination. Beginning October 1, 2007, and subject to the limits
159.5on total program enrollment specified in subdivision 3, the commissioner shall refer to
159.6the U special kids program children who:
159.7    (1) incur mental health expenses that exceed the qualifying level specified in
159.8subdivision 3;
159.9    (2) are currently receiving or at risk of needing inpatient mental health treatment,
159.10foster home care, or both; and
159.11    (3) voluntarily agree to participate in the program.
159.12    Subd. 3. Qualifying level of medical expenses. (a) Beginning October 1, 2007, the
159.13commissioner shall refer children for care coordination under this section if they incurred
159.14medical and mental health expenses of $250,000 or more in the previous fiscal year.
159.15    (b) The commissioner shall limit referrals to the extent necessary to ensure that total
159.16enrollment in the U special kids program does not exceed 25 children for the period
159.17October 1, 2007, through September 30, 2008; does not exceed 75 children for the
159.18period October 1, 2008, through September 30, 2009; and does not exceed 125 children
159.19beginning October 1, 2009.
159.20    Subd. 4. Case management. The U special kids program, beginning October 1,
159.212007, shall coordinate all nonmedical case management services provided to children who
159.22are required to receive care coordination under this section. The program may require all
159.23nonmedical case managers, including but not limited to county case managers and case
159.24managers for children served under a home and community-based waiver, to submit care
159.25plans for approval, and to document client compliance with the care plans. The U special
159.26kids program, beginning October 1, 2008, may employ or contract with nonmedical case
159.27managers to provide all nonmedical case management services to children required to
159.28receive care coordination under this section. The commissioner shall reimburse the
159.29U special kids program for case management services through the medical assistance
159.30program.
159.31    Subd. 5. Statewide availability of care coordination. The program may contract
159.32with other entities to provide care coordination services as defined in subdivision 1, in
159.33order to ensure the availability of these services in all regions of the state.
159.34    Subd. 6. Monitoring and evaluation. The commissioner shall monitor program
159.35outcomes and shall evaluate the extent to which referrals to the U special kids program
159.36have improved the quality and coordination of care and provided financial savings to the
160.1medical assistance program. The U special kids program shall submit to the commissioner,
160.2in the form and manner specified by the commissioner, all data and information necessary
160.3to monitor program outcomes and evaluate the program. The commissioner shall present a
160.4preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
160.5legislature by January 15, 2010.
160.6EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal
160.7approval, whichever is later. The commissioner shall notify the Office of the Revisor of
160.8Statutes when federal approval is obtained.

160.9    Sec. 19. [256B.194] FEDERAL PAYMENTS.
160.10    Subdivision 1. Payments at actual cost. If the Centers for Medicare & Medicaid
160.11Services (CMS) promulgates a final rule consistent with its stated intent in the proposed
160.12rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting
160.13payments to units of government, and notwithstanding Minnesota Statutes or Minnesota
160.14Rules to the contrary, for providers that are units of government, the commissioner may
160.15limit medical assistance and MinnesotaCare payments to a provider's actual cost of
160.16providing services, in accordance with the CMS final rule. If a final rule is promulgated,
160.17the commissioner may also require medical assistance and MinnesotaCare providers to
160.18provide any information necessary to determine Medicaid-related costs, and require the
160.19cooperation of providers in any audit or review necessary to ensure payments are limited
160.20to cost. This section does not apply to providers who are exempt from the provisions of
160.21the CMS final rule.
160.22    Subd. 2. Loss of federal financial participation. For all transfers, certified
160.23expenditures, and medical assistance payments listed below, if the commissioner
160.24determines that federal financial participation is no longer available for the medical
160.25assistance payments listed, then related obligations for the nonfederal share of payments
160.26and the medical assistance payments shall terminate. The commissioner shall notify all
160.27affected parties of the loss of federal financial participation, and the resulting payments
160.28and obligations that are terminated. If the commissioner determines that federal financial
160.29participation is no longer available for any medical assistance payments or contributions
160.30to the nonfederal share of medical assistance payments that have already been made, the
160.31commissioner may collect the medical assistance payments from providers and return
160.32contributions of the nonfederal share to its source. The transfers, certified expenditures,
160.33and medical assistance payments subject to this section are those specified in: sections
160.3462J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d;
160.35256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses
161.1(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws
161.22005, First Special Session chapter 4, article 9, section 2, subdivision 1.

161.3    Sec. 20. Minnesota Statutes 2006, section 256B.199, is amended to read:
161.4256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
161.5    (a) Hennepin County, and Hennepin County Medical Center, Ramsey County,
161.6Regions Hospital, the University of Minnesota, and Fairview-University Medical Center
161.7shall report quarterly to the commissioner beginning June 1, 2007, payments made during
161.8the second previous quarter that may qualify for reimbursement under federal law.
161.9    (b) Based on these reports, the commissioner shall apply for federal matching funds.
161.10These funds are appropriated to the commissioner for the payments under section 256.969,
161.11subdivision 27 to Hennepin County Medical Center.
161.12    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform
161.13the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
161.14hospital payment money expected to be available in the current federal fiscal year.
161.15    (d) This section sunsets on June 30, 2009. The commissioner shall report to
161.16the legislature by December 15, 2008, with recommendations for maximizing federal
161.17disproportionate share hospital payments after June 30, 2009.

161.18    Sec. 21. Minnesota Statutes 2006, section 256B.75, is amended to read:
161.19256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
161.20    (a) For outpatient hospital facility fee payments for services rendered on or after
161.21October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
161.22charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
161.23services for which there is a federal maximum allowable payment. Effective for services
161.24rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
161.25facility fees and emergency room facility fees shall be increased by eight percent over the
161.26rates in effect on December 31, 1999, except for those services for which there is a federal
161.27maximum allowable payment. Services for which there is a federal maximum allowable
161.28payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
161.29allowable payment. Total aggregate payment for outpatient hospital facility fee services
161.30shall not exceed the Medicare upper limit. If it is determined that a provision of this
161.31section conflicts with existing or future requirements of the United States government with
161.32respect to federal financial participation in medical assistance, the federal requirements
161.33prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
162.1avoid reduced federal financial participation resulting from rates that are in excess of
162.2the Medicare upper limitations.
162.3    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
162.4ambulatory surgery hospital facility fee services for critical access hospitals designated
162.5under section 144.1483, clause (10), shall be paid on a cost-based payment system that
162.6is based on the cost-finding methods and allowable costs of the Medicare program. All
162.7hospital outpatient services provided by any hospital exclusively devoted to the care of
162.8pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area
162.9must be paid for using the methodology established for critical access hospitals at a rate
162.10equal to fee-for-service rates plus 46 percent, as limited by allowable costs.
162.11    (c) Effective for services provided on or after July 1, 2003, rates that are based
162.12on the Medicare outpatient prospective payment system shall be replaced by a budget
162.13neutral prospective payment system that is derived using medical assistance data. The
162.14commissioner shall provide a proposal to the 2003 legislature to define and implement
162.15this provision.
162.16    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
162.17before third-party liability and spenddown, made to hospitals for outpatient hospital
162.18facility services is reduced by .5 percent from the current statutory rate.
162.19    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
162.20services provided on or after July 1, 2003, made to hospitals for outpatient hospital
162.21facility services before third-party liability and spenddown, is reduced five percent from
162.22the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
162.23excluded from this paragraph.
162.24EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services
162.25provided on or after that date.

162.26    Sec. 22. Minnesota Statutes 2006, section 256B.76, is amended to read:
162.27256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
162.28    (a) Effective for services rendered on or after October 1, 1992, the commissioner
162.29shall make payments for physician services as follows:
162.30    (1) payment for level one Centers for Medicare and Medicaid Services' common
162.31procedural coding system codes titled "office and other outpatient services," "preventive
162.32medicine new and established patient," "delivery, antepartum, and postpartum care,"
162.33"critical care," cesarean delivery and pharmacologic management provided to psychiatric
162.34patients, and level three codes for enhanced services for prenatal high risk, shall be paid
163.1at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
163.230, 1992. If the rate on any procedure code within these categories is different than the
163.3rate that would have been paid under the methodology in section 256B.74, subdivision 2,
163.4then the larger rate shall be paid;
163.5    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
163.6or (ii) 15.4 percent above the rate in effect on June 30, 1992;
163.7    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
163.8percentile of 1989, less the percent in aggregate necessary to equal the above increases
163.9except that payment rates for home health agency services shall be the rates in effect
163.10on September 30, 1992;
163.11    (4) effective for services rendered on or after January 1, 2000, payment rates for
163.12physician and professional services shall be increased by three percent over the rates in
163.13effect on December 31, 1999, except for home health agency and family planning agency
163.14services; and
163.15    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed
163.16care.
163.17    (b) Effective for services rendered on or after October 1, 1992, the commissioner
163.18shall make payments for dental services as follows:
163.19    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
163.20percent above the rate in effect on June 30, 1992;
163.21    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
163.22percentile of 1989, less the percent in aggregate necessary to equal the above increases;
163.23    (3) effective for services rendered on or after January 1, 2000, payment rates for
163.24dental services shall be increased by three percent over the rates in effect on December
163.2531, 1999;
163.26    (4) the commissioner shall award grants to community clinics or other nonprofit
163.27community organizations, political subdivisions, professional associations, or other
163.28organizations that demonstrate the ability to provide dental services effectively to public
163.29program recipients. Grants may be used to fund the costs related to coordinating access for
163.30recipients, developing and implementing patient care criteria, upgrading or establishing
163.31new facilities, acquiring furnishings or equipment, recruiting new providers, or other
163.32development costs that will improve access to dental care in a region. In awarding grants,
163.33the commissioner shall give priority to applicants that plan to serve areas of the state in
163.34which the number of dental providers is not currently sufficient to meet the needs of
163.35recipients of public programs or uninsured individuals. The commissioner shall consider
163.36the following in awarding the grants:
164.1    (i) potential to successfully increase access to an underserved population;
164.2    (ii) the ability to raise matching funds;
164.3    (iii) the long-term viability of the project to improve access beyond the period
164.4of initial funding;
164.5    (iv) the efficiency in the use of the funding; and
164.6    (v) the experience of the proposers in providing services to the target population.
164.7    The commissioner shall monitor the grants and may terminate a grant if the grantee
164.8does not increase dental access for public program recipients. The commissioner shall
164.9consider grants for the following:
164.10    (i) implementation of new programs or continued expansion of current access
164.11programs that have demonstrated success in providing dental services in underserved
164.12areas;
164.13    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to
164.14provide dental hygiene services; and
164.15    (iii) a program that organizes a network of volunteer dentists, establishes a system to
164.16refer eligible individuals to volunteer dentists, and through that network provides donated
164.17dental care services to public program recipients or uninsured individuals;
164.18    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
164.19shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
164.20    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000,
164.21for managed care; and
164.22    (7) effective for services provided on or after January 1, 2002, payment for
164.23diagnostic examinations and dental x-rays provided to children under age 21 shall be the
164.24lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
164.25    (c) Effective for dental services rendered on or after January 1, 2002, the
164.26commissioner may, within the limits of available appropriation, increase reimbursements
164.27to dentists and dental clinics deemed by the commissioner to be critical access dental
164.28providers. Reimbursement to a critical access dental provider may be increased by not
164.29more than 50 percent above the reimbursement rate that would otherwise be paid to the
164.30provider. Payments to For dental services rendered after June 30, 2007, the commissioner
164.31shall increase reimbursement by 33 percent above the reimbursement rate that would
164.32otherwise be paid to the provider. The commissioner shall pay the health plan companies
164.33shall be adjusted in amounts sufficient to reflect increased reimbursements to critical
164.34access dental providers as approved by the commissioner. In determining which dentists
164.35and dental clinics shall be deemed critical access dental providers, the commissioner
164.36shall review:
165.1    (1) the utilization rate in the service area in which the dentist or dental clinic operates
165.2for dental services to patients covered by medical assistance, general assistance medical
165.3care, or MinnesotaCare as their primary source of coverage;
165.4    (2) the level of services provided by the dentist or dental clinic to patients covered
165.5by medical assistance, general assistance medical care, or MinnesotaCare as their primary
165.6source of coverage; and
165.7    (3) whether the level of services provided by the dentist or dental clinic is critical to
165.8maintaining adequate levels of patient access within the service area.
165.9In the absence of a critical access dental provider in a service area, the commissioner may
165.10designate a dentist or dental clinic as a critical access dental provider if the dentist or
165.11dental clinic is willing to provide care to patients covered by medical assistance, general
165.12assistance medical care, or MinnesotaCare at a level which significantly increases access
165.13to dental care in the service area.
165.14    The commissioner shall annually establish a reimbursement schedule for critical
165.15access dental providers and provider-specific limits on total reimbursement received
165.16under the reimbursement schedule, and shall notify each critical access dental provider
165.17of the schedule and limit.
165.18    (d) An entity that operates both a Medicare certified comprehensive outpatient
165.19rehabilitation facility and a facility which was certified prior to January 1, 1993, that is
165.20licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33
165.21percent of the clients receiving rehabilitation services in the most recent calendar year are
165.22medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation
165.23services at rates that are 38 percent greater than the maximum reimbursement rate
165.24allowed under paragraph (a), clause (2), when those services are (1) provided within the
165.25comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing
165.26facilities owned by the entity.
165.27    (e) Effective for services rendered on or after January 1, 2007, the commissioner
165.28shall make payments for physician and professional services based on the Medicare
165.29relative value units (RVU's). This change shall be budget neutral and the cost of
165.30implementing RVU's will be incorporated in the established conversion factor.

165.31    Sec. 23. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
165.32    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
165.33eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
165.34care covers, except as provided in paragraph (c):
165.35    (1) inpatient hospital services;
166.1    (2) outpatient hospital services;
166.2    (3) services provided by Medicare certified rehabilitation agencies;
166.3    (4) prescription drugs and other products recommended through the process
166.4established in section 256B.0625, subdivision 13;
166.5    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
166.6for diabetics to monitor blood sugar level;
166.7    (6) eyeglasses and eye examinations provided by a physician or optometrist;
166.8    (7) hearing aids;
166.9    (8) prosthetic devices;
166.10    (9) laboratory and X-ray services;
166.11    (10) physician's services;
166.12    (11) medical transportation except special transportation;
166.13    (12) chiropractic services as covered under the medical assistance program;
166.14    (13) podiatric services;
166.15    (14) dental services as covered under the medical assistance program;
166.16    (15) outpatient services provided by a mental health center or clinic that is under
166.17contract with the county board and is established under section 245.62;
166.18    (16) day treatment services for mental illness provided under contract with the
166.19county board;
166.20    (17) prescribed medications for persons who have been diagnosed as mentally ill as
166.21necessary to prevent more restrictive institutionalization;
166.22    (18) psychological services, medical supplies and equipment, and Medicare
166.23premiums, coinsurance and deductible payments;
166.24    (19) medical equipment not specifically listed in this paragraph when the use of
166.25the equipment will prevent the need for costlier services that are reimbursable under
166.26this subdivision;
166.27    (20) services performed by a certified pediatric nurse practitioner, a certified family
166.28nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
166.29nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
166.30practitioner in independent practice, if (1) the service is otherwise covered under this
166.31chapter as a physician service, (2) the service provided on an inpatient basis is not included
166.32as part of the cost for inpatient services included in the operating payment rate, and (3) the
166.33service is within the scope of practice of the nurse practitioner's license as a registered
166.34nurse, as defined in section 148.171;
166.35    (21) services of a certified public health nurse or a registered nurse practicing in
166.36a public health nursing clinic that is a department of, or that operates under the direct
167.1authority of, a unit of government, if the service is within the scope of practice of the
167.2public health nurse's license as a registered nurse, as defined in section 148.171;
167.3    (22) telemedicine consultations, to the extent they are covered under section
167.4256B.0625, subdivision 3b ; and
167.5    (23) mental health telemedicine and psychiatric consultation as covered under
167.6section 256B.0625, subdivisions 46 and 48.;
167.7    (24) care coordination and patient education services provided by a community
167.8health worker according to section 256B.0625, subdivision 49; and
167.9    (25) regardless of the number of employees that an enrolled health care provider
167.10may have, sign language interpreter services when provided by an enrolled health care
167.11provider during the course of providing a direct, person-to-person covered health care
167.12service to an enrolled recipient who has a hearing loss and uses interpreting services.
167.13    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
167.14paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
167.15to inpatient hospital services, including physician services provided during the inpatient
167.16hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
167.17    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
167.18subdivision.
167.19    (c) In order to contain costs, the commissioner of human services shall select
167.20vendors of medical care who can provide the most economical care consistent with high
167.21medical standards and shall where possible contract with organizations on a prepaid
167.22capitation basis to provide these services. The commissioner shall consider proposals by
167.23counties and vendors for prepaid health plans, competitive bidding programs, block grants,
167.24or other vendor payment mechanisms designed to provide services in an economical
167.25manner or to control utilization, with safeguards to ensure that necessary services are
167.26provided. Before implementing prepaid programs in counties with a county operated or
167.27affiliated public teaching hospital or a hospital or clinic operated by the University of
167.28Minnesota, the commissioner shall consider the risks the prepaid program creates for the
167.29hospital and allow the county or hospital the opportunity to participate in the program in a
167.30manner that reflects the risk of adverse selection and the nature of the patients served by
167.31the hospital, provided the terms of participation in the program are competitive with the
167.32terms of other participants considering the nature of the population served. Payment for
167.33services provided pursuant to this subdivision shall be as provided to medical assistance
167.34vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
167.35payments made during fiscal year 1990 and later years, the commissioner shall consult
168.1with an independent actuary in establishing prepayment rates, but shall retain final control
168.2over the rate methodology.
168.3    (d) Effective January 1, 2008, drug coverage under general assistance medical care
168.4is limited to prescription drugs that:
168.5    (i) are covered under the medical assistance program as described in section
168.6256B.0625, subdivisions 13 and 13d; and
168.7    (ii) are provided by manufacturers that have fully executed general assistance
168.8medical care rebate agreements with the commissioner and comply with the agreements.
168.9Prescription drug coverage under general assistance medical care must conform to
168.10coverage under the medical assistance program according to section 256B.0625,
168.11subdivisions 13 to 13g.
168.12    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
168.13co-payments for services provided on or after October 1, 2003:
168.14    (1) $25 for eyeglasses;
168.15    (2) $25 for nonemergency visits to a hospital-based emergency room;
168.16    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
168.17subject to a $12 per month maximum for prescription drug co-payments. No co-payments
168.18shall apply to antipsychotic drugs when used for the treatment of mental illness; and
168.19    (4) 50 percent coinsurance on restorative dental services.
168.20    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive
168.21visits, eyeglasses, and nonemergency visits to a hospital-based emergency room.
168.22Recipients of general assistance medical care are responsible for all co-payments in this
168.23subdivision. The general assistance medical care reimbursement to the provider shall be
168.24reduced by the amount of the co-payment, except that reimbursement for prescription
168.25drugs shall not be reduced once a recipient has reached the $12 per month maximum for
168.26prescription drug co-payments. The provider collects the co-payment from the recipient.
168.27Providers may not deny services to recipients who are unable to pay the co-payment,
168.28except as provided in paragraph (f).
168.29    (f) (g) If it is the routine business practice of a provider to refuse service to an
168.30individual with uncollected debt, the provider may include uncollected co-payments
168.31under this section. A provider must give advance notice to a recipient with uncollected
168.32debt before services can be denied.
168.33    (g) (h) Any county may, from its own resources, provide medical payments for
168.34which state payments are not made.
168.35    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must
168.36not be reimbursed under general assistance medical care.
169.1    (i) (j) The maximum payment for new vendors enrolled in the general assistance
169.2medical care program after the base year shall be determined from the average usual and
169.3customary charge of the same vendor type enrolled in the base year.
169.4    (j) (k) The conditions of payment for services under this subdivision are the same
169.5as the conditions specified in rules adopted under chapter 256B governing the medical
169.6assistance program, unless otherwise provided by statute or rule.
169.7    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective
169.8July 1, 2003. This reduction is in addition to the five percent reduction effective July 1,
169.92003, and incorporated by reference in paragraph (i).
169.10    (l) (m) Payments for all other health services except inpatient, outpatient, and
169.11pharmacy services shall be reduced by five percent, effective July 1, 2003.
169.12    (m) (n) Payments to managed care plans shall be reduced by five percent for services
169.13provided on or after October 1, 2003.
169.14    (n) (o) A hospital receiving a reduced payment as a result of this section may apply
169.15the unpaid balance toward satisfaction of the hospital's bad debts.
169.16    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3
169.17for services provided on or after January 1, 2006. For purposes of this subdivision, a
169.18visit means an episode of service which is required because of a recipient's symptoms,
169.19diagnosis, or established illness, and which is delivered in an ambulatory setting by
169.20a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
169.21audiologist, optician, or optometrist.
169.22    (p) (q) Payments to managed care plans shall not be increased as a result of the
169.23removal of the $3 nonpreventive visit co-payment effective January 1, 2006.

169.24    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
169.25    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
169.26and (c), the MinnesotaCare benefit plan shall include the following co-payments and
169.27coinsurance requirements for all enrollees:
169.28    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
169.29subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
169.30$3,000 per family;
169.31    (2) $3 per prescription for adult enrollees;
169.32    (3) $25 for eyeglasses for adult enrollees;
169.33    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
169.34episode of service which is required because of a recipient's symptoms, diagnosis, or
169.35established illness, and which is delivered in an ambulatory setting by a physician or
170.1physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
170.2audiologist, optician, or optometrist; and
170.3    (5) $6 for nonemergency visits to a hospital-based emergency room.
170.4    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
170.5children under the age of 21 in households with family income equal to or less than 175
170.6percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
170.7parents and relative caretakers of children under the age of 21 in households with family
170.8income greater than 175 percent of the federal poverty guidelines for inpatient hospital
170.9admissions occurring on or after January 1, 2001.
170.10    (c) Paragraph (a), clauses (1) to (4), do does not apply to pregnant women and
170.11children under the age of 21.
170.12    (d) Adult enrollees with family gross income that exceeds 175 percent of the
170.13federal poverty guidelines and who are not pregnant shall be financially responsible for
170.14the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
170.15hospital benefit limit.
170.16    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
170.17or changes from one prepaid health plan to another during a calendar year, any charges
170.18submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
170.19expenses incurred by the enrollee for inpatient services, that were submitted or incurred
170.20prior to enrollment, or prior to the change in health plans, shall be disregarded.

170.21    Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:
170.22    Subdivision 1. Families with children. (a) Families with children with family
170.23income equal to or less than 275 percent of the federal poverty guidelines for the
170.24applicable family size shall be eligible for MinnesotaCare according to this section. All
170.25other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
170.26to enrollment under section 256L.07, shall apply unless otherwise specified.
170.27    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
170.28if the children are eligible. Children may be enrolled separately without enrollment by
170.29parents. However, if one parent in the household enrolls, both parents must enroll, unless
170.30other insurance is available. If one child from a family is enrolled, all children must
170.31be enrolled, unless other insurance is available. If one spouse in a household enrolls,
170.32the other spouse in the household must also enroll, unless other insurance is available.
170.33Families cannot choose to enroll only certain uninsured members.
171.1    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
171.2to the MinnesotaCare program. These persons are no longer counted in the parental
171.3household and may apply as a separate household.
171.4    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents
171.5are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the
171.6six-month period of eligibility.

171.7    Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:
171.8    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing
171.9in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee
171.10residing in a correctional or detention facility is not eligible at renewal of eligibility under
171.11section 256L.05, subdivision 3b 3a.

171.12    Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:
171.13    Subd. 7. Critical access dental providers. Effective for dental services provided
171.14to MinnesotaCare enrollees on or after between January 1, 2007, and June 30, 2007, the
171.15commissioner shall increase payment rates to dentists and dental clinics deemed by the
171.16commissioner to be critical access providers under section 256B.76, paragraph (c), by 50
171.17percent above the payment rate that would otherwise be paid to the provider. Effective
171.18for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the
171.19commissioner shall increase payment rates to dentists and dental clinics deemed by the
171.20commissioner to be critical access providers under section 256B.76, paragraph (c), by
171.2133 percent above the payment rate that would otherwise be paid to the provider. The
171.22commissioner shall adjust the rates paid on or after January 1, 2007, to pay the prepaid
171.23health plans under contract with the commissioner amounts sufficient to reflect this rate
171.24increase. The prepaid health plan must pass this rate increase to providers who have
171.25been identified by the commissioner as critical access dental providers under section
171.26256B.76 , paragraph (c).

171.27    Sec. 28. HENNEPIN COUNTY PILOT PROJECT.
171.28    The commissioner of human services shall support a pilot project in Hennepin
171.29County to demonstrate the effectiveness of alternative strategies to redetermine eligibility
171.30for certain recipient populations in the medical assistance program. The target populations
171.31for the demonstration are persons who are eligible based upon disability or age, who have
171.32chronic medical conditions, and who are expected to experience minimal change in income
171.33or assets from month to month. The commissioner and the county shall analyze the issues
172.1and strategies employed and the outcomes to determine reasonable efforts to streamline
172.2eligibility statewide. The duration of the pilot project shall be no more than two years.
172.3The commissioner shall apply for any federal waivers needed to implement this section.

172.4    Sec. 29. COUNTY-BASED PURCHASING STUDY.
172.5    The commissioner of health shall study county-based purchasing initiatives
172.6established under Minnesota Statutes, section 256B.692, and compare these initiatives
172.7to managed care plans serving medical assistance, general assistance medical care, and
172.8MinnesotaCare enrollees. The study must:
172.9    (1) provide a history and description of county-based purchasing initiatives,
172.10including state and federal requirements and any federal waivers Minnesota counties have
172.11applied for or received;
172.12    (2) provide a history and description of managed care plan participation in the
172.13prepaid medical assistance, prepaid general assistance medical care, and prepaid
172.14Minnesota programs, and the provision by managed care plans of third-party administrator
172.15services for county-based purchasing initiatives;
172.16    (3) provide relevant data, including limitations on data, data that was requested but
172.17not received, and explanations for why requested data was not received;
172.18    (4) provide recommendations for further data collection and research;
172.19    (5) summarize successes and challenges of the two service delivery methods;
172.20    (6) provide recommendations for possible expansion of county-based purchasing
172.21in rural and urban settings; and
172.22    (7) identify and describe features of county-based purchasing and managed care
172.23plans serving medical assistance, general assistance medical care, and MinnesotaCare
172.24enrollees, to provide a comparison of cost, quality, access, and community health
172.25improvement that includes, but is not limited to:
172.26    (i) descriptions of how health care and social services are integrated and coordinated
172.27for persons with complex care needs, including persons with high-risk pregnancies,
172.28adolescents, persons who are disabled, persons who are elderly, and persons with chronic
172.29health care and social needs;
172.30    (ii) use of monetary grants and surpluses to:
172.31    (A) increase provider reimbursement, including dental care reimbursement, in order
172.32to improve health care access; and
172.33    (B) improve community health beyond the requirements of the public health care
172.34programs, such as the funding of public education, research, and community initiatives to
172.35enhance utilization of preventive services, social services, or mental health care;
173.1    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or
173.2other charges, and top five management salaries;
173.3    (iv) reporting requirements of contracts with the Department of Human Services;
173.4    (v) public access to all information about management and administration, including
173.5but not limited to provider contracts and reimbursement, models of care management and
173.6coordination, utilization review, contracts with consultants and other vendors, handling of
173.7monetary grants and surpluses, and health outcomes data;
173.8    (vi) provider reimbursement by clinical practice area;
173.9    (vii) populations served, described by age, disability, income, race, language,
173.10occupation, and other demographic characteristics;
173.11    (viii) utilization of community-based prevention interventions, including but not
173.12limited to public health nursing visits to new parents, use of nurse-managed interventions
173.13to reduce cardiac hospitalizations, and the use of medical homes for chronic disease
173.14management;
173.15    (ix) utilization of cancer screening;
173.16    (x) utilization of interpreter services;
173.17    (xi) immunization rates for children age five and under;
173.18    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac
173.19illnesses;
173.20    (xiii) rates of rehospitalization within a month of hospital discharge;
173.21    (xiv) coordination with county agencies to increase enrollment;
173.22    (xv) number of new program enrollees and the rate of enrollment, including the
173.23percentage of eligible persons who become enrollees;
173.24    (xvi) enrollee satisfaction with their care; and
173.25    (xvii) number of enrollees who do not receive care.
173.26    Managed care plans, county-based purchasing initiatives, health care providers,
173.27counties, and the commissioner of human services shall, upon request, provide data to
173.28the commissioner of health that is necessary to complete the study. The commissioner of
173.29health shall submit the study to the legislature by December 31, 2007.

173.30    Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.
173.31    The commissioner of human services shall award a grant to the Neighborhood
173.32Health Care Network to pay the costs of maintaining and staffing a toll-free telephone
173.33number to provide callers with information on health coverage options, eligibility for
173.34MinnesotaCare and other health care programs, and health care providers that offer free or
173.35reduced-cost health care services.

174.1    Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.
174.2    The commissioner, after consulting with the Pharmacy Payment Reform Advisory
174.3Committee established under Laws 2006, chapter 282, article 16, section 15, may
174.4proportionally increase or decrease the dispensing fee for multiple-source generic drugs
174.5under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect
174.6the actual amount of reductions in program cost for ingredient reimbursement savings
174.7obtained.
174.8EFFECTIVE DATE.This section is effective upon implementation of changes to
174.9the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit
174.10Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).

174.11    Sec. 32. REPEALER.
174.12Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective
174.13July 1, 2007.

174.14ARTICLE 4

174.15CONTINUING CARE

174.16    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to
174.17read:
174.18    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The
174.19commissioner of health, in coordination with the commissioner of human services, may
174.20approve the renovation, replacement, upgrading, or relocation of a nursing home or
174.21boarding care home, under the following conditions:
174.22    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
174.23constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
174.24attached to a hospital that is also being replaced. The threshold allowed for this project
174.25under section 144A.073 shall be the maximum amount available to pay the additional
174.26medical assistance costs of the new facility;
174.27    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
174.28Louis County, provided that the 29 beds must be transferred from active or layaway status
174.29at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
174.30The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
174.31rate at that facility shall not be adjusted as a result of this transfer. The operating payment
174.32rate of the facility adding beds after completion of this project shall be the same as it was
175.1on the day prior to the day the beds are licensed and certified. This project shall not
175.2proceed unless it is approved and financed under the provisions of section 144A.073;
175.3    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
175.4the new beds are transferred from a 45-bed facility in Austin under common ownership
175.5that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
175.6under common ownership; (ii) the commissioner of human services is authorized by the
175.72004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
175.8money is available from planned closures of facilities under common ownership to make
175.9implementation of this clause budget-neutral to the state. The bed capacity of the Albert
175.10Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
175.11new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
175.12disease or related dementias; and
175.13    (4) to license and certify up to 80 beds transferred from an existing state-owned
175.14nursing facility in Cass County to a new facility located on the grounds of the
175.15Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
175.16determined based on the interim and settle-up payment provisions of Minnesota Rules,
175.17part 9549.0057, and the reimbursement provisions of section 256B.431. The property
175.18payment rate for the first three years of operation shall be $35 per day. For subsequent
175.19years, the property payment rate of $35 per day shall be adjusted for inflation as provided
175.20in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract
175.21under section 256B.434.; and
175.22    (5) to license and certify 180 beds transferred from an existing facility in
175.23Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a
175.24219-bed facility under common ownership that shall be closed following the transfer. The
175.25operating payment rate of the new facility after completion of this project shall be adjusted
175.26upward by $35 per day and the property payment rate shall be $34.049 per day.
175.27    (b) Projects approved under this subdivision shall be treated in a manner equivalent
175.28to projects approved under subdivision 4a.
175.29EFFECTIVE DATE.This section is effective the day following final enactment.

175.30    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:
175.31    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
175.32child, including a child determined eligible for medical assistance without consideration of
175.33parental income, must contribute to the cost of services used by making monthly payments
175.34on a sliding scale based on income, unless the child is married or has been married,
175.35parental rights have been terminated, or the child's adoption is subsidized according to
176.1section 259.67 or through title IV-E of the Social Security Act. The parental contribution
176.2is a partial or full payment for medical services provided for diagnostic, therapeutic,
176.3curing, treating, mitigating, rehabilitation, and maintenance and personal care services as
176.4defined in United States Code, title 26, section 213, needed by the child with a chronic
176.5illness or disability.
176.6    (b) For households with adjusted gross income equal to or greater than 100 percent
176.7of federal poverty guidelines, the parental contribution shall be computed by applying the
176.8following schedule of rates to the adjusted gross income of the natural or adoptive parents:
176.9    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
176.10poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
176.11contribution is $4 per month;
176.12    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
176.13poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
176.14the parental contribution shall be determined using a sliding fee scale established by the
176.15commissioner of human services which begins at one percent of adjusted gross income
176.16at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
176.17gross income for those with adjusted gross income up to 545 percent of federal poverty
176.18guidelines;
176.19    (3) if the adjusted gross income is greater than 545 percent of federal poverty
176.20guidelines and less than 675 percent of federal poverty guidelines, the parental
176.21contribution shall be 7.5 percent of adjusted gross income;
176.22    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
176.23poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
176.24contribution shall be determined using a sliding fee scale established by the commissioner
176.25of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
176.26federal poverty guidelines and increases to ten percent of adjusted gross income for those
176.27with adjusted gross income up to 975 percent of federal poverty guidelines; and
176.28    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
176.29poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
176.30income.
176.31    If the child lives with the parent, the annual adjusted gross income parental
176.32contribution is reduced by $2,400 prior to calculating the parental contribution $100
176.33per month. If the child resides in an institution specified in section 256B.35, the parent
176.34is responsible for the personal needs allowance specified under that section in addition
176.35to the parental contribution determined under this section. The parental contribution is
177.1reduced by any amount required to be paid directly to the child pursuant to a court order,
177.2but only if actually paid.
177.3    (c) The household size to be used in determining the amount of contribution under
177.4paragraph (b) includes natural and adoptive parents and their dependents, including the
177.5child receiving services. Adjustments in the contribution amount due to annual changes
177.6in the federal poverty guidelines shall be implemented on the first day of July following
177.7publication of the changes.
177.8    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
177.9natural or adoptive parents determined according to the previous year's federal tax form,
177.10except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
177.11have been used to purchase a home shall not be counted as income.
177.12    (e) The contribution shall be explained in writing to the parents at the time eligibility
177.13for services is being determined. The contribution shall be made on a monthly basis
177.14effective with the first month in which the child receives services. Annually upon
177.15redetermination or at termination of eligibility, if the contribution exceeded the cost of
177.16services provided, the local agency or the state shall reimburse that excess amount to
177.17the parents, either by direct reimbursement if the parent is no longer required to pay
177.18a contribution, or by a reduction in or waiver of parental fees until the excess amount
177.19is exhausted.
177.20    (f) The monthly contribution amount must be reviewed at least every 12 months;
177.21when there is a change in household size; and when there is a loss of or gain in income
177.22from one month to another in excess of ten percent. The local agency shall mail a written
177.23notice 30 days in advance of the effective date of a change in the contribution amount.
177.24A decrease in the contribution amount is effective in the month that the parent verifies a
177.25reduction in income or change in household size.
177.26    (g) Parents of a minor child who do not live with each other shall each pay the
177.27contribution required under paragraph (a). An amount equal to the annual court-ordered
177.28child support payment actually paid on behalf of the child receiving services shall be
177.29deducted from the adjusted gross income of the parent making the payment prior to
177.30calculating the parental contribution under paragraph (b).
177.31    (h) The contribution under paragraph (b) shall be increased by an additional five
177.32percent if the local agency determines that insurance coverage is available but not
177.33obtained for the child. For purposes of this section, "available" means the insurance is a
177.34benefit of employment for a family member at an annual cost of no more than five percent
177.35of the family's annual income. For purposes of this section, "insurance" means health
178.1and accident insurance coverage, enrollment in a nonprofit health service plan, health
178.2maintenance organization, self-insured plan, or preferred provider organization.
178.3    Parents who have more than one child receiving services shall not be required
178.4to pay more than the amount for the child with the highest expenditures. There shall
178.5be no resource contribution from the parents. The parent shall not be required to pay
178.6a contribution in excess of the cost of the services provided to the child, not counting
178.7payments made to school districts for education-related services. Notice of an increase in
178.8fee payment must be given at least 30 days before the increased fee is due.
178.9    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
178.10in the 12 months prior to July 1:
178.11    (1) the parent applied for insurance for the child;
178.12    (2) the insurer denied insurance;
178.13    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
178.14a complaint or appeal, in writing, to the commissioner of health or the commissioner of
178.15commerce, or litigated the complaint or appeal; and
178.16    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
178.17    For purposes of this section, "insurance" has the meaning given in paragraph (h).
178.18    A parent who has requested a reduction in the contribution amount under this
178.19paragraph shall submit proof in the form and manner prescribed by the commissioner or
178.20county agency, including, but not limited to, the insurer's denial of insurance, the written
178.21letter or complaint of the parents, court documents, and the written response of the insurer
178.22approving insurance. The determinations of the commissioner or county agency under this
178.23paragraph are not rules subject to chapter 14.

178.24    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:
178.25    Subd. 3. Amount of support grant; use. Support grant amounts shall be
178.26determined by the county social service agency. Services and items purchased with a
178.27support grant must:
178.28    (1) be over and above the normal costs of caring for the dependent if the dependent
178.29did not have a disability;
178.30    (2) be directly attributable to the dependent's disabling condition; and
178.31    (3) enable the family to delay or prevent the out-of-home placement of the dependent.
178.32    The design and delivery of services and items purchased under this section must
178.33suit the dependent's chronological age and be provided in the least restrictive environment
178.34possible, consistent with the needs identified in the individual service plan.
179.1    Items and services purchased with support grants must be those for which there
179.2are no other public or private funds available to the family. Fees assessed to parents
179.3for health or human services that are funded by federal, state, or county dollars are not
179.4reimbursable through this program.
179.5    In approving or denying applications, the county shall consider the following factors:
179.6    (1) the extent and areas of the functional limitations of the disabled child;
179.7    (2) the degree of need in the home environment for additional support; and
179.8    (3) the potential effectiveness of the grant to maintain and support the person in
179.9the family environment.
179.10    The maximum monthly grant amount shall be $250 per eligible dependent, or
179.11$3,000 per eligible dependent per state fiscal year, within the limits of available funds and
179.12as adjusted by any legislatively authorized cost of living adjustment. The county social
179.13service agency may consider the dependent's supplemental security income in determining
179.14the amount of the support grant.
179.15    Any adjustments to their monthly grant amount must be based on the needs of the
179.16family and funding availability.

179.17    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision
179.18to read:
179.19    Subd. 22. Provider rate increase; St. Louis County. A day training and
179.20habilitation provider in St. Louis County licensed to provide services to up to 80
179.21individuals shall receive a per diem rate increase that does not exceed 95 percent of the
179.22greater of 125 percent of the current statewide median or 125 percent of the regional
179.23average per diem rate, whichever is higher.

179.24    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
179.25to read:
179.26    Subd. 24. Disability linkage line. The commissioner shall establish the disability
179.27linkage line, a statewide consumer information, referral, and assistance system for people
179.28with disabilities and chronic illnesses that:
179.29    (1) provides information about state and federal eligibility requirements, benefits,
179.30and service options;
179.31    (2) makes referrals to appropriate support entities;
179.32    (3) delivers information and assistance based on national and state standards;
179.33    (4) assists people to make well-informed decisions; and
179.34    (5) supports the timely resolution of service access and benefit issues.

180.1    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:
180.2    Subdivision 1. Purpose and goals. The commissioner of human services shall
180.3establish a consumer support grant program for individuals with functional limitations and
180.4their families who wish to purchase and secure their own supports. The commissioner and
180.5local agencies shall jointly develop an implementation plan which must include a way to
180.6resolve the issues related to county liability. The program shall:
180.7    (1) make support grants available to individuals or families as an effective alternative
180.8to the developmental disability family support program, personal care attendant services,
180.9home health aide services, and private duty nursing services;
180.10    (2) provide consumers more control, flexibility, and responsibility over their services
180.11and supports;
180.12    (3) promote local program management and decision making; and
180.13    (4) encourage the use of informal and typical community supports.

180.14    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:
180.15    Subd. 2. Definitions. For purposes of this section, the following terms have the
180.16meanings given them:
180.17    (a) "County board" means the county board of commissioners for the county of
180.18financial responsibility as defined in section 256G.02, subdivision 4, or its designated
180.19representative. When a human services board has been established under sections 402.01
180.20to 402.10, it shall be considered the county board for the purposes of this section.
180.21    (b) "Family" means the person's birth parents, adoptive parents or stepparents,
180.22siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece,
180.23nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is
180.24at least 18 years of age.
180.25    (c) "Functional limitations" means the long-term inability to perform an activity or
180.26task in one or more areas of major life activity, including self-care, understanding and use
180.27of language, learning, mobility, self-direction, and capacity for independent living. For the
180.28purpose of this section, the inability to perform an activity or task results from a mental,
180.29emotional, psychological, sensory, or physical disability, condition, or illness.
180.30    (d) "Informed choice" means a voluntary decision made by the person or,
180.31the person's legal representative, or other authorized representative after becoming
180.32familiarized with the alternatives to:
180.33    (1) select a preferred alternative from a number of feasible alternatives;
180.34    (2) select an alternative which may be developed in the future; and
180.35    (3) refuse any or all alternatives.
181.1    (e) "Local agency" means the local agency authorized by the county board or,
181.2for counties not participating in the consumer grant program by July 1, 2002, the
181.3commissioner, to carry out the provisions of this section.
181.4    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in
181.5subdivision 3.
181.6    (g) "Authorized representative" means an individual designated by the person or
181.7their legal representative to act on their behalf. This individual may be a family member,
181.8guardian, representative payee, or other individual designated by the person or their legal
181.9representative, if any, to assist in purchasing and arranging for supports. For the purposes
181.10of this section, an authorized representative is at least 18 years of age.
181.11    (h) "Screening" means the screening of a person's service needs under sections
181.12256B.0911 and 256B.092.
181.13    (i) "Supports" means services, care, aids, environmental modifications, or assistance
181.14purchased by the person or the person's family, the person's legal representative, or other
181.15authorized representative. Examples of supports include respite care, assistance with daily
181.16living, and assistive technology. For the purpose of this section, notwithstanding the
181.17provisions of section 144A.43, supports purchased under the consumer support program
181.18are not considered home care services.
181.19    (j) "Program of origination" means the program the individual transferred from
181.20when approved for the consumer support grant program.

181.21    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:
181.22    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a
181.23consumer support grant if the person meets all of the following criteria:
181.24    (1) the person is eligible for and has been approved to receive services under
181.25medical assistance as determined under sections 256B.055 and 256B.056 or the person
181.26has been approved to receive a grant under the developmental disability family support
181.27program under section 252.32;
181.28    (2) the person is able to direct and purchase the person's own care and supports, or
181.29the person has a family member, legal representative, or other authorized representative
181.30who can purchase and arrange supports on the person's behalf;
181.31    (3) the person has functional limitations, requires ongoing supports to live in the
181.32community, and is at risk of or would continue institutionalization without such supports;
181.33and
182.1    (4) the person will live in a home. For the purpose of this section, "home" means the
182.2person's own home or home of a person's family member. These homes are natural home
182.3settings and are not licensed by the Department of Health or Human Services.
182.4    (b) Persons may not concurrently receive a consumer support grant if they are:
182.5    (1) receiving personal care attendant and home health aide services, or private duty
182.6nursing under section 256B.0625; a developmental disability family support grant; or
182.7alternative care services under section 256B.0913; or
182.8    (2) residing in an institutional or congregate care setting.
182.9    (c) A person or person's family receiving a consumer support grant shall not be
182.10charged a fee or premium by a local agency for participating in the program.
182.11    (d) Individuals receiving home and community-based waivers under United States
182.12Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except
182.13for individuals receiving consumer support grants before July 1, 2003, as long as other
182.14eligibility criteria are met.
182.15    (e) The commissioner shall establish a budgeted appropriation each fiscal year
182.16for the consumer support grant program. The number of individuals participating in
182.17the program will be adjusted so the total amount allocated to counties does not exceed
182.18the amount of the budgeted appropriation. The budgeted appropriation will be adjusted
182.19annually to accommodate changes in demand for the consumer support grants.

182.20    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:
182.21    Subd. 4. Support grants; criteria and limitations. (a) A county board may
182.22choose to participate in the consumer support grant program. If a county has not chosen
182.23to participate by July 1, 2002, the commissioner shall contract with another county or
182.24other entity to provide access to residents of the nonparticipating county who choose
182.25the consumer support grant option. The commissioner shall notify the county board
182.26in a county that has declined to participate of the commissioner's intent to enter into
182.27a contract with another county or other entity at least 30 days in advance of entering
182.28into the contract. The local agency shall establish written procedures and criteria to
182.29determine the amount and use of support grants. These procedures must include, at least,
182.30the availability of respite care, assistance with daily living, and adaptive aids. The local
182.31agency may establish monthly or annual maximum amounts for grants and procedures
182.32where exceptional resources may be required to meet the health and safety needs of the
182.33person on a time-limited basis, however, the total amount awarded to each individual may
182.34not exceed the limits established in subdivision 11.
183.1    (b) Support grants to a person or a person's family, a person's legal representative,
183.2or other authorized representative will be provided through a monthly subsidy payment
183.3and be in the form of cash, voucher, or direct county payment to vendor. Support grant
183.4amounts must be determined by the local agency. Each service and item purchased with a
183.5support grant must meet all of the following criteria:
183.6    (1) it must be over and above the normal cost of caring for the person if the person
183.7did not have functional limitations;
183.8    (2) it must be directly attributable to the person's functional limitations;
183.9    (3) it must enable the person or the person's family, a person's legal representative,
183.10or other authorized representative to delay or prevent out-of-home placement of the
183.11person; and
183.12    (4) it must be consistent with the needs identified in the service agreement, when
183.13applicable.
183.14    (c) Items and services purchased with support grants must be those for which there
183.15are no other public or private funds available to the person or the person's family, a person's
183.16legal representative, or other authorized representative. Fees assessed to the person or the
183.17person's family for health and human services are not reimbursable through the grant.
183.18    (d) In approving or denying applications, the local agency shall consider the
183.19following factors:
183.20    (1) the extent and areas of the person's functional limitations;
183.21    (2) the degree of need in the home environment for additional support; and
183.22    (3) the potential effectiveness of the grant to maintain and support the person in the
183.23family environment or the person's own home.
183.24    (e) At the time of application to the program or screening for other services,
183.25the person or the person's family, a person's legal representative, or other authorized
183.26representative shall be provided sufficient information to ensure an informed choice
183.27of alternatives by the person, the person's legal representative, or other authorized
183.28representative, if any, or the person's family. The application shall be made to the local
183.29agency and shall specify the needs of the person and family, the form and amount of
183.30grant requested, the items and services to be reimbursed, and evidence of eligibility for
183.31medical assistance.
183.32    (f) Upon approval of an application by the local agency and agreement on a support
183.33plan for the person or person's family, the local agency shall make grants to the person or
183.34the person's family. The grant shall be in an amount for the direct costs of the services or
183.35supports outlined in the service agreement.
184.1    (g) Reimbursable costs shall not include costs for resources already available, such as
184.2special education classes, day training and habilitation, case management, other services to
184.3which the person is entitled, medical costs covered by insurance or other health programs,
184.4or other resources usually available at no cost to the person or the person's family.
184.5    (h) The state of Minnesota, the county boards participating in the consumer
184.6support grant program, or the agencies acting on behalf of the county boards in the
184.7implementation and administration of the consumer support grant program shall not be
184.8liable for damages, injuries, or liabilities sustained through the purchase of support by
184.9the individual, the individual's family, or the authorized representative under this section
184.10with funds received through the consumer support grant program. Liabilities include but
184.11are not limited to: workers' compensation liability, the Federal Insurance Contributions
184.12Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section,
184.13participating county boards and agencies acting on behalf of county boards are exempt
184.14from the provisions of section 268.04.

184.15    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:
184.16    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
184.17transferring persons to the consumer support grant program from the developmental
184.18disability family support program and personal care assistant services, home health
184.19aide services, or private duty nursing services, the amount of funds transferred by the
184.20commissioner between the developmental disability family support program account, the
184.21medical assistance account, or the consumer support grant account shall be based on each
184.22county's participation in transferring persons to the consumer support grant program
184.23from those programs and services.
184.24    (b) At the beginning of each fiscal year, county allocations for consumer support
184.25grants shall be based on:
184.26    (1) the number of persons to whom the county board expects to provide consumer
184.27supports grants;
184.28    (2) their eligibility for current program and services;
184.29    (3) the amount of nonfederal dollars allowed under subdivision 11; and
184.30    (4) projected dates when persons will start receiving grants. County allocations shall
184.31be adjusted periodically by the commissioner based on the actual transfer of persons or
184.32service openings, and the nonfederal dollars associated with those persons or service
184.33openings, to the consumer support grant program.
185.1    (c) The amount of funds transferred by the commissioner from the medical
185.2assistance account for an individual may be changed if it is determined by the county or its
185.3agent that the individual's need for support has changed.
185.4    (d) The authority to utilize funds transferred to the consumer support grant account
185.5for the purposes of implementing and administering the consumer support grant program
185.6will not be limited or constrained by the spending authority provided to the program
185.7of origination.
185.8    (e) The commissioner may use up to five percent of each county's allocation, as
185.9adjusted, for payments for administrative expenses, to be paid as a proportionate addition
185.10to reported direct service expenditures.
185.11    (f) The county allocation for each individual or individual's family cannot exceed
185.12the amount allowed under subdivision 11.
185.13    (g) The commissioner may recover, suspend, or withhold payments if the county
185.14board, local agency, or grantee does not comply with the requirements of this section.
185.15    (h) Grant funds unexpended by consumers shall return to the state once a year. The
185.16annual return of unexpended grant funds shall occur in the quarter following the end of
185.17the state fiscal year.

185.18    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:
185.19    Subd. 10. Consumer responsibilities. Persons receiving grants under this section
185.20shall:
185.21    (1) spend the grant money in a manner consistent with their agreement with the
185.22local agency;
185.23    (2) notify the local agency of any necessary changes in the grant or the items on
185.24which it is spent;
185.25    (3) notify the local agency of any decision made by the person, the a person's legal
185.26representative, or the person's family or other authorized representative that would change
185.27their eligibility for consumer support grants;
185.28    (4) arrange and pay for supports; and
185.29    (5) inform the local agency of areas where they have experienced difficulty securing
185.30or maintaining supports.

185.31    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:
185.32256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS
185.33LONG-TERM CARE; LOCAL PROGRAMS.
186.1    The ombudsman for older Minnesotans long-term care serves in the classified service
186.2under section 256.01, subdivision 7, in an office within the Minnesota Board on Aging that
186.3incorporates the long-term care ombudsman program required by the Older Americans
186.4Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)
186.5(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota
186.6Board on Aging may make grants to and designate local programs for the provision of
186.7ombudsman services to clients in county or multicounty areas. The local program may not
186.8be an agency engaged in the provision of nursing home care, hospital care, or home care
186.9services either directly or by contract, or have the responsibility for planning, coordinating,
186.10funding, or administering nursing home care, hospital care, or home care services.

186.11    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:
186.12    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing
186.13home licensed under sections 144A.02 to 144A.10 or; a boarding care home licensed
186.14under sections 144.50 to 144.56; or a licensed or registered residential setting which
186.15provides or arranges for the provision of home care services.

186.16    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:
186.17    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a
186.18request is made for, ombudsman services and is (a) a resident of a long-term care facility
186.19or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or
186.20denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or
186.21requesting a home care service.

186.22    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:
186.23    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a
186.24conspicuous place the address and telephone number of the office. A home care service
186.25provider shall provide all recipients, including those in elderly housing with services
186.26under chapter 144D, with the address and telephone number of the office. Counties shall
186.27provide clients receiving a consumer support grant or a service allowance long-term care
186.28consultation services under section 256B.0911 or home and community-based services
186.29through a state or federally funded program with the name, address, and telephone number
186.30of the office. The posting or notice is subject to approval by the ombudsman.

186.31    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:
187.1    Subd. 4. Access to long-term care and acute care facilities and clients. The
187.2ombudsman or designee may:
187.3    (1) enter any long-term care facility without notice at any time;
187.4    (2) enter any acute care facility without notice during normal business hours;
187.5    (3) enter any acute care facility without notice at any time to interview a patient or
187.6observe services being provided to the patient as part of an investigation of a matter that is
187.7within the scope of the ombudsman's authority, but only if the ombudsman's or designee's
187.8presence does not intrude upon the privacy of another patient or interfere with routine
187.9hospital services provided to any patient in the facility;
187.10    (4) communicate privately and without restriction with any client in accordance
187.11with section 144.651, as long as the ombudsman has the client's consent for such
187.12communication;
187.13    (5) inspect records of a long-term care facility, home care service provider, or acute
187.14care facility that pertain to the care of the client according to sections section 144.335 and
187.15144.651; and
187.16    (6) with the consent of a client or client's legal guardian, the ombudsman or
187.17designated staff shall have access to review records pertaining to the care of the client
187.18according to sections section 144.335 and 144.651. If a client cannot consent and has no
187.19legal guardian, access to the records is authorized by this section.
187.20    A person who denies access to the ombudsman or designee in violation of this
187.21subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a
187.22misdemeanor.

187.23    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:
187.24    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take
187.25discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a
187.26patient, resident, or guardian or family member of a patient, resident, or guardian for filing
187.27in good faith a complaint with or providing information to the ombudsman or designee
187.28including volunteers. A person who violates this subdivision or who aids, abets, invites,
187.29compels, or coerces another to do so is guilty of a misdemeanor.
187.30    (b) There shall be a rebuttable presumption that any adverse action, as defined below,
187.31within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose
187.32of this clause, the term "adverse action" refers to action taken by the entity involved in a
187.33report against the person making the report or the person with respect to whom the report
187.34was made because of the report, and includes, but is not limited to:
187.35    (1) discharge or transfer from a facility;
188.1    (2) termination of service;
188.2    (3) restriction or prohibition of access to the facility or its residents;
188.3    (4) discharge from or termination of employment;
188.4    (5) demotion or reduction in remuneration for services; and
188.5    (6) any restriction of rights set forth in section 144.651 or, 144A.44, or 144A.751.

188.6    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:
188.7    Subdivision 1. Classification. Except as provided in this section, data maintained
188.8by the office under sections 256.974 to 256.9744 are private data on individuals or
188.9nonpublic data as defined in section 13.02, subdivision 9 or 12, and must be maintained
188.10in accordance with the requirements of Public Law 100-75 the Older Americans Act, as
188.11amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).

188.12    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:
188.13    Subd. 7. Consumer information and assistance; senior linkage. (a) The
188.14Minnesota Board on Aging shall operate a statewide information and assistance service
188.15to aid older Minnesotans and their families in making informed choices about long-term
188.16care options and health care benefits. Language services to persons with limited English
188.17language skills may be made available. The service, known as Senior LinkAge Line, must
188.18be available during business hours through a statewide toll-free number and must also
188.19be available through the Internet.
188.20    (b) The service must assist older adults, caregivers, and providers in accessing
188.21information about choices in long-term care services that are purchased through private
188.22providers or available through public options. The service must:
188.23    (1) develop a comprehensive database that includes detailed listings in both
188.24consumer- and provider-oriented formats;
188.25    (2) make the database accessible on the Internet and through other telecommunication
188.26and media-related tools;
188.27    (3) link callers to interactive long-term care screening tools and make these tools
188.28available through the Internet by integrating the tools with the database;
188.29    (4) develop community education materials with a focus on planning for long-term
188.30care and evaluating independent living, housing, and service options;
188.31    (5) conduct an outreach campaign to assist older adults and their caregivers in
188.32finding information on the Internet and through other means of communication;
188.33    (6) implement a messaging system for overflow callers and respond to these callers
188.34by the next business day;
189.1    (7) link callers with county human services and other providers to receive more
189.2in-depth assistance and consultation related to long-term care options; and
189.3    (8) link callers with quality profiles for nursing facilities and other providers
189.4developed by the commissioner of health.; and
189.5    (9) incorporate information about housing with services and consumer rights
189.6within the MinnesotaHelp.info network long-term care database to facilitate consumer
189.7comparison of services and costs among housing with services establishments and with
189.8other in-home services and to support financial self-sufficiency as long as possible.
189.9Housing with services establishments and their arranged home care providers shall provide
189.10information to the commissioner of human services that is consistent with information
189.11required by the commissioner of health under section 144G.06, the Uniform Consumer
189.12Information Guide. The commissioner of human services shall provide the data to the
189.13Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
189.14care database.
189.15    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
189.16of the statewide information and assistance, and submit this evaluation to the legislature
189.17by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
189.18in service delivery, continuity in information between the service and identified linkages,
189.19and potential use of private funding to enhance the service.
189.20EFFECTIVE DATE.This section is effective the day following final enactment.

189.21    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to
189.22read:
189.23    Subd. 1a. Income and assets generally. Unless specifically required by state law or
189.24rule or federal law or regulation, the methodologies used in counting income and assets
189.25to determine eligibility for medical assistance for persons whose eligibility category is
189.26based on blindness, disability, or age of 65 or more years, the methodologies for the
189.27supplemental security income program shall be used, except as provided under subdivision
189.283, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be
189.29counted as income for purposes of this subdivision until July 1 of each year. Effective
189.30upon federal approval, for children eligible under section 256B.055, subdivision 12, or
189.31for home and community-based waiver services whose eligibility for medical assistance
189.32is determined without regard to parental income, child support payments, including any
189.33payments made by an obligor in satisfaction of or in addition to a temporary or permanent
189.34order for child support, and Social Security payments are not counted as income. For
189.35families and children, which includes all other eligibility categories, the methodologies
190.1under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal
190.2Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
190.3Law 104-193, shall be used, except that effective October 1, 2003, the earned income
190.4disregards and deductions are limited to those in subdivision 1c. For these purposes, a
190.5"methodology" does not include an asset or income standard, or accounting method,
190.6or method of determining effective dates.

190.7    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:
190.8    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.
190.9    To be eligible for medical assistance, a person whose eligibility is based on blindness,
190.10disability, or age of 65 or more years must not individually own more than $3,000 $6,000
190.11in assets, or if a member of a household with two family members, husband and wife, or
190.12parent and child, the household must not own more than $6,000 $12,000 in assets, plus
190.13$200 $400 for each additional legal dependent. In addition to these maximum amounts,
190.14an eligible individual or family may accrue interest on these amounts, but they must be
190.15reduced to the maximum at the time of an eligibility redetermination. The accumulation
190.16of the clothing and personal needs allowance according to section 256B.35 must also be
190.17reduced to the maximum at the time of the eligibility redetermination. The value of assets
190.18that are not considered in determining eligibility for medical assistance is the value of
190.19those assets excluded under the supplemental security income program for aged, blind,
190.20and disabled persons, with the following exceptions:
190.21    (a) Household goods and personal effects are not considered.
190.22    (b) Capital and operating assets of a trade or business that the local agency
190.23determines are necessary to the person's ability to earn an income are not considered.
190.24    (c) Motor vehicles are excluded to the same extent excluded by the supplemental
190.25security income program.
190.26    (d) Assets designated as burial expenses are excluded to the same extent excluded by
190.27the supplemental security income program. Burial expenses funded by annuity contracts
190.28or life insurance policies must irrevocably designate the individual's estate as contingent
190.29beneficiary to the extent proceeds are not used for payment of selected burial expenses.
190.30    (e) Effective upon federal approval, for a person who no longer qualifies as an
190.31employed person with a disability due to loss of earnings, assets allowed while eligible
190.32for medical assistance under section 256B.057, subdivision 9, are not considered for 12
190.33months, beginning with the first month of ineligibility as an employed person with a
190.34disability, to the extent that the person's total assets remain within the allowed limits of
190.35section 256B.057, subdivision 9, paragraph (b).
191.1    (f) When a person enrolled in medical assistance under section 256B.057,
191.2subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive
191.3months before the person's 65th birthday, the assets owned by the person and the person's
191.4spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph
191.5(b), when determining eligibility for medical assistance under section 256B.055,
191.6subdivision 7. The income of a spouse of a person enrolled in medical assistance under
191.7section 256B.057, subdivision 9, during each of the 24 consecutive months before the
191.8person's 65th birthday must be disregarded when determining eligibility for medical
191.9assistance under section 256B.055, subdivision 7, when the person reaches age 65. This
191.10paragraph does not apply at the time the person or the person's spouse requests medical
191.11assistance payment for long-term care services.
191.12EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase
191.13in the asset standard for persons whose eligibility for medical assistance is based on
191.14blindness, disability, or age of 65 or more years is effective July 1, 2008.

191.15    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to
191.16read:
191.17    Subd. 5c. Excess income standard. (a) The excess income standard for families
191.18with children is the standard specified in subdivision 4.
191.19    (b) The excess income standard for a person whose eligibility is based on blindness,
191.20disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
191.21family size. Effective July 1, 2002, the excess income standard for this paragraph shall
191.22equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess
191.23income standard for this paragraph shall equal 85 percent of the federal poverty guidelines.
191.24The excess income standard for this paragraph shall be increased by five percentage points
191.25on July 1 of each of the next three years, so that the excess income standard shall equal
191.26100 percent of the federal poverty guidelines effective July 1, 2010.
191.27EFFECTIVE DATE.This section is effective July 1, 2007.

191.28    Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
191.29read:
191.30    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner
191.31shall execute a data use agreement with the Centers for Medicare and Medicaid Services
191.32to obtain the long-term care minimum data set data to assist residents of nursing facilities
191.33who have establish a process with the Centers for Independent Living that allows a person
192.1residing in a Minnesota nursing facility to receive needed information, consultation, and
192.2assistance from one of the centers about the available community support options that may
192.3enable the person to relocate to the community, if the person: (1) is under the age of 65,
192.4(2) has indicated a desire to live in the community. The commissioner shall in turn enter
192.5into agreements with the Centers for Independent Living to provide information about
192.6assistance for persons who want to move to the community. The commissioner shall work
192.7with the Centers for Independent Living on both the content of the information to be
192.8provided and privacy protections for the individual residents, and (3) has signed a release
192.9of information authorized by the person or the person's appointed legal representative.
192.10The process established under this subdivision shall be coordinated with the long-term
192.11care consultation service activities established in section 256B.0911.

192.12    Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
192.13read:
192.14    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
192.15meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
192.16$6.50 for lunch, or $8 for dinner.
192.17    (b) Medical assistance reimbursement for lodging for persons traveling to receive
192.18medical care may not exceed $50 per day unless prior authorized by the local agency.
192.19    (c) Medical assistance direct mileage reimbursement to the eligible person or the
192.20eligible person's driver may not exceed 20 cents per mile.
192.21    (d) Regardless of the number of employees that an enrolled health care provider
192.22may have, medical assistance covers sign and oral language interpreter services when
192.23provided by an enrolled health care provider during the course of providing a direct,
192.24person-to-person covered health care service to an enrolled recipient with limited English
192.25proficiency or who has a hearing loss and uses interpreting services.

192.26    Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
192.27subdivision to read:
192.28    Subd. 49. Self-directed supports option. Upon federal approval, medical
192.29assistance covers the self-directed supports option as defined under section 256B.0657 and
192.30section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.
192.31EFFECTIVE DATE.This section is effective upon federal approval of the state
192.32Medicaid plan amendment. The commissioner of human services shall inform the Office
192.33of the Revisor of Statutes when approval is obtained.

193.1    Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.
193.2    Subdivision 1. Definition. "Self-directed supports option" means personal
193.3assistance, supports, items, and related services purchased under an approved budget
193.4plan and budget by a recipient.
193.5    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
193.6who:
193.7    (1) is a recipient of medical assistance as determined under sections 256B.055,
193.8256B.056, and 256B.057, subdivision 9;
193.9    (2) is eligible for personal care assistant services under section 256B.0655;
193.10    (3) lives in the person's own apartment or home, which is not owned, operated, or
193.11controlled by a provider of services not related by blood or marriage;
193.12    (4) has the ability to hire, fire, supervise, establish staff compensation for, and
193.13manage the individuals providing services, and to choose and obtain items, related
193.14services, and supports as described in the participant's plan. If the recipient is not able to
193.15carry out these functions but has a legal guardian or parent to carry them out, the guardian
193.16or parent may fulfill these functions on behalf of the recipient; and
193.17    (5) has not been excluded or disenrolled by the commissioner.
193.18    (b) The commissioner may disenroll or exclude recipients, including guardians and
193.19parents, under the following circumstances:
193.20    (1) recipients who have been restricted by the Primary Care Utilization Review
193.21Committee may be excluded for a specified time period; and
193.22    (2) recipients who exit the self-directed supports option during the recipient's
193.23service plan year shall not access the self-directed supports option for the remainder
193.24of that service plan year.
193.25    Subd. 3. Eligibility for other services. Selection of the self-directed supports
193.26option by a recipient shall not restrict access to other medically necessary care and
193.27services furnished under the state plan medical assistance benefit, including home care
193.28targeted case management, except that a person receiving home and community-based
193.29waiver services, a family support grant or a consumer support grant is not eligible for
193.30funding under the self-directed supports option.
193.31    Subd. 4. Assessment requirements. (a) The self-directed supports option
193.32assessment must meet the following requirements:
193.33    (1) it shall be conducted by the county public health nurse or a certified public
193.34health nurse under contract with the county;
193.35    (2) it shall be conducted face-to-face in the recipient's home initially, and at least
193.36annually thereafter; when there is a significant change in the recipient's condition; and
194.1when there is a change in the need for personal care assistant services. A recipient who is
194.2residing in a facility may be assessed for the self-directed support option for the purpose
194.3of returning to the community using this option; and
194.4    (3) it shall be completed using the format established by the commissioner.
194.5    (b) The results of the assessment and recommendations shall be communicated to
194.6the commissioner and the recipient by the county public health nurse or certified public
194.7health nurse under contract with the county.
194.8    Subd. 5. Self-directed supports option plan requirements. (a) The plan for the
194.9self-directed supports option must meet the following requirements:
194.10    (1) the plan must be completed using a person-centered process that:
194.11    (i) builds upon the recipient's capacity to engage in activities that promote
194.12community life;
194.13    (ii) respects the recipient's preferences, choices, and abilities;
194.14    (iii) involves families, friends, and professionals in the planning or delivery of
194.15services or supports as desired or required by the recipient; and
194.16    (iv) addresses the need for personal care assistant services identified in the recipient's
194.17self-directed supports option assessment;
194.18    (2) the plan shall be developed by the recipient or by the guardian of an adult
194.19recipient or by a parent or guardian of a minor child, with the assistance of an enrolled
194.20medical assistance home care targeted case manager provider who meets the requirements
194.21established for using a person-centered planning process and shall be reviewed at least
194.22annually upon reassessment or when there is a significant change in the recipient's
194.23condition; and
194.24    (3) the plan must include the total budget amount available divided into monthly
194.25amounts that cover the number of months of personal care assistant services authorization
194.26included in the budget. The amount used each month may vary, but additional funds shall
194.27not be provided above the annual personal care assistant services authorized amount
194.28unless a change in condition is documented.
194.29    (b) The commissioner shall:
194.30    (1) establish the format and criteria for the plan as well as the requirements for
194.31providers who assist with plan development;
194.32    (2) review the assessment and plan and, within 30 days after receiving the
194.33assessment and plan, make a decision on approval of the plan;
194.34    (3) notify the recipient, parent, or guardian of approval or denial of the plan and
194.35provide notice of the right to appeal under section 256.045; and
194.36    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.
195.1    Subd. 6. Services covered. (a) Services covered under the self-directed supports
195.2option include:
195.3    (1) personal care assistant services under section 256B.0655; and
195.4    (2) items, related services, and supports, including assistive technology, that increase
195.5independence or substitute for human assistance to the extent expenditures would
195.6otherwise be used for human assistance.
195.7    (b) Items, supports, and related services purchased under this option shall not be
195.8considered home care services for the purposes of section 144A.43.
195.9    Subd. 7. Noncovered services. Services or supports that are not eligible for
195.10payment under the self-directed supports option include:
195.11    (1) services, goods, or supports that do not benefit the recipient;
195.12    (2) any fees incurred by the recipient, such as Minnesota health care program fees
195.13and co-pays, legal fees, or costs related to advocate agencies;
195.14    (3) insurance, except for insurance costs related to employee coverage or fiscal
195.15support entity payments;
195.16    (4) room and board and personal items that are not related to the disability, except
195.17that medically prescribed specialized diet items may be covered if they reduce the need for
195.18human assistance;
195.19    (5) home modifications that add square footage;
195.20    (6) home modifications for a residence other than the primary residence of the
195.21recipient, or in the event of a minor with parents not living together, the primary residences
195.22of the parents;
195.23    (7) expenses for travel, lodging, or meals related to training the recipient, the parent
195.24or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or
195.25unpaid caregivers that exceed $500 in a 12-month period;
195.26    (8) experimental treatment;
195.27    (9) any service or item covered by other medical assistance state plan services,
195.28including prescription and over-the-counter medications, compounds, and solutions and
195.29related fees, including premiums and co-payments;
195.30    (10) membership dues or costs, except when the service is necessary and appropriate
195.31to treat a physical condition or to improve or maintain the recipient's physical condition.
195.32The condition must be identified in the recipient's plan of care and monitored by a
195.33Minnesota health care program enrolled physician;
195.34    (11) vacation expenses other than the cost of direct services;
195.35    (12) vehicle maintenance or modifications not related to the disability;
195.36    (13) tickets and related costs to attend sporting or other recreational events; and
196.1    (14) costs related to Internet access, except when necessary for operation of assistive
196.2technology, to increase independence, or to substitute for human assistance.
196.3    Subd. 8. Self-directed budget requirements. The budget for the provision of the
196.4self-directed service option shall be equal to the greater of either:
196.5    (1) the annual amount of personal care assistant services under section 256B.0655
196.6that the recipient has used in the most recent 12-month period; or
196.7    (2) the amount determined using the consumer support grant methodology under
196.8section 256.476, subdivision 11, except that the budget amount shall include the federal
196.9and nonfederal share of the average service costs.
196.10    Subd. 9. Quality assurance and risk management. (a) The commissioner
196.11shall establish quality assurance and risk management measures for use in developing
196.12and implementing self-directed plans and budgets that (1) recognize the roles and
196.13responsibilities involved in obtaining services in a self-directed manner, and (2) assure
196.14the appropriateness of such plans and budgets based upon a recipient's resources and
196.15capabilities. These measures must include (i) background studies, and (ii) backup and
196.16emergency plans, including disaster planning.
196.17    (b) The commissioner shall provide ongoing technical assistance and resource and
196.18educational materials for families and recipients selecting the self-directed option.
196.19    (c) Performance assessments measures, such as of a recipient's satisfaction with the
196.20services and supports, and ongoing monitoring of health and well-being shall be identified
196.21in consultation with the stakeholder group.
196.22    Subd. 10. Fiscal support entity. (a) Each recipient shall choose a fiscal support
196.23entity provider certified by the commissioner to make payments for services, items,
196.24supports, and administrative costs related to managing a self-directed service plan
196.25authorized for payment in the approved plan and budget. Recipients shall also choose
196.26the payroll, agency with choice, or the fiscal conduit model of financial and service
196.27management.
196.28    (b) The fiscal support entity:
196.29    (1) may not limit or restrict the recipient's choice of service or support providers,
196.30including use of the payroll, agency with choice, or fiscal conduit model of financial
196.31and service management;
196.32    (2) must have a written agreement with the recipient or the recipient's representative
196.33that identifies the duties and responsibilities to be performed and the specific related
196.34charges;
197.1    (3) must provide the recipient and the home care targeted case manager with a
197.2monthly written summary of the self-directed supports option services that were billed,
197.3including charges from the fiscal support entity;
197.4    (4) must be knowledgeable of and comply with Internal Revenue Service
197.5requirements necessary to process employer and employee deductions, provide appropriate
197.6and timely submission of employer tax liabilities, and maintain documentation to support
197.7medical assistance claims;
197.8    (5) must have current and adequate liability insurance and bonding and sufficient
197.9cash flow and have on staff or under contract a certified public accountant or an individual
197.10with a baccalaureate degree in accounting; and
197.11    (6) must maintain records to track all self-directed supports option services
197.12expenditures, including time records of persons paid to provide supports and receipts for
197.13any goods purchased. The records must be maintained for a minimum of five years from
197.14the claim date and be available for audit or review upon request. Claims submitted by
197.15the fiscal support entity must correspond with services, amounts, and time periods as
197.16authorized in the recipient's self-directed supports option plan.
197.17    (c) The commissioner shall have authority to:
197.18    (1) set or negotiate rates with fiscal support entities;
197.19    (2) limit the number of fiscal support entities;
197.20    (3) identify a process to certify and recertify fiscal support entities and assure fiscal
197.21support entities are available to recipients throughout the state; and
197.22    (4) establish a uniform format and protocol to be used by eligible fiscal support
197.23entities.
197.24    Subd. 11. Stakeholder consultation. The commissioner shall consult with a
197.25statewide consumer-directed services stakeholder group, including representatives of
197.26all types of consumer-directed service users, advocacy organizations, counties, and
197.27consumer-directed service providers. The commissioner shall seek recommendations
197.28from this stakeholder group in developing:
197.29    (1) the self-directed plan format;
197.30    (2) requirements and guidelines for the person-centered plan assessment and
197.31planning process;
197.32    (3) implementation of the option and the quality assurance and risk management
197.33techniques; and
197.34    (4) standards and requirements, including rates for the personal support plan
197.35development provider and the fiscal support entity; policies; training; and implementation.
197.36The stakeholder group shall provide recommendations on the repeal of the personal care
198.1assistant choice option, transition issues, and whether the consumer support grant program
198.2under section 256.476 should be modified. The stakeholder group shall meet at least
198.3three times each year to provide advice on policy, implementation, and other aspects of
198.4consumer and self-directed services.
198.5EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of
198.6the state Medicaid plan amendment. The commissioner of human services shall inform
198.7the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11
198.8is effective July 1, 2007.

198.9    Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to
198.10read:
198.11    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
198.12services planning, or other assistance intended to support community-based living,
198.13including persons who need assessment in order to determine waiver or alternative care
198.14program eligibility, must be visited by a long-term care consultation team within ten
198.15working days after the date on which an assessment was requested or recommended.
198.16Assessments must be conducted according to paragraphs (b) to (g) (i).
198.17    (b) The county may utilize a team of either the social worker or public health nurse,
198.18or both, to conduct the assessment in a face-to-face interview. The consultation team
198.19members must confer regarding the most appropriate care for each individual screened or
198.20assessed.
198.21    (c) The long-term care consultation team must assess the health and social needs of
198.22the person, using an assessment form provided by the commissioner.
198.23    (d) The team must conduct the assessment in a face-to-face interview with the
198.24person being assessed and the person's legal representative, if applicable.
198.25    (e) The team must provide the person, or the person's legal representative, with
198.26written recommendations for facility- or community-based services. The team must
198.27document that the most cost-effective alternatives available were offered to the individual.
198.28For purposes of this requirement, "cost-effective alternatives" means community services
198.29and living arrangements that cost the same as or less than nursing facility care.
198.30    (f) If the person chooses to use community-based services, the team must provide
198.31the person or the person's legal representative with a written community support plan,
198.32regardless of whether the individual is eligible for Minnesota health care programs.
198.33The person may request assistance in developing a community support plan without
198.34participating in a complete assessment.
199.1    (g) The person has the right to make the final decision between nursing facility
199.2placement and community placement after the screening team's recommendation, except
199.3as provided in subdivision 4a, paragraph (c).
199.4    (h) The team must give the person receiving assessment or support planning, or
199.5the person's legal representative, materials, and forms supplied by the commissioner
199.6containing the following information:
199.7    (1) the need for and purpose of preadmission screening and assessment if the person
199.8selects nursing facility placement;
199.9    (2) the role of the long-term care consultation assessment and support planning in
199.10waiver and alternative care program eligibility determination;
199.11    (2) (3) information about Minnesota health care programs;
199.12    (3) (4) the person's freedom to accept or reject the recommendations of the team;
199.13    (4) (5) the person's right to confidentiality under the Minnesota Government Data
199.14Practices Act, chapter 13; and
199.15    (6) the long-term care consultant's decision regarding the person's need for nursing
199.16facility level of care;
199.17    (5) (7) the person's right to appeal the decision regarding the need for nursing facility
199.18level of care or the county's final decisions regarding public programs eligibility according
199.19to section 256.045, subdivision 3.
199.20    (i) Face-to-face assessment completed as part of eligibility determination for
199.21the alternative care, elderly waiver, community alternatives for disabled individuals,
199.22community alternative care, and traumatic brain injury waiver programs under sections
199.23256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
199.24than 60 calendar days after the date of assessment. The effective eligibility start date
199.25for these programs can never be prior to the date of assessment. If an assessment was
199.26completed more than 60 days before the effective waiver or alternative care program
199.27eligibility start date, assessment and support plan information must be updated in a
199.28face-to-face visit and documented in the department's Medicaid Management Information
199.29System (MMIS). The effective date of program eligibility in this case cannot be prior to
199.30the date the updated assessment is completed.

199.31    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
199.32read:
199.33    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
199.34provide assistance to persons residing in a nursing facility, hospital, regional treatment
199.35center, or intermediate care facility for persons with developmental disabilities who
200.1request or are referred for assistance. Transition assistance must include assessment,
200.2community support plan development, referrals to Minnesota health care programs,
200.3and referrals to programs that provide assistance with housing. Transition assistance
200.4must also include information about the Centers for Independent Living and about other
200.5organizations that can provide assistance with relocation efforts, and information about
200.6contacting these organizations to obtain their assistance and support.
200.7    (b) The county shall develop transition processes with institutional social workers
200.8and discharge planners to ensure that:
200.9    (1) persons admitted to facilities receive information about transition assistance
200.10that is available;
200.11    (2) the assessment is completed for persons within ten working days of the date of
200.12request or recommendation for assessment; and
200.13    (3) there is a plan for transition and follow-up for the individual's return to the
200.14community. The plan must require notification of other local agencies when a person
200.15who may require assistance is screened by one county for admission to a facility located
200.16in another county.
200.17    (c) If a person who is eligible for a Minnesota health care program is admitted to a
200.18nursing facility, the nursing facility must include a consultation team member or the case
200.19manager in the discharge planning process.

200.20    Sec. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
200.21subdivision to read:
200.22    Subd. 3c. Transition to housing with services. (a) Transitional consultation shall
200.23be offered to all prospective residents 65 years of age or older regardless of income, assets,
200.24or funding sources before housing with services establishments offering or providing
200.25assisted living execute a lease or contract with the prospective resident. The purpose of
200.26transitional long-term care consultation is to support persons with current or anticipated
200.27long-term care needs in making informed choices among options that include the most
200.28cost-effective and least restrictive settings, and to delay spenddown to eligibility for
200.29publicly funded programs by connecting people to alternative services in their homes
200.30before transition to housing with services.
200.31    (b) Transitional consultation services are provided as determined by the
200.32commissioner of human services in partnership with county long-term care consultation
200.33units, and the Area Agencies on Aging, and are a combination of telephone-based
200.34and in-person assistance provided under models developed by the commissioner. The
200.35consultation is to be performed in a manner which provides objective and complete
201.1information. Transitional consultation must be provided within five working days of the
201.2request of the prospective resident as follows:
201.3    (1) the consultation must be provided by a qualified professional as determined by
201.4the commissioner;
201.5    (2) the consultation must include a review of the prospective resident's reasons for
201.6considering assisted living, the prospective resident's personal goals, a discussion of the
201.7prospective resident's immediate and projected long-term care needs, and alternative
201.8community services or assisted living settings that may meet the prospective resident's
201.9needs; and
201.10    (3) the prospective resident will be informed of the availability of long-term care
201.11consultation services described in subdivision 3a that are available at no charge to the
201.12prospective resident to assist the prospective resident in assessment and planning to
201.13meet the prospective resident's long-term care needs. Regardless of the consultation,
201.14prospective residents maintain the right to choose housing with services or assisted living,
201.15if that is their choice.
201.16EFFECTIVE DATE.This section is effective October 1, 2008.

201.17    Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to
201.18read:
201.19    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the
201.20federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are
201.21limited to:
201.22    (1) a person who, having entered an acute care facility from a certified nursing
201.23facility, is returning to a certified nursing facility;
201.24    (2) a person transferring from one certified nursing facility in Minnesota to another
201.25certified nursing facility in Minnesota; and
201.26    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified
201.27in Code of Federal Regulations, title 42, section 483.106(b)(2):
201.28    (i) the person is admitted to a nursing facility directly from a hospital after receiving
201.29acute inpatient care at the hospital;
201.30    (ii) the person requires nursing facility services for the same condition for which
201.31care was provided in the hospital; and
201.32    (iii) the attending physician has certified before the nursing facility admission that
201.33the person is likely to receive less than 30 days of nursing facility services.
201.34    (b) Persons who are exempt from preadmission screening for purposes of level of
201.35care determination include:
202.1    (1) persons described in paragraph (a);
202.2    (2) an individual who has a contractual right to have nursing facility care paid for
202.3indefinitely by the veterans' administration;
202.4    (3) an individual enrolled in a demonstration project under section 256B.69,
202.5subdivision 8 , at the time of application to a nursing facility; and
202.6    (4) an individual currently being served under the alternative care program or under
202.7a home and community-based services waiver authorized under section 1915(c) of the
202.8federal Social Security Act; and.
202.9    (5) individuals admitted to a certified nursing facility for a short-term stay, which
202.10is expected to be 14 days or less in duration based upon a physician's certification, and
202.11who have been assessed and approved for nursing facility admission within the previous
202.12six months. This exemption applies only if the consultation team member determines at
202.13the time of the initial assessment of the six-month period that it is appropriate to use the
202.14nursing facility for short-term stays and that there is an adequate plan of care for return to
202.15the home or community-based setting. If a stay exceeds 14 days, the individual must be
202.16referred no later than the first county working day following the 14th resident day for a
202.17screening, which must be completed within five working days of the referral. The payment
202.18limitations in subdivision 7 apply to an individual found at screening to not meet the level
202.19of care criteria for admission to a certified nursing facility.
202.20    (c) Persons admitted to a Medicaid-certified nursing facility from the community
202.21on an emergency basis as described in paragraph (d) or from an acute care facility on a
202.22nonworking day must be screened the first working day after admission.
202.23    (d) Emergency admission to a nursing facility prior to screening is permitted when
202.24all of the following conditions are met:
202.25    (1) a person is admitted from the community to a certified nursing or certified
202.26boarding care facility during county nonworking hours;
202.27    (2) a physician has determined that delaying admission until preadmission screening
202.28is completed would adversely affect the person's health and safety;
202.29    (3) there is a recent precipitating event that precludes the client from living safely in
202.30the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
202.31inability to continue to provide care;
202.32    (4) the attending physician has authorized the emergency placement and has
202.33documented the reason that the emergency placement is recommended; and
202.34    (5) the county is contacted on the first working day following the emergency
202.35admission.
203.1Transfer of a patient from an acute care hospital to a nursing facility is not considered
203.2an emergency except for a person who has received hospital services in the following
203.3situations: hospital admission for observation, care in an emergency room without hospital
203.4admission, or following hospital 24-hour bed care.
203.5    (e) A nursing facility must provide a written notice to persons who satisfy the criteria
203.6in paragraph (a), clause (3), information to all persons admitted regarding the person's
203.7right to request and receive long-term care consultation services as defined in subdivision
203.81a. The notice information must be provided prior to the person's discharge from the
203.9facility and in a format specified by the commissioner.

203.10    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to
203.11read:
203.12    Subd. 4c. Screening requirements. (a) A person may be screened for nursing
203.13facility admission by telephone or in a face-to-face screening interview. Consultation team
203.14members shall identify each individual's needs using the following categories:
203.15    (1) the person needs no face-to-face screening interview to determine the need
203.16for nursing facility level of care based on information obtained from other health care
203.17professionals;
203.18    (2) the person needs an immediate face-to-face screening interview to determine the
203.19need for nursing facility level of care and complete activities required under subdivision
203.204a; or
203.21    (3) the person may be exempt from screening requirements as outlined in subdivision
203.224b, but will need transitional assistance after admission or in-person follow-along after
203.23a return home.
203.24    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
203.25facility must be screened prior to admission.
203.26    (c) The long-term care consultation team shall recommend a case mix classification
203.27for persons admitted to a certified nursing facility when sufficient information is received
203.28to make that classification. The nursing facility is authorized to conduct all case mix
203.29assessments for persons who have been screened prior to admission for whom the county
203.30did not recommend a case mix classification. The nursing facility is authorized to conduct
203.31all case mix assessments for persons admitted to the facility prior to a preadmission
203.32screening. The county retains the responsibility of distributing appropriate case mix
203.33forms to the nursing facility.
203.34    (d) (c) The county screening or intake activity must include processes to identify
203.35persons who may require transition assistance as described in subdivision 3b.

204.1    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to
204.2read:
204.3    Subd. 6. Payment for long-term care consultation services. (a) The total payment
204.4for each county must be paid monthly by certified nursing facilities in the county. The
204.5monthly amount to be paid by each nursing facility for each fiscal year must be determined
204.6by dividing the county's annual allocation for long-term care consultation services by 12
204.7to determine the monthly payment and allocating the monthly payment to each nursing
204.8facility based on the number of licensed beds in the nursing facility. Payments to counties
204.9in which there is no certified nursing facility must be made by increasing the payment
204.10rate of the two facilities located nearest to the county seat.
204.11    (b) The commissioner shall include the total annual payment determined under
204.12paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
204.13according to section 256B.431, subdivision 2b, paragraph (g), or 256B.435.
204.14    (c) In the event of the layaway, delicensure and decertification, or removal from
204.15layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
204.16the per diem payment amount in paragraph (b) and may adjust the monthly payment
204.17amount in paragraph (a). The effective date of an adjustment made under this paragraph
204.18shall be on or after the first day of the month following the effective date of the layaway,
204.19delicensure and decertification, or removal from layaway.
204.20    (d) Payments for long-term care consultation services are available to the county
204.21or counties to cover staff salaries and expenses to provide the services described in
204.22subdivision 1a. The county shall employ, or contract with other agencies to employ, within
204.23the limits of available funding, sufficient personnel to provide long-term care consultation
204.24services while meeting the state's long-term care outcomes and objectives as defined in
204.25section 256B.0917, subdivision 1. The county shall be accountable for meeting local
204.26objectives as approved by the commissioner in the biennial home and community-based
204.27services quality assurance plan on a form provided by the commissioner.
204.28    (e) Notwithstanding section 256B.0641, overpayments attributable to payment of the
204.29screening costs under the medical assistance program may not be recovered from a facility.
204.30    (f) The commissioner of human services shall amend the Minnesota medical
204.31assistance plan to include reimbursement for the local consultation teams.
204.32    (g) The county may bill, as case management services, assessments, support
204.33planning, and follow-along provided to persons determined to be eligible for case
204.34management under Minnesota health care programs. No individual or family member
204.35shall be charged for an initial assessment or initial support plan development provided
204.36under subdivision 3a or 3b.

205.1    Sec. 33. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
205.2subdivision to read:
205.3    Subd. 6a. Withholding. If any provider obligated to pay the long-term care
205.4consultation amount as described in subdivision 6 is more than two months delinquent in
205.5the timely payment of the monthly installment, the commissioner may withhold payments,
205.6penalties, and interest in accordance with the methods outlined in section 256.9657,
205.7subdivision 7a. Any amount withheld under this provision must be returned to the county
205.8to whom the delinquent payments were due.

205.9    Sec. 34. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to
205.10read:
205.11    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
205.12reimbursement for nursing facilities shall be authorized for a medical assistance recipient
205.13only if a preadmission screening has been conducted prior to admission or the county has
205.14authorized an exemption. Medical assistance reimbursement for nursing facilities shall
205.15not be provided for any recipient who the local screener has determined does not meet the
205.16level of care criteria for nursing facility placement or, if indicated, has not had a level II
205.17OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of
205.181987 completed unless an admission for a recipient with mental illness is approved by the
205.19local mental health authority or an admission for a recipient with developmental disability
205.20is approved by the state developmental disability authority.
205.21    (b) The nursing facility must not bill a person who is not a medical assistance
205.22recipient for resident days that preceded the date of completion of screening activities as
205.23required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
205.24resident days in the nursing facility resident day totals reported to the commissioner.
205.25    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid
205.26Services for a waiver allowing team approval of Medicaid payments for certified nursing
205.27facility care. An individual has a choice and makes the final decision between nursing
205.28facility placement and community placement after the screening team's recommendation,
205.29except as provided in subdivision 4a, paragraph (c).

205.30    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to
205.31read:
205.32    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
205.33    (a) Funding for services under the alternative care program is available to persons who
205.34meet the following criteria:
206.1    (1) the person has been determined by a community assessment under section
206.2256B.0911 to be a person who would require the level of care provided in a nursing
206.3facility, but for the provision of services under the alternative care program;
206.4    (2) the person is age 65 or older;
206.5    (3) the person would be eligible for medical assistance within 135 days of admission
206.6to a nursing facility;
206.7    (4) the person is not ineligible for the payment of long-term care services by the
206.8medical assistance program due to an asset transfer penalty under section 256B.0595 or
206.9equity interest in the home exceeding $500,000 as stated in section 256B.056;
206.10    (5) the person needs long-term care services that are not funded through other state
206.11or federal funding;
206.12    (6) the monthly cost of the alternative care services funded by the program for
206.13this person does not exceed 75 percent of the monthly limit described under section
206.14256B.0915, subdivision 3a . This monthly limit does not prohibit the alternative care client
206.15from payment for additional services, but in no case may the cost of additional services
206.16purchased under this section exceed the difference between the client's monthly service
206.17limit defined under section 256B.0915, subdivision 3, and the alternative care program
206.18monthly service limit defined in this paragraph. If medical care-related supplies and
206.19equipment or environmental modifications and adaptations are or will be purchased for
206.20an alternative care services recipient, the costs may be prorated on a monthly basis for
206.21up to 12 consecutive months beginning with the month of purchase. If the monthly cost
206.22of a recipient's other alternative care services exceeds the monthly limit established in
206.23this paragraph, the annual cost of the alternative care services shall be determined. In this
206.24event, the annual cost of alternative care services shall not exceed 12 times the monthly
206.25limit described in this paragraph; and
206.26    (7) the person is making timely payments of the assessed monthly fee.
206.27A person is ineligible if payment of the fee is over 60 days past due, unless the person
206.28agrees to:
206.29    (i) the appointment of a representative payee;
206.30    (ii) automatic payment from a financial account;
206.31    (iii) the establishment of greater family involvement in the financial management of
206.32payments; or
206.33    (iv) another method acceptable to the county lead agency to ensure prompt fee
206.34payments.
206.35    The county shall lead agency may extend the client's eligibility as necessary while
206.36making arrangements to facilitate payment of past-due amounts and future premium
207.1payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall
207.2not be reinstated for a period of 30 days.
207.3    (b) Alternative care funding under this subdivision is not available for a person
207.4who is a medical assistance recipient or who would be eligible for medical assistance
207.5without a spenddown or waiver obligation. A person whose initial application for medical
207.6assistance and the elderly waiver program is being processed may be served under the
207.7alternative care program for a period up to 60 days. If the individual is found to be eligible
207.8for medical assistance, medical assistance must be billed for services payable under the
207.9federally approved elderly waiver plan and delivered from the date the individual was
207.10found eligible for the federally approved elderly waiver plan. Notwithstanding this
207.11provision, alternative care funds may not be used to pay for any service the cost of which:
207.12(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
207.13or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
207.14to participate in the federally approved elderly waiver program under the special income
207.15standard provision.
207.16    (c) Alternative care funding is not available for a person who resides in a licensed
207.17nursing home, certified boarding care home, hospital, or intermediate care facility, except
207.18for case management services which are provided in support of the discharge planning
207.19process for a nursing home resident or certified boarding care home resident to assist with
207.20a relocation process to a community-based setting.
207.21    (d) Alternative care funding is not available for a person whose income is greater
207.22than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
207.23to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
207.24year for which alternative care eligibility is determined, who would be eligible for the
207.25elderly waiver with a waiver obligation.

207.26    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to
207.27read:
207.28    Subd. 5. Services covered under alternative care. Alternative care funding may
207.29be used for payment of costs of:
207.30    (1) adult day care;
207.31    (2) home health aide;
207.32    (3) homemaker services;
207.33    (4) personal care;
207.34    (5) case management;
207.35    (6) respite care;
208.1    (7) care-related supplies and equipment;
208.2    (8) meals delivered to the home;
208.3    (9) nonmedical transportation;
208.4    (10) nursing services;
208.5    (11) chore services;
208.6    (12) companion services;
208.7    (13) nutrition services;
208.8    (14) training for direct informal caregivers;
208.9    (15) telehome care to provide services in their own homes in conjunction with
208.10in-home visits;
208.11    (16) discretionary services, for which counties may make payment from their
208.12alternative care program allocation or services not otherwise defined in this section
208.13or section 256B.0625, following approval by the commissioner consumer-directed
208.14community services under the alternative care programs which are available statewide and
208.15limited to the average monthly expenditures representative of all alternative care program
208.16participants for the same case mix resident class assigned in the most recent fiscal year for
208.17which complete expenditure data is available;
208.18    (17) environmental modifications and adaptations; and
208.19    (18) direct cash payments for which counties may make payment from their
208.20alternative care program allocation to clients for the purpose of purchasing services,
208.21following approval by the commissioner, and subject to the provisions of subdivision 5h,
208.22until approval and implementation of consumer-directed services through the federally
208.23approved elderly waiver plan. Upon implementation, consumer-directed services under
208.24the alternative care program are available statewide and limited to the average monthly
208.25expenditures representative of all alternative care program participants for the same case
208.26mix resident class assigned in the most recent fiscal year for which complete expenditure
208.27data is available discretionary services, for which lead agencies may make payment from
208.28their alternative care program allocation for services not otherwise defined in this section
208.29or section 256B.0625, following approval by the commissioner.
208.30    Total annual payments for discretionary services and direct cash payments, until
208.31the federally approved consumer-directed service option is implemented statewide, for
208.32all clients within a county may served by a lead agency must not exceed 25 percent of
208.33that county's lead agency's annual alternative care program base allocation. Thereafter,
208.34discretionary services are limited to 25 percent of the county's annual alternative care
208.35program base allocation.

209.1    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to
209.2read:
209.3    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in
209.4statute, the services, service definitions, and standards for alternative care services shall
209.5be the same as the services, service definitions, and standards specified in the federally
209.6approved elderly waiver plan, except for alternative care does not cover transitional
209.7support services, assisted living services, adult foster care services, and residential care
209.8services and benefits defined under section 256B.0625 that meet primary and acute
209.9health care needs.
209.10    (b) The county lead agency must ensure that the funds are not used to supplant
209.11or supplement services available through other public assistance or services programs.,
209.12including supplementation of client co-pays, deductibles, premiums, or other cost-sharing
209.13arrangements for health-related benefits and services or entitlement programs and services
209.14that are available to the person, but in which they have elected not to enroll. For a provider
209.15of supplies and equipment when the monthly cost of the supplies and equipment is less
209.16than $250, persons or agencies must be employed by or under a contract with the county
209.17lead agency or the public health nursing agency of the local board of health in order to
209.18receive funding under the alternative care program. Supplies and equipment may be
209.19purchased from a vendor not certified to participate in the Medicaid program if the cost for
209.20the item is less than that of a Medicaid vendor.
209.21    (c) Personal care services must meet the service standards defined in the federally
209.22approved elderly waiver plan, except that a county lead agency may contract with a
209.23client's relative who meets the relative hardship waiver requirements or a relative who
209.24meets the criteria and is also the responsible party under an individual service plan that
209.25ensures the client's health and safety and supervision of the personal care services by a
209.26qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship
209.27is established by the county lead agency when the client's care causes a relative caregiver
209.28to do any of the following: resign from a paying job, reduce work hours resulting in lost
209.29wages, obtain a leave of absence resulting in lost wages, incur substantial client-related
209.30expenses, provide services to address authorized, unstaffed direct care time, or meet
209.31special needs of the client unmet in the formal service plan.

209.32    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to
209.33read:
209.34    Subd. 8. Requirements for individual care plan. (a) The case manager shall
209.35implement the plan of care for each alternative care client and ensure that a client's
210.1service needs and eligibility are reassessed at least every 12 months. The plan shall
210.2include any services prescribed by the individual's attending physician as necessary to
210.3allow the individual to remain in a community setting. In developing the individual's care
210.4plan, the case manager should include the use of volunteers from families and neighbors,
210.5religious organizations, social clubs, and civic and service organizations to support the
210.6formal home care services. The county lead agency shall be held harmless for damages or
210.7injuries sustained through the use of volunteers under this subdivision including workers'
210.8compensation liability. The county of service case manager shall provide documentation
210.9in each individual's plan of care and, if requested, to the commissioner that the most
210.10cost-effective alternatives available have been offered to the individual and that the
210.11individual was free to choose among available qualified providers, both public and private,
210.12including qualified case management or service coordination providers other than those
210.13employed by any county; however, the county or tribe maintains responsibility for prior
210.14authorizing services in accordance with statutory and administrative requirements. The
210.15case manager must give the individual a ten-day written notice of any denial, termination,
210.16or reduction of alternative care services.
210.17    (b) The county of service or tribe must provide access to and arrange for case
210.18management services, including assuring implementation of the plan. "County of service"
210.19has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of
210.20service must notify the county of financial responsibility of the approved care plan and
210.21the amount of encumbered funds.

210.22    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to
210.23read:
210.24    Subd. 9. Contracting provisions for providers. Alternative care funds paid to
210.25service providers are subject to audit by the commissioner for fiscal and utilization control.
210.26    The lead agency must select providers for contracts or agreements using the
210.27following criteria and other criteria established by the county lead agency:
210.28    (1) the need for the particular services offered by the provider;
210.29    (2) the population to be served, including the number of clients, the length of time
210.30services will be provided, and the medical condition of clients;
210.31    (3) the geographic area to be served;
210.32    (4) quality assurance methods, including appropriate licensure, certification, or
210.33standards, and supervision of employees when needed;
210.34    (5) rates for each service and unit of service exclusive of county lead agency
210.35administrative costs;
211.1    (6) evaluation of services previously delivered by the provider; and
211.2    (7) contract or agreement conditions, including billing requirements, cancellation,
211.3and indemnification.
211.4    The county lead agency must evaluate its own agency services under the criteria
211.5established for other providers.

211.6    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to
211.7read:
211.8    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal
211.9years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of
211.10each year, the commissioner shall allocate to county agencies the state funds available for
211.11alternative care for persons eligible under subdivision 2.
211.12    (b) The adjusted base for each county lead agency is the county's lead agency's
211.13current fiscal year base allocation plus any targeted funds approved during the current
211.14fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each
211.15county lead agency, the determination of alternative care program expenditures shall be
211.16based on payments for services rendered from April 1 through March 31 in the base year,
211.17to the extent that claims have been submitted and paid by June 1 of that year.
211.18    (c) If the alternative care program expenditures as defined in paragraph (b) are 95
211.19percent or more of the county's lead agency's adjusted base allocation, the allocation for
211.20the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that
211.21inflation is included in the state budget.
211.22    (d) If the alternative care program expenditures as defined in paragraph (b) are less
211.23than 95 percent of the county's lead agency's adjusted base allocation, the allocation
211.24for the next fiscal year is the adjusted base allocation less the amount of unspent funds
211.25below the 95 percent level.
211.26    (e) If the annual legislative appropriation for the alternative care program is
211.27inadequate to fund the combined county lead agency allocations for a biennium, the
211.28commissioner shall distribute to each county lead agency the entire annual appropriation
211.29as that county's lead agency's percentage of the computed base as calculated in paragraphs
211.30(c) and (d).
211.31    (f) On agreement between the commissioner and the lead agency, the commissioner
211.32may have discretion to reallocate alternative care base allocations distributed to lead
211.33agencies in which the base amount exceeds program expenditures.

212.1    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to
212.2read:
212.3    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make
212.4additional money available to counties lead agencies with the greatest need. Targeted
212.5funds are not intended to be distributed equitably among all counties lead agencies, but
212.6rather, allocated to those with long-term care strategies that meet state goals.
212.7    (b) The funds available for targeted funding shall be the total appropriation for each
212.8fiscal year minus county lead agency allocations determined under subdivision 10 as
212.9adjusted for any inflation increases provided in appropriations for the biennium.
212.10    (c) The commissioner shall allocate targeted funds to counties lead agencies that
212.11demonstrate to the satisfaction of the commissioner that they have developed feasible
212.12plans to increase alternative care spending. In making targeted funding allocations, the
212.13commissioner shall use the following priorities:
212.14    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in
212.15fiscal year 1990. Counties remain in this priority until they have been restored to their
212.16fiscal year 1990 level plus inflation;
212.17    (2) counties lead agencies that sustain a base allocation reduction for failure to spend
212.1895 percent of the allocation if they demonstrate that the base reduction should be restored;
212.19    (3) counties lead agencies that propose projects to divert community residents from
212.20nursing home placement or convert nursing home residents to community living; and
212.21    (4) counties lead agencies that can otherwise justify program growth by
212.22demonstrating the existence of waiting lists, demographically justified needs, or other
212.23unmet needs.
212.24    (d) Counties Lead agencies that would receive targeted funds according to
212.25paragraph (c) must demonstrate to the commissioner's satisfaction that the funds
212.26would be appropriately spent by showing how the funds would be used to further the
212.27state's alternative care goals as described in subdivision 1, and that the county has the
212.28administrative and service delivery capability to use them.
212.29    (e) The commissioner shall request applications make applications available for
212.30targeted funds by November 1 of each year. The counties lead agencies selected for
212.31targeted funds shall be notified of the amount of their additional funding. Targeted funds
212.32allocated to a county lead agency in one year shall be treated as part of the county's lead
212.33agency's base allocation for that year in determining allocations for subsequent years. No
212.34reallocations between counties lead agencies shall be made.

213.1    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to
213.2read:
213.3    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients
213.4to help pay for the cost of participating in the program. The amount of the fee for the
213.5alternative care client shall be determined as follows:
213.6    (1) when the alternative care client's income less recurring and predictable medical
213.7expenses is less than 100 percent of the federal poverty guideline effective on July 1 of
213.8the state fiscal year in which the fee is being computed, and total assets are less than
213.9$10,000, the fee is zero;
213.10    (2) when the alternative care client's income less recurring and predictable medical
213.11expenses is equal to or greater than 100 percent but less than 150 percent of the federal
213.12poverty guideline effective on July 1 of the state fiscal year in which the fee is being
213.13computed, and total assets are less than $10,000, the fee is five percent of the cost of
213.14alternative care services;
213.15    (3) when the alternative care client's income less recurring and predictable medical
213.16expenses is equal to or greater than 150 percent but less than 200 percent of the federal
213.17poverty guidelines effective on July 1 of the state fiscal year in which the fee is being
213.18computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative
213.19care services;
213.20    (4) when the alternative care client's income less recurring and predictable medical
213.21expenses is equal to or greater than 200 percent of the federal poverty guidelines effective
213.22on July 1 of the state fiscal year in which the fee is being computed and assets are less than
213.23$10,000, the fee is 30 percent of the cost of alternative care services; and
213.24    (5) when the alternative care client's assets are equal to or greater than $10,000, the
213.25fee is 30 percent of the cost of alternative care services.
213.26    For married persons, total assets are defined as the total marital assets less the
213.27estimated community spouse asset allowance, under section 256B.059, if applicable. For
213.28married persons, total income is defined as the client's income less the monthly spousal
213.29allotment, under section 256B.058.
213.30    All alternative care services shall be included in the estimated costs for the purpose
213.31of determining the fee.
213.32    Fees are due and payable each month alternative care services are received unless the
213.33actual cost of the services is less than the fee, in which case the fee is the lesser amount.
213.34    (b) The fee shall be waived by the commissioner when:
213.35    (1) a person who is residing in a nursing facility is receiving case management only;
214.1    (2) a married couple is requesting an asset assessment under the spousal
214.2impoverishment provisions;
214.3    (3) a person is found eligible for alternative care, but is not yet receiving alternative
214.4care services including case management services; or
214.5    (4) a person has chosen to participate in a consumer-directed service plan for which
214.6the cost is no greater than the total cost of the person's alternative care service plan less
214.7the monthly fee amount that would otherwise be assessed.
214.8    (c) The county agency must record in the state's receivable system the client's
214.9assessed fee amount or the reason the fee has been waived. The commissioner will bill
214.10and collect the fee from the client. Money collected must be deposited in the general fund
214.11and is appropriated to the commissioner for the alternative care program. The client must
214.12supply the county lead agency with the client's Social Security number at the time of
214.13application. The county lead agency shall supply the commissioner with the client's Social
214.14Security number and other information the commissioner requires to collect the fee from
214.15the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in
214.16chapter 270A and other methods available to the commissioner. The commissioner may
214.17require counties lead agencies to inform clients of the collection procedures that may be
214.18used by the state if a fee is not paid. This paragraph does not apply to alternative care
214.19pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section
214.20133, if a county operating under the pilot project reports the following dollar amounts
214.21to the commissioner quarterly:
214.22    (1) total fees billed to clients;
214.23    (2) total collections of fees billed; and
214.24    (3) balance of fees owed by clients.
214.25If a county lead agency does not adhere to these reporting requirements, the commissioner
214.26may terminate the billing, collecting, and remitting portions of the pilot project and require
214.27the county lead agency involved to operate under the procedures set forth in this paragraph.

214.28    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to
214.29read:
214.30    Subd. 13. County Lead agency biennial plan. The county lead agency biennial
214.31plan for long-term care consultation services under section 256B.0911, the alternative
214.32care program under this section, and waivers for the elderly under section 256B.0915,
214.33shall be submitted by the lead agency as the home and community-based services quality
214.34assurance plan on a form provided by the commissioner.

215.1    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to
215.2read:
215.3    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless
215.4otherwise specified in statute, providers must be enrolled as Minnesota health care
215.5program providers and abide by the requirements for provider participation according to
215.6Minnesota Rules, part 9505.0195.
215.7    (b) Payment for provided alternative care services as approved by the client's
215.8case manager shall occur through the invoice processing procedures of the department's
215.9Medicaid Management Information System (MMIS). To receive payment, the county lead
215.10agency or vendor must submit invoices within 12 months following the date of service.
215.11The county lead agency and its vendors under contract shall not be reimbursed for services
215.12which exceed the county allocation.
215.13    (c) The county lead agency shall negotiate individual rates with vendors and may
215.14authorize service payment for actual costs up to the county's current approved rate.
215.15Notwithstanding any other rule or statutory provision to the contrary, the commissioner
215.16shall not be authorized to increase rates by an annual inflation factor, unless so authorized
215.17by the legislature. To improve access to community services and eliminate payment
215.18disparities between the alternative care program and the elderly waiver program, the
215.19commissioner shall establish statewide maximum service rate limits and eliminate
215.20county-specific service rate limits.
215.21    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5,
215.22paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative
215.23care statewide maximum rate or the elderly waiver statewide maximum rate.
215.24    (2) Counties Lead agencies may negotiate individual service rates with vendors for
215.25actual costs up to the statewide maximum service rate limit.

215.26    Sec. 45. Minnesota Statutes 2006, section 256B.0915, is amended to read:
215.27256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.
215.28    Subdivision 1. Authority. The commissioner is authorized to apply for a home
215.29and community-based services waiver for the elderly, authorized under section 1915(c)
215.30of the Social Security Act, in order to obtain federal financial participation to expand
215.31the availability of services for persons who are eligible for medical assistance. The
215.32commissioner may apply for additional waivers or pursue other federal financial
215.33participation which is advantageous to the state for funding home care services for the
215.34frail elderly who are eligible for medical assistance. The provision of waivered services
216.1to elderly and disabled medical assistance recipients must comply with the criteria for
216.2service definitions and provider standards approved in the waiver.
216.3    Subd. 1a. Elderly waiver case management services. (a) Elderly case management
216.4services under the home and community-based services waiver for elderly individuals are
216.5available from providers meeting qualification requirements and the standards specified
216.6in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case
216.7management services.
216.8    Case management services assist individuals who receive waiver services in gaining
216.9access to needed waiver and other state plan services, as well as needed medical, social,
216.10educational, and other services regardless of the funding source for the services to which
216.11access is gained.
216.12    A case aide shall provide assistance to the case manager in carrying out
216.13administrative activities of the case management function. The case aide may not assume
216.14responsibilities that require professional judgment including assessments, reassessments,
216.15and care plan development. The case manager is responsible for providing oversight of
216.16the case aide.
216.17    Case managers shall be responsible for ongoing monitoring of the provision of
216.18services included in the individual's plan of care. Case managers shall initiate and oversee
216.19the process of assessment and reassessment of the individual's care and review plan of
216.20care at intervals specified in the federally approved waiver plan.
216.21    (b) The county of service or tribe must provide access to and arrange for case
216.22management services. County of service has the meaning given it in Minnesota Rules,
216.23part 9505.0015, subpart 11.
216.24    Subd. 1b. Provider qualifications and standards. The commissioner must
216.25enroll qualified providers of elderly case management services under the home
216.26and community-based waiver for the elderly under section 1915(c) of the Social
216.27Security Act. The enrollment process shall ensure the provider's ability to meet the
216.28qualification requirements and standards in this subdivision and other federal and state
216.29requirements of this service. An elderly case management provider is an enrolled medical
216.30assistance provider who is determined by the commissioner to have all of the following
216.31characteristics:
216.32    (1) the demonstrated capacity and experience to provide the components of
216.33case management to coordinate and link community resources needed by the eligible
216.34population;
217.1    (2) administrative capacity and experience in serving the target population for
217.2whom it will provide services and in ensuring quality of services under state and federal
217.3requirements;
217.4    (3) a financial management system that provides accurate documentation of services
217.5and costs under state and federal requirements;
217.6    (4) the capacity to document and maintain individual case records under state and
217.7federal requirements; and
217.8    (5) the county lead agency may allow a case manager employed by the county lead
217.9agency to delegate certain aspects of the case management activity to another individual
217.10employed by the county lead agency provided there is oversight of the individual by
217.11the case manager. The case manager may not delegate those aspects which require
217.12professional judgment including assessments, reassessments, and care plan development.
217.13Lead agencies include counties, health plans, and federally recognized tribes who
217.14authorize services under this section.
217.15    Subd. 1c. Case management activities under the state plan. The commissioner
217.16shall seek an amendment to the home and community-based services waiver for the
217.17elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner
217.18is unable to secure the approval of the secretary of health and human services for the
217.19requested waiver amendment by December 31, 1993, the commissioner shall amend
217.20the medical assistance state plan to provide that case management provided under the
217.21home and community-based services waiver for the elderly is performed by counties
217.22as an administrative function for the proper and effective administration of the state
217.23medical assistance plan. The state shall reimburse counties for the nonfederal share of
217.24costs for case management performed as an administrative function under the home and
217.25community-based services waiver for the elderly.
217.26    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.
217.27    Notwithstanding the provisions of section 256B.056, the commissioner shall make the
217.28following amendment to the medical assistance elderly waiver program effective July 1,
217.291999, or upon federal approval, whichever is later.
217.30    A recipient's maintenance needs will be an amount equal to the Minnesota
217.31supplemental aid equivalent rate as defined in section 256I.03, subdivision 5, plus the
217.32medical assistance personal needs allowance as defined in section 256B.35, subdivision
217.331 , paragraph (a), when applying posteligibility treatment of income rules to the gross
217.34income of elderly waiver recipients, except for individuals whose income is in excess of
217.35the special income standard according to Code of Federal Regulations, title 42, section
217.36435.236 . Recipient maintenance needs shall be adjusted under this provision each July 1.
218.1    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend
218.2the federal waiver and the medical assistance state plan to allow apply:
218.3    (1) the spousal impoverishment criteria as authorized under United States Code, title
218.442, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059,
218.5except that the amendment shall seek to add to;
218.6    (2) the personal needs allowance permitted in section 256B.0575,; and
218.7    (3) an amount equivalent to the group residential housing rate as set by section
218.8256I.03, subdivision 5 , and according to the approved federal waiver and medical
218.9assistance state plan.
218.10    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that
218.11a county lead agency may serve must be allocated according to the number of medical
218.12assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be
218.13served with the approval of the commissioner.
218.14    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered
218.15services to an individual elderly waiver client shall be the weighted average monthly
218.16nursing facility rate of the case mix resident class to which the elderly waiver client would
218.17be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's
218.18maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first
218.19day of the state fiscal year in which the resident assessment system as described in section
218.20256B.437 for nursing home rate determination is implemented. Effective on the first day
218.21of the state fiscal year in which the resident assessment system as described in section
218.22256B.437 for nursing home rate determination is implemented and the first day of each
218.23subsequent state fiscal year, the monthly limit for the cost of waivered services to an
218.24individual elderly waiver client shall be the rate of the case mix resident class to which the
218.25waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
218.26in effect on the last day of the previous state fiscal year, adjusted by the greater of any
218.27legislatively adopted home and community-based services percentage rate increase or the
218.28average statewide percentage increase in nursing facility payment rates.
218.29    (b) If extended medical supplies and equipment or environmental modifications are
218.30or will be purchased for an elderly waiver client, the costs may be prorated for up to
218.3112 consecutive months beginning with the month of purchase. If the monthly cost of a
218.32recipient's waivered services exceeds the monthly limit established in paragraph (a), the
218.33annual cost of all waivered services shall be determined. In this event, the annual cost of
218.34all waivered services shall not exceed 12 times the monthly limit of waivered services as
218.35described in paragraph (a).
219.1    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
219.2facility. (a) For a person who is a nursing facility resident at the time of requesting a
219.3determination of eligibility for elderly waivered services, a monthly conversion limit for
219.4the cost of elderly waivered services may be requested. The monthly conversion limit for
219.5the cost of elderly waiver services shall be the resident class assigned under Minnesota
219.6Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where
219.7the resident currently resides until July 1 of the state fiscal year in which the resident
219.8assessment system as described in section 256B.437 for nursing home rate determination
219.9is implemented. Effective on July 1 of the state fiscal year in which the resident
219.10assessment system as described in section 256B.437 for nursing home rate determination
219.11is implemented, the monthly conversion limit for the cost of elderly waiver services
219.12shall be the per diem nursing facility rate as determined by the resident assessment
219.13system as described in section 256B.437 for that resident in the nursing facility where
219.14the resident currently resides multiplied by 365 and divided by 12, less the recipient's
219.15maintenance needs allowance as described in subdivision 1d. The initially approved
219.16conversion rate may be adjusted by the greater of any subsequent legislatively adopted
219.17home and community-based services percentage rate increase or the average statewide
219.18percentage increase in nursing facility payment rates. The limit under this subdivision
219.19only applies to persons discharged from a nursing facility after a minimum 30-day stay
219.20and found eligible for waivered services on or after July 1, 1997. For conversions from the
219.21nursing home to the elderly waiver with consumer directed community support services,
219.22the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal
219.23to the percentage difference between the consumer directed services budget limit that
219.24would be assigned according to the federally approved waiver plan and the corresponding
219.25community case mix cap, but not to exceed 50 percent.
219.26    (b) The following costs must be included in determining the total monthly costs
219.27for the waiver client:
219.28    (1) cost of all waivered services, including extended medical supplies and equipment
219.29and environmental modifications and adaptations; and
219.30    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
219.31by medical assistance.
219.32    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance
219.33funding for skilled nursing services, private duty nursing, home health aide, and personal
219.34care services for waiver recipients must be approved by the case manager and included in
219.35the individual care plan.
220.1    (b) A county lead agency is not required to contract with a provider of supplies and
220.2equipment if the monthly cost of the supplies and equipment is less than $250.
220.3    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered
220.4a difficulty of care payment and shall not include room and board. The adult foster
220.5care service rate shall be negotiated between the county lead agency and the foster care
220.6provider. The elderly waiver payment for the foster care service in combination with
220.7the payment for all other elderly waiver services, including case management, must not
220.8exceed the limit specified in subdivision 3a, paragraph (a).
220.9    Subd. 3e. Assisted living Customized living service rate. (a) Payment for assisted
220.10living service customize living services shall be a monthly rate negotiated and authorized
220.11by the county agency based on an individualized service plan for each resident and may
220.12not cover direct rent or food costs. lead agency within the parameters established by
220.13the commissioner. The payment agreement must delineate the services that have been
220.14customized for each recipient and specify the amount of each service to be provided. The
220.15lead agency shall ensure that there is a documented need for all services authorized.
220.16Customized living services must not include rent or raw food costs. The negotiated
220.17payment rate must be based on services to be provided. Negotiated rates must not exceed
220.18payment rates for comparable elderly waiver or medical assistance services and must
220.19reflect economies of scale.
220.20    (b) The individualized monthly negotiated payment for assisted living customized
220.21living services as described in section 256B.0913, subdivisions 5d to 5f, and residential
220.22care services as described in section 256B.0913, subdivision 5c, shall not exceed the
220.23nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit
220.24is being calculated, of the greater of either the statewide or any of the geographic
220.25groups' weighted average monthly nursing facility rate of the case mix resident class
220.26to which the elderly waiver eligible client would be assigned under Minnesota Rules,
220.27parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in
220.28subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident
220.29assessment system as described in section 256B.437 for nursing home rate determination
220.30is implemented. Effective on July 1 of the state fiscal year in which the resident
220.31assessment system as described in section 256B.437 for nursing home rate determination
220.32is implemented and July 1 of each subsequent state fiscal year, the individualized monthly
220.33negotiated payment for the services described in this clause shall not exceed the limit
220.34described in this clause which was in effect on June 30 of the previous state fiscal year
220.35and which has been adjusted by the greater of any legislatively adopted home and
221.1community-based services cost-of-living percentage increase or any legislatively adopted
221.2statewide percent rate increase for nursing facilities.
221.3    (c) The individualized monthly negotiated payment for assisted Customized living
221.4services described in section 144A.4605 and are delivered by a provider licensed by the
221.5Department of Health as a class A or class F home care provider or an assisted living
221.6home care provider and provided in a building that is registered as a housing with services
221.7establishment under chapter 144D and that provides 24-hour supervision in combination
221.8with the payment for other elderly waiver services, including case management, must not
221.9exceed the limit specified in subdivision 3a.
221.10    Subd. 3f. Individual service rates; expenditure forecasts. (a) The county lead
221.11agency shall negotiate individual service rates with vendors and may authorize payment
221.12for actual costs up to the county's lead agency's current approved rate. Persons or agencies
221.13must be employed by or under a contract with the county lead agency or the public health
221.14nursing agency of the local board of health in order to receive funding under the elderly
221.15waiver program, except as a provider of supplies and equipment when the monthly cost of
221.16the supplies and equipment is less than $250.
221.17    (b) Reimbursement for the medical assistance recipients under the approved waiver
221.18shall be made from the medical assistance account through the invoice processing
221.19procedures of the department's Medicaid Management Information System (MMIS),
221.20only with the approval of the client's case manager. The budget for the state share of the
221.21Medicaid expenditures shall be forecasted with the medical assistance budget, and shall
221.22be consistent with the approved waiver.
221.23    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access
221.24to community services and eliminate payment disparities between the alternative care
221.25program and the elderly waiver, the commissioner shall establish statewide maximum
221.26service rate limits and eliminate county-specific lead agency-specific service rate limits.
221.27    (b) Effective July 1, 2001, for service rate limits, except those described or defined in
221.28subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
221.29care statewide maximum rate or the elderly waiver statewide maximum rate.
221.30    (c) Counties Lead agencies may negotiate individual service rates with vendors for
221.31actual costs up to the statewide maximum service rate limit.
221.32    Subd. 3h. Service rate limits; 24-hour customized living services. The payment
221.33rates for 24-hour customized living services is a monthly rate negotiated and authorized by
221.34the lead agency within the parameters established by the commissioner of human services.
221.35The payment agreement must delineate the services that have been customized for each
221.36recipient and specify the amount of each service to be provided. The lead agency shall
222.1ensure that there is a documented need for all services authorized. The lead agency shall
222.2not authorize 24-hour customized living services unless there is a documented need for
222.324-hour supervision. For purposes of this section, "24-hour supervision" means that the
222.4recipient requires assistance due to needs related to one or more of the following:
222.5    (1) intermittent assistance with toileting or transferring;
222.6    (2) cognitive or behavioral issues;
222.7    (3) a medical condition that requires clinical monitoring; or
222.8    (4) other conditions or needs as defined by the commissioner of human services.
222.9The lead agency shall ensure that the frequency and mode of supervision of the recipient
222.10and the qualifications of staff providing supervision are described and meet the needs
222.11of the recipient. Customized living services must not include rent or raw food costs.
222.12The negotiated payment rate for 24-hour customized living services must be based on
222.13services to be provided. Negotiated rates must not exceed payment rates for comparable
222.14elderly waiver or medical assistance services and must reflect economies of scale. The
222.15individually negotiated 24-hour customized living payments, in combination with the
222.16payment for other elderly waiver services, including case management, must not exceed
222.17the recipient's community budget cap specified in subdivision 3a.
222.18    Subd. 4. Termination notice. The case manager must give the individual a ten-day
222.19written notice of any denial, reduction, or termination of waivered services.
222.20    Subd. 5. Assessments and reassessments for waiver clients. Each client shall
222.21receive an initial assessment of strengths, informal supports, and need for services in
222.22accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
222.23client served under the elderly waiver must be conducted at least every 12 months and
222.24at other times when the case manager determines that there has been significant change
222.25in the client's functioning. This may include instances where the client is discharged
222.26from the hospital.
222.27    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided
222.28a copy of a written care plan that meets the requirements outlined in section 256B.0913,
222.29subdivision 8 . The care plan must be implemented by the county administering waivered
222.30services of service when it is different than the county of financial responsibility. The
222.31county of service administering waivered services must notify the county of financial
222.32responsibility of the approved care plan.
222.33    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health
222.34plan is liable for nursing home services or elderly waiver services according to section
222.35256B.69, subdivision 6a , is not eligible to also receive county-administered elderly waiver
222.36services under this section.
223.1    Subd. 8. Services and supports. (a) Services and supports shall meet the
223.2requirements set out in United States Code, title 42, section 1396n.
223.3    (b) Services and supports shall promote consumer choice and be arranged and
223.4provided consistent with individualized, written care plans.
223.5    (c) The state of Minnesota, county, managed care organization, or tribal government
223.6under contract to administer the elderly waiver shall not be liable for damages, injuries,
223.7or liabilities sustained through the purchase of direct supports or goods by the person,
223.8the person's family, or the authorized representatives with funds received through
223.9consumer-directed community support services under the federally approved waiver plan.
223.10Liabilities include, but are not limited to, workers' compensation liability, the Federal
223.11Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
223.12    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary
223.13provisions of this section, or those in other state laws or rules, the commissioner may
223.14develop a model for tribal management of the elderly waiver program and implement this
223.15model through a contract between the state and any of the state's federally recognized tribal
223.16governments. The model shall include the provision of tribal waiver case management,
223.17assessment for personal care assistance, and administrative requirements otherwise carried
223.18out by counties lead agencies but shall not include tribal financial eligibility determination
223.19for medical assistance.
223.20EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.

223.21    Sec. 46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to
223.22read:
223.23    Subd. 8. Living-at-home/block nurse program grant. (a) The organization
223.24awarded the contract under subdivision 7, shall develop and administer a grant program
223.25to establish or expand up to 33 51 community-based organizations that will implement
223.26living-at-home/block nurse programs that are designed to enable senior citizens to live as
223.27independently as possible in their homes and in their communities. At least one-half of
223.28the programs must be in counties outside the seven-county metropolitan area. Nonprofit
223.29organizations and units of local government are eligible to apply for grants to establish
223.30the community organizations that will implement living-at-home/block nurse programs.
223.31In awarding grants, the organization awarded the contract under subdivision 7 shall give
223.32preference to nonprofit organizations and units of local government from communities
223.33that:
223.34    (1) have high nursing home occupancy rates;
223.35    (2) have a shortage of health care professionals;
224.1    (3) are located in counties adjacent to, or are located in, counties with existing
224.2living-at-home/block nurse programs; and
224.3    (4) meet other criteria established by LAH/BN, Inc., in consultation with the
224.4commissioner.
224.5    (b) Grant applicants must also meet the following criteria:
224.6    (1) the local community demonstrates a readiness to establish a community model
224.7of care, including the formation of a board of directors, advisory committee, or similar
224.8group, of which at least two-thirds is comprised of community citizens interested in
224.9community-based care for older persons;
224.10    (2) the program has sponsorship by a credible, representative organization within
224.11the community;
224.12    (3) the program has defined specific geographic boundaries and defined its
224.13organization, staffing and coordination/delivery of services;
224.14    (4) the program demonstrates a team approach to coordination and care, ensuring
224.15that the older adult participants, their families, the formal and informal providers are all
224.16part of the effort to plan and provide services; and
224.17    (5) the program provides assurances that all community resources and funding will
224.18be coordinated and that other funding sources will be maximized, including a person's
224.19own resources.
224.20    (c) Grant applicants must provide a minimum of five percent of total estimated
224.21development costs from local community funding. Grants shall be awarded for four-year
224.22periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant
224.23period. The organization under contract may increase the grant amount for applicants from
224.24communities that have socioeconomic characteristics that indicate a higher level of need
224.25for assistance. Subject to the availability of funding, grants and grant renewals awarded or
224.26entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years,
224.27unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the
224.28living-at-home/block nurse program in compliance with the requirements of paragraphs
224.29(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph
224.30may be used for both program development and the delivery of services.
224.31    (d) Each living-at-home/block nurse program shall be designed by representatives of
224.32the communities being served to ensure that the program addresses the specific needs of
224.33the community residents. The programs must be designed to:
224.34    (1) incorporate the basic community, organizational, and service delivery principles
224.35of the living-at-home/block nurse program model;
225.1    (2) provide senior citizens with registered nurse directed assessment, provision and
225.2coordination of health and personal care services on a sliding fee basis as an alternative
225.3to expensive nursing home care;
225.4    (3) provide information, support services, homemaking services, counseling, and
225.5training for the client and family caregivers;
225.6    (4) encourage the development and use of respite care, caregiver support, and
225.7in-home support programs, such as adult foster care and in-home adult day care;
225.8    (5) encourage neighborhood residents and local organizations to collaborate in
225.9meeting the needs of senior citizens in their communities;
225.10    (6) recruit, train, and direct the use of volunteers to provide informal services and
225.11other appropriate support to senior citizens and their caregivers; and
225.12    (7) provide coordination and management of formal and informal services to senior
225.13citizens and their families using less expensive alternatives.

225.14    Sec. 47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to
225.15read:
225.16    Subd. 3. County certification of persons providing adult foster care to related
225.17persons. A person exempt from licensure under section 245A.03, subdivision 2, who
225.18provides adult foster care to a related individual age 65 and older, and who meets the
225.19requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the
225.20county to provide adult foster care. A person certified by the county to provide adult foster
225.21care may be reimbursed for services provided and eligible for funding under sections
225.22256B.0913 and section 256B.0915, if the relative would suffer a financial hardship as
225.23a result of providing care. For purposes of this subdivision, financial hardship refers
225.24to a situation in which a relative incurs a substantial reduction in income as a result of
225.25resigning from a full-time job or taking a leave of absence without pay from a full-time
225.26job to care for the client.

225.27    Sec. 48. Minnesota Statutes 2006, section 256B.095, is amended to read:
225.28256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
225.29    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
225.30disabilities, which includes an alternative quality assurance licensing system for programs,
225.31is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
225.32Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
225.33services provided to persons with developmental disabilities. A county, at its option, may
225.34choose to have all programs for persons with developmental disabilities located within
226.1the county licensed under chapter 245A using standards determined under the alternative
226.2quality assurance licensing system or may continue regulation of these programs under
226.3the licensing system operated by the commissioner. The project expires on June 30,
226.42009 2014.
226.5    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
226.6participate in the quality assurance system established under paragraph (a). The
226.7commission established under section 256B.0951 may, at its option, allow additional
226.8counties to participate in the system.
226.9    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
226.10may establish a quality assurance system under this section. A new system established
226.11under this section shall have the same rights and duties as the system established
226.12under paragraph (a). A new system shall be governed by a commission under section
226.13256B.0951 . The commissioner shall appoint the initial commission members based
226.14on recommendations from advocates, families, service providers, and counties in the
226.15geographic area included in the new system. Counties that choose to participate in a
226.16new system shall have the duties assigned under section 256B.0952. The new system
226.17shall establish a quality assurance process under section 256B.0953. The provisions of
226.18section 256B.0954 shall apply to a new system established under this paragraph. The
226.19commissioner shall delegate authority to a new system established under this paragraph
226.20according to section 256B.0955.
226.21    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
226.22programs for persons with disabilities and older adults.

226.23    Sec. 49. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to
226.24read:
226.25    Subdivision 1. Membership. The Quality Assurance Commission is established.
226.26The commission consists of at least 14 but not more than 21 members as follows: at
226.27least three but not more than five members representing advocacy organizations; at
226.28least three but not more than five members representing consumers, families, and their
226.29legal representatives; at least three but not more than five members representing service
226.30providers; at least three but not more than five members representing counties; and the
226.31commissioner of human services or the commissioner's designee. The first commission
226.32shall establish membership guidelines for the transition and recruitment of membership for
226.33the commission's ongoing existence. Members of the commission who do not receive a
226.34salary or wages from an employer for time spent on commission duties may receive a per
226.35diem payment when performing commission duties and functions. All members may be
227.1reimbursed for expenses related to commission activities. Notwithstanding the provisions
227.2of section 15.059, subdivision 5, the commission expires on June 30, 2009 2014.

227.3    Sec. 50. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND
227.4IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
227.5SERVICES.
227.6    Subdivision 1. Scope. In order to improve the quality of services provided to
227.7Minnesotans with disabilities and to meet the requirements of the federally approved home
227.8and community-based waivers under section 1915c of the Social Security Act, a statewide
227.9quality assurance and improvement system for Minnesotans receiving disability services
227.10shall be developed. The disability services included are the home and community-based
227.11services waiver programs for persons with developmental disabilities under section
227.12256B.092, subdivision 4, and persons with disabilities under section 256B.49.
227.13    Subd. 2. Stakeholder advisory group. The commissioner shall consult with a
227.14stakeholder advisory group on the development and implementation of the state quality
227.15management, assurance, and improvement system, including representatives from:
227.16disability service recipients, disability service providers, disability advocacy groups,
227.17county human service agencies, and state agency staff from the Departments of Human
227.18Services and Health and ombudsman for mental health and developmental disabilities on
227.19the development of a statewide quality assurance and improvement system.
227.20    Subd. 3. Annual survey of service recipients. The commissioner, in consultation
227.21with the stakeholder advisory group, shall develop and conduct an annual independent
227.22random statewide survey of between five and ten percent of service recipients to determine
227.23the effectiveness and quality of disability services. The survey shall be consistent with
227.24the system performance expectations of the Centers for Medicare and Medicaid Services
227.25quality management requirements and framework. The survey shall analyze whether
227.26desired outcomes have been achieved for persons with different demographic, diagnostic,
227.27health, and functional needs and receiving different types of services, in different settings,
227.28with different costs. The survey shall be field tested during 2008 and implemented by
227.29February 1, 2009. Annual statewide and regional reports of the results shall be published
227.30for use by regions, counties, and providers to plan and measure the impact of quality
227.31improvement activities.
227.32    Subd. 4. Improvements for incident reporting, investigation, analysis, and
227.33follow-up. In consultation with the stakeholder advisory group, the commissioner shall
227.34identify the information, data sources, and technology needed to improve the system
227.35of incident reporting, including:
228.1    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and
228.2    (2) investigation, analysis, and follow-up for disability services.
228.3    The commissioner must ensure that the federal home and community-based waiver
228.4requirements are met and that incidents that may have jeopardized safety; health; or
228.5violated service-related assurances, civil and human rights, and other protections designed
228.6to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon
228.7in a timely manner.
228.8    Subd. 5. Biennial report. The commissioner shall provide a biennial report to the
228.9chairs of the legislative committees with jurisdiction over health and human services
228.10policy and funding beginning January 15, 2009, on the development and activities of the
228.11quality management, assurance, and improvement system designed to meet the federal
228.12requirements under the home and community-based services waiver programs for persons
228.13with disabilities. By January 15, 2008, the commissioner shall provide a preliminary
228.14report on the priorities for meeting the federal requirements, progress on the annual
228.15survey, recommendations for improvements in the incident reporting system, and a plan
228.16for incorporating the quality assurance efforts under section 256B.095 and other regional
228.17efforts into the statewide system.

228.18    Sec. 51. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:
228.19    Subdivision 1. In general. The commissioner shall determine prospective
228.20payment rates for resident care costs. For rates established on or after July 1, 1985, the
228.21commissioner shall develop procedures for determining operating cost payment rates that
228.22take into account the mix of resident needs, geographic location, and other factors as
228.23determined by the commissioner. The commissioner shall consider whether the fact that a
228.24facility is attached to a hospital or has an average length of stay of 180 days or less should
228.25be taken into account in determining rates. The commissioner shall consider the use of the
228.26standard metropolitan statistical areas when developing groups by geographic location.
228.27The commissioner shall provide notice to each nursing facility on or before May 1 August
228.2815 of the rates effective for the following rate year except that if legislation is pending on
228.29May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the
228.30rates after the legislation is enacted and provide notice to each facility as soon as possible.
228.31    Compensation for top management personnel shall continue to be categorized as a
228.32general and administrative cost and is subject to any limits imposed on that cost category.

228.33    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to
228.34read:
229.1    Subd. 2e. Contracts for services for ventilator-dependent persons. (a)
229.2The commissioner may negotiate with a nursing facility eligible to receive medical
229.3assistance payments to provide services to a ventilator-dependent person identified by the
229.4commissioner according to criteria developed by the commissioner, including:
229.5    (1) nursing facility care has been recommended for the person by a preadmission
229.6screening team;
229.7    (2) the person has been hospitalized and no longer requires inpatient acute care
229.8hospital services; and
229.9    (3) the commissioner has determined that necessary services for the person cannot
229.10be provided under existing nursing facility rates.
229.11    The commissioner may negotiate an adjustment to the operating cost payment
229.12rate for a nursing facility with a resident who is ventilator-dependent, for that resident.
229.13The negotiated adjustment must reflect only the actual additional cost of meeting the
229.14specialized care needs of a ventilator-dependent person identified by the commissioner
229.15for whom necessary services cannot be provided under existing nursing facility rates and
229.16which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or
229.179505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before
229.18July 1, 2001, and have their payment rate under this subdivision negotiated after July 1,
229.192001, the negotiated payment rate must not exceed 200 percent of the highest multiple
229.20bedroom payment rate for the facility, as initially established by the commissioner for the
229.21rate year for case mix classification K; or, upon implementation of the RUG's-based case
229.22mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a
229.23nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300
229.24percent of the facility's multiple bedroom payment rate for case mix classification K; or,
229.25upon implementation of the RUG's-based case mix system, 300 percent of the highest
229.26RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private
229.27paying residents under the provisions of section 256B.48, subdivision 1.
229.28    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to
229.29care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever
229.30is later, the operating payment rates for residents determined eligible under paragraph (a)
229.31of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds
229.32and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300
229.33percent of the facility's highest RUG rate.

229.34    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to
229.35read:
230.1    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the
230.2rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571
230.3per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom.
230.4For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a
230.5single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060,
230.6subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per
230.7bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060,
230.8subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per
230.9bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060,
230.10subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the
230.11Census: Composite fixed-weighted price index as published in the C30 Report, Value
230.12of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed
230.13Investments in Structures; Special Care.
230.14    (b) Rental factor. For the rate year beginning July 1, 1988, the commissioner shall
230.15increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8,
230.16item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing
230.17nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation
230.18services used by the state's contracted appraisers. For rate years beginning on or after July
230.191, 1989, the rental factor is the amount determined under this paragraph for the rate year
230.20beginning July 1, 1988.
230.21    (c) Occupancy factor. For rate years beginning on or after July 1, 1988, in order
230.22to determine property-related payment rates under Minnesota Rules, part 9549.0060,
230.23for all nursing facilities except those whose average length of stay in a skilled level of
230.24care within a nursing facility is 180 days or less, the commissioner shall use 95 percent
230.25of capacity days. For a nursing facility whose average length of stay in a skilled level of
230.26care within a nursing facility is 180 days or less, the commissioner shall use the greater of
230.27resident days or 80 percent of capacity days but in no event shall the divisor exceed 95
230.28percent of capacity days.
230.29    (d) Equipment allowance. For rate years beginning on July 1, 1988, and July 1,
230.301989, the commissioner shall add ten cents per resident per day to each nursing facility's
230.31property-related payment rate. The ten-cent property-related payment rate increase is not
230.32cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the
230.33commissioner shall increase each nursing facility's equipment allowance as established
230.34in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For
230.35rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be
230.36adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E.
231.1For the rate period beginning October 1, 1992, the equipment allowance for each nursing
231.2facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the
231.3allowance must be adjusted annually for inflation.
231.4    (e) Post chapter 199 related-organization debts and interest expense. For rate
231.5years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item
231.6E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983,
231.7provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010
231.8to 9510.0480, the debt is subject to repayment through annual principal payments, and
231.9the nursing facility demonstrates to the commissioner's satisfaction that the interest rate
231.10on the debt was less than market interest rates for similar arm's-length transactions at
231.11the time the debt was incurred. If the debt was incurred due to a sale between family
231.12members, the nursing facility must also demonstrate that the seller no longer participates
231.13in the management or operation of the nursing facility. Debts meeting the conditions of
231.14this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010
231.15to 9549.0080.
231.16    (f) Building capital allowance for nursing facilities with operating leases. For
231.17rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs
231.18incurred for the nursing facility's buildings shall receive its building capital allowance
231.19computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating
231.20lease provides that the lessee's rent is adjusted to recognize improvements made by the
231.21lessor and related debt, the costs for capital improvements and related debt shall be allowed
231.22in the computation of the lessee's building capital allowance, provided that reimbursement
231.23for these costs under an operating lease shall not exceed the rate otherwise paid.

231.24    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to
231.25read:
231.26    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.
231.27    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
231.28for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under
231.29section 144A.071 or 144A.073 after July 1, 1999, or any building project that is a
231.30relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the
231.31replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
231.32rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
231.33the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
231.349549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
231.35adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000.

232.1    Sec. 55. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:
232.2    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
232.3have their payment rates determined under this section rather than section 256B.431, the
232.4commissioner shall establish a rate under this subdivision. The nursing facility must enter
232.5into a written contract with the commissioner.
232.6    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
232.7contract under this section is the payment rate the facility would have received under
232.8section 256B.431.
232.9    (c) A nursing facility's case mix payment rates for the second and subsequent years
232.10of a facility's contract under this section are the previous rate year's contract payment
232.11rates plus an inflation adjustment and, for facilities reimbursed under this section or
232.12section 256B.431, an adjustment to include the cost of any increase in Health Department
232.13licensing fees for the facility taking effect on or after July 1, 2001. The index for the
232.14inflation adjustment must be based on the change in the Consumer Price Index-all items
232.15(United States City average) (CPI-U) forecasted by the commissioner of finance's national
232.16economic consultant, as forecasted in the fourth quarter of the calendar year preceding
232.17the rate year. The inflation adjustment must be based on the 12-month period from the
232.18midpoint of the previous rate year to the midpoint of the rate year for which the rate
232.19is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July
232.201, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1,
232.212007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only
232.22to the property-related payment rate, except that adjustments to include the cost of any
232.23increase in Health Department licensing fees taking effect on or after July 1, 2001, shall
232.24be provided. Beginning in 2005, adjustment to the property payment rate under this
232.25section and section 256B.431 shall be effective on October 1. In determining the amount
232.26of the property-related payment rate adjustment under this paragraph, the commissioner
232.27shall determine the proportion of the facility's rates that are property-related based on the
232.28facility's most recent cost report.
232.29    (d) The commissioner shall develop additional incentive-based payments of up to
232.30five percent above a facility's operating payment rate for achieving outcomes specified
232.31in a contract. The commissioner may solicit contract amendments and implement those
232.32which, on a competitive basis, best meet the state's policy objectives. The commissioner
232.33shall limit the amount of any incentive payment and the number of contract amendments
232.34under this paragraph to operate the incentive payments within funds appropriated for this
232.35purpose. The contract amendments may specify various levels of payment for various
232.36levels of performance. Incentive payments to facilities under this paragraph may be in the
233.1form of time-limited rate adjustments or onetime supplemental payments. In establishing
233.2the specified outcomes and related criteria, the commissioner shall consider the following
233.3state policy objectives:
233.4    (1) successful diversion or discharge of residents to the residents' prior home or other
233.5community-based alternatives;
233.6    (2) adoption of new technology to improve quality or efficiency;
233.7    (3) improved quality as measured in the Nursing Home Report Card;
233.8    (4) reduced acute care costs; and
233.9    (5) any additional outcomes proposed by a nursing facility that the commissioner
233.10finds desirable.
233.11    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
233.12take action to come into compliance with existing or pending requirements of the life
233.13safety code provisions or other federal regulations governing sprinkler systems shall
233.14receive reimbursement for the costs associated with compliance if all of the following
233.15conditions are met:
233.16    (1) the expenses associated with compliance occurred on or after January 1, 2005,
233.17and before December 31, 2008;
233.18    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073,
233.19or 256B.434, subdivision 4f; and
233.20    (3) the total allowable costs reported under this paragraph are less than the minimum
233.21threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.
233.22The commissioner shall use funds appropriated for this purpose to provide to qualifying
233.23nursing facilities a rate adjustment beginning October 1, 2007, and ending September
233.2430, 2008. Nursing facilities that have expended funds or anticipate the need to expend
233.25funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler
233.26system or (2) replacing all or portions of an existing sprinkler system may submit to the
233.27commissioner by June 30, 2007, on a form provided by the commissioner the actual
233.28costs of a completed project or the estimated costs, based on a project bid, of a planned
233.29project. The commissioner shall calculate a rate adjustment equal to the allowable
233.30costs of the project divided by the resident days reported for the report year ending
233.31September 30, 2006. If the costs from all projects exceed the appropriation for this
233.32purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the
233.33qualifying facilities by reducing the rate adjustment determined for each facility by an
233.34equal percentage. If the rate adjustments under this subdivision are reduced to fit the
233.35appropriation, facilities may include the portion of the costs that are not reimbursed by
233.36the rate adjustment as part of a project that meets the requirements of subdivision 4f.
234.1If the commissioner determines that there are any unexpended funds for the purposes
234.2of this paragraph, the commissioner may allocate the remainder of the funds to the
234.3qualifying facilities on a pro rata basis for other physical plant changes required by the
234.4nursing facility in order to meet the most recent life safety code compliance standards.
234.5Facilities that used estimated costs when requesting the rate adjustment shall report to
234.6the commissioner by January 31, 2009, on the use of these funds on a form provided by
234.7the commissioner. If the nursing facility fails to provide the report, the commissioner
234.8shall recoup the funds appropriated to the facility for this purpose. If the facility reports
234.9expenditures allowable under this subdivision that are less than the amount received in the
234.10facility's annualized rate adjustment, the commissioner shall recoup the difference.

234.11    Sec. 56. Minnesota Statutes 2006, section 256B.434, is amended by adding a
234.12subdivision to read:
234.13    Subd. 4i. Nursing facility rate increase effective October 1, 2007; Hennepin
234.14County. For the rate year beginning October 1, 2007, the commissioner shall provide to
234.15a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an
234.16increase in the property payment rate of $6.52 per resident per day. The increase under
234.17this subdivision must be added following the determination under this chapter of the
234.18payment rate for the rate year beginning October 1, 2007, and must be included in the
234.19facility's total payment rate for purposes of determining future rates under this section or
234.20any other section.

234.21    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a
234.22subdivision to read:
234.23    Subd. 4j. Rate increase for facilities in Chisago County. Effective October
234.241, 2007, operating payment rates of all nursing facilities in Chisago County that are
234.25reimbursed under this section or section 256B.441 shall be increased to be equal, for
234.26a RUG's rate with a weight of 1.00, to the geographic group III median rate for the
234.27same RUG's weight. The percentage of the operating payment rate for each facility to
234.28be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that
234.29facility's September 30, 2007, operating payment rate. This subdivision applies only if it
234.30results in a rate increase. Increases provided by this subdivision shall be added to the rate
234.31determined under any new reimbursement system established under section 256B.441.

234.32    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a
234.33subdivision to read:
235.1    Subd. 4k. Nursing facility rate increase effective January 1, 2008; Hennepin
235.2County. Effective January 1, 2008, a nursing facility in Hennepin County licensed for
235.3137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix
235.4payment rate to offset property tax payments due as a result of the facility's conversion
235.5from nonprofit to for-profit status. The increase under this subdivision must be added
235.6following the determination under this chapter of the payment rate for the rate year
235.7beginning October 1, 2007, and must be included in the facility's total payment rate for the
235.8purposes of determining future rates under this section or any other section.

235.9    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a
235.10subdivision to read:
235.11    Subd. 4l. Property rate adjustment; Kanabec County. The commissioner
235.12shall allow a property rate adjustment for a facility located in Kanabec County that
235.13was approved for a moratorium exception project in 2001, but experienced a delay and
235.14additional costs associated with the project, and completed the project in 2005. The
235.15property payment rate for the rate years beginning October 1, 2007, and ending September
235.1630, 2009, must be $22.73 per resident day. For subsequent years, the property rate of
235.17$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as
235.18long as the facility has a contract under this section.

235.19    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a
235.20subdivision to read:
235.21    Subd. 4m. Rate increase for facilities in Rice County. Effective July 1, 2007,
235.22operating payment rates of nursing facilities in Rice County located within two miles
235.23of Scott County or Dakota County that are reimbursed under this section or section
235.24256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the
235.25geographic group III median rate for the same RUG's weight. The percentage of the
235.26operating payment rate for each facility to be case-mix adjusted must be equal to the
235.27percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment
235.28rate. This subdivision applies only if it results in a rate increase.

235.29    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a
235.30subdivision to read:
235.31    Subd. 4n. Facility rate increase. Forthe rate year beginning October 1, 2007, a
235.32nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive
235.33a rate increase of $2.64 in each case mix payment rate to offset property tax payments
236.1due as a result of the facility's conversion from nonprofit to for-profit status. The increase
236.2under this subdivision shall be added to the payment rates in effect for the facility on
236.3September 30, 2007, and shall be included in the facility's total payment rates for the
236.4purposes of determining future rates under this section or any other section.

236.5    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a
236.6subdivision to read:
236.7    Subd. 19. Nursing facility rate increases beginning October 1, 2007, and
236.8October 1, 2008. (a) For the rate year beginning October 1, 2007, the commissioner
236.9shall make available to each nursing facility reimbursed under this section operating
236.10payment rate adjustments equal to three percent of the operating payment rates in effect
236.11on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner
236.12shall make available to each nursing facility reimbursed under this section operating
236.13payment rate adjustments equal to three percent of the operating payment rates in effect
236.14on September 30, 2008.
236.15    (b) Seventy-five percent of the money resulting from the rate adjustments under
236.16paragraph (a) must be used for increases in compensation-related costs of eligible
236.17employees.
236.18    (c) For purposes of this subdivision, eligible employees includes all persons directly
236.19employed by the nursing facility on or after the effective date of the rate adjustments,
236.20except:
236.21    (1) persons employed in the central office of a corporation that has an ownership
236.22interest in the nursing facility or exercises control over the nursing facility; and
236.23    (2) persons paid by the nursing facility under a management contract.
236.24    (d) The commissioner shall allow as compensation-related costs all costs for:
236.25    (1) wages and salaries;
236.26    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
236.27compensation;
236.28    (3) the employer's share of health and dental insurance, life insurance, disability
236.29insurance, long-term care insurance, uniform allowance, and pensions; and
236.30    (4) other benefits provided, subject to the approval of the commissioner.
236.31    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the
236.32requirements in paragraph (b) shall be provided to nursing facilities effective October
236.331 of each year.
236.34    (f) Nursing facilities may apply for the portion of the rate adjustments under
236.35paragraph (a) that is subject to the requirements in paragraph (b). The application
237.1must be submitted to the commissioner within six months of the effective date of the
237.2rate adjustments, and the nursing facility must provide additional information required
237.3by the commissioner within nine months of the effective date of the rate adjustments.
237.4The commissioner must respond to all applications within three weeks of receipt.
237.5The commissioner may waive the deadlines in this paragraph under extraordinary
237.6circumstances, to be determined at the sole discretion of the commissioner. The
237.7application must contain:
237.8    (1) an estimate of the amounts of money that must be used as specified in paragraph
237.9(b);
237.10    (2) a detailed distribution plan specifying the allowable compensation-related
237.11increases the nursing facility will implement to use the funds available in clause (1);
237.12    (3) a description of how the nursing facility will notify eligible employees of
237.13the contents of the approved application, which must provide for giving each eligible
237.14employee a copy of the approved application, excluding the information required in clause
237.15(1), or posting a copy of the approved application, excluding the information required in
237.16clause (1), for a period of at least six weeks in an area of the nursing facility to which all
237.17eligible employees have access; and
237.18    (4) instructions for employees who believe they have not received the
237.19compensation-related increases specified in clause (2), as approved by the commissioner,
237.20and which must include a mailing address, e-mail address, and the telephone number
237.21that may be used by the employee to contact the commissioner or the commissioner's
237.22representative.
237.23    (g) The commissioner shall ensure that cost increases in distribution plans under
237.24paragraph (f), clause (2), that may be included in approved applications, comply with
237.25requirements in clauses (1) to (4):
237.26    (1) costs to be incurred during the applicable rate year resulting from wage and
237.27salary increases implemented prior to the first day of the nursing facility's payroll period
237.28that includes October 1 of each year shall be allowed if they were not used in a prior
237.29year's application;
237.30    (2) a portion of the costs resulting from tenure-related wage or salary increases may
237.31be considered to be allowable compensation-related increases, in accordance with existing
237.32formulas that the commissioner shall provide;
237.33    (3) the annualized amount of increases in costs for the employer's share of health
237.34and dental insurance, life insurance, disability insurance, and workers' compensation shall
237.35be allowable compensation-related increases if they are effective on or after April 1 of
238.1the year in which the rate adjustments are effective and prior to April 1 of the following
238.2year; and
238.3    (4) for nursing facilities in which employees are represented by an exclusive
238.4bargaining representative, an agreement negotiated and agreed to by the employer and
238.5the exclusive bargaining representative constitutes the plan. The commissioner shall not
238.6review and shall not require changes to the portions of the plan covered by collective
238.7bargaining agreements. A negotiated agreement may constitute the plan only if the
238.8agreement is finalized after the date of enactment of all increases for the rate year and
238.9signed by both parties prior to submission to the commissioner.
238.10    (h) The commissioner shall review applications received under paragraph (f) and
238.11shall provide the portion of the rate adjustments under paragraph (b) if the requirements of
238.12this subdivision have been met. The rate adjustments shall be effective October 1 of each
238.13year. Notwithstanding paragraph (a), if the approved application distributes less money
238.14than is available, the amount of the rate adjustment shall be reduced so that the amount of
238.15money made available is equal to the amount to be distributed.

238.16    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a
238.17subdivision to read:
238.18    Subd. 20. Payment of Public Employees Retirement Association costs. Nursing
238.19facilities that participate in the Public Employees Retirement Association (PERA) shall
238.20have the component of their payment rate associated with the costs of PERA determined
238.21for each rate year. Effective for rate years beginning on and after October 1, 2007, the
238.22commissioner shall determine the portion of the payment rate in effect on September 30
238.23each year and shall subtract that amount from the payment rate to be effective on the
238.24following October 1. The portion that shall be deemed to be included in the September 30,
238.252007, rate that is associated with PERA costs shall be the allowed costs in the facility's
238.26base for determining rates under this section, divided by the resident days reported for that
238.27year. The commissioner shall add to the payment rate to be effective on October 1 each
238.28year an amount equal to the reported costs associated with PERA, for the year ended on
238.29the most recent September 30 for which data is available, divided by total resident days
238.30for that year, as reported by the facility and audited under section 256B.441.

238.31    Sec. 64. Minnesota Statutes 2006, section 256B.437, is amended by adding a
238.32subdivision to read:
238.33    Subd. 11. Big Stone County rate adjustment. Notwithstanding the time period
238.34specified in subdivision 3, the commissioner shall approve a planned closure rate
239.1adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a
239.250-bed facility in Graceville. The adjustment shall be calculated according to subdivisions
239.33 and 6.

239.4    Sec. 65. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:
239.5    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a
239.6case mix index to each resident class based on the Centers for Medicare and Medicaid
239.7Services staff time measurement study and adjusted for Minnesota-specific wage indices.
239.8The case mix indices assigned to each resident class shall be published in the Minnesota
239.9State Register at least 120 days prior to the implementation of the 34 group, RUG-III
239.10resident classification system.
239.11    (b) An index maximization approach shall be used to classify residents.
239.12    (c) After implementation of the revised case mix system, the commissioner of
239.13human services may annually rebase case mix indices and base rates using more current
239.14data on average wage rates and staff time measurement studies. This rebasing shall be
239.15calculated under subdivision 7, paragraph (b). The commissioner shall publish in the
239.16Minnesota State Register adjusted case mix indices at least 45 days prior to the effective
239.17date of the adjusted case mix indices.

239.18    Sec. 66. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:
239.19    Subdivision 1. Development and implementation of quality profiles. (a) The
239.20commissioner of human services, in cooperation with the commissioner of health, shall
239.21develop and implement a quality profile system for nursing facilities and, beginning not
239.22later than July 1, 2004, other providers of long-term care services, except when the quality
239.23profile system would duplicate requirements under section 256B.5011, 256B.5012, or
239.24256B.5013 . Beginning July 1, 2008, the commissioners shall include quality profiles of
239.25nursing homes that are not medical assistance certified in the Minnesota Nursing Home
239.26Report Card. The nonmedical assistance certified nursing homes may provide to the
239.27commissioners information necessary to conduct consumer satisfaction surveys and to
239.28determine other quality measures. The system must be developed and implemented to the
239.29extent possible without the collection of significant amounts of new data. To the extent
239.30possible, the system must incorporate or be coordinated with information on quality
239.31maintained by area agencies on aging, long-term care trade associations, and other entities.
239.32The system must be designed to provide information on quality to:
239.33    (1) consumers and their families to facilitate informed choices of service providers;
240.1    (2) providers to enable them to measure the results of their quality improvement
240.2efforts and compare quality achievements with other service providers; and
240.3    (3) public and private purchasers of long-term care services to enable them to
240.4purchase high-quality care.
240.5    (b) The system must be developed in consultation with the long-term care task force,
240.6area agencies on aging, and representatives of consumers, providers, and labor unions.
240.7Within the limits of available appropriations, the commissioners may employ consultants
240.8to assist with this project.

240.9    Sec. 67. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:
240.10    Subdivision 1. Rate determination Rebasing of nursing facility operating cost
240.11payment rates. (a) The commissioner shall establish a value-based nursing facility
240.12reimbursement system which will provide facility-specific, prospective rates for nursing
240.13facilities participating in the medical assistance program. The rates shall be determined
240.14using an annual statistical and cost report filed by each nursing facility. The total payment
240.15rate shall be composed of four rate components: direct care services, support services,
240.16external fixed, and property-related rate components. The payment rate shall be derived
240.17from statistical measures of actual costs incurred in facility operation of nursing facilities.
240.18From this cost basis, the components of the total payment rate shall be adjusted for quality
240.19of services provided, recognition of staffing levels, geographic variation in labor costs, and
240.20resident acuity. The commissioner shall rebase nursing facility operating cost payment
240.21rates to align payments to facilities with the cost of providing care. The rebased operating
240.22cost payment rates shall be calculated using the statistical and cost report filed by each
240.23nursing facility for the report period ending one year prior to the rate year.
240.24    (b) Rates shall be rebased annually. The new operating cost payment rates based on
240.25this section shall take effect beginning with the rate year beginning October 1, 2009, and
240.26shall be phased in over three rate years through October 1, 2011.
240.27    (c) Operating cost payment rates shall be rebased on October 1, 2012, and every
240.28two years after that date.
240.29    (d) Operating cost payment rates for rate years in which rebasing does not occur
240.30shall be increased by the Global Insight SNF Market Basket inflation factor from the
240.31midpoint of the previous rate year to the midpoint of the next rate year.
240.32    (e) Each cost reporting year shall begin on October 1 and end on the following
240.33September 30. Beginning in 2006, a statistical and cost report shall be filed by each
240.34nursing facility by January 15. Notice of rates shall be distributed by August 15 and the
240.35rates shall go into effect on October 1 for one year.
241.1    (c) The commissioner shall begin to phase in the new reimbursement system
241.2beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.

241.3    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:
241.4    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to
241.542 42a have the meanings given unless otherwise provided for in this section.

241.6    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:
241.7    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for
241.8administering the overall activities of the nursing home. These costs include salaries and
241.9wages of the administrator, assistant administrator, business office employees, security
241.10guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
241.11related to business office functions, licenses, and permits except as provided in the
241.12external fixed costs category, employee recognition, travel including meals and lodging,
241.13training, voice and data communication or transmission, office supplies, liability insurance
241.14and other forms of insurance not designated to other areas, personnel recruitment, legal
241.15services, accounting services, management or business consultants, data processing,
241.16information technology, Web site, central or home office costs, business meetings and
241.17seminars, postage, fees for professional organizations, subscriptions, security services,
241.18advertising, board of director's fees, working capital interest expense, and bad debts and
241.19bad debt collection fees.

241.20    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:
241.21    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility
241.22which are necessary for the operation of the facility and the care of residents and which
241.23are reviewed by the department for accuracy, reasonableness, and compliance with this
241.24section and generally accepted accounting principles. All references to costs in this section
241.25shall be assumed to refer to allowed costs.

241.26    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to
241.27read:
241.28    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages
241.29of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees
241.30assigned to the kitchen and dining room, and associated fringe benefits and payroll
241.31taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs
241.32of raw food (both normal and special diet food), dietary supplies, and food preparation
242.1and serving. Also included are special dietary supplements used for tube feeding or oral
242.2feeding, such as elemental high nitrogen diet, even if written as a prescription item by a
242.3physician.

242.4    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to
242.5read:
242.6    Subd. 11. Direct care costs category. "Direct care costs category" "Direct care
242.7costs" means costs for nursing services, activities, and social services the wages of nursing
242.8administration, staff education, direct care registered nurses, licensed practical nurses,
242.9certified nursing assistants, trained medication aides, and associated fringe benefits and
242.10payroll taxes; services from a supplemental nursing services agency; supplies that are
242.11stocked at nursing stations or on the floor and distributed or used individually, including,
242.12but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice
242.13bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
242.14enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products,
242.15thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
242.16agents, drugs that are not paid for on a separate fee schedule by the medical assistance
242.17program or any other payer, and technology related to the provision of nursing care to
242.18residents, such as electronic charting systems.

242.19    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to
242.20read:
242.21    Subd. 13. External fixed costs category. "External fixed costs category" "External
242.22fixed costs" means costs related to the nursing home surcharge under section 256.9657,
242.23subdivision 1 ; licensure fees under section 144.122; long-term care consultation fees
242.24under section 256B.0911, subdivision 6; family advisory council fee under section
242.25 144A.33 ; scholarships under section 256B.431, subdivision 36; planned closure rate
242.26adjustments under section 256B.436 or 256B.437; or single bed room incentives under
242.27section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

242.28    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to
242.29read:
242.30    Subd. 14. Facility average case mix index. "Facility average case mix index" or
242.31"CMI" means a numerical value score that describes the relative resource use for all
242.32residents within the groups under the resource utilization group (RUG-III) classification
242.33system prescribed by the commissioner based on an assessment of each resident. The
243.1facility average CMI shall be computed as the standardized days divided by total days for
243.2all residents in the facility. The RUG's weights used in this section shall be as follows
243.3for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB
243.41.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2
243.51.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676;
243.6BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023;
243.7PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1
243.80.651; and DDF 1.000

243.9    Sec. 75. Minnesota Statutes 2006, section 256B.441, is amended by adding a
243.10subdivision to read:
243.11    Subd. 14a. Facility type groups. Facilities shall be classified into two groups,
243.12called "facility type groups," which shall consist of:
243.13    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota
243.14Rules, parts 9570.2000 to 9570.3400; and
243.15    (2) freestanding: all other facilities.

243.16    Sec. 76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to
243.17read:
243.18    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group
243.19life, health, dental, workers' compensation, and other employee insurances and pension,
243.20profit-sharing, and retirement plans for which the employer pays all or a portion of the
243.21costs and that are available to at least all employees who work at least 20 hours per week.

243.22    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to
243.23read:
243.24    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the
243.25salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
243.26employees and associated fringe benefits and payroll taxes. It also includes the cost of
243.27housekeeping supplies, including, but not limited to, cleaning and lavatory supplies and
243.28contract services.

243.29    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to
243.30read:
243.31    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant
243.32operations costs" means the costs for the salaries and wages of the maintenance supervisor,
244.1engineers, heating-plant employees, and other maintenance employees and associated
244.2fringe benefits and payroll taxes. It also includes direct costs for maintenance and
244.3operation of the building and grounds, including, but not limited to, fuel, electricity,
244.4medical waste and garbage removal, water, sewer, supplies, tools, and repairs.

244.5    Sec. 79. Minnesota Statutes 2006, section 256B.441, is amended by adding a
244.6subdivision to read:
244.7    Subd. 28a. Other direct care costs. "Other direct care costs" means the costs
244.8for the salaries and wages and associated fringe benefits and payroll taxes of mental
244.9health workers, religious personnel, and other direct care employees not specified in
244.10the definition of direct care costs.

244.11    Sec. 80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to
244.12read:
244.13    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer
244.14groups," which by county. The groups shall consist of:
244.15    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed
244.16per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000
244.17to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
244.18Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
244.19Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
244.20    (2) boarding care homes - facilities that have more than 50 percent of their beds
244.21licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth,
244.22Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard,
244.23Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod,
244.24Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca,
244.25Watonwan, or Wilkin County; and
244.26    (3) standard - all other facilities group three: facilities in all other counties.

244.27    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to
244.28read:
244.29    Subd. 31. Prior rate-setting method system operating cost payment rate. "Prior
244.30rate-setting method" "Prior system operating cost payment rate" means the operating cost
244.31payment rate determination process in effect prior to October 1, 2006 on September 30,
244.322009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate
245.1adjustments under section 256B.436 or 256B.437, or single bed room incentives under
245.2section 256B.431, subdivision 42.

245.3    Sec. 82. Minnesota Statutes 2006, section 256B.441, is amended by adding a
245.4subdivision to read:
245.5    Subd. 33a. Raw food costs. "Raw food costs" means the cost of food provided to
245.6nursing facility residents. Also included are special dietary supplements used for tube
245.7feeding or oral feeding, such as elemental high nitrogen diet.

245.8    Sec. 83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to
245.9read:
245.10    Subd. 34. Related organization. "Related organization" means a person that
245.11furnishes goods or services to a nursing facility and that is a close relative of a nursing
245.12facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility,
245.13or an affiliate of a close relative of an affiliate of a nursing facility. As used in this
245.14subdivision, paragraphs (a) to (d) apply:
245.15    (a) "Affiliate" means a person that directly, or indirectly through one or more
245.16intermediaries, controls or is controlled by, or is under common control with another
245.17person.
245.18    (b) "Person" means an individual, a corporation, a partnership, an association, a
245.19trust, an unincorporated organization, or a government or political subdivision.
245.20    (c) "Close relative of an affiliate of a nursing facility" means an individual whose
245.21relationship by blood, marriage, or adoption to an individual who is an affiliate of a
245.22nursing facility is no more remote than first cousin.
245.23    (d) "Control" including the terms "controlling," "controlled by," and "under common
245.24control with" means the possession, direct or indirect, of the power to direct or cause the
245.25direction of the management, operations, or policies of a person, whether through the
245.26ownership of voting securities, by contract, or otherwise, or to influence in any manner
245.27other than through an arms length, legal transaction.

245.28    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to
245.29read:
245.30    Subd. 38. Social services costs. "Social services costs" means the costs for the
245.31salaries and wages of the supervisor and other social work employees, associated fringe
245.32benefits and payroll taxes, supplies, services, and consultants. This category includes the
245.33cost of those employees who manage and process admission to the nursing facility.

246.1    Sec. 85. Minnesota Statutes 2006, section 256B.441, is amended by adding a
246.2subdivision to read:
246.3    Subd. 42a. Therapy costs. "Therapy costs" means any costs related to medical
246.4assistance therapy services provided to residents that are not billed separately from the
246.5daily operating rate.

246.6    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a
246.7subdivision to read:
246.8    Subd. 48. Calculation of operating per diems. The direct care per diem for
246.9each facility shall be the facility's direct care costs divided by its standardized days.
246.10The other care-related per diem shall be the sum of the facility's activities costs, other
246.11direct care costs, raw food costs, therapy costs, and social services costs, divided by the
246.12facility's resident days. The other operating per diem shall be the sum of the facility's
246.13administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
246.14and plant operations costs divided by the facility's resident days.

246.15    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a
246.16subdivision to read:
246.17    Subd. 49. Determination of total care-related per diem. The total care-related
246.18per diem for each facility shall be the sum of the direct care per diem and the other
246.19care-related per diem.

246.20    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a
246.21subdivision to read:
246.22    Subd. 50. Determination of total care-related limit. The limit on the total
246.23care-related per diem shall be determined for each peer group and facility type group
246.24combination. A facility's total care-related per diems shall be limited to 120 percent of the
246.25median for the facility's peer and facility type group. The facility-specific direct care costs
246.26used in making this comparison and in the calculation of the median shall be based on a
246.27RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
246.28diem reduced to the limit. If a reduction of the total care-related per diem is necessary
246.29because of this limit, the reduction shall be made proportionally to both the direct care per
246.30diem and the other care-related per diem.

246.31    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a
246.32subdivision to read:
247.1    Subd. 51. Determination of other operating limit. The limit on the other operating
247.2per diem shall be determined for each peer group. A facility's other operating per diem
247.3shall be limited to 105 percent of the median for its peer group. A facility that is above
247.4that limit shall have its other operating per diem reduced to the limit.

247.5    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a
247.6subdivision to read:
247.7    Subd. 52. Determination of efficiency incentive. Each facility shall be eligible
247.8for an efficiency incentive based on its other operating per diem. A facility with an other
247.9operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency
247.10incentive. All other facilities shall receive an incentive calculated as 50 percent times the
247.11difference between the facility's other operating per diem and its other operating per diem
247.12limit, up to a maximum incentive of $3.

247.13    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a
247.14subdivision to read:
247.15    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
247.16shall calculate a payment rate for external fixed costs.
247.17    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
247.18shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
247.19home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
247.20result of its number of nursing home beds divided by its total number of licensed beds.
247.21    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
247.22shall be the amount of the fee divided by actual resident days.
247.23    (c) The portion related to scholarships shall be determined under section 256B.431,
247.24subdivision 36.
247.25    (d) The portion related to long-term care consultation shall be determined according
247.26to section 256B.0911, subdivision 6.
247.27    (e) The portion related to development and education of resident and family advisory
247.28councils under section 144A.33 shall be $5 divided by 365.
247.29    (f) The portion related to planned closure rate adjustments shall be as determined
247.30under sections 256B.436 and 256B.437, subdivision 6.
247.31    (g) The portions related to property insurance, real estate taxes, special assessments,
247.32and payments made in lieu of real estate taxes directly identified or allocated to the nursing
247.33facility shall be the actual amounts divided by actual resident days.
248.1    (h) The portion related to the Public Employees Retirement Association shall be
248.2actual costs divided by resident days.
248.3    (i) The single bed room incentives shall be as determined under section 256B.431,
248.4subdivision 42.
248.5    (j) The payment rate for external fixed costs shall be the sum of the amounts in
248.6paragraphs (a) to (i).

248.7    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a
248.8subdivision to read:
248.9    Subd. 54. Adjustment of per diem for inflation. The total care-related per diem
248.10and other operating per diem calculated under this section shall be adjusted for inflation to
248.11adjust for the delay between the reporting year and the rate year. The total care-related
248.12payment rate and other operating payment rate shall be calculated as the per diem
248.13increased by the Global Insight Consumer Price Index urban inflation factor for the period
248.14from the midpoint of the reporting year to the midpoint of the rate year.

248.15    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a
248.16subdivision to read:
248.17    Subd. 55. Determination of total payment rates. In rate years when rates are
248.18rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total
248.19care-related payment rate, other operating payment rate, efficiency incentive, external
248.20fixed cost rate, and the property rate determined under section 256B.434. To determine
248.21a total payment rate for each RUG's level, the total care-related payment rate shall be
248.22divided into the direct care payment rate and the other care-related payment rate, and the
248.23direct care payment rate multiplied by the RUG's weight for each RUG's level using the
248.24weights in subdivision 14.

248.25    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a
248.26subdivision to read:
248.27    Subd. 56. Phase-in of rebased operating cost payment rates. For the rate years
248.28beginning October 1, 2009, October 1, 2010, and October 1, 2011, the operating cost
248.29payment rate calculated under this section shall be phased in by blending it with the
248.30operating cost payment rate determined under section 256B.434. For the rate year
248.31beginning October 1, 2009, the operating cost payment rate for each facility shall be
248.3225 percent of the operating cost payment rate from this section, and 75 percent of the
248.33operating cost payment rate from section 256B.434. For the rate year beginning October 1,
249.12010, the operating cost payment rate for each facility shall be 35 percent of the operating
249.2cost payment rate from this section, and 65 percent of the operating cost payment rate
249.3from section 256B.434. For the rate year beginning October 1, 2011, the operating cost
249.4payment rate for each facility shall be the operating cost payment rate determined under
249.5this section. The blending of operating cost payment rates under this section shall be
249.6performed separately for each RUG's class.

249.7    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a
249.8subdivision to read:
249.9    Subd. 57. Adjustment for inflation during phase-in of rebased operating cost
249.10payment rates. During the phase-in of operating cost payment rates under subdivision
249.1156, both the operating costs per diem under this section and the operating cost payment
249.12rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year
249.13for the operating cost per diems shall be the Global Insight Consumer Price Index urban
249.14inflation factor from the midpoint of the reporting year to the midpoint of the current rate
249.15year. The adjustment for each year for the operating cost payment rate under section
249.16256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the
249.17midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.

249.18    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a
249.19subdivision to read:
249.20    Subd. 58. Hold harmless. For the rate years beginning October 1, 2009, October 1,
249.212010, and October 1, 2011, no nursing facility shall receive an operating cost payment
249.22rate less than its operating cost payment rate under section 256B.434. The comparison
249.23of operating cost payment rates under this section shall be made for each of the RUG's
249.24classes separately, and the operating cost payment rates under section 256B.434 used
249.25under this section shall not include the inflation increases described in subdivision 57.

249.26    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a
249.27subdivision to read:
249.28    Subd. 59. Appeals. Nursing facilities may appeal, as defined under section 256B.50,
249.29the determination of a payment rate established under this chapter.

249.30    Sec. 98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:
249.31    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and
249.32community-based service waivers, as authorized under section 1915(c) of the Social
250.1Security Act to serve persons under the age of 65 who are determined to require the level
250.2of care provided in a nursing home and persons who require the level of care provided in a
250.3hospital. The commissioner shall apply for the home and community-based waivers in
250.4order to:
250.5    (i) promote the support of persons with disabilities in the most integrated settings;
250.6    (ii) expand the availability of services for persons who are eligible for medical
250.7assistance;
250.8    (iii) promote cost-effective options to institutional care; and
250.9    (iv) obtain federal financial participation.
250.10    (b) The provision of waivered services to medical assistance recipients with
250.11disabilities shall comply with the requirements outlined in the federally approved
250.12applications for home and community-based services and subsequent amendments,
250.13including provision of services according to a service plan designed to meet the needs of
250.14the individual. For purposes of this section, the approved home and community-based
250.15application is considered the necessary federal requirement.
250.16    (c) The commissioner shall provide interested persons serving on agency advisory
250.17committees and, task forces, the Centers for Independent Living, and others upon who
250.18request, with to be on a list to receive, notice of, and an opportunity to comment on,
250.19at least 30 days before any effective dates, (1) any substantive changes to the state's
250.20disability services program manual, or (2) changes or amendments to the federally
250.21approved applications for home and community-based waivers, prior to their submission
250.22to the federal Centers for Medicare and Medicaid Services.
250.23    (d) The commissioner shall seek approval, as authorized under section 1915(c) of
250.24the Social Security Act, to allow medical assistance eligibility under this section for
250.25children under age 21 without deeming of parental income or assets.
250.26    (e) The commissioner shall seek approval, as authorized under section 1915(c) of
250.27the Social Act, to allow medical assistance eligibility under this section for individuals
250.28under age 65 without deeming the spouse's income or assets.

250.29    Sec. 99. Minnesota Statutes 2006, section 256B.49, is amended by adding a
250.30subdivision to read:
250.31    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
250.32seek federal approval for medical assistance reimbursement of independent living skills
250.33services, foster care waiver service, supported employment, prevocational service,
250.34structured day service, and adult day care under the home and community-based waiver
251.1for persons with a traumatic brain injury, the community alternatives for disabled
251.2individuals waivers, and the community alternative care waivers.
251.3    (b) Medical reimbursement shall be made only when the provider demonstrates
251.4evidence of its capacity to meet basic health, safety, and protection standards through
251.5one of the methods in paragraphs (c) to (e).
251.6    (c) The provider is licensed to provide services under chapter 245B and agrees to
251.7apply these standards to services funded through the traumatic brain injury, community
251.8alternatives for disabled, or community alternative care home and community-based
251.9waivers.
251.10    (d) The local agency contracting for the services certifies on a form provided by the
251.11commissioner that the provider has the capacity to meet the individual needs as identified
251.12in each person's individual service plan. When certifying that the service provider meets
251.13the necessary provider qualifications, the local agency shall verify that the provider has
251.14policies and procedures governing the following:
251.15    (1) protection of the consumer's rights and privacy;
251.16    (2) risk assessment and planning;
251.17    (3) record keeping and reporting of incidents and emergencies with documentation
251.18of corrective action if needed;
251.19    (4) service outcomes, regular reviews of progress, and periodic reports;
251.20    (5) complaint and grievance procedures;
251.21    (6) service termination or suspension;
251.22    (7) necessary training and supervision of direct care staff that includes:
251.23    (i) documentation in personnel files of 20 hours of orientation training in providing
251.24training related to service provision;
251.25    (ii) training in recognizing the symptoms and effects of certain disabilities, health
251.26conditions, and positive behavioral supports and interventions; and
251.27    (iii) a minimum of five hours of related training annually; and
251.28    (8) when applicable, the local agency shall verify that the provider has policies and
251.29procedures in place governing the following:
251.30    (i) safe medication administration;
251.31    (ii) proper handling of consumer funds; and
251.32    (iii) behavioral interventions that are in compliance with prohibitions and standards
251.33developed by the commissioner to meet federal requirements regarding the use of
251.34restraints and restrictive interventions.
252.1    (e) For foster care waiver services or independent living skills services, the local
252.2agency contracting for the services certifies on a form provided by the commissioner that
252.3the provider meets the following:
252.4    (1) the provider of foster care waiver services is licensed to provide adult foster
252.5care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under
252.6Minnesota Rules, parts 2960.3000 to 2960.3230;
252.7    (2) the provider of independent living skills services also provides licensed foster
252.8care services and agrees to apply the foster care standards under Minnesota Rules, parts
252.99555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart
252.108; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10
252.11and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those
252.12services; and
252.13    (3) the provider has policies and procedures applying to the provision of foster
252.14care waiver services or independent living skills services that govern (i) behavioral
252.15interventions that are in compliance with prohibitions and standards developed by the
252.16commissioner to meet federal requirements regarding the use of restraints and restrictive
252.17interventions and (ii) documentation of service needs and outcomes, regular reviews
252.18of progress, and periodic reports.
252.19    (f) The local agency shall review each provider's continued compliance with
252.20the basic health, safety, and protection standards on a regular basis. For the review
252.21of paragraph (e), the local agency shall coordinate the review with the county review
252.22of foster care licensure.
252.23EFFECTIVE DATE.This section is effective the day following final enactment.

252.24    Sec. 100. Minnesota Statutes 2006, section 256B.5012, is amended by adding a
252.25subdivision to read:
252.26    Subd. 7. ICF/MR rate increases October 1, 2007, and October 1, 2008. (a) For
252.27the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall
252.28make available to each facility reimbursed under this section an adjustment to the total
252.29operating payment rate of three percent.
252.30    (b) Seventy-five percent of the money resulting from the rate adjustment under
252.31paragraph (a) must be used to increase wages and benefits and pay associated costs for
252.32employees, except for administrative and central office employees. Seventy-five percent
252.33of the money received by a facility as a result of the rate adjustment provided in paragraph
252.34(a) must be used only for wage, benefit, and staff increases implemented on or after
252.35the effective date of the rate increase each year, and must not be used for increases
253.1implemented prior to that date. The wage adjustment eligible employees may receive may
253.2vary based on merit, seniority, or other factors determined by the provider.
253.3    (c) For each facility, the commissioner shall make available an adjustment, based
253.4on occupied beds, using the percentage specified in paragraph (a) multiplied by the total
253.5payment rate, including variable rate but excluding the property-related payment rate, in
253.6effect on the preceding day. The total payment rate must include the adjustment provided
253.7in section 256B.501, subdivision 12.
253.8    (d) A facility whose payment rates are governed by closure agreements, receivership
253.9agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment
253.10otherwise granted under this subdivision.
253.11    (e) A facility may apply for the portion of the payment rate adjustment provided
253.12under paragraph (a) for employee wages and benefits and associated costs. The application
253.13must be made to the commissioner and contain a plan by which the facility will distribute
253.14the funds according to paragraph (b). For facilities in which the employees are represented
253.15by an exclusive bargaining representative, an agreement negotiated and agreed to by
253.16the employer and the exclusive bargaining representative constitutes the plan. The
253.17commissioner shall not review, and shall not require changes, to the portion or portions
253.18of the plan covered by collective bargaining agreements. A negotiated agreement may
253.19constitute the plan only if the agreement is finalized after the date of enactment of all rate
253.20increases for the rate year. The commissioner shall review the plan to ensure that the
253.21payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a
253.22facility must submit its plan by March 31, 2008, and December 31, 2008, respectively.
253.23If a facility's plan is effective for its employees after the first day of the applicable rate
253.24period that the funds are available, the payment rate adjustment per diem is effective
253.25the same date as its plan.
253.26    (f) A copy of the approved distribution plan must be made available to all employees
253.27by giving each employee a copy or by posting it in an area of the facility to which all
253.28employees have access. If an employee does not receive the wage and benefit adjustment
253.29described in the facility's approved plan and is unable to resolve the problem with the
253.30facility's management or through the employee's union representative, the employee
253.31may contact the commissioner at an address or telephone number provided by the
253.32commissioner and included in the approved plan.

253.33    Sec. 101. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to
253.34read:
254.1    Subd. 23. Alternative services; elderly and disabled persons. (a) The
254.2commissioner may implement demonstration projects to create alternative integrated
254.3delivery systems for acute and long-term care services to elderly persons and persons
254.4with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
254.5coordination, improve access to quality services, and mitigate future cost increases.
254.6The commissioner may seek federal authority to combine Medicare and Medicaid
254.7capitation payments for the purpose of such demonstrations and may contract with
254.8Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
254.9services shall be administered according to the terms and conditions of the federal contract
254.10and demonstration provisions. For the purpose of administering medical assistance funds,
254.11demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
254.12of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
254.13with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
254.14items B and C, which do not apply to persons enrolling in demonstrations under this
254.15section. An initial open enrollment period may be provided. Persons who disenroll from
254.16demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
254.17to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
254.18the health plan's participation is subsequently terminated for any reason, the person shall
254.19be provided an opportunity to select a new health plan and shall have the right to change
254.20health plans within the first 60 days of enrollment in the second health plan. Persons
254.21required to participate in health plans under this section who fail to make a choice of
254.22health plan shall not be randomly assigned to health plans under these demonstrations.
254.23Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
254.24subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
254.25the commissioner may contract with managed care organizations, including counties, to
254.26serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
254.27disabled persons only. For persons with a primary diagnosis of developmental disability,
254.28serious and persistent mental illness, or serious emotional disturbance, the commissioner
254.29must ensure that the county authority has approved the demonstration and contracting
254.30design. Enrollment in these projects for persons with disabilities shall be voluntary. The
254.31commissioner shall not implement any demonstration project under this subdivision for
254.32persons with a primary diagnosis of developmental disabilities, serious and persistent
254.33mental illness, or serious emotional disturbance, without approval of the county board of
254.34the county in which the demonstration is being implemented.
254.35    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
254.36to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
255.19525.1330 , 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
255.2under this section projects for persons with developmental disabilities. The commissioner
255.3may capitate payments for ICF/MR services, waivered services for developmental
255.4disabilities, including case management services, day training and habilitation and
255.5alternative active treatment services, and other services as approved by the state and by
255.6the federal government. Case management and active treatment must be individualized
255.7and developed in accordance with a person-centered plan. Costs under these projects may
255.8not exceed costs that would have been incurred under fee-for-service. Beginning July 1,
255.92003, and until two four years after the pilot project implementation date, subcontractor
255.10participation in the long-term care developmental disability pilot is limited to a nonprofit
255.11long-term care system providing ICF/MR services, home and community-based waiver
255.12services, and in-home services to no more than 120 consumers with developmental
255.13disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the
255.14legislature prior to expansion of the developmental disability pilot project. This paragraph
255.15expires two four years after the implementation date of the pilot project.
255.16    (c) Before implementation of a demonstration project for disabled persons, the
255.17commissioner must provide information to appropriate committees of the house of
255.18representatives and senate and must involve representatives of affected disability groups
255.19in the design of the demonstration projects.
255.20    (d) A nursing facility reimbursed under the alternative reimbursement methodology
255.21in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
255.22provide services under paragraph (a). The commissioner shall amend the state plan and
255.23seek any federal waivers necessary to implement this paragraph.
255.24    (e) The commissioner, in consultation with the commissioners of commerce and
255.25health, may approve and implement programs for all-inclusive care for the elderly (PACE)
255.26according to federal laws and regulations governing that program and state laws or rules
255.27applicable to participating providers. The process for approval of these programs shall
255.28begin only after the commissioner receives grant money in an amount sufficient to cover
255.29the state share of the administrative and actuarial costs to implement the programs during
255.30state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
255.31account in the special revenue fund and are appropriated to the commissioner to be used
255.32solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
255.33not required to be licensed or certified as a health plan company as defined in section
255.3462Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
255.35and found to be eligible for services under the elderly waiver or community alternatives
255.36for disabled individuals or who are already eligible for Medicaid but meet level of
256.1care criteria for receipt of waiver services may choose to enroll in the PACE program.
256.2Medicare and Medicaid services will be provided according to this subdivision and
256.3federal Medicare and Medicaid requirements governing PACE providers and programs.
256.4PACE enrollees will receive Medicaid home and community-based services through the
256.5PACE provider as an alternative to services for which they would otherwise be eligible
256.6through home and community-based waiver programs and Medicaid State Plan Services.
256.7The commissioner shall establish Medicaid rates for PACE providers that do not exceed
256.8costs that would have been incurred under fee-for-service or other relevant managed care
256.9programs operated by the state.
256.10    (f) The commissioner shall seek federal approval to expand the Minnesota disability
256.11health options (MnDHO) program established under this subdivision in stages, first to
256.12regional population centers outside the seven-county metro area and then to all areas
256.13of the state. Until January 1, 2008 July 1, 2009, expansion for MnDHO projects that
256.14include home and community-based services is limited to the two projects and service
256.15areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that
256.16include home and community-based services shall remain voluntary. Costs for home
256.17and community-based services included under MnDHO must not exceed costs that
256.18would have been incurred under the fee-for-service program. In developing program
256.19specifications for expansion of integrated programs, the commissioner shall involve and
256.20consult the state-level stakeholder group established in subdivision 28, paragraph (d),
256.21including consultation on whether and how to include home and community-based waiver
256.22programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
256.23of the house and senate committees with jurisdiction over health and human services
256.24policy and finance by February 1, 2007.
256.25    (g) Notwithstanding section 256B.0261, health plans providing services under this
256.26section are responsible for home care targeted case management and relocation targeted
256.27case management. Services must be provided according to the terms of the waivers and
256.28contracts approved by the federal government.

256.29    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to
256.30read:
256.31    Subd. 28. Medicare special needs plans; medical assistance basic health care.
256.32    (a) The commissioner may contract with qualified Medicare-approved special needs
256.33plans to provide medical assistance basic health care services to persons with disabilities,
256.34including those with developmental disabilities. Basic health care services include:
257.1    (1) those services covered by the medical assistance state plan except for ICF/MR
257.2services, home and community-based waiver services, case management for persons with
257.3developmental disabilities under section 256B.0625, subdivision 20a, and personal care
257.4and certain home care services defined by the commissioner in consultation with the
257.5stakeholder group established under paragraph (d); and
257.6    (2) basic health care services may also include risk for up to 100 days of nursing
257.7facility services for persons who reside in a noninstitutional setting and home health
257.8services related to rehabilitation as defined by the commissioner after consultation with
257.9the stakeholder group.
257.10    The commissioner may exclude other medical assistance services from the basic
257.11health care benefit set. Enrollees in these plans can access any excluded services on the
257.12same basis as other medical assistance recipients who have not enrolled.
257.13    Unless a person is otherwise required to enroll in managed care, enrollment in these
257.14plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
257.15enrollment with an option to opt out is not voluntary enrollment.
257.16    (b) Beginning January 1, 2007, the commissioner may contract with qualified
257.17Medicare special needs plans to provide basic health care services under medical
257.18assistance to persons who are dually eligible for both Medicare and Medicaid and those
257.19Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
257.20The commissioner shall consult with the stakeholder group under paragraph (d) (e) in
257.21developing program specifications for these services. The commissioner shall report to
257.22the chairs of the house and senate committees with jurisdiction over health and human
257.23services policy and finance by February 1, 2007, on implementation of these programs and
257.24the need for increased funding for the ombudsman for managed care and other consumer
257.25assistance and protections needed due to enrollment in managed care of persons with
257.26disabilities. Payment for Medicaid services provided under this subdivision for the months
257.27of May and June will be made no earlier than July 1 of the same calendar year.
257.28    (c) Beginning January 1, 2008, the commissioner may expand contracting under this
257.29subdivision to all persons with disabilities not otherwise required to enroll in managed
257.30care.
257.31    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and
257.32senate committees with jurisdiction over health and human services policy and finance on
257.33the initial results of implementation of contracts with qualified Medicare special needs
257.34plans to provide basic health care services under medical assistance to persons who are
257.35dually eligible for both Medicare and Medicaid. This report shall include an overall
257.36assessment of the impact on quality of care including actual costs and benefits.
258.1    (e) The commissioner shall establish a state-level stakeholder group to provide
258.2advice on managed care programs for persons with disabilities, including both MnDHO
258.3and contracts with special needs plans that provide basic health care services as described
258.4in paragraphs (a) and (b). The stakeholder group shall include representatives of the
258.5counties and labor organizations representing county social service workers, members,
258.6consumer advocates, and providers, and provide advice on program expansions under this
258.7subdivision and subdivision 23, including:
258.8    (1) implementation efforts;
258.9    (2) consumer protections; and
258.10    (3) program specifications such as quality assurance measures, data collection and
258.11reporting, and evaluation of costs, quality, and results.; and
258.12    (4) county safety net protections for persons with disabilities.
258.13    (e) (f) Each plan under contract to provide medical assistance basic health care
258.14services shall establish a local or regional stakeholder group, including representatives
258.15of the counties covered by the plan and labor organizations representing county social
258.16service workers, members, consumer advocates, and current providers, for advice on
258.17issues that arise in the local or regional area.

258.18    Sec. 103. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.
258.19     (a) The commissioner of human services shall combine the existing biennial base
258.20level funding for deaf-blind services into a single grant program. At least 35 percent
258.21of the total funding is awarded for services and other supports to deaf-blind children
258.22and their families and at least 25 percent is awarded for services and other supports to
258.23deaf-blind adults.
258.24    The commissioner shall award grants for the purposes of:
258.25    (1) providing services and supports to individuals who are deaf-blind; and
258.26    (2) developing and providing training to counties and the network of senior citizen
258.27service providers. The purpose of the training grants is to teach counties how to use
258.28existing programs that capture federal financial participation to meet the needs of eligible
258.29deaf-blind persons and to build capacity of senior service programs to meet the needs of
258.30seniors with a dual sensory hearing and vision loss.
258.31    (b) The commissioner may make grants:
258.32    (1) for services and training provided by organizations; and
258.33    (2) to develop and administer consumer-directed services.
258.34    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant
258.35under paragraph (a).
259.1    (d) Deaf-blind service providers are not required to, but may, provide intervenor
259.2services as part of the service package provided with grant funds under this section.

259.3    Sec. 104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:
259.4    Subd. 2. Standard of assistance for persons eligible for medical assistance
259.5waivers or at risk of placement in a group residential housing facility. The state
259.6standard of assistance for a person (1) who is eligible for a medical assistance home
259.7and community-based services waiver or a person, (2) who has been determined by the
259.8local agency to meet the plan requirements for placement in a group residential housing
259.9facility under section 256I.04, subdivision 1a, or (3) who is eligible for a shelter needy
259.10payment under subdivision 5, paragraph (f), is the standard established in subdivision 3,
259.11paragraph (a) or (b).

259.12    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:
259.13    Subd. 5. Special needs. In addition to the state standards of assistance established in
259.14subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
259.15Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
259.16center, or a group residential housing facility.
259.17    (a) The county agency shall pay a monthly allowance for medically prescribed
259.18diets if the cost of those additional dietary needs cannot be met through some other
259.19maintenance benefit. The need for special diets or dietary items must be prescribed by
259.20a licensed physician. Costs for special diets shall be determined as percentages of the
259.21allotment for a one-person household under the thrifty food plan as defined by the United
259.22States Department of Agriculture. The types of diets and the percentages of the thrifty
259.23food plan that are covered are as follows:
259.24    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
259.25    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
259.26of thrifty food plan;
259.27    (3) controlled protein diet, less than 40 grams and requires special products, 125
259.28percent of thrifty food plan;
259.29    (4) low cholesterol diet, 25 percent of thrifty food plan;
259.30    (5) high residue diet, 20 percent of thrifty food plan;
259.31    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
259.32    (7) gluten-free diet, 25 percent of thrifty food plan;
259.33    (8) lactose-free diet, 25 percent of thrifty food plan;
259.34    (9) antidumping diet, 15 percent of thrifty food plan;
260.1    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
260.2    (11) ketogenic diet, 25 percent of thrifty food plan.
260.3    (b) Payment for nonrecurring special needs must be allowed for necessary home
260.4repairs or necessary repairs or replacement of household furniture and appliances using
260.5the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
260.6as long as other funding sources are not available.
260.7    (c) A fee for guardian or conservator service is allowed at a reasonable rate
260.8negotiated by the county or approved by the court. This rate shall not exceed five percent
260.9of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
260.10guardian or conservator is a member of the county agency staff, no fee is allowed.
260.11    (d) The county agency shall continue to pay a monthly allowance of $68 for
260.12restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
260.131990, and who eats two or more meals in a restaurant daily. The allowance must continue
260.14until the person has not received Minnesota supplemental aid for one full calendar month
260.15or until the person's living arrangement changes and the person no longer meets the criteria
260.16for the restaurant meal allowance, whichever occurs first.
260.17    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
260.18is allowed for representative payee services provided by an agency that meets the
260.19requirements under SSI regulations to charge a fee for representative payee services. This
260.20special need is available to all recipients of Minnesota supplemental aid regardless of
260.21their living arrangement.
260.22    (f) Notwithstanding the language in this subdivision, an amount equal to the
260.23maximum allotment authorized by the federal Food Stamp Program for a single individual
260.24which is in effect on the first day of January July of the previous each year will be added to
260.25the standards of assistance established in subdivisions 1 to 4 for individuals adults under
260.26the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or
260.27an adult mental health residential treatment program under section 256B.0622, and who
260.28are shelter needy; (2) self-directed supports option participants defined under section
260.29256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based
260.30waiver recipients living in their own rented, leased, or owned apartment or home not
260.31owned, operated, or controlled by a provider of service not related by blood or marriage.
260.32Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy
260.33benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible
260.34individual who receives this benefit prior to age 65 may continue to receive the benefit
260.35after the age of 65.
261.1    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not
261.2receiving medial assistance home and community-based waiver services, are eligible for
261.3a state-funded transitional supports allowance under section 256B.49, subdivision 16,
261.4paragraph (e), to establish their own residence not owned, operated, or controlled by a
261.5provider of service not related by blood or marriage.
261.6    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
261.7exceed 40 percent of the assistance unit's gross income before the application of this
261.8special needs standard. "Gross income" for the purposes of this section is the applicant's or
261.9recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
261.10in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
261.11state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
261.12considered shelter needy for purposes of this paragraph.

261.13    Sec. 106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:
261.14    Subd. 3. Moratorium on the development of group residential housing beds. (a)
261.15County agencies shall not enter into agreements for new group residential housing beds
261.16with total rates in excess of the MSA equivalent rate except: (1) for group residential
261.17housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
261.18provided the facility is needed to meet the census reduction targets for persons with
261.19developmental disabilities at regional treatment centers; (2) to ensure compliance with
261.20the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements
261.21for inappropriately placed persons with developmental disabilities or mental illness;
261.22(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
261.23provide housing for chronic inebriates who are repetitive users of detoxification centers
261.24and are refused placement in emergency shelters because of their state of intoxication,
261.25and planning for the specialized facility must have been initiated before July 1, 1991, in
261.26anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
261.27subdivision 20a , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for
261.28up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County
261.29for homeless adults with a mental illness, a history of substance abuse, or human
261.30immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this
261.31section, "homeless adult" means a person who is living on the street or in a shelter or
261.32discharged from a regional treatment center, community hospital, or residential treatment
261.33program and has no appropriate housing available and lacks the resources and support
261.34necessary to access appropriate housing. At least 70 percent of the supportive housing
261.35units must serve homeless adults with mental illness, substance abuse problems, or human
262.1immunodeficiency virus or acquired immunodeficiency syndrome who are about to be
262.2or, within the previous six months, has been discharged from a regional treatment center,
262.3or a state-contracted psychiatric bed in a community hospital, or a residential mental
262.4health or chemical dependency treatment program. If a person meets the requirements of
262.5subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group
262.6residential housing rate for that person is limited to the supplementary rate under section
262.7256I.05, subdivision 1a , and is determined by subtracting the amount of the person's
262.8countable income that exceeds the MSA equivalent rate from the group residential housing
262.9supplementary rate. A resident in a demonstration project site who no longer participates
262.10in the demonstration program shall retain eligibility for a group residential housing
262.11payment in an amount determined under section 256I.06, subdivision 8, using the MSA
262.12equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30,
262.131997, if federal matching funds are available and the services can be provided through a
262.14managed care entity. If federal matching funds are not available, then service funding will
262.15continue under section 256I.05, subdivision 1a; or (6) (5) for group residential housing
262.16beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which
262.17are used exclusively for recipients receiving home and community-based waiver services
262.18under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who
262.19resided in a nursing facility for the six months immediately prior to the month of entry
262.20into the group residential housing setting. The group residential housing rate for these
262.21beds must be set so that the monthly group residential housing payment for an individual
262.22occupying the bed when combined with the nonfederal share of services delivered under
262.23the waiver for that person does not exceed the nonfederal share of the monthly medical
262.24assistance payment made for the person to the nursing facility in which the person resided
262.25prior to entry into the group residential housing establishment. The rate may not exceed
262.26the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds,
262.27resulting in a total of 32 beds, for a facility located in Hennepin County providing services
262.28for recovering and chemically dependent men that has had a group residential housing
262.29contract with the county and has been licensed as a board and lodge facility with special
262.30services since 1980; (7) for a group residential housing provider located in Stearns County
262.31that operates a 40-bed facility, that received financing through the Minnesota Housing
262.32Finance Agency Ending Long-Term Homelessness Initiative and serves chemically
262.33dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential
262.34housing provider located in Crow Wing County that serves a chemically dependent
262.35clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length
262.36of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in
263.1St. Louis County which opened in January 2006 that will serve chemically dependent
263.2persons operated by a group residential housing provider that currently operates a 304-bed
263.3facility in Minneapolis; and (10) for a group residential housing provider that operates two
263.4ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
263.5which provide community support and serve the mental health needs of individuals who
263.6have chronically lived unsheltered, providing 24-hour-a-day supervision.
263.7    (b) A county agency may enter into a group residential housing agreement for beds
263.8with rates in excess of the MSA equivalent rate in addition to those currently covered
263.9under a group residential housing agreement if the additional beds are only a replacement
263.10of beds with rates in excess of the MSA equivalent rate which have been made available
263.11due to closure of a setting, a change of licensure or certification which removes the beds
263.12from group residential housing payment, or as a result of the downsizing of a group
263.13residential housing setting. The transfer of available beds from one county to another can
263.14only occur by the agreement of both counties.

263.15    Sec. 107. Minnesota Statutes 2006, section 256I.05, is amended by adding a
263.16subdivision to read:
263.17    Subd. 1h. Supplementary rate for certain facilities serving chemically
263.18dependent males. Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a
263.19county agency shall negotiate a supplementary rate in addition to the rate specified in
263.20subdivision 1, not to exceed $737.87 per month, including any legislatively authorized
263.21inflationary adjustments, for a group residential housing provider that:
263.22    (1) is located in Ramsey County and has had a group residential housing contract
263.23with the county since 1982 and has been licensed as a board and lodge facility with special
263.24services since 1979; and
263.25    (2) serves recovering and chemically dependent males, providing 24-hour-a-day
263.26supervision.

263.27    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a
263.28subdivision to read:
263.29    Subd. 1i. Supplementary rate for certain facilities; Hennepin County.
263.30    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate
263.31a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
263.32per month, including any legislatively authorized inflationary adjustments, for a facility
263.33located in Hennepin County with a capacity of up to 48 beds that has been licensed since
264.11978 as a board and lodging facility and that until August 1, 2007, operated as a licensed
264.2chemical dependency treatment program.
264.3EFFECTIVE DATE.This section is effective the day following final enactment.

264.4    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a
264.5subdivision to read:
264.6    Subd. 1j. Supplementary rate for certain facilities; St. Louis County. (a)
264.7Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
264.8county agency shall negotiate a supplementary rate in addition to the rate specified in
264.9subdivision 1, not to exceed $700 per month, including any legislatively authorized
264.10inflationary adjustments, for a 60-bed facility in St. Louis County which opened in
264.11January 2006 that will serve chemically dependent persons operated by a group residential
264.12housing provider that currently operates a 304-bed facility in Minneapolis.
264.13    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not
264.14already receive a supplementary rate.

264.15    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a
264.16subdivision to read:
264.17    Subd. 1k. Supplementary rate for certain facilities; Crow Wing County.
264.18    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
264.19county agency shall negotiate a supplementary rate in addition to the rate specified in
264.20subdivision 1, not to exceed $700 per month, including any legislatively authorized
264.21inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve
264.22chemically dependent persons operated by a group residential housing provider that
264.23currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which
264.24opened in January of 2006.

264.25    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a
264.26subdivision to read:
264.27    Subd. 1l. Supplementary rate for certain facilities; Stearns County.
264.28    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
264.29shall negotiate a supplementary service rate in addition to the rate specified in subdivision
264.301, not to exceed $700 per month, including any legislatively authorized inflationary
264.31adjustments, for a group residential housing provider located in Stearns County that
264.32operates a 40-bed facility, that received financing through the Minnesota Housing Finance
265.1Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
265.2clientele, providing 24-hour-a-day supervision.

265.3    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a
265.4subdivision to read:
265.5    Subd. 1m. Supplementary rate for certain facilities; St. Louis County.
265.6    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
265.7shall negotiate a supplementary service rate in addition to the rate specified in subdivision
265.81, not to exceed $700 per month, including any legislatively authorized inflationary
265.9adjustments, for a group residential housing provider located in St. Louis County that
265.10operates a 30-bed facility, that received financing through the Minnesota Housing Finance
265.11Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
265.12clientele, providing 24-hour-a-day supervision.

265.13    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a
265.14subdivision to read:
265.15    Subd. 1n. Supplemental rate for certain facilities; Hennepin and Ramsey
265.16Counties. Notwithstanding the provisions of this section, beginning July 1, 2007, a county
265.17agency shall negotiate a supplemental service rate in addition to the rate specified in
265.18subdivision 1, not to exceed $715.78 per month, including any legislatively authorized
265.19inflationary adjustments, for a group residential housing provider that operates two
265.20ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
265.21which provide community support and serve the mental health needs of individuals who
265.22have chronically lived unsheltered, providing 24-hour-a-day supervision.

265.23    Sec. 114. Laws 2000, chapter 340, section 19, is amended to read:
265.24    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.
265.25    (a) Expenditures for housing with services and adult foster care shall be excluded
265.26when determining average monthly expenditures per client for alternative care pilot
265.27projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.
265.28    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall
265.29continue until June 30, 2005 2007.
265.30EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for
265.31activities related to discontinuing pilot projects under this section.

265.32    Sec. 115. Laws 2006, chapter 282, article 20, section 37, is amended to read:
266.1    Sec. 37. REPAYMENT DELAY.
266.2    A county that overspent its allowed amounts in calendar year 2004 or 2005 under
266.3the waivered services program for persons with developmental disabilities shall not be
266.4required to pay back the amount of overspending until May 31, 2007.
266.5EFFECTIVE DATE.This section is effective the day following final enactment.

266.6    Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.
266.7    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the
266.8recommendation of a county agency, the commissioner of human services shall grant a
266.9license with any necessary variances to a nonresidential program for youth which provides
266.10services to youth with disabilities under age 21 during nonschool hours established
266.11to ensure health and safety, prevent out-of-home placement, and increase community
266.12inclusion of youth with disabilities. The nonresidential youth program is subject to the
266.13conditions of any variances granted and with consumer rights under Minnesota Statutes,
266.14section 245B.04, consumer protection standards under Minnesota Statutes, section
266.15245B.05, service standards under Minnesota Statutes, section 245B.06, management
266.16standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under
266.17Minnesota Statutes, section 245A.151, until the commissioner develops other licensure
266.18requirements for this type of program.
266.19    (b) By February 1, 2008, the commissioner shall recommend amendments to
266.20licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of
266.21appropriate services for school-age youth with disabilities under age 21 who need
266.22supervision and services to develop skills necessary to maintain personal safety and
266.23increase their independence, productivity, and participation in their communities during
266.24nonschool hours. As part of developing the recommendations, the commissioner shall
266.25survey county agencies to determine how the needs of youth with disabilities under age 21
266.26who require supervision and support services are being met and the funding sources used.
266.27The recommendations must be provided to the house and senate chairs of the committees
266.28with jurisdiction over licensing of programs for youth with disabilities.

266.29    Sec. 117. INDEPENDENT LIVING.
266.30    An individual who has lived in one of the facilities under Minnesota Statutes,
266.31section 256I.05, subdivision 1n, who is being transitioned to independent living as
266.32part of the program plan continues to be eligible for group residential housing and the
266.33supplemental service rate negotiated with the county under Minnesota Statutes, section
266.34256I.05, subdivision 1n.

267.1    Sec. 118. ASSISTIVE TECHNOLOGY STUDY AND REPORT.
267.2    Subdivision 1. Study. (a) During the biennium ending June 30, 2009, the Council
267.3on Disability shall facilitate a statewide study of the assistive technology needs of
267.4people with disabling conditions, and seniors. As part of the study, the council shall
267.5identify community-based service providers, state agencies, and other entities involved in
267.6providing assistive technology supports. The study shall also examine the creation of an
267.7assistive technology pretax savings account to allow disabled persons to set aside pretax
267.8and unearned income to purchase assistive technology devices, equipment, and services.
267.9    (b) The council shall provide oversight and direction to the Minnesota Regions
267.10Assistive Technology Collaborative during the biennium ending June 30, 2009.
267.11    Subd. 2. Report. The council shall present to the chairs of the house and senate
267.12committees having jurisdiction over human services, by January 1, 2009, a report of the
267.13findings of the study, including proposed legislation creating a statewide comprehensive
267.14plan to meet the assistive technology needs of people with disabling conditions and
267.15seniors. The statewide plan must include steps to coordinate and streamline assistive
267.16technology services and the creation of an assistive technology pretax savings account.

267.17    Sec. 119. COMMUNITY SERVICES PROVIDER RATE INCREASES.
267.18    (a) The commissioner of human services shall increase allocations, reimbursement
267.19rates, or rate limits, as applicable, by three percent for the rate period beginning October 1,
267.202007, and the rate period beginning October 1, 2008, effective for services rendered on
267.21or after those dates.
267.22    (b) The three percent annual rate increase described in this section must be provided
267.23to:
267.24    (1) home and community-based waivered services for persons with developmental
267.25disabilities or related conditions under Minnesota Statutes, section 256B.501;
267.26    (2) home and community-based waivered services for the elderly under Minnesota
267.27Statutes, section 256B.0915;
267.28    (3) waivered services under community alternatives for disabled individuals under
267.29Minnesota Statutes, section 256B.49;
267.30    (4) community alternative care waivered services under Minnesota Statutes, section
267.31256B.49;
267.32    (5) traumatic brain injury waivered services under Minnesota Statutes, section
267.33256B.49;
267.34    (6) nursing services and home health services under Minnesota Statutes, section
267.35256B.0625, subdivision 6a;
268.1    (7) personal care services and nursing supervision of personal care services under
268.2Minnesota Statutes, section 256B.0625, subdivision 19a;
268.3    (8) private duty nursing services under Minnesota Statutes, section 256B.0625,
268.4subdivision 7;
268.5    (9) day training and habilitation services for adults with developmental disabilities
268.6or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
268.7additional cost of rate adjustments on day training and habilitation service, provided as a
268.8social service under Minnesota Statutes, section 256M.60;
268.9    (10) alternative care services under Minnesota Statutes, section 256B.0913;
268.10    (11) adult residential program grants under Minnesota Statutes, section 245.73;
268.11    (12) adult and children's mental health grants under Minnesota Rules, parts
268.129535.1700 to 9535.1760;
268.13    (13) the group residential housing supplementary service rate under Minnesota
268.14Statutes, section 256I.05, subdivision 1a;
268.15    (14) adult mental health integrated fund grants under Minnesota Statutes, section
268.16245.4661;
268.17    (15) semi-independent living services (SILS) under Minnesota Statutes, section
268.18252.275, including SILS funding under county social services grants formerly funded
268.19under Minnesota Statutes, chapter 256I;
268.20    (16) community support services for deaf and hard-of-hearing adults with mental
268.21illness who use or wish to use sign language as their primary means of communication
268.22under Minnesota Statutes, section 256.01, subdivision 2;
268.23    (17) living skills training programs for persons with intractable epilepsy who need
268.24assistance in the transition to independent living under Laws 1988, chapter 689;
268.25    (18) physical therapy services under Minnesota Statutes, sections 256B.0625,
268.26subdivision 8, and 256D.03, subdivision 4;
268.27    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625,
268.28subdivision 8a, and 256D.03, subdivision 4;
268.29    (20) speech-language therapy services under Minnesota Statutes, section 256D.03,
268.30subdivision 4, and Minnesota Rules, part 9505.0390;
268.31    (21) respiratory therapy services under Minnesota Statutes, section 256D.03,
268.32subdivision 4, and Minnesota Rules, part 9505.0295;
268.33    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
268.34and 256B.0928;
269.1    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233;
269.2256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter
269.35, section 20;
269.4    (24) children's therapeutic services and supports under Minnesota Statutes, section
269.5256B.0943;
269.6    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;
269.7    (26) consumer support grants under Minnesota Statutes, section 256.476;
269.8    (27) family support grants under Minnesota Statutes, section 252.32;
269.9    (28) case management services to persons with HIV or AIDS under Minnesota
269.10Statutes, section 256.01, subdivision 19; and
269.11    (29) adult rehabilitative mental health services under Minnesota Statutes, section
269.12256B.0623.
269.13    (c) Providers that receive a rate increase under this section shall use 75 percent of
269.14the additional revenue to increase wages and benefits and pay associated costs for all
269.15employees, except for management fees, the administrator, and central office staff.
269.16    (d) For public employees, the increase for wages and benefits for certain staff is
269.17available and pay rates must be increased only to the extent that they comply with laws
269.18governing public employees' collective bargaining. Money received by a provider for pay
269.19increases under this section may be used only for increases implemented on or after the
269.20first day of the rate period in which the increase is available and must not be used for
269.21increases implemented prior to that date.
269.22    (e) A copy of the provider's plan for complying with paragraph (c) must be made
269.23available to all employees by giving each employee a copy or by posting a copy in an area
269.24of the provider's operation to which all employees have access. If an employee does not
269.25receive the adjustment, if any, described in the plan and is unable to resolve the problem
269.26with the provider, the employee may contact the employee's union representative. If the
269.27employee is not covered by a collective bargaining agreement, the employee may contact
269.28the commissioner at a telephone number provided by the commissioner and included in
269.29the provider's plan.
269.30    (f) The commissioner and each county agency shall take steps necessary to
269.31implement the increases required by this section on the dates specified, and the increases
269.32must be effective on the dates specified, regardless of the client's service authorization date
269.33and notwithstanding the terms of any provider contract, service agreement, or schedule
269.34that limits when a county may increase payment rates.

269.35    Sec. 120. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.
270.1    The commissioner of human services shall study access to dental services for
270.2persons with disabilities, and shall present recommendations for improving access to
270.3dental services to the legislature by January 15, 2008. The study must examine physical
270.4and geographic access, the willingness of dentists to serve persons with disabilities
270.5enrolled in state health care programs, reimbursement rates for dental service providers,
270.6and other factors identified by the commissioner.

270.7    Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
270.8    By October 1, 2007, the commissioner shall seek federal approval to allow persons
270.9who have been eligible for medical assistance for employed persons with disabilities
270.10(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24
270.11consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility
270.12rules as long as they qualify.

270.13    Sec. 122. MINNESOTA RULES.
270.14    The Department of Administration shall publish adopted rules in the State Register
270.15making the terminology changes specified in section 92 in Minnesota Rules. Upon
270.16publication in the State Register, the terminology changes for Minnesota Rules are
270.17adopted without further administrative action.

270.18    Sec. 123. REVISOR'S INSTRUCTION.
270.19    The revisor of statutes shall change the terms in column A to the terms in column B
270.20wherever they appear in Minnesota Statutes:

270.21		Column A		Column B
270.22 270.23 270.24 270.25 270.26		"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans"		"Office of Ombudsman for Long-Term Care"
270.27 270.28		"ombudsman for older Minnesotans"		"ombudsman for long-term care"

270.29    Sec. 124. REPEALER.
270.30Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
270.31252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h;
270.32and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.

271.1ARTICLE 5

271.2MENTAL HEALTH

271.3    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to
271.4read:
271.5    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the
271.6brain or a clinically significant disorder of thought, mood, perception, orientation,
271.7memory, or behavior that is listed in the clinical manual of the International Classification
271.8of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0
271.9or the corresponding code in the American Psychiatric Association's Diagnostic and
271.10Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and
271.11that seriously limits a person's capacity to function in primary aspects of daily living such
271.12as personal relations, living arrangements, work, and recreation.
271.13    (b) An "adult with acute mental illness" means an adult who has a mental illness that
271.14is serious enough to require prompt intervention.
271.15    (c) For purposes of case management and community support services, a "person
271.16with serious and persistent mental illness" means an adult who has a mental illness and
271.17meets at least one of the following criteria:
271.18    (1) the adult has undergone two or more episodes of inpatient care for a mental
271.19illness within the preceding 24 months;
271.20    (2) the adult has experienced a continuous psychiatric hospitalization or residential
271.21treatment exceeding six months' duration within the preceding 12 months;
271.22    (3) the adult has been treated by a crisis team two or more times within the preceding
271.2324 months;
271.24    (4) the adult:
271.25    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline
271.26personality disorder;
271.27    (ii) indicates a significant impairment in functioning; and
271.28    (iii) has a written opinion from a mental health professional, in the last three years,
271.29stating that the adult is reasonably likely to have future episodes requiring inpatient or
271.30residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
271.31management or community support services are provided;
271.32    (4) (5) the adult has, in the last three years, been committed by a court as a person
271.33who is mentally ill under chapter 253B, or the adult's commitment has been stayed or
271.34continued; or
272.1    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time
272.2period has expired or the adult was eligible as a child under section 245.4871, subdivision
272.36 ; and (ii) has a written opinion from a mental health professional, in the last three years,
272.4stating that the adult is reasonably likely to have future episodes requiring inpatient or
272.5residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
272.6management or community support services are provided.

272.7    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision
272.8to read:
272.9    Subd. 3. Responsibility not duplicated. For individuals who have health care
272.10coverage, the county board is not responsible for providing mental health services which
272.11are within the limits of the individual's health care coverage.

272.12    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:
272.13245.4874 DUTIES OF COUNTY BOARD.
272.14    Subdivision 1. Duties of the county board. (a) The county board must:
272.15    (1) develop a system of affordable and locally available children's mental health
272.16services according to sections 245.487 to 245.4887;
272.17    (2) establish a mechanism providing for interagency coordination as specified in
272.18section 245.4875, subdivision 6;
272.19    (3) consider the assessment of unmet needs in the county as reported by the local
272.20children's mental health advisory council under section 245.4875, subdivision 5, paragraph
272.21(b), clause (3). The county shall provide, upon request of the local children's mental health
272.22advisory council, readily available data to assist in the determination of unmet needs;
272.23    (4) assure that parents and providers in the county receive information about how to
272.24gain access to services provided according to sections 245.487 to 245.4887;
272.25    (5) coordinate the delivery of children's mental health services with services
272.26provided by social services, education, corrections, health, and vocational agencies to
272.27improve the availability of mental health services to children and the cost-effectiveness of
272.28their delivery;
272.29    (6) assure that mental health services delivered according to sections 245.487
272.30to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
272.31assessment and individual treatment plan;
272.32    (7) provide the community with information about predictors and symptoms of
272.33emotional disturbances and how to access children's mental health services according to
272.34sections 245.4877 and 245.4878;
273.1    (8) provide for case management services to each child with severe emotional
273.2disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
273.3subdivisions 1, 3, and 5 ;
273.4    (9) provide for screening of each child under section 245.4885 upon admission
273.5to a residential treatment facility, acute care hospital inpatient treatment, or informal
273.6admission to a regional treatment center;
273.7    (10) prudently administer grants and purchase-of-service contracts that the county
273.8board determines are necessary to fulfill its responsibilities under sections 245.487 to
273.9245.4887 ;
273.10    (11) assure that mental health professionals, mental health practitioners, and case
273.11managers employed by or under contract to the county to provide mental health services
273.12are qualified under section 245.4871;
273.13    (12) assure that children's mental health services are coordinated with adult mental
273.14health services specified in sections 245.461 to 245.486 so that a continuum of mental
273.15health services is available to serve persons with mental illness, regardless of the person's
273.16age;
273.17    (13) assure that culturally informed mental health consultants are used as necessary
273.18to assist the county board in assessing and providing appropriate treatment for children of
273.19cultural or racial minority heritage; and
273.20    (14) consistent with section 245.486, arrange for or provide a children's mental
273.21health screening to a child receiving child protective services or a child in out-of-home
273.22placement, a child for whom parental rights have been terminated, a child found to be
273.23delinquent, and a child found to have committed a juvenile petty offense for the third or
273.24subsequent time, unless a screening has been performed within the previous 180 days, or
273.25the child is currently under the care of a mental health professional. The court or county
273.26agency must notify a parent or guardian whose parental rights have not been terminated of
273.27the potential mental health screening and the option to prevent the screening by notifying
273.28the court or county agency in writing. The screening shall be conducted with a screening
273.29instrument approved by the commissioner of human services according to criteria that
273.30are updated and issued annually to ensure that approved screening instruments are valid
273.31and useful for child welfare and juvenile justice populations, and shall be conducted
273.32by a mental health practitioner as defined in section 245.4871, subdivision 26, or a
273.33probation officer or local social services agency staff person who is trained in the use of
273.34the screening instrument. Training in the use of the instrument shall include training in the
273.35administration of the instrument, the interpretation of its validity given the child's current
273.36circumstances, the state and federal data practices laws and confidentiality standards, the
274.1parental consent requirement, and providing respect for families and cultural values.
274.2If the screen indicates a need for assessment, the child's family, or if the family lacks
274.3mental health insurance, the local social services agency, in consultation with the child's
274.4family, shall have conducted a diagnostic assessment, including a functional assessment,
274.5as defined in section 245.4871. The administration of the screening shall safeguard the
274.6privacy of children receiving the screening and their families and shall comply with the
274.7Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance
274.8Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be
274.9considered private data and the commissioner shall not collect individual screening results.
274.10    (b) When the county board refers clients to providers of children's therapeutic
274.11services and supports under section 256B.0943, the county board must clearly identify
274.12the desired services components not covered under section 256B.0943 and identify the
274.13reimbursement source for those requested services, the method of payment, and the
274.14payment rate to the provider.
274.15    Subd. 2. Responsibility not duplicated. For individuals who have health care
274.16coverage, the county board is not responsible for providing mental health services which
274.17are within the limits of the individual's health care coverage.

274.18    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
274.19    Subd. 5. Special contracts; bordering states. (a) An individual who is detained,
274.20committed, or placed on an involuntary basis under chapter 253B may be confined or
274.21treated in a bordering state pursuant to a contract under this section. An individual who is
274.22detained, committed, or placed on an involuntary basis under the civil law of a bordering
274.23state may be confined or treated in Minnesota pursuant to a contract under this section. A
274.24peace or health officer who is acting under the authority of the sending state may transport
274.25an individual to a receiving agency that provides services pursuant to a contract under
274.26this section and may transport the individual back to the sending state under the laws
274.27of the sending state. Court orders valid under the law of the sending state are granted
274.28recognition and reciprocity in the receiving state for individuals covered by a contract
274.29under this section to the extent that the court orders relate to confinement for treatment
274.30or care of mental illness or chemical dependency. Such treatment or care may address
274.31other conditions that may be co-occurring with the mental illness or chemical dependency.
274.32These court orders are not subject to legal challenge in the courts of the receiving state.
274.33Individuals who are detained, committed, or placed under the law of a sending state and
274.34who are transferred to a receiving state under this section continue to be in the legal
274.35custody of the authority responsible for them under the law of the sending state. Except
275.1in emergencies, those individuals may not be transferred, removed, or furloughed from
275.2a receiving agency without the specific approval of the authority responsible for them
275.3under the law of the sending state.
275.4    (b) While in the receiving state pursuant to a contract under this section, an
275.5individual shall be subject to the sending state's laws and rules relating to length of
275.6confinement, reexaminations, and extensions of confinement. No individual may be sent
275.7to another state pursuant to a contract under this section until the receiving state has
275.8enacted a law recognizing the validity and applicability of this section.
275.9    (c) If an individual receiving services pursuant to a contract under this section leaves
275.10the receiving agency without permission and the individual is subject to involuntary
275.11confinement under the law of the sending state, the receiving agency shall use all
275.12reasonable means to return the individual to the receiving agency. The receiving agency
275.13shall immediately report the absence to the sending agency. The receiving state has the
275.14primary responsibility for, and the authority to direct, the return of these individuals
275.15within its borders and is liable for the cost of the action to the extent that it would be
275.16liable for costs of its own resident.
275.17    (d) Responsibility for payment for the cost of care remains with the sending agency.
275.18    (e) This subdivision also applies to county contracts under subdivision 2 which
275.19include emergency care and treatment provided to a county resident in a bordering state.
275.20    (f) If a Minnesota resident is admitted to a facility in a bordering state under this
275.21chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
275.22an advance practice registered nurse certified in mental health, who is licensed in the
275.23bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
275.24253B.12, and 253B.17 subject to the same requirements and limitations in section
275.25253B.02, subdivision 7.

275.26    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:
275.27    Subd. 2. Program. The commissioner of human services shall establish a program
275.28for the treatment of compulsive gamblers. The commissioner may contract with an
275.29entity with expertise regarding the treatment of compulsive gambling to operate the
275.30program. The program may include the establishment of a statewide toll-free number,
275.31resource library, public education programs; regional in-service training programs and
275.32conferences for health care professionals, educators, treatment providers, employee
275.33assistance programs, and criminal justice representatives; and the establishment of
275.34certification standards for programs and service providers. The commissioner may enter
275.35into agreements with other entities and may employ or contract with consultants to
276.1facilitate the provision of these services or the training of individuals to qualify them to
276.2provide these services. The program may also include inpatient and outpatient treatment
276.3and rehabilitation services and for residents in a temporary or permanent residential
276.4setting for mental health or chemical dependency, and individuals in jails or correctional
276.5facilities. The program may also include research studies. The research studies must
276.6include baseline and prevalence studies for adolescents and adults to identify those at the
276.7highest risk. The program must be approved by the commissioner before it is established.

276.8    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:
276.9    Subd. 5. Standards. The commissioner shall create standards for treatment and
276.10provider qualifications for the treatment component of the compulsive gambling program.
276.11The commissioner, in coordination with the commissioner of corrections, shall create
276.12standards for the assessment and treatment of compulsive gamblers in programs operated
276.13by the commissioner of corrections.

276.14    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.
276.15    Prior to placement of a child in a foster care home, the child foster care provider, if
276.16required to be licensed, must complete two hours of training that addresses the causes,
276.17symptoms, and key warning signs of mental health disorders; cultural considerations; and
276.18effective approaches for dealing with a child's behaviors. At least one hour of the annual
276.1912-hour training requirement for foster parents must be on children's mental health issues
276.20and treatment. Training curriculum shall be approved by the commissioner of human
276.21services.

276.22    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:
276.23    Subdivision 1. County portion for cost of care. Except for chemical dependency
276.24services provided under sections 254B.01 to 254B.09, the client's county shall pay to the
276.25state of Minnesota a portion of the cost of care provided in a regional treatment center
276.26or a state nursing facility to a client legally settled in that county. A county's payment
276.27shall be made from the county's own sources of revenue and payments shall be paid as
276.28follows: payments to the state from the county shall equal 20 percent a percentage of the
276.29cost of care, as determined by the commissioner, for each day, or the portion thereof, that
276.30the client spends at a regional treatment center or a state nursing facility. according to
276.31the following schedule for each admission:
276.32    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January
276.331, 2008, to June 30, 2009, and zero percent thereafter;
277.1    (2) 20 percent for days 31 to 60; and
277.2    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January
277.31, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent
277.4thereafter.
277.5 If payments received by the state under sections 246.50 to 246.53 exceed 80 percent the
277.6noncounty portion of the cost of care, the county shall be responsible for paying the state
277.7only the remaining amount. The county shall not be entitled to reimbursement from
277.8the client, the client's estate, or from the client's relatives, except as provided in section
277.9246.53 . No such payments shall be made for any client who was last committed prior to
277.10July 1, 1947.

277.11    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to
277.12read:
277.13    Subd. 20. Mental health case management. (a) To the extent authorized by rule
277.14of the state agency, medical assistance covers case management services to persons with
277.15serious and persistent mental illness and children with severe emotional disturbance.
277.16Services provided under this section must meet the relevant standards in sections 245.461
277.17to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
277.18Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
277.19    (b) Entities meeting program standards set out in rules governing family community
277.20support services as defined in section 245.4871, subdivision 17, are eligible for medical
277.21assistance reimbursement for case management services for children with severe
277.22emotional disturbance when these services meet the program standards in Minnesota
277.23Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
277.24    (c) Medical assistance and MinnesotaCare payment for mental health case
277.25management shall be made on a monthly basis. In order to receive payment for an eligible
277.26child, the provider must document at least a face-to-face contact with the child, the child's
277.27parents, or the child's legal representative. To receive payment for an eligible adult, the
277.28provider must document:
277.29    (1) at least a face-to-face contact with the adult or the adult's legal representative; or
277.30    (2) at least a telephone contact with the adult or the adult's legal representative and
277.31document a face-to-face contact with the adult or the adult's legal representative within
277.32the preceding two months.
277.33    (d) Payment for mental health case management provided by county or state staff
277.34shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
278.1paragraph (b), with separate rates calculated for child welfare and mental health, and
278.2within mental health, separate rates for children and adults.
278.3    (e) Payment for mental health case management provided by Indian health services
278.4or by agencies operated by Indian tribes may be made according to this section or other
278.5relevant federally approved rate setting methodology.
278.6    (f) Payment for mental health case management provided by vendors who contract
278.7with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
278.8or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
278.9service to other payers. If the service is provided by a team of contracted vendors, the
278.10county or tribe may negotiate a team rate with a vendor who is a member of the team. The
278.11team shall determine how to distribute the rate among its members. No reimbursement
278.12received by contracted vendors shall be returned to the county or tribe, except to reimburse
278.13the county or tribe for advance funding provided by the county or tribe to the vendor.
278.14    (g) If the service is provided by a team which includes contracted vendors, tribal
278.15staff, and county or state staff, the costs for county or state staff participation in the team
278.16shall be included in the rate for county-provided services. In this case, the contracted
278.17vendor, the tribal agency, and the county may each receive separate payment for services
278.18provided by each entity in the same month. In order to prevent duplication of services,
278.19each entity must document, in the recipient's file, the need for team case management and
278.20a description of the roles of the team members.
278.21    (h) The commissioner shall calculate the nonfederal share of actual medical
278.22assistance and general assistance medical care payments for each county, based on the
278.23higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999,
278.24and transfer one-half of the result from medical assistance and general assistance medical
278.25care to each county's mental health grants under section 256E.12 for calendar year 1999.
278.26The annualized minimum amount added to each county's mental health grant shall be
278.27$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce
278.28the statewide growth factor in order to fund these minimums. The annualized total amount
278.29transferred shall become part of the base for future mental health grants for each county.
278.30    (i) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
278.31for mental health case management shall be provided by the recipient's county of
278.32responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
278.33funds or funds used to match other federal funds. If the service is provided by a tribal
278.34agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
278.35service is paid by the state without a federal share through fee-for-service, 50 percent of
278.36the cost shall be provided by the recipient's county of responsibility.
279.1    (j) Notwithstanding any administrative rule to the contrary, prepaid medical
279.2assistance, general assistance medical care, and MinnesotaCare include mental health case
279.3management. When the service is provided through prepaid capitation, the nonfederal
279.4share is paid by the state and the county pays no share.
279.5    (j) (k) The commissioner may suspend, reduce, or terminate the reimbursement to a
279.6provider that does not meet the reporting or other requirements of this section. The county
279.7of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
279.8agency, is responsible for any federal disallowances. The county or tribe may share this
279.9responsibility with its contracted vendors.
279.10    (k) (l) The commissioner shall set aside a portion of the federal funds earned for
279.11county expenditures under this section to repay the special revenue maximization account
279.12under section 256.01, subdivision 2, clause (15). The repayment is limited to:
279.13    (1) the costs of developing and implementing this section; and
279.14    (2) programming the information systems.
279.15    (l) (m) Payments to counties and tribal agencies for case management expenditures
279.16under this section shall only be made from federal earnings from services provided
279.17under this section. When this service is paid by the state without a federal share through
279.18fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
279.19county-contracted vendors shall include both the federal earnings, the state share, and the
279.20county share.
279.21    (m) (n) Notwithstanding section 256B.041, county payments for the cost of mental
279.22health case management services provided by county or state staff shall not be made
279.23to the commissioner of finance. For the purposes of mental health case management
279.24services provided by county or state staff under this section, the centralized disbursement
279.25of payments to counties under section 256B.041 consists only of federal earnings from
279.26services provided under this section.
279.27    (n) (o) Case management services under this subdivision do not include therapy,
279.28treatment, legal, or outreach services.
279.29    (o) (p) If the recipient is a resident of a nursing facility, intermediate care facility,
279.30or hospital, and the recipient's institutional care is paid by medical assistance, payment
279.31for case management services under this subdivision is limited to the last 180 days of
279.32the recipient's residency in that facility and may not exceed more than six months in a
279.33calendar year.
279.34    (p) (q) Payment for case management services under this subdivision shall not
279.35duplicate payments made under other program authorities for the same purpose.
280.1    (q) (r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the
280.2changes required by this section, including changes in number of persons receiving
280.3mental health case management, changes in hours of service per person, and changes in
280.4caseload size.
280.5    (r) (s) For each calendar year beginning with the calendar year 2001, the annualized
280.6amount of state funds for each county determined under paragraph (h) shall be adjusted by
280.7the county's percentage change in the average number of clients per month who received
280.8case management under this section during the fiscal year that ended six months prior to
280.9the calendar year in question, in comparison to the prior fiscal year.
280.10    (s) (t) For counties receiving the minimum allocation of $3,000 or $5,000 described
280.11in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county
280.12receives the higher of the following amounts:
280.13    (1) a continuation of the minimum allocation in paragraph (h); or
280.14    (2) an amount based on that county's average number of clients per month who
280.15received case management under this section during the fiscal year that ended six months
280.16prior to the calendar year in question, times the average statewide grant per person per
280.17month for counties not receiving the minimum allocation.
280.18    (t) (u) The adjustments in paragraphs (s) and (t) shall be calculated separately for
280.19children and adults.
280.20EFFECTIVE DATE.This section is effective January 1, 2009, except the
280.21amendment to paragraph (i) is effective January 1, 2008.

280.22    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to
280.23read:
280.24    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject
280.25to federal approval, medical assistance covers treatment foster care services according to
280.26section 256B.0946.

280.27    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to
280.28read:
280.29    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041,
280.30payments to counties for residential services provided by a residential facility shall only
280.31be made of federal earnings for services provided under this section, and the nonfederal
280.32share of costs for services provided under this section shall be paid by the county from
280.33sources other than federal funds or funds used to match other federal funds. Payment to
280.34counties for services provided according to this section shall be a proportion of the per
281.1day contract rate that relates to rehabilitative mental health services and shall not include
281.2payment for costs or services that are billed to the IV-E program as room and board.
281.3    (b) Per diem rates paid to providers under this section by prepaid plans shall be the
281.4proportion of the per-day contract rate that relates to rehabilitative mental health services
281.5and shall not include payment for group foster care costs or services that are billed to the
281.6county of financial responsibility.
281.7    (c) The commissioner shall set aside a portion not to exceed five percent of the
281.8federal funds earned for county expenditures under this section to cover the state costs of
281.9administering this section. Any unexpended funds from the set-aside shall be distributed
281.10to the counties in proportion to their earnings under this section.
281.11EFFECTIVE DATE.This section is effective January 1, 2009.

281.12    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:
281.13    Subd. 5g. Payment for covered services. For services rendered on or after January
281.141, 2003, the total payment made to managed care plans for providing covered services
281.15under the medical assistance and general assistance medical care programs is reduced by
281.16.5 percent from their current statutory rates. This provision excludes payments for nursing
281.17home services, home and community-based waivers, and payments to demonstration
281.18projects for persons with disabilities, and mental health services added as covered benefits
281.19after December 31, 2007.

281.20    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:
281.21    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g,
281.22the total payment made to managed care plans under the medical assistance program is
281.23reduced 1.0 percent for services provided on or after October 1, 2003, and an additional
281.241.0 percent for services provided on or after January 1, 2004. This provision excludes
281.25payments for nursing home services, home and community-based waivers, and payments
281.26to demonstration projects for persons with disabilities, and mental health services added as
281.27covered benefits after December 1, 2007.

281.28    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:
281.29256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
281.30    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007,
281.31payment rates shall be increased by 23.7 percent over the rates in effect on January 1,
281.322006, for:
282.1    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
282.2    (2) community mental health centers under section 256B.0625, subdivision 5; and
282.3    (3) mental health clinics and centers certified under Minnesota Rules, parts
282.49520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated
282.5as essential community providers under section 62Q.19.
282.6    (b) This increase applies to group skills training when provided as a component of
282.7children's therapeutic services and support, psychotherapy, medication management,
282.8evaluation and management, diagnostic assessment, explanation of findings, psychological
282.9testing, neuropsychological services, direction of behavioral aides, and inpatient
282.10consultation.
282.11    (c) This increase does not apply to rates that are governed by section 256B.0625,
282.12subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are
282.13negotiated with the county, rates that are established by the federal government, or rates
282.14that increased between January 1, 2004, and January 1, 2005.
282.15    (d) The commissioner shall adjust rates paid to prepaid health plans under contract
282.16with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid
282.17health plan must pass this rate increase to the providers identified in paragraph (a)
282.18paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers
282.19identified in paragraphs (a), (e), and (f).
282.20    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over
282.21the rates in effect on December 31, 2007, for:
282.22    (1) medication education services provided on or after January 1, 2008, by adult
282.23rehabilitative mental health services providers certified under section 256B.0623; and
282.24    (2) mental health behavioral aide services provided on or after January 1, 2008, by
282.25children's therapeutic services and support providers certified under section 256B.0943.
282.26    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
282.27children's therapeutic services and support providers certified under section 256B.0943
282.28and not already included in paragraph (a), payment rates for MinnesotaCare shall be
282.29increased by 23.7 percent over the rates in effect on December 31, 2007.

282.30    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
282.31    Subdivision 1. Covered health services. For individuals under section 256L.04,
282.32subdivision 7 , with income no greater than 75 percent of the federal poverty guidelines
282.33or for families with children under section 256L.04, subdivision 1, all subdivisions of
282.34this section apply. "Covered health services" means the health services reimbursed
282.35under chapter 256B, with the exception of inpatient hospital services, special education
283.1services, private duty nursing services, adult dental care services other than services
283.2covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
283.3medical transportation services, personal care assistant and case management services,
283.4nursing home or intermediate care facilities services, inpatient mental health services,
283.5and chemical dependency services. Outpatient mental health services covered under the
283.6MinnesotaCare program are limited to diagnostic assessments, psychological testing,
283.7explanation of findings, mental health telemedicine, psychiatric consultation, medication
283.8management by a physician, day treatment, partial hospitalization, and individual, family,
283.9and group psychotherapy.
283.10    "Covered health services" also includes intensive mental health outpatient treatment
283.11for dialectical behavioral therapy for adults.
283.12    No public funds shall be used for coverage of abortion under MinnesotaCare
283.13except where the life of the female would be endangered or substantial and irreversible
283.14impairment of a major bodily function would result if the fetus were carried to term; or
283.15where the pregnancy is the result of rape or incest.
283.16    Covered health services shall be expanded as provided in this section.
283.17EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for
283.18mental health case management is effective January 1, 2009.

283.19    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
283.20    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
283.21and (c), the MinnesotaCare benefit plan shall include the following co-payments and
283.22coinsurance requirements for all enrollees:
283.23    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
283.24subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
283.25$3,000 per family;
283.26    (2) $3 per prescription for adult enrollees;
283.27    (3) $25 for eyeglasses for adult enrollees;
283.28    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
283.29episode of service which is required because of a recipient's symptoms, diagnosis, or
283.30established illness, and which is delivered in an ambulatory setting by a physician or
283.31physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
283.32audiologist, optician, or optometrist; and
283.33    (5) $6 for nonemergency visits to a hospital-based emergency room.
283.34    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
283.35children under the age of 21 in households with family income equal to or less than 175
284.1percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
284.2parents and relative caretakers of children under the age of 21 in households with family
284.3income greater than 175 percent of the federal poverty guidelines for inpatient hospital
284.4admissions occurring on or after January 1, 2001.
284.5    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
284.6under the age of 21.
284.7    (d) Paragraph (a), clause (4), does not apply to mental health services.
284.8    (e) Adult enrollees with family gross income that exceeds 175 percent of the
284.9federal poverty guidelines and who are not pregnant shall be financially responsible for
284.10the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
284.11hospital benefit limit.
284.12    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
284.13or changes from one prepaid health plan to another during a calendar year, any charges
284.14submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
284.15expenses incurred by the enrollee for inpatient services, that were submitted or incurred
284.16prior to enrollment, or prior to the change in health plans, shall be disregarded.

284.17    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:
284.18256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE
284.19ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
284.20    (a) "Covered health services" for individuals under section 256L.04, subdivision
284.217 , with income above 75 percent, but not exceeding 175 percent, of the federal poverty
284.22guideline means:
284.23    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and
284.24subject to an annual limitation of $10,000;
284.25    (2) physician services provided during an inpatient stay; and
284.26    (3) physician services not provided during an inpatient stay; outpatient hospital
284.27services; freestanding ambulatory surgical center services; chiropractic services; lab and
284.28diagnostic services; diabetic supplies and equipment; mental health services as covered
284.29under chapter 256B; and prescription drugs; subject to the following co-payments:
284.30    (i) $50 co-pay per emergency room visit;
284.31    (ii) $3 co-pay per prescription drug; and
284.32    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental
284.33health services or community mental health services.
284.34The services covered under this section may be provided by a physician, physician
284.35ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or
285.1other mental health providers covered under chapter 256B if the services are within the
285.2scope of practice of that health care professional.
285.3    For purposes of this section, "a visit" means an episode of service which is required
285.4because of a recipient's symptoms, diagnosis, or established illness, and which is delivered
285.5in an ambulatory setting by any health care provider identified in this paragraph.
285.6    Enrollees are responsible for all co-payments in this section.
285.7    (b) Reimbursement to the providers shall be reduced by the amount of the
285.8co-payment, except that reimbursement for prescription drugs shall not be reduced once a
285.9recipient has reached the $20 per month maximum for prescription drug co-payments.
285.10The provider collects the co-payment from the recipient. Providers may not deny services
285.11to recipients who are unable to pay the co-payment, except as provided in paragraph (c).
285.12    (c) If it is the routine business practice of a provider to refuse service to an individual
285.13with uncollected debt, the provider may include uncollected co-payments under this
285.14section. A provider must give advance notice to a recipient with uncollected debt before
285.15services can be denied.
285.16EFFECTIVE DATE.This section is effective January 1, 2008, except coverage
285.17for mental health case management under paragraph (a), clause (3), is effective January
285.181, 2009.

285.19    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:
285.20    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after
285.21October 1, 2003, the total payment made to managed care plans under the MinnesotaCare
285.22program is reduced 1.0 percent. This provision excludes payments for mental health
285.23services added as covered benefits after December 31, 2007.

285.24    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:
285.25    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted
285.26of theft under section 609.52, embezzlement of public funds under section 609.54, or
285.27forgery under section 609.625, 609.63, or 609.631, the probation officer shall determine in
285.28the report prepared under subdivision 1 whether or not compulsive gambling contributed
285.29to the commission of the offense. If so, the report shall contain the results of a compulsive
285.30gambling assessment conducted in accordance with this subdivision. The probation officer
285.31shall make an appointment for the offender to undergo the assessment if so indicated.
285.32    (b) The compulsive gambling assessment report must include a recommended level
285.33of treatment for the offender if the assessor concludes that the offender is in need of
285.34compulsive gambling treatment. The assessment must be conducted by an assessor
286.1qualified under section 245.98, subdivision 2a, to perform these assessments or to
286.2provide compulsive gambling treatment. An assessor providing a compulsive gambling
286.3assessment may not have any direct or shared financial interest or referral relationship
286.4resulting in shared financial gain with a treatment provider. If an independent assessor is
286.5not available, the probation officer may use the services of an assessor with a financial
286.6interest or referral relationship as authorized under rules adopted by the commissioner
286.7of human services under section 245.98, subdivision 2a.
286.8    (c) The commissioner of human services shall reimburse the assessor for the
286.9costs associated with a compulsive gambling assessment at a rate established by the
286.10commissioner up to a maximum of $100 for each assessment. To the extent practicable, the
286.11commissioner shall standardize reimbursement rates for assessments. The commissioner
286.12shall reimburse these costs after receiving written verification from the probation officer
286.13that the assessment was performed and found acceptable.
286.14    (d) The commissioner shall make a report to the legislature by January 15, 2008,
286.15regarding the transfer of funds to counties for state registered nurses employed in
286.16community mental health pilot projects as part of the assertive community treatment
286.17teams under section 245.4661. The report shall address the impact of the nursing shortage
286.18on replacing these positions, continuity of patient care if these positions cannot be filled,
286.19and ways to maintain state registered nurses in these positions until the nurse retires or
286.20leaves employment. No funds for state registered nurse positions may be transferred
286.21before the report date.

286.22    Sec. 20. CASE MANAGEMENT; BEST PRACTICES.
286.23    The commissioner of human services, in consultation with consumers, families,
286.24counties, and other interested stakeholders, will develop recommendations for changes in
286.25the adult mental health act related to case management, consistent with evidence-based
286.26and best practices.

286.27    Sec. 21. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.
286.28    Subdivision 1. Pilot project authorized; purpose. A two-year Regional Children's
286.29Mental Health Initiative pilot project is established to improve children's mental health
286.30service coordination, communication, and processes in Blue Earth, Brown, Faribault,
286.31Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The
286.32purpose of the Regional Children's Mental Health Initiative will be to plan and develop
286.33new programs and services related to children's mental health in south central Minnesota.
287.1    Subd. 2. Goals. To accomplish its purpose, the Regional Children's Mental Health
287.2Initiative shall have the following goals:
287.3    (1) work to streamline delivery and regional access to services;
287.4    (2) share strategies and resources for the management of out-of-home placements;
287.5    (3) establish standard protocols and operating procedures for functions that are
287.6performed across all counties;
287.7    (4) share information to improve resource allocation and service delivery across
287.8counties;
287.9    (5) evaluate outcomes of various treatment alternatives;
287.10    (6) create a network for and provide support to service delivery groups;
287.11    (7) establish a regional process to match children in need of out-of-home placement
287.12with foster homes that can meet their needs; and
287.13    (8) recruit and retain foster homes.
287.14    Subd. 3. Director's Council. The Director's Council shall govern the operations of
287.15the Regional Children's Mental Health Initiative. Members of the Director's Council shall
287.16represent each of the 11 counties participating in the pilot project.
287.17    Subd. 4. Regional Children's Mental Health Initiative Team. The members
287.18of the Regional Children's Mental Health Initiative Team shall conduct planning and
287.19development of new and modified children's mental health programs and services in the
287.20region. Members of the team shall reflect the cultural, demographic, and geographic
287.21diversity of the region and shall be composed of representatives from each of the
287.22following:
287.23    (1) the medical community;
287.24    (2) human services;
287.25    (3) corrections;
287.26    (4) education;
287.27    (5) mental health providers and vendors;
287.28    (6) advocacy organizations;
287.29    (7) parents; and
287.30    (8) children and youth.
287.31    Subd. 5. Authority. The regional children's mental health initiative shall have the
287.32authority to develop and implement the following programs:
287.33    (1) Flexible funding payments. This program will make funds available to respond to
287.34the unique and unpredictable needs of children with mental health issues such as the need
287.35for prescription drugs, transportation, clothing, and assessments not otherwise available.
288.1    (2) Transition to self-sufficiency. This program will help youths between the ages of
288.214 and 21 establish professional relationships, find jobs, build financial foundations, and
288.3learn to fulfill their roles as productive citizens.
288.4    (3) Crisis response. This program will establish public and private partnerships
288.5to offer a range of options to meet the needs of children in crisis. Methods to meet
288.6these needs may include accessible local services, holistic assessments, urgent care and
288.7stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.
288.8    (4) Integrated services for complex conditions. This program will design, develop,
288.9and implement packages of integrated services to meet the needs of children with specific,
288.10complex conditions.
288.11    Subd. 6. Evaluation and report. The regional children's mental health initiative
288.12shall develop a method for evaluating the effectiveness of this pilot project focusing on
288.13identifiable goals and outcomes. An interim report on the pilot project's effectiveness
288.14shall be submitted to the house and senate finance committees having jurisdiction over
288.15mental health, the commissioner of human services, and the Minnesota Association of
288.16County Social Service Administrators no later than December 31, 2008. A final report
288.17is due no later than December 31, 2009.

288.18    Sec. 22. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO
288.19CHILDREN.
288.20    Organizations that are certified to provide children's therapeutic services and
288.21supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant.
288.22Grants are to be used to provide trauma-focused evidence-based practices to children
288.23who are living in a battered women's shelter, homeless shelter, transitional housing, or
288.24supported housing. Children served must have been exposed to or witnessed domestic
288.25violence, have been exposed to or witnessed community violence, or be a refugee. Priority
288.26shall be given to organizations that demonstrate collaboration with battered women's
288.27shelters, homeless shelters, or providers of transitional housing or supported housing. The
288.28commissioner shall specify which constitutes evidence-based practice. Organizations shall
288.29use all available funding streams.

288.30    Sec. 23. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.
288.31    (a) The commissioner of human services shall fund demonstration projects for high
288.32risk adults with serious mental illness and co-occurring substance abuse problems. The
288.33projects must include, but not be limited to, the following:
289.1    (1) housing services, including rent or housing subsidies, housing with clinical
289.2staff, or housing support;
289.3    (2) assertive outreach services; and
289.4    (3) intensive direct therapeutic, rehabilitative, and care management services
289.5oriented to harm reduction.
289.6    (b) The commissioner shall work with providers to ensure proper licensure or
289.7certification to meet medical assistance or third-party payor reimbursement requirements.

289.8    Sec. 24. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S
289.9MENTAL HEALTH PILOT PROJECT.
289.10    Subdivision 1. Pilot project authorized. The commissioner of human services
289.11shall fund a three-year pilot project to measure the effect of children's identified mental
289.12health needs, including social and emotional needs, on Minnesota family investment
289.13program (MFIP) participants' ability to obtain and retain employment. The project shall
289.14also measure the effect on work activity of MFIP participants' needs to address their
289.15children's identified mental health needs.
289.16    Subd. 2. Provider and agency proposals. (a) Interested MFIP providers and
289.17agencies shall:
289.18    (1) submit proposals defining how they will identify participants whose children
289.19have mental health needs that hinder the employment process;
289.20    (2) connect families with appropriate developmental, social, and emotional
289.21screenings and services; and
289.22    (3) incorporate those services into the participant's employment plan.
289.23Each proposal under this paragraph must include an evaluation component.
289.24    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP
289.25participants of the following:
289.26    (1) the availability of developmental, social, and emotional screening tools for
289.27children and youth;
289.28    (2) the purpose of the screenings;
289.29    (3) how the information will be used to assist the participants in identifying and
289.30addressing potential barriers to employment; and
289.31    (4) that their employment plan may be modified based on the screening results.
289.32    Subd. 3. Program components. (a) MFIP providers shall obtain the participant's
289.33written consent for participation in the pilot project, including consent for developmental,
289.34social, and emotional screening.
290.1    (b) MFIP providers shall coordinate with county social service agencies and health
290.2plans to assist recipients in arranging referrals indicated by the screening results.
290.3    (c) Tools used for developmental, social, and emotional screenings shall be approved
290.4by the commissioner of human services.
290.5    Subd. 4. Program evaluation. The commissioner of human services shall conduct
290.6an evaluation of the pilot project to determine:
290.7    (1) the number of participants who took part in the screening;
290.8    (2) the number of children who were screened and what screening tools were used;
290.9    (3) the number of children who were identified in the screening who needed referral
290.10or follow-up services;
290.11    (4) the number of children who received services, what agency provided the services,
290.12and what type of services were provided;
290.13    (5) the number of employment plans that were adjusted to include the activities
290.14recommended in the screenings;
290.15    (6) the changes in work participation rates;
290.16    (7) the changes in earned income;
290.17    (8) the changes in sanction rates; and
290.18    (9) the participants' report of program effectiveness.
290.19    Subd. 5. Work activity. Participant involvement in screenings and subsequent
290.20referral and follow-up services shall count as work activity under Minnesota Statutes,
290.21section 256J.49, subdivision 13.

290.22    Sec. 25. SOCIAL AND ECONOMIC COSTS OF GAMBLING.
290.23    Subdivision 1. Report. The commissioner of human services, in consultation with
290.24the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed
290.25vendors, shall prepare a report that provides a process and funding mechanism to study the
290.26issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate
290.27of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall
290.28include in the report potential financial commitments made by stakeholders and others in
290.29order to fund the study. The report is due to the legislative committees having jurisdiction
290.30over compulsive gambling issues by December 1, 2007.
290.31    Subd. 2. Issues to be addressed. The study must address:
290.32    (1) state, local, and tribal government policies and practices in Minnesota to legalize
290.33or prohibit gambling;
290.34    (2) the relationship between gambling and crime in Minnesota, including: (i) the
290.35relationship between gambling and overall crime rates; (ii) the relationship between
291.1gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child
291.2neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement
291.3and regulation practices that are intended to address the relationship between gambling
291.4and levels of crime;
291.5    (3) the relationship between expanded gambling and increased rates of problem
291.6gambling in Minnesota, including the impact of pathological or problem gambling on
291.7individuals, families, businesses, social institutions, and the economy;
291.8    (4) the social impact of gambling on individuals, families, businesses, and social
291.9institutions in Minnesota, including an analysis of the relationship between gambling and
291.10depression, abuse, divorce, homelessness, suicide, and bankruptcy;
291.11    (5) the economic impact of gambling on state, local, and tribal economies in
291.12Minnesota; and
291.13    (6) any other issues deemed necessary in assessing the social and economic impact
291.14of gambling in Minnesota.
291.15    Subd. 3. Quantification of social and economic impact. The study shall quantify
291.16the social and economic impact on both (1) state, local, and tribal governments in
291.17Minnesota, and (2) Minnesota's communities and social institutions, including individuals,
291.18families, and businesses within those communities and institutions.

291.19    Sec. 26. REPEALER.
291.20Minnesota Rules, part 9585.0030, is repealed.

291.21ARTICLE 6

291.22DEPARTMENT OF HEALTH

291.23    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:
291.24    Subd. 2. Definitions. For purposes of this section, the terms defined in this
291.25subdivision have the meanings given.
291.26    (a) "Access" means the financial, temporal, and geographic availability of health
291.27care to individuals who need it.
291.28    (b) (a) "Capital expenditure" means an expenditure which, under generally accepted
291.29accounting principles, is not properly chargeable as an expense of operation and
291.30maintenance.
291.31    (c) "Cost" means the amount paid by consumers or third party payers for health
291.32care services or products.
291.33    (d) "Date of the major spending commitment" means the date the provider formally
291.34obligated itself to the major spending commitment. The obligation may be incurred
292.1by entering into a contract, making a down payment, issuing bonds or entering a loan
292.2agreement to provide financing for the major spending commitment, or taking some other
292.3formal, tangible action evidencing the provider's intention to make the major spending
292.4commitment.
292.5    (e) (b) "Health care service" means:
292.6    (1) a service or item that would be covered by the medical assistance program
292.7under chapter 256B if provided in accordance with medical assistance requirements to an
292.8eligible medical assistance recipient; and
292.9    (2) a service or item that would be covered by medical assistance except that it is
292.10characterized as experimental, cosmetic, or voluntary.
292.11    "Health care service" does not include retail, over-the-counter sales of
292.12nonprescription drugs and other retail sales of health-related products that are not generally
292.13paid for by medical assistance and other third-party coverage.
292.14    (f) (c) "Major spending commitment" means an expenditure in excess of $1,000,000
292.15for:
292.16    (1) acquisition of a unit of medical equipment;
292.17    (2) a capital expenditure for a single project for the purposes of providing health
292.18care services, other than for the acquisition of medical equipment;
292.19    (3) offering a new specialized service not offered before;
292.20    (4) planning for an activity that would qualify as a major spending commitment
292.21under this paragraph; or
292.22    (5) a project involving a combination of two or more of the activities in clauses
292.23(1) to (4).
292.24    The cost of acquisition of medical equipment, and the amount of a capital
292.25expenditure, is the total cost to the provider regardless of whether the cost is distributed
292.26over time through a lease arrangement or other financing or payment mechanism.
292.27    (g) (d) "Medical equipment" means fixed and movable equipment that is used by
292.28a provider in the provision of a health care service. "Medical equipment" includes, but
292.29is not limited to, the following:
292.30    (1) an extracorporeal shock wave lithotripter;
292.31    (2) a computerized axial tomography (CAT) scanner;
292.32    (3) a magnetic resonance imaging (MRI) unit;
292.33    (4) a positron emission tomography (PET) scanner; and
292.34    (5) emergency and nonemergency medical transportation equipment and vehicles.
293.1    (h) (e) "New specialized service" means a specialized health care procedure or
293.2treatment regimen offered by a provider that was not previously offered by the provider,
293.3including, but not limited to:
293.4    (1) cardiac catheterization services involving high-risk patients as defined in the
293.5Guidelines for Coronary Angiography established by the American Heart Association
293.6and the American College of Cardiology;
293.7    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or
293.8any other service for transplantation of any other organ;
293.9    (3) megavoltage radiation therapy;
293.10    (4) open heart surgery;
293.11    (5) neonatal intensive care services; and
293.12    (6) any new medical technology for which premarket approval has been granted by
293.13the United States Food and Drug Administration, excluding implantable and wearable
293.14devices.
293.15    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic,
293.16obstetrics, mental health, chemical dependency, and emergency services.

293.17    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:
293.18    Subd. 4a. Expenditure reporting. (a) A provider making a major spending
293.19commitment after April 1, 1992, shall submit notification of the expenditure to the
293.20commissioner and provide the commissioner with any relevant background information.
293.21    (b) Notification must include a report, submitted within 60 days after the date of the
293.22major spending commitment, using terms conforming to the definitions in section 62J.03
293.23and this section. Each report is subject to retrospective review and must contain:
293.24    (1) a detailed description of the major spending commitment, including the specific
293.25dollar amount of each expenditure, and its purpose;
293.26    (2) the date of the major spending commitment;
293.27    (3) a statement of the expected impact that the major spending commitment will
293.28have on charges by the provider to patients and third party payers;
293.29    (4) a statement of the expected impact on the clinical effectiveness or quality of care
293.30received by the patients that the provider expects to serve;
293.31    (5) a statement of the extent to which equivalent services or technology are already
293.32available to the provider's actual and potential patient population;
293.33    (6) a statement of the distance from which the nearest equivalent services or
293.34technology are already available to the provider's actual and potential population;
293.35    (7) a statement describing the pursuit of any lawful collaborative arrangements; and
294.1    (8) a statement of assurance that the provider will not use, purchase, or perform
294.2health care technologies and procedures that are not clinically effective and cost-effective,
294.3unless the technology is used for experimental or research purposes to determine whether
294.4a technology or procedure is clinically effective and cost-effective.
294.5    The provider may submit any additional information that it deems relevant.
294.6    (c) The commissioner may request additional information from a provider for the
294.7purpose of review of a report submitted by that provider, and may consider relevant
294.8information from other sources. A provider shall provide any information requested by
294.9the commissioner within the time period stated in the request, or within 30 days after the
294.10date of the request if the request does not state a time.
294.11    (d) If the provider fails to submit a complete and timely expenditure report, including
294.12any additional information requested by the commissioner, the commissioner may make
294.13the provider's subsequent major spending commitments subject to the procedures of
294.14prospective review and approval under subdivision 6a.
294.15    Each hospital, outpatient surgical center, diagnostic imaging center, and physician
294.16clinic shall report annually to the commissioner on all major spending commitments,
294.17in the form and manner specified by the commissioner. The report shall include the
294.18following information:
294.19    (a) a description of major spending commitments made during the previous year,
294.20including the total dollar amount of major spending commitments and purpose of the
294.21expenditures;
294.22    (b) the cost of land acquisition, construction of new facilities, and renovation of
294.23existing facilities;
294.24    (c) the cost of purchased or leased medical equipment, by type of equipment;
294.25    (d) expenditures by type for specialty care and new specialized services;
294.26    (e) information on the amount and types of added capacity for diagnostic imaging
294.27services, outpatient surgical services, and new specialized services; and
294.28    (f) information on investments in electronic medical records systems.
294.29For hospitals and outpatient surgical centers, this information shall be included in reports
294.30to the commissioner that are required under section 144.698. For diagnostic imaging
294.31centers, this information shall be included in reports to the commissioner that are required
294.32under section 144.565. For physician clinics, this information shall be included in reports
294.33to the commissioner that are required under section 62J.41. For all other health care
294.34providers that are subject to this reporting requirement, reports must be submitted to the
294.35commissioner by March 1 each year for the preceding calendar year.

295.1    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:
295.2    Subd. 7. Exceptions. (a) The retrospective review process as described in
295.3subdivision 5a and the prospective review and approval process as described in subdivision
295.46a reporting requirement in subdivision 4a do does not apply to:
295.5    (1) a major spending commitment to replace existing equipment with comparable
295.6equipment used for direct patient care, upgrades of equipment beyond the current model,
295.7or comparable model must be reported;
295.8    (2) (1) a major spending commitment made by a research and teaching institution
295.9for purposes of conducting medical education, medical research supported or sponsored
295.10by a medical school, or by a federal or foundation grant or clinical trials;
295.11    (3) a major spending commitment to repair, remodel, or replace existing buildings or
295.12fixtures if, in the judgment of the commissioner, the project does not involve a substantial
295.13expansion of service capacity or a substantial change in the nature of health care services
295.14provided;
295.15    (4) (2) a major spending commitment for building maintenance including heating,
295.16water, electricity, and other maintenance-related expenditures; and
295.17    (5) (3) a major spending commitment for activities, not directly related to the
295.18delivery of patient care services, including food service, laundry, housekeeping, and
295.19other service-related activities; and.
295.20    (6) a major spending commitment for computer equipment or data systems not
295.21directly related to the delivery of patient care services, including computer equipment or
295.22data systems related to medical record automation.
295.23    (b) In addition to the exceptions listed in paragraph (a), the prospective review and
295.24approval process described in subdivision 6a reporting requirement in subdivision 4a does
295.25not apply to mergers, acquisitions, and other changes in ownership or control that, in the
295.26judgment of the commissioner, do not involve a substantial expansion of service capacity
295.27or a substantial change in the nature of health care services provided.

295.28    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:
295.29    Subdivision 1. Cost containment data to be collected from providers. The
295.30commissioner shall require health care providers to collect and provide both patient
295.31specific information and descriptive and financial aggregate data on:
295.32    (1) the total number of patients served;
295.33    (2) the total number of patients served by state of residence and Minnesota county;
295.34    (3) the site or sites where the health care provider provides services;
296.1    (4) the number of individuals employed, by type of employee, by the health care
296.2provider;
296.3    (5) the services and their costs for which no payment was received;
296.4    (6) total revenue by type of payer or by groups of payers, including but not limited
296.5to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service
296.6plan corporations, commercial insurers, health maintenance organizations, and individual
296.7patients;
296.8    (7) revenue from research activities;
296.9    (8) revenue from educational activities;
296.10    (9) revenue from out-of-pocket payments by patients;
296.11    (10) revenue from donations; and
296.12    (11) a report on health care capital expenditures during the previous year, as required
296.13by section 62J.17; and
296.14    (11) (12) any other data required by the commissioner, including data in
296.15unaggregated form, for the purposes of developing spending estimates, setting spending
296.16limits, monitoring actual spending, and monitoring costs.
296.17The commissioner may, by rule, modify the data submission categories listed above if the
296.18commissioner determines that this will reduce the reporting burden on providers without
296.19having a significant negative effect on necessary data collection efforts.

296.20    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:
296.21    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1,
296.221996, all institutional inpatient hospital services, ancillary services, institutionally owned
296.23or operated outpatient services rendered by providers in Minnesota, and institutional
296.24or noninstitutional home health services that are not being billed using an equivalent
296.25electronic billing format, must be billed using the uniform billing form CMS 1450, except
296.26as provided in subdivision 5.
296.27    (b) The instructions and definitions for the use of the uniform billing form CMS
296.281450 shall be in accordance with the uniform billing form manual specified by the
296.29commissioner. In promulgating these instructions, the commissioner may utilize the
296.30manual developed by the National Uniform Billing Committee, as adopted and finalized
296.31by the Minnesota Uniform Billing Committee.
296.32    (c) Services to be billed using the uniform billing form CMS 1450 include:
296.33institutional inpatient hospital services and distinct units in the hospital such as psychiatric
296.34unit services, physical therapy unit services, swing bed (SNF) services, inpatient state
296.35psychiatric hospital services, inpatient skilled nursing facility services, home health
297.1services (Medicare part A), and hospice services; ancillary services, where benefits are
297.2exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals,
297.3skilled nursing facilities, and home health (Medicare part B); institutional owned or
297.4operated outpatient services such as waivered services, hospital outpatient services,
297.5including ambulatory surgical center services, hospital referred laboratory services,
297.6hospital-based ambulance services, and other hospital outpatient services, skilled nursing
297.7facilities, home health, freestanding renal dialysis centers, comprehensive outpatient
297.8rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health
297.9clinics, and community mental health centers; home health services such as home health
297.10intravenous therapy providers, waivered services, personal care attendants, and hospice;
297.11and any other health care provider certified by the Medicare program to use this form.
297.12    (d) On and after January 1, 1996, a mother and newborn child must be billed
297.13separately, and must not be combined on one claim form.
297.14    (e) Services provided by Medicare Critical Access Hospitals electing Method
297.15II billing will be allowed an exception to this provision to allow the inclusion of the
297.16professional fees on the CMS 1450.

297.17    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:
297.18    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all
297.19noninstitutional health care services rendered by providers in Minnesota except dental
297.20or pharmacy providers, that are not currently being billed using an equivalent electronic
297.21billing format, must be billed using the health insurance claim form CMS 1500, except as
297.22provided in subdivision 5.
297.23    (b) The instructions and definitions for the use of the uniform billing form CMS
297.241500 shall be in accordance with the manual developed by the Administrative Uniformity
297.25Committee entitled standards for the use of the CMS 1500 form, dated February 1994,
297.26as further defined by the commissioner.
297.27    (c) Services to be billed using the uniform billing form CMS 1500 include physician
297.28services and supplies, durable medical equipment, noninstitutional ambulance services,
297.29independent ancillary services including occupational therapy, physical therapy, speech
297.30therapy and audiology, home infusion therapy, podiatry services, optometry services,
297.31mental health licensed professional services, substance abuse licensed professional
297.32services, nursing practitioner professional services, certified registered nurse anesthetists,
297.33chiropractors, physician assistants, laboratories, medical suppliers, and other health care
297.34providers such as day activity centers and freestanding ambulatory surgical centers.
298.1    (d) Services provided by Medicare Critical Access Hospitals electing Method
298.2II billing will be allowed an exception to this provision to allow the inclusion of the
298.3professional fees on the CMS 1450.

298.4    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:
298.5    Subd. 2. General characteristics. (a) The Minnesota uniform health care
298.6identification card must be a preprinted card constructed of plastic, paper, or any other
298.7medium that conforms with ANSI and ISO 7810 physical characteristics standards. The
298.8card dimensions must also conform to ANSI and ISO 7810 physical characteristics
298.9standard. The use of a signature panel is optional. The uniform prescription drug
298.10information contained on the card must conform with the format adopted by the NCPDP
298.11and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of
298.12the fields required to submit a claim in conformance with the most recent pharmacy
298.13identification card implementation guide produced by the NCPDP. All information
298.14required to submit a prescription drug claim, exclusive of information provided on a
298.15prescription that is required by law, must be included on the card in a clear, readable, and
298.16understandable manner. If a health benefit plan requires a conditional or situational field,
298.17as defined by the NCPDP, the conditional or situational field must conform to the most
298.18recent pharmacy information card implementation guide produced by the NCPDP.
298.19    (b) The Minnesota uniform health care identification card must have an essential
298.20information window on the front side with the following data elements: card issuer name,
298.21electronic transaction routing information, card issuer identification number, cardholder
298.22(insured) identification number, and cardholder (insured) identification name. No optional
298.23data may be interspersed between these data elements.
298.24    (c) Standardized labels are required next to human readable data elements and
298.25must come before the human data elements.

298.26    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:
298.27    Subd. 3. Human readable data elements. (a) The following are the minimum
298.28human readable data elements that must be present on the front side of the Minnesota
298.29uniform health care identification card:
298.30    (1) card issuer name or logo, which is the name or logo that identifies the card issuer.
298.31The card issuer name or logo may be located at the top of the card. No standard label
298.32is required for this data element;
298.33    (2) complete electronic transaction routing information including, at a minimum,
298.34the international identification number. The standardized label of this data element
299.1is "RxBIN." Processor control numbers and group numbers are required if needed to
299.2electronically process a prescription drug claim. The standardized label for the process
299.3control numbers data element is "RxPCN" and the standardized label for the group
299.4numbers data element is "RxGrp," except that if the group number data element is a
299.5universal element to be used by all health care providers, the standardized label may be
299.6"Grp." To conserve vertical space on the card, the international identification number and
299.7the processor control number may be printed on the same line;
299.8     (3) cardholder (insured) identification number, which is the unique identification
299.9number of the individual card holder established and defined under this section. The
299.10standardized label for the data element is "ID";
299.11    (4) cardholder (insured) identification name, which is the name of the individual
299.12card holder. The identification name must be formatted as follows: first name, space,
299.13optional middle initial, space, last name, optional space and name suffix. The standardized
299.14label for this data element is "Name";
299.15    (5) care type, which is the description of the group purchaser's plan product under
299.16which the beneficiary is covered. The description shall include the health plan company
299.17name and the plan or product name. The standardized label for this data element is
299.18"Care Type";
299.19    (6) service type, which is the description of coverage provided such as hospital,
299.20dental, vision, prescription, or mental health. The standard label for this data element
299.21is "Svc Type"; and
299.22    (7) provider/clinic name, which is the name of the primary care clinic the card
299.23holder is assigned to by the health plan company. The standard label for this field is
299.24"PCP." This information is mandatory only if the health plan company assigns a specific
299.25primary care provider to the card holder.
299.26    (b) The following human readable data elements shall be present on the back side
299.27of the Minnesota uniform health care identification card. These elements must be left
299.28justified, and no optional data elements may be interspersed between them:
299.29    (1) claims submission names and addresses, which are the names and addresses of
299.30the entity or entities to which claims should be submitted. If different destinations are
299.31required for different types of claims, this must be labeled;
299.32    (2) telephone numbers and names that pharmacies and other health care providers
299.33may call for assistance. These telephone numbers and names are required on the back
299.34side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies
299.35or other providers with assistance or with the telephone numbers and names of contacts
299.36for assistance; and
300.1    (3) telephone numbers and names; which are the telephone numbers and names of the
300.2following contacts with a standardized label describing the service function as applicable:
300.3    (i) eligibility and benefit information;
300.4    (ii) utilization review;
300.5    (iii) precertification; or
300.6    (iv) customer services.
300.7    (c) The following human readable data elements are mandatory on the back
300.8side of the Minnesota uniform health care identification card for health maintenance
300.9organizations:
300.10    (1) emergency care authorization telephone number or instruction on how to receive
300.11authorization for emergency care. There is no standard label required for this information;
300.12and
300.13    (2) one of the following:
300.14    (i) telephone number to call to appeal to or file a complaint with the commissioner of
300.15health; or
300.16    (ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone
300.17number to call to file a complaint with the ombudsperson designated by the commissioner
300.18of human services under section 256B.69 and the address to appeal to the commissioner of
300.19human services. There is no standard label required for this information.
300.20    (d) All human readable data elements not required under paragraphs (a) to (c) are
300.21optional and may be used at the issuer's discretion.

300.22    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision
300.23to read:
300.24    Subd. 1a. Demonstration project. The commissioner of health shall award a
300.25demonstration project grant to a community-based health care initiative to develop and
300.26operate a community-based health care coverage program to operate within Carlton,
300.27Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years
300.28and must comply with all the requirements of this section.

300.29    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
300.30    Subd. 3. Approval. (a) Prior to the operation of a community-based health care
300.31coverage program, a community-based health initiative shall submit to the commissioner
300.32of health for approval the community-based health care coverage program developed by
300.33the initiative. The commissioner shall only approve a program that has been awarded
300.34a community access program grant from the United States Department of Health and
301.1Human Services. The commissioner shall ensure that the program meets the federal grant
301.2requirements and any requirements described in this section and is actuarially sound based
301.3on a review of appropriate records and methods utilized by the community-based health
301.4initiative in establishing premium rates for the community-based health care coverage
301.5program.
301.6    (b) Prior to approval, the commissioner shall also ensure that:
301.7    (1) the benefits offered comply with subdivision 8 and that there are adequate
301.8numbers of health care providers participating in the community-based health network to
301.9deliver the benefits offered under the program;
301.10    (2) the activities of the program are limited to activities that are exempt under this
301.11section or otherwise from regulation by the commissioner of commerce;
301.12    (3) the complaint resolution process meets the requirements of subdivision 10; and
301.13    (4) the data privacy policies and procedures comply with state and federal law.

301.14    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
301.15    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval
301.16by the commissioner of health a community-based health care coverage program. The
301.17operational structure established by the initiative shall include, but is not limited to:
301.18    (1) establishing a process for enrolling eligible individuals and their dependents;
301.19    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
301.20    (3) providing payment to participating providers;
301.21    (4) establishing a benefit set according to subdivision 8 and establishing premium
301.22rates and cost-sharing requirements;
301.23    (5) creating incentives to encourage primary care and wellness services; and
301.24    (6) initiating disease management services, as appropriate.
301.25    (b) The payments collected under paragraph (a), clause (2), may be used to capture
301.26available federal funds.

301.27    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
301.28    Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the
301.29commissioner of health on January 15, April 15, July 15, and October 15 of each year,
301.30with the first report due January 15, 2007 2008. The status report shall include:
301.31    (1) the financial status of the program, including the premium rates, cost per member
301.32per month, claims paid out, premiums received, and administrative expenses;
301.33    (2) a description of the health care benefits offered and the services utilized;
302.1    (3) the number of employers participating, the number of employees and dependents
302.2covered under the program, and the number of health care providers participating;
302.3    (4) a description of the health outcomes to be achieved by the program and a status
302.4report on the performance measurements to be used and collected; and
302.5    (5) any other information requested by the commissioner of health or commerce or
302.6the legislature.
302.7    (b) The initiative shall contract with an independent entity to conduct an evaluation
302.8of the program to be submitted to the commissioners of health and commerce and the
302.9legislature by January 15, 2009 2010. The evaluation shall include:
302.10    (1) an analysis of the health outcomes established by the initiative and the
302.11performance measurements to determine whether the outcomes are being achieved;
302.12    (2) an analysis of the financial status of the program, including the claims to
302.13premiums loss ratio and utilization and cost experience;
302.14    (3) the demographics of the enrollees, including their age, gender, family income,
302.15and the number of dependents;
302.16    (4) the number of employers and employees who have been denied access to the
302.17program and the basis for the denial;
302.18    (5) specific analysis on enrollees who have aggregate medical claims totaling over
302.19$5,000 per year, including data on the enrollee's main diagnosis and whether all the
302.20medical claims were covered by the program;
302.21    (6) number of enrollees referred to state public assistance programs;
302.22    (7) a comparison of employer-subsidized health coverage provided in a comparable
302.23geographic area to the designated community-based geographic area served by the
302.24program, including, to the extent available:
302.25    (i) the difference in the number of employers with 50 or fewer employees offering
302.26employer-subsidized health coverage;
302.27    (ii) the difference in uncompensated care being provided in each area; and
302.28    (iii) a comparison of health care outcomes and measurements established by the
302.29initiative; and
302.30    (8) any other information requested by the commissioner of health or commerce.

302.31    Sec. 13. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:
302.32    Subd. 14. Sunset. This section expires December 31, 2011 2012.

302.33    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.
303.1    Subdivision 1. Short title. Sections 144.291 to 144.298 may be cited as the
303.2Minnesota Health Records Act.
303.3    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
303.4terms have the meanings given.
303.5    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3,
303.6paragraph (b).
303.7    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03,
303.8subdivision 6.
303.9    (c) Health record. "Health record" means any information, whether oral or recorded
303.10in any form or medium, that relates to the past, present, or future physical or mental health
303.11or condition of a patient; the provision of health care to a patient; or the past, present, or
303.12future payment for the provision of health care to a patient.
303.13    (d) Identifying information. "Identifying information" means the patient's name,
303.14address, date of birth, gender, parent's or guardian's name regardless of the age of the
303.15patient, and other nonclinical data which can be used to uniquely identify a patient.
303.16    (e) Individually identifiable form. "Individually identifiable form" means a form in
303.17which the patient is or can be identified as the subject of the health records.
303.18    (f) Medical emergency. "Medical emergency" means medically necessary care
303.19which is immediately needed to preserve life, prevent serious impairment to bodily
303.20functions, organs, or parts, or prevent placing the physical or mental health of the patient
303.21in serious jeopardy.
303.22    (g) Patient. "Patient" means a natural person who has received health care services
303.23from a provider for treatment or examination of a medical, psychiatric, or mental
303.24condition, the surviving spouse and parents of a deceased patient, or a person the patient
303.25appoints in writing as a representative, including a health care agent acting according to
303.26chapter 145C, unless the authority of the agent has been limited by the principal in the
303.27principal's health care directive. Except for minors who have received health care services
303.28under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or
303.29guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.
303.30    (h) Provider. "Provider" means:
303.31    (1) any person who furnishes health care services and is regulated to furnish the
303.32services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
303.33151, 153, or 153A;
303.34    (2) a home care provider licensed under section 144A.46;
303.35    (3) a health care facility licensed under this chapter or chapter 144A;
303.36    (4) a physician assistant registered under chapter 147A; and
304.1    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
304.2148B.71.
304.3    (i) Record locator service. "Record locator service" means an electronic index of
304.4patient identifying information that directs providers in a health information exchange to
304.5the location of patient health records held by providers and group purchasers.
304.6    (j) Related health care entity. "Related health care entity" means an affiliate of
304.7the provider releasing the health records.

304.8    Sec. 15. [144.292] PATIENT RIGHTS.
304.9    Subdivision 1. Scope. Patients have the rights specified in this section regarding the
304.10treatment the patient receives and the patient's health record.
304.11    Subd. 2. Patient access. Upon request, a provider shall supply to a patient complete
304.12and current information possessed by that provider concerning any diagnosis, treatment,
304.13and prognosis of the patient in terms and language the patient can reasonably be expected
304.14to understand.
304.15    Subd. 3. Additional patient rights. A patient's right specified in this section and
304.16sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and
304.17144.652 and any other provision of law relating to the access of a patient to the patient's
304.18health records.
304.19    Subd. 4. Notice of rights; information on release. A provider shall provide to
304.20patients, in a clear and conspicuous manner, a written notice concerning practices and
304.21rights with respect to access to health records. The notice must include an explanation of:
304.22    (1) disclosures of health records that may be made without the written consent of the
304.23patient, including the type of records and to whom the records may be disclosed; and
304.24    (2) the right of the patient to have access to and obtain copies of the patient's health
304.25records and other information about the patient that is maintained by the provider.
304.26    The notice requirements of this subdivision are satisfied if the notice is included with
304.27the notice and copy of the patient and resident bill of rights under section 144.652 or if it
304.28is displayed prominently in the provider's place of business. The commissioner of health
304.29shall develop the notice required in this subdivision and publish it in the State Register.
304.30    Subd. 5. Copies of health records to patients. Except as provided in section
304.31144.296, upon a patient's written request, a provider, at a reasonable cost to the patient,
304.32shall promptly furnish to the patient:
304.33    (1) copies of the patient's health record, including but not limited to laboratory
304.34reports, x-rays, prescriptions, and other technical information used in assessing the
304.35patient's health conditions; or
305.1    (2) the pertinent portion of the record relating to a condition specified by the patient.
305.2    With the consent of the patient, the provider may instead furnish only a summary
305.3of the record. The provider may exclude from the health record written speculations
305.4about the patient's health condition, except that all information necessary for the patient's
305.5informed consent must be provided.
305.6    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for
305.7purposes of reviewing current medical care, the provider must not charge a fee.
305.8    (b) When a provider or its representative makes copies of patient records upon a
305.9patient's request under this section, the provider or its representative may charge the
305.10patient or the patient's representative no more than 75 cents per page, plus $10 for time
305.11spent retrieving and copying the records, unless other law or a rule or contract provide for
305.12a lower maximum charge. This limitation does not apply to x-rays. The provider may
305.13charge a patient no more than the actual cost of reproducing x-rays, plus no more than
305.14$10 for the time spent retrieving and copying the x-rays.
305.15    (c) The respective maximum charges of 75 cents per page and $10 for time provided
305.16in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
305.17calendar year as provided in this subdivision. The permissible maximum charges shall
305.18change each year by an amount that reflects the change, as compared to the previous year,
305.19in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
305.20published by the Department of Labor.
305.21    (d) A provider or its representative must not charge a fee to provide copies of records
305.22requested by a patient or the patient's authorized representative if the request for copies
305.23of records is for purposes of appealing a denial of Social Security disability income or
305.24Social Security disability benefits under title II or title XVI of the Social Security Act. For
305.25the purpose of further appeals, a patient may receive no more than two medical record
305.26updates without charge, but only for medical record information previously not provided.
305.27For purposes of this paragraph, a patient's authorized representative does not include units
305.28of state government engaged in the adjudication of Social Security disability claims.
305.29    Subd. 7. Withholding health records from patient. (a) If a provider reasonably
305.30determines that the information is detrimental to the physical or mental health of the
305.31patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider
305.32may withhold the information from the patient and may supply the information to an
305.33appropriate third party or to another provider. The other provider or third party may
305.34release the information to the patient.
306.1    (b) A provider shall release information upon written request unless, prior to the
306.2request, a provider has designated and described a specific basis for withholding the
306.3information as authorized by paragraph (a).

306.4    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.
306.5    Subdivision 1. Release or disclosure of health records. Health records can be
306.6released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.
306.7    Subd. 2. Patient consent to release of records. A provider, or a person who
306.8receives health records from a provider, may not release a patient's health records to a
306.9person without:
306.10    (1) a signed and dated consent from the patient or the patient's legally authorized
306.11representative authorizing the release;
306.12    (2) specific authorization in law; or
306.13    (3) a representation from a provider that the provider holds a consent from the
306.14patient.
306.15    Subd. 3. Release from one provider to another. A patient's health record,
306.16including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical
306.17information used in assessing the patient's condition, or the pertinent portion of the record
306.18relating to a specific condition, or a summary of the record, shall promptly be furnished to
306.19another provider upon the written request of the patient. The written request shall specify
306.20the name of the provider to whom the health record is to be furnished. The provider who
306.21furnishes the health record or summary may retain a copy of the materials furnished. The
306.22patient shall be responsible for the reasonable costs of furnishing the information.
306.23    Subd. 4. Duration of consent. Except as provided in this section, a consent is
306.24valid for one year or for a lesser period specified in the consent or for a different period
306.25provided by law.
306.26    Subd. 5. Exceptions to consent requirement. This section does not prohibit the
306.27release of health records:
306.28    (1) for a medical emergency when the provider is unable to obtain the patient's
306.29consent due to the patient's condition or the nature of the medical emergency;
306.30    (2) to other providers within related health care entities when necessary for the
306.31current treatment of the patient; or
306.32    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
306.33types of health care facilities licensed by this chapter and chapter 144A that are licensed
306.34in another state when a patient:
306.35    (i) is returning to the health care facility and unable to provide consent; or
307.1    (ii) who resides in the health care facility, has services provided by an outside
307.2resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
307.3to provide consent.
307.4    Subd. 6. Consent does not expire. Notwithstanding subdivision 4, if a patient
307.5explicitly gives informed consent to the release of health records for the purposes and
307.6restrictions in clauses (1) and (2), the consent does not expire after one year for:
307.7    (1) the release of health records to a provider who is being advised or consulted with
307.8in connection with the releasing provider's current treatment of the patient;
307.9    (2) the release of health records to an accident and health insurer, health service plan
307.10corporation, health maintenance organization, or third-party administrator for purposes of
307.11payment of claims, fraud investigation, or quality of care review and studies, provided that:
307.12    (i) the use or release of the records complies with sections 72A.49 to 72A.505;
307.13    (ii) further use or release of the records in individually identifiable form to a person
307.14other than the patient without the patient's consent is prohibited; and
307.15    (iii) the recipient establishes adequate safeguards to protect the records from
307.16unauthorized disclosure, including a procedure for removal or destruction of information
307.17that identifies the patient.
307.18    Subd. 7. Exception to consent. Subdivision 2 does not apply to the release of health
307.19records to the commissioner of health or the Health Data Institute under chapter 62J,
307.20provided that the commissioner encrypts the patient identifier upon receipt of the data.
307.21    Subd. 8. Record locator service. (a) A provider or group purchaser may send
307.22patient identifying information and information about the location of the patient's health
307.23records to a record locator service without consent from the patient. Except in the case of
307.24a medical emergency, a provider participating in a health information exchange using a
307.25record locator service cannot access patient identifying information and information
307.26about the location of the patient's health records until the patient has provided consent.
307.27The Minnesota Department of Health may not access the record locator service or receive
307.28data from the record locator service. Only a provider may access patient identifying
307.29information in a record locator service. The consent does not expire and may be revoked
307.30by the patient at any time by providing written notice of the revocation to the provider.
307.31    (b) A health information exchange maintaining a record locator service or an entity
307.32maintaining a record locator service for a health information exchange must maintain an
307.33audit log of providers accessing information in a record locator service that minimally
307.34contains information on:
307.35    (1) the identity of the provider accessing the information;
307.36    (2) the identity of the patient whose information was accessed by the provider; and
308.1    (3) the date the information was accessed.
308.2    (c) No group purchaser may in any way require a provider to participate in any
308.3record locator service as a condition of payment or participation.
308.4    (d) A record locator service must provide a mechanism for patients to opt out of
308.5including their identifying information and information about the location of their health
308.6records in a record locator service. At a minimum, any consent form that permits a
308.7provider to access a record locator service must include a check-box option that allows a
308.8patient to completely opt out of the record locator service which shall be clearly displayed
308.9to the patient. A provider participating in a health information exchange with a record
308.10locator service who receives a patient's request to completely opt out of the record locator
308.11service or to not have a specific provider contact in the record locator service shall be
308.12responsible for removing the patient's information from the record locator service.
308.13    Subd. 9. Documentation of release. (a) In cases where a provider releases health
308.14records without patient consent as authorized by law, the release must be documented in
308.15the patient's health record. In the case of a release under section 144.294, subdivision 2, the
308.16documentation must include the date and circumstances under which the release was made,
308.17the person or agency to whom the release was made, and the records that were released.
308.18    (b) When a health record is released using a representation from a provider that
308.19holds a consent from the patient, the releasing provider shall document:
308.20    (1) the provider requesting the health records;
308.21    (2) the identity of the patient;
308.22    (3) the health records requested; and
308.23    (4) the date the health records were requested.

308.24    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.
308.25    Subdivision 1. Provider inquiry. Upon the written request of a spouse, parent,
308.26child, or sibling of a patient being evaluated for or diagnosed with mental illness, a
308.27provider shall inquire of a patient whether the patient wishes to authorize a specific
308.28individual to receive information regarding the patient's current and proposed course of
308.29treatment. If the patient so authorizes, the provider shall communicate to the designated
308.30individual the patient's current and proposed course of treatment. Section 144.293,
308.31subdivisions 2 and 4, apply to consents given under this subdivision.
308.32    Subd. 2. Disclosure to law enforcement agency. Notwithstanding section 144.293,
308.33subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
308.34health to a law enforcement agency if the law enforcement agency provides the name
308.35of the patient and communicates that the:
309.1    (1) patient is currently involved in an emergency interaction with the law
309.2enforcement agency; and
309.3    (2) disclosure of the records is necessary to protect the health or safety of the patient
309.4or of another person.
309.5    The scope of disclosure under this subdivision is limited to the minimum necessary
309.6for law enforcement to respond to the emergency. A law enforcement agency that obtains
309.7health records under this subdivision shall maintain a record of the requestor, the provider
309.8of the information, and the patient's name. Health records obtained by a law enforcement
309.9agency under this subdivision are private data on individuals as defined in section 13.02,
309.10subdivision 12, and must not be used by law enforcement for any other purpose.
309.11    Subd. 3. Records release for family and caretaker; mental health care. (a)
309.12Notwithstanding section 144.293, a provider providing mental health care and treatment
309.13may disclose health record information described in paragraph (b) about a patient to a
309.14family member of the patient or other person who requests the information if:
309.15    (1) the request for information is in writing;
309.16    (2) the family member or other person lives with, provides care for, or is directly
309.17involved in monitoring the treatment of the patient;
309.18    (3) the involvement under clause (2) is verified by the patient's mental health care
309.19provider, the patient's attending physician, or a person other than the person requesting the
309.20information, and is documented in the patient's medical record;
309.21    (4) before the disclosure, the patient is informed in writing of the request, the name
309.22of the person requesting the information, the reason for the request, and the specific
309.23information being requested;
309.24    (5) the patient agrees to the disclosure, does not object to the disclosure, or is
309.25unable to consent or object, and the patient's decision or inability to make a decision is
309.26documented in the patient's medical record; and
309.27    (6) the disclosure is necessary to assist in the provision of care or monitoring of the
309.28patient's treatment.
309.29    (b) The information disclosed under this paragraph is limited to diagnosis, admission
309.30to or discharge from treatment, the name and dosage of the medications prescribed, side
309.31effects of the medication, consequences of failure of the patient to take the prescribed
309.32medication, and a summary of the discharge plan.
309.33    (c) If a provider reasonably determines that providing information under this
309.34subdivision would be detrimental to the physical or mental health of the patient or is
309.35likely to cause the patient to inflict self harm or to harm another, the provider must not
309.36disclose the information.
310.1    (d) This subdivision does not apply to disclosures for a medical emergency or
310.2to family members as authorized or required under subdivision 1 or section 144.293,
310.3subdivision 5, clause (1).

310.4    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL
310.5RESEARCH.
310.6    Subdivision 1. Methods of release. (a) Notwithstanding section 144.293,
310.7subdivisions 2 and 4, health records may be released to an external researcher solely for
310.8purposes of medical or scientific research only as follows:
310.9    (1) health records generated before January 1, 1997, may be released if the patient
310.10has not objected or does not elect to object after that date;
310.11    (2) for health records generated on or after January 1, 1997, the provider must:
310.12    (i) disclose in writing to patients currently being treated by the provider that health
310.13records, regardless of when generated, may be released and that the patient may object, in
310.14which case the records will not be released; and
310.15    (ii) use reasonable efforts to obtain the patient's written general authorization that
310.16describes the release of records in item (i), which does not expire but may be revoked or
310.17limited in writing at any time by the patient or the patient's authorized representative;
310.18    (3) the provider must advise the patient of the rights specified in clause (4); and
310.19    (4) the provider must, at the request of the patient, provide information on how the
310.20patient may contact an external researcher to whom the health record was released and
310.21the date it was released.
310.22    (b) Authorization may be established if an authorization is mailed at least two
310.23times to the patient's last known address with a postage prepaid return envelope and a
310.24conspicuous notice that the patient's medical records may be released if the patient does
310.25not object, and at least 60 days have expired since the second notice was sent.
310.26    Subd. 2. Duties of researcher. In making a release for research purposes, the
310.27provider shall make a reasonable effort to determine that:
310.28    (1) the use or disclosure does not violate any limitations under which the record
310.29was collected;
310.30    (2) the use or disclosure in individually identifiable form is necessary to accomplish
310.31the research or statistical purpose for which the use or disclosure is to be made;
310.32    (3) the recipient has established and maintains adequate safeguards to protect the
310.33records from unauthorized disclosure, including a procedure for removal or destruction of
310.34information that identifies the patient; and
311.1    (4) further use or release of the records in individually identifiable form to a person
311.2other than the patient without the patient's consent is prohibited.

311.3    Sec. 19. [144.296] COPIES OF VIDEOTAPES.
311.4    A provider may not release a copy of a videotape of a child victim or alleged victim
311.5of physical or sexual abuse without a court order under section 13.03, subdivision 6, or
311.6as provided in section 611A.90. This section does not limit the right of a patient to view
311.7the videotape.

311.8    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.
311.9    This section applies to the subject and provider of an independent medical
311.10examination requested by or paid for by a third party. Notwithstanding section 144.293, a
311.11provider may release health records created as part of an independent medical examination
311.12to the third party who requested or paid for the examination.

311.13    Sec. 21. [144.298] PENALTIES.
311.14    Subdivision 1. Licensing action. A violation of sections 144.291 to 144.298 may
311.15be grounds for disciplinary action against a provider by the appropriate licensing board
311.16or agency.
311.17    Subd. 2. Allocation of liability. In adjudicating a dispute involving the disclosure
311.18of patient health records, a court shall use the criteria in this subdivision in determining
311.19how liability will be allocated.
311.20    (a) When requesting health records using consent, a person warrants that the consent:
311.21    (1) contains no information known to the person to be false; and
311.22    (2) accurately states the patient's desire to have health records disclosed or that there
311.23is specific authorization in law.
311.24    (b) When requesting health records using consent or the representation authorized in
311.25section 144.293, subdivision 2, a provider warrants that the request:
311.26    (1) contains no information known to the provider to be false;
311.27    (2) accurately states the patient's desire to have health records disclosed or that
311.28there is specific authorization in law; and
311.29    (3) does not exceed any limits imposed by the patient in the consent.
311.30    (c) When disclosing health records, a person releasing health records warrants that
311.31the person:
311.32    (1) has complied with the requirements of this section regarding disclosure of
311.33health records;
312.1    (2) knows of no information related to the request that is false; and
312.2    (3) has complied with the limits set by the patient in the consent or as described
312.3in the representation of consent.
312.4    (d) A court of this state presumes that:
312.5    (1) a request made by a person that complies with the provisions of this section is
312.6valid and represents the wishes of the patient;
312.7    (2) the information listed in a consent or representation of consent is accurate;
312.8    (3) the recipient of a consent or representation of consent has no knowledge or
312.9notice that the person making the request breached a duty to the patient or does not
312.10rightfully have a consent;
312.11    (4) the signature on the consent or representation of consent is not forged;
312.12    (5) the consent or representation of consent was not obtained under false pretenses;
312.13and
312.14    (6) the consent or representation of consent was not altered without the patient's
312.15permission.
312.16    (e) No person or provider may disclaim or contractually limit the application of this
312.17section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity
312.18restricts liability for misrepresentation against persons reasonably relying on the consent,
312.19representation of consent, or disclosure.
312.20    (f) A court of this state shall give effect to liability allocations between the parties
312.21provided by contract that does not allocate liability to the detriment of the patient and the
312.22allocation is consistent with the requirements of sections 144.291 to 144.298.
312.23    (g) A patient is eligible to receive compensatory damages plus costs and reasonable
312.24attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.
312.25    Subd. 3. Liability for a record locator service. A patient is eligible to receive
312.26compensatory damages plus costs and reasonable attorney fees if a health information
312.27exchange maintaining a record locator service, or an entity maintaining a record locator
312.28service for a health information exchange, negligently or intentionally violates the
312.29provisions of section 144.293, subdivision 8.

312.30    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:
312.31144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD
312.32GRANTS.
312.33    Subdivision 1. Definitions. The following definitions are used for the purposes
312.34of this section.
313.1    (a) "Eligible community e-health collaborative" means an existing or newly
313.2established collaborative to support the adoption and use of interoperable electronic
313.3health records. A collaborative must consist of at least three two or more eligible health
313.4care entities in at least two of the categories listed in paragraph (b) and have a focus on
313.5interconnecting the members of the collaborative for secure and interoperable exchange of
313.6health care information.
313.7    (b) "Eligible health care entity" means one of the following:
313.8    (1) community clinics, as defined under section 145.9268;
313.9    (2) hospitals eligible for rural hospital capital improvement grants, as defined
313.10in section 144.148;
313.11    (3) physician clinics located in a community with a population of less than 50,000
313.12according to United States Census Bureau statistics and outside the seven-county
313.13metropolitan area;
313.14    (4) nursing facilities licensed under sections 144A.01 to 144A.27;
313.15    (5) community health boards or boards of health as established under chapter 145A;
313.16    (6) nonprofit entities with a purpose to provide health information exchange
313.17coordination governed by a representative, multi-stakeholder board of directors; and
313.18    (7) other providers of health or health care services approved by the commissioner
313.19for which interoperable electronic health record capability would improve quality of
313.20care, patient safety, or community health.
313.21    Subd. 2. Grants authorized. The commissioner of health shall award grants to:
313.22    (a) eligible community e-health collaborative projects to improve the implementation
313.23and use of interoperable electronic health records including but not limited to the
313.24following projects:
313.25    (1) collaborative efforts to host and support fully functional interoperable electronic
313.26health records in multiple care settings;
313.27    (2) electronic medication history and electronic patient registration medical history
313.28information;
313.29    (3) electronic personal health records for persons with chronic diseases and for
313.30prevention services;
313.31    (4) rural and underserved community models for electronic prescribing; and
313.32    (5) enabling modernize local public health information systems to rapidly and
313.33electronically exchange information needed to participate in community e-health
313.34collaboratives or for public health emergency preparedness and response.; and
313.35    (6) implement regional or community-based health information exchange
313.36organizations;
314.1    (b) community clinics, as defined under section 145.9268, to implement and use
314.2interoperable electronic health records, including but not limited to the following projects:
314.3    (1) efforts to plan for and implement fully functional, standards-based interoperable
314.4electronic health records; and
314.5    (2) purchases and implementation of computer hardware, software, and technology
314.6to fully implement interoperable electronic health records;
314.7    (c) regional or community-based health information exchange organizations to
314.8connect and facilitate the exchange of health information between eligible health care
314.9entities, including but not limited to the development, testing, and implementation of:
314.10    (1) data exchange standards, including data, vocabulary, and messaging standards,
314.11for the exchange of health information, provided that such standards are consistent with
314.12state and national standards;
314.13    (2) security standards necessary to ensure the confidentiality and integrity of health
314.14records;
314.15    (3) computer interfaces and mechanisms for standardizing health information
314.16exchanged between eligible health care entities;
314.17    (4) a record locator service for identifying the location of patient health records; or
314.18    (5) interfaces and mechanisms for implementing patient consent requirements; and
314.19    (d) community health boards and boards of health as established under chapter
314.20145A to modernize local public health information systems to be standards-based and
314.21interoperable with other electronic health records and information systems, or for
314.22enhanced public health emergency preparedness and response.
314.23    Grant funds may not be used for construction of health care or other buildings or
314.24facilities.
314.25    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible
314.26community e-health collaborative, community clinic, regional or community-based health
314.27information exchange, or community health boards and boards of health must submit an
314.28application to the commissioner of health by the deadline established by the commissioner.
314.29A grant may be awarded upon the signing of a grant contract. In awarding grants, the
314.30commissioner shall give preference to projects benefiting providers located in rural and
314.31underserved areas of Minnesota which the commissioner has determined have an unmet
314.32need for the development and funding of electronic health records. Applicants may apply
314.33for and the commissioner may award grants for one-year, two-year, or three-year periods.
314.34    (b) An application must be on a form and contain information as specified by the
314.35commissioner but at a minimum must contain:
314.36    (1) a description of the purpose or project for which grant funds will be used;
315.1    (2) a description of the problem or problems the grant funds will be used to address,
315.2including an assessment of the likelihood of the project occurring absent grant funding;
315.3    (3) a description of achievable objectives, a workplan, budget, budget narrative, a
315.4project communications plan, a timeline for implementation and completion of processes
315.5or projects enabled by the grant, and an assessment of privacy and security issues and a
315.6proposed approach to address these issues;
315.7    (4) a description of the health care entities and other groups participating in the
315.8project, including identification of the lead entity responsible for applying for and
315.9receiving grant funds;
315.10    (5) a plan for how patients and consumers will be involved in development of
315.11policies and procedures related to the access to and interchange of information;
315.12    (6) evidence of consensus and commitment among the health care entities and others
315.13who developed the proposal and are responsible for its implementation; and
315.14    (7) a plan for documenting and evaluating results of the grant. ; and
315.15    (8) a plan for use of data exchange standards, including data and vocabulary.
315.16    (c) The commissioner shall review each application to determine whether the
315.17application is complete and whether the applicant and the project are eligible for a
315.18grant. In evaluating applications, the commissioner shall take into consideration factors,
315.19including but not limited to, the following:
315.20    (1) the degree to which the proposal interconnects the various providers of care with
315.21other health care entities in the applicant's geographic community;
315.22    (2) the degree to which the project provides for the interoperability of electronic
315.23health records or related health information technology between the members of the
315.24collaborative, and presence and scope of a description of how the project intends to
315.25interconnect with other providers not part of the project into the future;
315.26    (3) the degree to which the project addresses current unmet needs pertaining
315.27to interoperable electronic health records in a geographic area of Minnesota and the
315.28likelihood that the needs would not be met absent grant funds;
315.29    (4) the applicant's thoroughness and clarity in describing the project, how the project
315.30will improve patient safety, quality of care, and consumer empowerment, and the role of
315.31the various collaborative members;
315.32    (5) the recommendations of the Health Information and Technology Infrastructure
315.33Advisory Committee; and
315.34    (6) other factors that the commissioner deems relevant.
316.1    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall
316.2be required to provide $1 in the form of cash or in-kind staff or services for each $3
316.3provided under the grant program.
316.4    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion
316.5over the size and number of grants awarded.
316.6    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the
316.7overall effectiveness of the grant program. The commissioner shall collect progress
316.8and expenditure reports to evaluate the grant program from the eligible community
316.9collaboratives receiving grants.

316.10    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:
316.11144.565 DIAGNOSTIC IMAGING FACILITIES.
316.12    Subdivision 1. Utilization and services data; economic and financial interests.
316.13    The commissioner shall require diagnostic imaging facilities and providers of diagnostic
316.14imaging services in Minnesota to annually report by March 1 each year for the preceding
316.15fiscal year to the commissioner, in the form and manner specified by the commissioner:
316.16    (1) utilization data for each health plan company and each public program,
316.17including workers' compensation, as follows: of diagnostic imaging services as defined
316.18in subdivision 4, paragraph (b);
316.19    (i) the number of computerized tomography (CT) procedures performed;
316.20    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and
316.21    (iii) the number of positron emission tomography (PET) procedures performed; and
316.22    (2) the names of all physicians with any financial or economic interest and all other
316.23individuals with a ten percent or greater financial or economic interest in the facility.;
316.24    (3) the location where procedures were performed;
316.25    (4) the number of units of each type of fixed, portable, and mobile scanner used at
316.26each location;
316.27    (5) the average number of hours per month each mobile scanner was operated at
316.28each location;
316.29    (6) the number of hours per month each scanner was leased, if applicable;
316.30    (7) the total number of diagnostic imaging procedures billed for by the provider at
316.31each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph
316.32(b); and
316.33    (8) a report on major health care capital expenditures during the previous year, as
316.34required by section 62J.17.
317.1    Subd. 2. Commissioner's right to inspect records. If the report is not filed or
317.2the commissioner of health has reason to believe the report is incomplete or false, the
317.3commissioner shall have the right to inspect diagnostic imaging facility books, audits,
317.4and records.
317.5    Subd. 3. Separate reports. For a diagnostic imaging facility that is not attached
317.6or not contiguous to a hospital or a hospital affiliate, the commissioner shall require
317.7the information in subdivision 1 be reported separately for each detached diagnostic
317.8imaging facility as part of the report required under section 144.702. If any entity owns
317.9more than one diagnostic imaging facility, that entity must report by individual facility.
317.10Reports must include only services that were billed by the provider of diagnostic imaging
317.11services submitting the report. If a diagnostic imaging facility leases capacity, technical
317.12services, or professional services to one or more other providers of diagnostic imaging
317.13services, each provider must submit a separate annual report to the commissioner for all
317.14diagnostic imaging services that it provided and billed. The owner of the leased capacity
317.15must provide a report listing the names and addresses of providers to whom the diagnostic
317.16imaging services and equipment were leased.
317.17    Subd. 4. Definitions. For purposes of this section, the following terms have the
317.18meanings given:
317.19    (a) "Diagnostic imaging facility" means a health care facility that provides is not
317.20a hospital or location licensed as a hospital which offers diagnostic imaging services
317.21through the use of ionizing radiation or other imaging technique including, but not limited
317.22to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a
317.23freestanding or mobile basis in Minnesota, regardless of whether the equipment used
317.24to provide the service is owned or leased. For the purposes of this section, diagnostic
317.25imaging facility includes, but is not limited to, facilities such as a physician's office, clinic,
317.26mobile transport vehicle, outpatient imaging center, or surgical center.
317.27    (b) "Diagnostic imaging service" means the use of ionizing radiation or other
317.28imaging technique on a human patient including, but not limited to, magnetic resonance
317.29imaging (MRI) or computerized tomography (CT), positron emission tomography (PET),
317.30or single photon emission computerized tomography (SPECT) scans using fixed, portable,
317.31or mobile equipment.
317.32    (b) (c) "Financial or economic interest" means a direct or indirect:
317.33    (1) equity or debt security issued by an entity, including, but not limited to, shares of
317.34stock in a corporation, membership in a limited liability company, beneficial interest in
317.35a trust, units or other interests in a partnership, bonds, debentures, notes or other equity
317.36interests or debt instruments, or any contractual arrangements;
318.1    (2) membership, proprietary interest, or co-ownership with an individual, group, or
318.2organization to which patients, clients, or customers are referred to; or
318.3    (3) employer-employee or independent contractor relationship, including, but not
318.4limited to, those that may occur in a limited partnership, profit-sharing arrangement, or
318.5other similar arrangement with any facility to which patients are referred, including any
318.6compensation between a facility and a health care provider, the group practice of which
318.7the provider is a member or employee or a related party with respect to any of them.
318.8    (c) (d) "Freestanding Fixed equipment" means a stationary diagnostic imaging
318.9facility that is not located within a: machine installed in a permanent location.
318.10    (1) hospital;
318.11    (2) location licensed as a hospital; or
318.12    (3) physician's office or clinic where the professional practice of medicine by
318.13licensed physicians is the primary purpose and not the provision of ancillary services
318.14such as diagnostic imaging.
318.15    (d) (e) "Mobile equipment" means a diagnostic imaging facility that is transported to
318.16various sites not including movement within a hospital or a physician's office or clinic
318.17machine in a self-contained transport vehicle designed to be brought to a temporary offsite
318.18location to perform diagnostic imaging services.
318.19    (f) "Portable equipment" means a diagnostic imaging machine designed to be
318.20temporarily transported within a permanent location to perform diagnostic imaging
318.21services.
318.22    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility
318.23or an entity that offers and bills for diagnostic imaging services at a facility owned or
318.24leased by the entity.
318.25    Subd. 5. Reports open to public inspection. All reports filed pursuant to this
318.26section shall be open to public inspection.

318.27    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS
318.28CONTROL PROGRAMS.
318.29    In order to improve the prevention of hospital-associated bloodstream infections due
318.30to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish
318.31an MRSA control program that meets Minnesota Department of Health best practices
318.32standards as published January 15, 2008, including considerations of:
318.33    (1) identification of all MRSA-colonized patients in all intensive care units, and
318.34other at-risk patients identified by the hospital, through active surveillance testing;
319.1    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an
319.2appropriate manner;
319.3    (3) monitoring and strict enforcement of hand hygiene requirements; and
319.4    (4) maintenance of records.

319.5    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:
319.6    Subd. 26. Right to associate. (a) Residents may meet with and receive visitors
319.7and participate in activities of commercial, religious, political, as defined in section
319.8203B.11 and community groups without interference at their discretion if the activities
319.9do not infringe on the right to privacy of other residents or are not programmatically
319.10contraindicated. This includes:
319.11    (1) the right to join with other individuals within and outside the facility to work for
319.12improvements in long-term care;
319.13    (2) the right to visitation by an individual the patient has appointed as the patient's
319.14health care agent under chapter 145C;
319.15    (3) the right to visitation and health care decision making by an individual designated
319.16by the patient under paragraph (c).
319.17    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure
319.18of patient or resident identifying information to callers and visitors, the patient or
319.19resident, or the legal guardian or conservator of the patient or resident, shall be given the
319.20opportunity to authorize disclosure of the patient's or resident's presence in the facility
319.21to callers and visitors who may seek to communicate with the patient or resident. To the
319.22extent possible, the legal guardian or conservator of a patient or resident shall consider the
319.23opinions of the patient or resident regarding the disclosure of the patient's or resident's
319.24presence in the facility.
319.25    (c) Upon admission to a facility, the patient or resident, or the legal guardian
319.26or conservator of the patient or resident, must be given the opportunity to designate
319.27a person who is not related who will have the status of the patient's next of kin with
319.28respect to visitation and making a health care decision. A designation must be included
319.29in the patient's health record. With respect to making a health care decision, a health
319.30care directive or appointment of a health care agent under chapter 145C prevails over a
319.31designation made under this paragraph. The unrelated person may also be identified as
319.32such by the patient or by the patient's family.

319.33    Sec. 26. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
320.1    Subdivision 1. Definitions. For purposes of this section, "federally qualified health
320.2center" means an entity that is receiving a grant under United States Code, title 42,
320.3section 254b, or, based on the recommendation of the Health Resources and Services
320.4Administration within the Public Health Service, is determined by the secretary to meet
320.5the requirements for receiving such a grant.
320.6    Subd. 2. Allocation of subsidies. The commissioner of health shall distribute
320.7subsidies to federally qualified health centers operating in Minnesota to continue, expand,
320.8and improve federally qualified health center services to low-income populations. The
320.9commissioner shall distribute the funds appropriated under this section to federally
320.10qualified health centers operating in Minnesota as of January 1, 2007. The amount of
320.11each subsidy shall be in proportion to each federally qualified health center's amount of
320.12discounts granted to patients during calendar year 2006 as reported on the federal Uniform
320.13Data System report in conformance with the Bureau of Primary Health Care Program
320.14Expectations Policy Information Notice 98-23, except that each eligible federally qualified
320.15health center shall receive at least two percent but no more than 30 percent of the total
320.16amount of money available under this section.

320.17    Sec. 27. Minnesota Statutes 2006, section 145C.05, is amended to read:
320.18145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.
320.19    Subdivision 1. Content. A health care directive executed pursuant to this chapter
320.20may, but need not, be in the form contained in section 145C.16.
320.21    Subd. 2. Provisions that may be included. (a) A health care directive may include
320.22provisions consistent with this chapter, including, but not limited to:
320.23    (1) the designation of one or more alternate health care agents to act if the named
320.24health care agent is not reasonably available to serve;
320.25    (2) directions to joint health care agents regarding the process or standards by which
320.26the health care agents are to reach a health care decision for the principal, and a statement
320.27whether joint health care agents may act independently of one another;
320.28    (3) limitations, if any, on the right of the health care agent or any alternate health
320.29care agents to receive, review, obtain copies of, and consent to the disclosure of the
320.30principal's medical records or to visit the principal when the principal is a patient in a
320.31health care facility;
320.32    (4) limitations, if any, on the nomination of the health care agent as guardian for
320.33purposes of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;
321.1    (5) a document of gift for the purpose of making an anatomical gift, as set forth in
321.2sections 525.921 to 525.9224, or an amendment to, revocation of, or refusal to make
321.3an anatomical gift;
321.4    (6) a declaration regarding intrusive mental health treatment under section 253B.03,
321.5subdivision 6d , or a statement that the health care agent is authorized to give consent for
321.6the principal under section 253B.04, subdivision 1a;
321.7    (7) a funeral directive as provided in section 149A.80, subdivision 2;
321.8    (8) limitations, if any, to the effect of dissolution or annulment of marriage or
321.9termination of domestic partnership on the appointment of a health care agent under
321.10section 145C.09, subdivision 2;
321.11    (9) specific reasons why a principal wants a health care provider or an employee
321.12of a health care provider attending the principal to be eligible to act as the principal's
321.13health care agent;
321.14    (10) health care instructions by a woman of child bearing age regarding how she
321.15would like her pregnancy, if any, to affect health care decisions made on her behalf; and
321.16    (11) health care instructions regarding artificially administered nutrition or hydration.
321.17    (b) A health care directive may include a statement of the circumstances under
321.18which the directive becomes effective other than upon the judgment of the principal's
321.19attending physician in the following situations:
321.20    (1) a principal who in good faith generally selects and depends upon spiritual means
321.21or prayer for the treatment or care of disease or remedial care and does not have an
321.22attending physician, may include a statement appointing an individual who may determine
321.23the principal's decision-making capacity; and
321.24    (2) a principal who in good faith does not generally select a physician or a health
321.25care facility for the principal's health care needs may include a statement appointing an
321.26individual who may determine the principal's decision-making capacity, provided that if
321.27the need to determine the principal's capacity arises when the principal is receiving care
321.28under the direction of an attending physician in a health care facility, the determination
321.29must be made by an attending physician after consultation with the appointed individual.
321.30    If a person appointed under clause (1) or (2) is not reasonably available and the
321.31principal is receiving care under the direction of an attending physician in a health care
321.32facility, an attending physician shall determine the principal's decision-making capacity.
321.33    (c) A health care directive may authorize a health care agent to make health care
321.34decisions for a principal even though the principal retains decision-making capacity.

322.1    Sec. 28. Minnesota Statutes 2006, section 145C.07, is amended by adding a
322.2subdivision to read:
322.3    Subd. 5. Visitation. A health care agent may visit the principal when the
322.4principal is a patient in a health care facility regardless of whether the principal retains
322.5decision-making capacity, unless:
322.6    (1) the principal has otherwise specified in the health care directive;
322.7    (2) a principal who retains decision-making capacity indicates otherwise; or
322.8    (3) a health care provider reasonably determines that the principal must be isolated
322.9from all visitors or that the presence of the health care agent would endanger the health or
322.10safety of the principal, other patients, or the facility in which the care is being provided.

322.11    Sec. 29. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:
322.12    Subdivision 1. License required annually. A license is required annually for every
322.13person, firm, or corporation engaged in the business of conducting a food and beverage
322.14service establishment, hotel, motel, lodging establishment, or resort. Any person wishing
322.15to operate a place of business licensed in this section shall first make application, pay the
322.16required fee specified in this section, and receive approval for operation, including plan
322.17review approval. Seasonal and temporary food stands and special event food stands are
322.18not required to submit plans. Nonprofit organizations operating a special event food
322.19stand with multiple locations at an annual one-day event shall be issued only one license.
322.20Application shall be made on forms provided by the commissioner and shall require
322.21the applicant to state the full name and address of the owner of the building, structure,
322.22or enclosure, the lessee and manager of the food and beverage service establishment,
322.23hotel, motel, lodging establishment, or resort; the name under which the business is to
322.24be conducted; and any other information as may be required by the commissioner to
322.25complete the application for license.

322.26    Sec. 30. HEALTH PROMOTION PROGRAM.
322.27    The State Community Health Services Advisory Committee established in
322.28Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and
322.29implement an ongoing comprehensive health promotion program that can effect change
322.30more effectively and at lower cost at a community level rather than through individual
322.31counseling and change promotion. The program shall use proven public health strategies
322.32to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term
322.33approach to reducing preventable disability, chronic health conditions, and disease. The
322.34focus shall be on community based initiatives that address childhood and adult obesity,
323.1tobacco and substance abuse, improved activity levels among senior citizens, and other
323.2lifestyle issues that impact health and healthcare costs. Because of its population health
323.3focus, funding shall be related to the size of the population to be served. The plan shall be
323.4completed by September 15, 2007, and shared with the Legislative Health Care Access
323.5Commission.

323.6    Sec. 31. INJUNCTIVE RELIEF REPORT.
323.7    The commissioner of health shall present to the 2008 legislature, by December 15,
323.82007, recommendations to fund the cost of bringing actions for injunctive relief under
323.9Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).

323.10    Sec. 32. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE;
323.11ESTABLISHMENT.
323.12    (a) The commissioner of health shall establish a Diagnostic Imaging Services
323.13Advisory Committee to perform the following duties:
323.14    (1) gather and analyze data to understand the factors driving utilization of diagnostic
323.15imaging services, including computed tomography (CT), magnetic resonance imaging
323.16(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA),
323.17and nuclear cardiology, in the state relative to evidence-based guidelines; and
323.18    (2) develop recommendations, based on the data collected, on how to improve
323.19the delivery of evidence-based diagnostic imaging services. In developing these
323.20recommendations, the advisory committee shall consider the impacts on patient care,
323.21premium costs, and administrative simplicity.
323.22    (b) The members of the Diagnostic Imaging Services Advisory Committee shall
323.23include the commissioners of health and human services or the commissioners' designees
323.24and the following:
323.25    (1) three physicians representing speciality and geographic diversity, appointed by
323.26the Minnesota Medical Association;
323.27    (2) two hospital representatives, one from a metropolitan hospital and one from a
323.28rural hospital, appointed by the Minnesota Hospital Association;
323.29    (3) three health plan company representatives appointed by the Minnesota Council
323.30of Health Plans;
323.31    (4) two representatives appointed by the Institute for Clinical System Improvement;
323.32and
323.33    (5) one clinic manager appointed by the Minnesota Medical Group Management
323.34Association.
324.1    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later
324.2than September 1, 2007. The commissioner shall report back to the legislature no later
324.3than January 15, 2008. The advisory committee is governed under Minnesota Statutes,
324.4section 15.059, except that members shall not receive a per diem and may only be
324.5reimbursed for expenses.
324.6    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services
324.7may be developed by health plans. The commissioner of health shall report the agreement
324.8to the chairs of the senate and house health care committees immediately.
324.9EFFECTIVE DATE.This section is effective July 1, 2007.

324.10    Sec. 33. HEARING AID DISPENSER FEES.
324.11    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section
324.12153A.17, may not be increased until after the Department of Health provides a report to
324.13the legislature regarding the need and reasons for fee increases.

324.14    Sec. 34. REVISOR'S INSTRUCTION.
324.15    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references
324.16in column A with the references in column B.

324.17	Column A	Column B
324.18	section 144.335	sections 144.291 to 144.298
324.19	section 144.335, subdivision 1	section 144.291, subdivision 2
324.20 324.21	section 144.335, subdivision 1, paragraph (b)	section 144.291, subdivision 2, paragraph (h)
324.22 324.23	section 144.335, subdivision 2, paragraphs (a) and (b)	section 144.292, subdivisions 2 and 5
324.24	section 144.335, subdivision 2	section 144.292
324.25	section 144.335, subdivision 3a	section 144.294, subdivision 2
324.26 324.27	section 144.335, subdivision 3a, paragraph (d)	section 144.295
324.28 324.29	section 144.335, subdivision 3a, paragraph (f)	section 144.294
324.30	section 144.335, subdivision 3b	section 144.293, subdivision 7

324.31    Sec. 35. REPEALER.
324.32(a) Minnesota Statutes 2006, section 144.335, is repealed.
324.33(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are
324.34repealed, effective the day following final enactment.

325.1ARTICLE 7

325.2MISCELLANEOUS

325.3    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a
325.4subdivision to read:
325.5    Subd. 2a. Base budget detail. Within one week of the release of the budget forecasts
325.6required in section 16A.102 in November of an even-numbered year and February of an
325.7odd-numbered year, the commissioner, after consulting with the commissioners of human
325.8services and health, must provide to the legislature information at the program, budget
325.9activity and management activity level for the base level budget of the Department of
325.10Human Services and the Department of Health for the next biennium. The information
325.11must be organized in a manner that explains how base level budget appropriations are
325.12projected to be spent. Within one week of the release of the budget forecasts required in
325.13section 16A.102 in November of an even-numbered year, the commissioner must also
325.14provide the legislature with the information submitted by the commissioners of human
325.15services and health under subdivision 2, clauses (3) and (4).

325.16    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:
325.1743A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.
325.18    Subdivision 1. Intent. The legislature finds that the creation of a statewide program
325.19to provide public employees and other eligible persons with life insurance and hospital,
325.20medical, and dental benefit coverage through provider organizations would result in a
325.21greater utilization more efficient use of government resources and would advance the
325.22health and welfare of the citizens of the state.
325.23    Subd. 2. Definitions. For the purpose of this section, the terms defined in this
325.24subdivision have the meaning given them.
325.25    (a) Commissioner. "Commissioner" means the commissioner of employee relations.
325.26    (b) Employee. "Employee" means:
325.27    (1) a person who is a public employee within the definition of section 179A.03,
325.28subdivision 14 , who is insurance eligible and is employed by an eligible employer;
325.29    (2) an elected public official of an eligible employer who is insurance eligible;
325.30    (3) a person employed by a labor organization or employee association certified as
325.31an exclusive representative of employees of an eligible employer or by another public
325.32employer approved by the commissioner, so long as the plan meets the requirements of a
325.33governmental plan under United States Code, title 29, section 1002(32); or
325.34    (4) a person employed by a county or municipal hospital.
326.1    (c) Eligible employer. "Eligible employer" means:
326.2    (1) a public employer within the definition of section 179A.03, subdivision 15, that
326.3is a town, county, city, school district as defined in section 120A.05, service cooperative
326.4as defined in section 123A.21, intermediate district as defined in section 136D.01,
326.5Cooperative Center for Vocational Education as defined in section 123A.22, regional
326.6management information center as defined in section 123A.23, or an education unit
326.7organized under the joint powers action, section 471.59; or
326.8    (2) an exclusive representative of employees, as defined in paragraph (b);
326.9    (3) a county or municipal hospital; or
326.10    (4) another public employer approved by the commissioner; or
326.11    (5) a nursing home as defined in section 144A.01, subdivision 5, located in this state.
326.12    (d) Exclusive representative. "Exclusive representative" means an exclusive
326.13representative as defined in section 179A.03, subdivision 8.
326.14    (e) Labor-Management Committee. "Labor-Management Committee" means the
326.15committee established by subdivision 4.
326.16    (f) Program. "Program" means the statewide public employees insurance program
326.17created by subdivision 3.
326.18    Subd. 3. Public employee insurance program. The commissioner shall be the
326.19administrator of the public employee insurance program and may determine its funding
326.20arrangements. The commissioner may contract with a qualified entity to perform the
326.21administrative functions. The commissioner shall model the program after the plan
326.22established in section 43A.18, subdivision 2, but may modify adopt variations from that
326.23plan, in consultation with the Labor-Management Committee. The variations may include
326.24different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.
326.25    Subd. 4. Labor-Management Committee. (a) The Labor-Management Committee
326.26consists of ten members appointed by the commissioner. The Labor-Management
326.27Committee must comprise five members who represent employees, including at least
326.28one retired employee, and five members who represent eligible employers. Committee
326.29members are eligible for expense reimbursement in the same manner and amount as
326.30authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. The
326.31commissioner shall consult with the labor-management committee in major decisions
326.32that affect the program. The committee shall study issues and make recommendations
326.33relating to the insurance program including, but not limited to, flexible benefits, utilization
326.34review, quality assessment, and cost efficiency. The committee continues to exist while
326.35the program remains in operation.
327.1    (b) The five members of the Labor-Management Committee who represent
327.2employees must be chosen by the commissioner from among persons nominated as
327.3provided in this paragraph. Exclusive representatives of employees of counties, cities,
327.4school districts, and nursing homes are entitled to nominate two candidates for the
327.5Labor-Management Committee from each of those four categories, and the commissioner
327.6shall appoint one of those two nominees from each category. The commissioner shall
327.7choose the fifth employee to represent retired employees.
327.8    (c) The five members of the Labor-Management Committee who represent employers
327.9must be chosen by the commissioner from among persons nominated as provided in
327.10this paragraph. The Association of Minnesota Counties, Minnesota League of Cities,
327.11Minnesota School Boards Association, and the Minnesota Association of Nursing Homes
327.12are each entitled to nominate two candidates for the committee, and the commissioner
327.13shall appoint one of those from each group. The commissioner shall select the fifth
327.14employer member from an employer participating in the program and not represented
327.15by the other four employer members, if any, or if that is not reasonably possible, the
327.16commissioner may appoint any other person as the fifth employer representative.
327.17    Subd. 5. Public employee participation. (a) Participation in the program is subject
327.18to the conditions in this subdivision.
327.19    (b) Each exclusive representative for an eligible employer determines whether the
327.20employees it represents will participate in the program. The exclusive representative shall
327.21give the employer notice of intent to participate at least 30 60 days before the expiration
327.22date of the collective bargaining agreement preceding the collective bargaining agreement
327.23that covers the date of entry into the program. Either all or none of the employees
327.24represented by an exclusive representative must participate. The exclusive representative
327.25and the eligible employer shall give notice to the commissioner of the determination to
327.26participate in the program at least 30 60 days before entry into the program. Entry into the
327.27program is governed by a schedule established by the commissioner.
327.28    (c) Employees not represented by exclusive representatives may become members
327.29of the program upon a determination of an eligible employer to include these employees
327.30in the program. Either all or none of the employer's unrepresented employees must
327.31participate. The eligible employer shall give at least 30 60 days' notice to the commissioner
327.32before entering the program. Entry into the program is governed by a schedule established
327.33by the commissioner.
327.34    (d) Participation in the program is for a two-year three-year term. Participation is
327.35automatically renewed for an additional two-year three-year term unless the exclusive
327.36representative, or the employer for unrepresented employees, gives the commissioner
328.1notice of withdrawal at least 30 60 days before expiration of the participation period. A
328.2group that withdraws must wait two years before rejoining, except with the approval of
328.3the commissioner. An exclusive representative, or employer for unrepresented employees,
328.4may also withdraw if premiums increase 50 percent by more than 20 percent in excess of
328.5the Consumer Price Index for all urban consumers or more from one insurance year to
328.6the next.
328.7    (e) The exclusive representative shall give the employer notice of intent to withdraw
328.8to the commissioner at least 30 60 days before the expiration date of a collective
328.9bargaining agreement that includes the date on which the term of participation expires.
328.10    (f) Each participating eligible employer shall notify the commissioner of the names
328.11of individuals who will be participating within two weeks of after the commissioner
328.12receiving receives notice of the parties' intent to participate. The employer shall also
328.13submit other information as required by the commissioner for administration of the
328.14program.
328.15    (g) An employer that withdraws from the program under circumstances that do not
328.16permit withdrawal under this subdivision is liable to the board for premiums payable by
328.17the employer until the time that the employer is eligible to withdraw, and the employer
328.18shall pay those premiums voluntarily and no later than their due date. If the premiums are
328.19not paid voluntarily, the board has authority to and shall collect these premiums under any
328.20method permitted by law for a governmental or nongovernmental creditor of the employer.
328.21    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the
328.22benefits of the program. The program shall include employee hospital, medical, dental,
328.23and life insurance for employees and hospital and medical benefits for dependents. Health
328.24maintenance organization options and other delivery system options may be provided if
328.25they are available, cost-effective, and capable of servicing the number of people covered
328.26in the program. Participation in optional coverages may be provided by collective
328.27bargaining agreements. For employees not represented by an exclusive representative, the
328.28employer may offer the optional coverages to eligible employees and their dependents
328.29provided in the program. Health coverage must include at least the benefits required of a
328.30health plan company regulated under chapter 62A, 62C, or 62D.
328.31    (b) The commissioner, with the assistance of the Labor-Management Committee,
328.32shall periodically assess whether it is financially feasible for the program to offer or to
328.33continue an individual retiree program that has competitive premium rates and benefits.
328.34If the commissioner determines it to be feasible to offer an individual retiree program,
328.35the commissioner shall announce the applicable benefits, premium rates, and terms of
328.36participation. Eligibility to participate in the individual retiree program is governed by
329.1subdivision 8, but applies to retirees of eligible employers that do not participate in the
329.2program and to those retirees' dependents and surviving spouses.
329.3    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided
329.4by the program or a successor program relating to expenses incurred for medical treatment
329.5or services of a physician health care provider must also include chiropractic treatment
329.6and services of a chiropractor any other type of licensed, certified, or registered health care
329.7provider to the extent that the chiropractic services and treatment are within the scope of
329.8chiropractic licensure the provider's licensure, certification, or registration.
329.9    This subdivision is intended to provide equal access to benefits for program members
329.10who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long
329.11as the treatment falls within the chiropractor's scope of practice. This subdivision is not
329.12intended to change or add to the benefits provided for in the program.
329.13    Subd. 7. Premiums. (a) The proportion of premium paid by the employer and
329.14employee is subject to collective bargaining or personnel policies. If, at the beginning of
329.15the coverage period, no collective bargaining agreement has been finalized, the increased
329.16dollar costs, if any, from the previous year is the sole responsibility of the individual
329.17participant until a collective bargaining agreement states otherwise. Premiums, including
329.18an administration fee, shall be established by the commissioner. The commissioner may
329.19decide to rate specific employers separately for premium purposes, if the commissioner
329.20determines that doing so is in the best interests of the program. Each employer shall pay
329.21monthly the amounts due for employee benefits including the amounts under subdivision
329.228 to the commissioner no later than the dates established by the commissioner. If an
329.23employer fails to make the payments as required, the commissioner may shall cancel
329.24program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph
329.25(d).
329.26    (b) The premium charged for an employer's first month in the program must be
329.27three times the regular monthly premium charged to that employer, to help establish
329.28and maintain the program's financial resources. The extra two months premium must
329.29be refunded to the employer if the employer leaves the program, if the refund would
329.30not reduce the program's reserves below the level determined to be appropriate by the
329.31commissioner.
329.32    Subd. 8. Continuation of coverage. (a) A former employee of an employer
329.33participating in the program who is receiving a public pension disability benefit or an
329.34annuity or has met the age and service requirements necessary to receive an annuity under
329.35chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's
329.36dependents, are eligible to participate in the program. This participation is at the person's
330.1expense unless a collective bargaining agreement or personnel policy provides otherwise.
330.2Premiums for these participants must be established by the commissioner.
330.3    The commissioner may provide policy exclusions for preexisting conditions
330.4only when there is a break in coverage between a participant's coverage under the
330.5employment-based group insurance program and the participant's coverage under this
330.6section. An employer shall notify an employee of the option to participate under this
330.7paragraph no later than the effective date of retirement. The retired employee or the
330.8employer of a participating group on behalf of a current or retired employee shall notify
330.9the commissioner within 30 days of the effective date of retirement of intent to participate
330.10in the program according to the rules established by the commissioner.
330.11    (b) The spouse of a deceased employee or former employee may purchase the
330.12benefits provided at premiums established by the commissioner if the spouse was a
330.13dependent under the employee's or former employee's coverage under this section at the
330.14time of the death. The spouse remains eligible to participate in the program as long as
330.15the group that included the deceased employee or former employee participates in the
330.16program. Coverage under this clause must be coordinated with relevant insurance benefits
330.17provided through the federally sponsored Medicare program.
330.18    (c) The program benefits must continue in the event of strike permitted by section
330.19179A.18 , if the exclusive representative chooses to have coverage continue and the
330.20employee pays the total monthly premiums when due.
330.21    (d) A participant who discontinues coverage may not reenroll.
330.22    (d) Persons participating under these paragraphs this subdivision shall make
330.23appropriate premium payments in the time and manner established by the commissioner.
330.24They are not subject to the payment of the extra payments required under subdivision 7,
330.25paragraph (b).
330.26    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury
330.27consists of deposits of the premiums received from employers participating in the
330.28program and transfers before July 1, 1994, from the excess contributions holding account
330.29established by section 353.65, subdivision 7. All money in the fund is appropriated to
330.30the commissioner to pay insurance premiums, approved claims, refunds, administrative
330.31costs, and other related service costs. Premiums paid by employers to the fund are exempt
330.32from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of
330.33money to cover the estimated costs of claims incurred but unpaid. The State Board of
330.34Investment shall invest the money according to section 11A.24. Investment income and
330.35losses attributable to the fund must be credited to the fund.
331.1    Subd. 10. Exemption. The public employee insurance program and, where
331.2applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C,
331.362D, 62E, and 62H, section 471.617, subdivisions 2 and 3, and the bidding requirements
331.4of section 471.6161, except as otherwise provided in subdivision 6, paragraph (a).
331.5    Subd. 11. Reinsurance. The commissioner may, on behalf of the program,
331.6participate in an insured or self-insured reinsurance pool.

331.7    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:
331.862H.02 REQUIRED PROVISIONS.
331.9    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and
331.10individual excess stop-loss coverage provided by an insurance company licensed by the
331.11state of Minnesota.
331.12    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred,
331.13unpaid claim liability in the event of plan termination. In addition,
331.14    (c) The plan of self-insurance must have participating employers fund an amount at
331.15least equal to the point at which the excess or stop-loss insurer has contracted to assume
331.16100 percent of additional liability.
331.17    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance
331.18contract to the commissioner of commerce at least 30 days prior to the proposed plan's
331.19effective date and at least 30 days subsequent to any renewal date. The commissioner shall
331.20review the contract to determine if they meet the standards established by sections 62H.01
331.21to 62H.08 and respond within a 30-day period.
331.22    (e) Any excess or stop-loss insurance plan must contain a provision that the excess
331.23or stop-loss insurer will give the plan and the commissioner of commerce a minimum of
331.24180 days' notice of termination or nonrenewal. If the plan fails to secure replacement
331.25coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the
331.26commissioner shall issue an order providing for the orderly termination of the plan.
331.27    (f) The commissioner may waive the requirements of this section and of any rule
331.28relating to the requirements of this section, if the commissioner determines that a joint
331.29self-insurance plan has established alternative arrangements that fully fund the plan's
331.30liability or incurred but unpaid claims. The commissioner may not waive the requirement
331.31that a joint self-insurance plan have excess stop-loss coverage.
331.32EFFECTIVE DATE.This section is effective the day following final enactment.

331.33    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.
332.1    (a) A health plan must cover sign language interpreter services provided to deaf and
332.2hard-of-hearing enrollees and language interpreter services provided to enrollees with
332.3limited English proficiency in order to facilitate the provision of health care services by a
332.4provider. For purposes of this section, "provider" has the meaning given in section 62J.03,
332.5subdivision 8, and includes a health care provider facility; and "health plan" includes
332.6coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10).
332.7Interpreter services may be provided in person, by telephone, facsimile, video or audio
332.8streaming, or by video conference. In accordance with paragraphs (b) and (c), a health
332.9plan company shall reimburse either the party providing interpreter services directly
332.10for the costs of language interpreter services provided to the enrollee or the provider
332.11arranging for the provision of interpreter services. Providers that employ or contract
332.12with interpreters may bill and shall be reimbursed directly by health plan companies for
332.13such services in accordance with paragraph (b). A health plan company shall provide to
332.14enrollees, upon request, the policies and procedures for addressing the needs of deaf and
332.15hard-of-hearing enrollees and enrollees with limited English proficiency. All parties
332.16providing interpreter services must disclose their methods for ensuring competency upon
332.17request of any health plan company, provider, or consumer.
332.18    (b) A health plan company shall pay for interpreter services as required in paragraph
332.19(a) by establishing a network of interpreter service providers and requiring use of its own
332.20network of interpreter services providers. The health plan company shall consider, as part
332.21of its interpreter service provider network, entering into an agreement with a provider for
332.22use of an interpreter service provider employed by or under contract with the provider if:
332.23    (1) the provider accepts as reimbursement for services rendered by the provider's
332.24employed or contracted interpreter service provider the lesser of either the health plan
332.25company's reimbursement rate for its in-network interpreter service providers or the
332.26provider's fee for services rendered by the provider's interpreter service provider; and
332.27    (2) the interpreter service provider meets the published quality standards of the
332.28health plan company.
332.29    (c) If a health plan company's or a provider's employed or contracted interpreter
332.30service provider is unavailable to provide interpreter services, the health plan company
332.31shall reimburse the interpreter service provider at the lesser of the health plan company's
332.32median reimbursement rate for its in-network interpreter service providers or the
332.33interpreter service provider's fee. An interpreter service provider not employed or under
332.34contract with a health plan company or provider who fails to meet the quality standards
332.35of a health plan company or as required by law, shall be ineligible for reimbursement
332.36under this section.
333.1    (d) If the health plan company pays the interpreter service provider directly, it has no
333.2obligation to pay the provider under this section.
333.3    (e) Nothing in this section requires a health plan company to establish a network
333.4of interpreter service providers.
333.5EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans
333.6issued or renewed to provide coverage to Minnesota residents on or after that date unless
333.7the legislature enacts alternative funding sources based on the recommendations of the
333.8commissioner.

333.9    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision
333.10to read:
333.11    Subd. 5. Base budget detail. The commissioner shall provide the commissioner
333.12of finance with the information necessary to provide base budget detail to the legislature
333.13under section 16A.10, subdivision 2a.

333.14    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision
333.15to read:
333.16    Subd. 11. Dispensing by protocol. A registered nurse in a family planning agency
333.17as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives
333.18prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant
333.19to a dispensing protocol established by the agency's medical director or under the direction
333.20of a physician. The dispensing protocol must address the requirements of sections 151.01,
333.21subdivision 30, and 151.212, subdivision 1.

333.22    Sec. 7. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:
333.23    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of
333.24professional practice only, may prescribe, administer, and dispense a legend drug, and may
333.25cause the same to be administered by a nurse, a physician assistant, or medical student or
333.26resident under the practitioner's direction and supervision, and may cause a person who
333.27is an appropriately certified, registered, or licensed health care professional to prescribe,
333.28dispense, and administer the same within the expressed legal scope of the person's practice
333.29as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug,
333.30without reference to a specific patient, by directing a nurse, pursuant to section 148.235,
333.31subdivisions 8 and 9 , physician assistant, or medical student or resident to adhere to
333.32a particular practice guideline or protocol when treating patients whose condition falls
333.33within such guideline or protocol, and when such guideline or protocol specifies the
334.1circumstances under which the legend drug is to be prescribed and administered. An
334.2individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
334.3order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
334.4This paragraph applies to a physician assistant only if the physician assistant meets the
334.5requirements of section 147A.18.
334.6    (b) A licensed practitioner that dispenses for profit a legend drug that is to be
334.7administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
334.8file with the practitioner's licensing board a statement indicating that the practitioner
334.9dispenses legend drugs for profit, the general circumstances under which the practitioner
334.10dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
334.11dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
334.12with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
334.13any amount received by the practitioner in excess of the acquisition cost of a legend drug
334.14for legend drugs that are purchased in prepackaged form, or (2) any amount received
334.15by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
334.16making the drug available if the legend drug requires compounding, packaging, or other
334.17treatment. The statement filed under this paragraph is public data under section 13.03.
334.18This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
334.19pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
334.20dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
334.21To dispense for profit does not include dispensing by a community health clinic when the
334.22profit from dispensing is used to meet operating expenses.
334.23    (c) A prescription or drug order for a legend drug is not valid unless it is issued
334.24for a legitimate medical purpose arising from a prescriber-patient relationship that
334.25includes a documented patient evaluation adequate to establish diagnoses and identify
334.26underlying conditions and contraindications to the treatment. Treatment, including issuing
334.27a prescription or drug order, based solely on an online questionnaire does not constitute a
334.28legitimate medical purpose.

334.29    Sec. 8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
334.30read:
334.31    Subd. 2d. Identification requirement for schedule II or III controlled substance.
334.32    No person may dispense a controlled substance included in schedule II or III without
334.33requiring the person purchasing the controlled substance, who need not be the person for
334.34whom the controlled substance prescription is written, to present valid photographic
335.1identification, unless the person purchasing the controlled substance, or if applicable the
335.2person for whom the controlled substance prescription is written, is known to the dispenser.

335.3    Sec. 9. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES
335.4PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
335.5    Subdivision 1. Definitions. For purposes of this section, the terms defined in this
335.6subdivision have the meanings given.
335.7    (a) "Board" means the Minnesota State Board of Pharmacy established under
335.8chapter 151.
335.9    (b) "Controlled substances" means those substances listed in section 152.02,
335.10subdivisions 3 and 4, and those substances defined by the board pursuant to section
335.11152.02, subdivisions 8 and 12.
335.12    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
335.1330. Dispensing does not include the direct administering of a controlled substance to a
335.14patient by a licensed health care professional.
335.15    (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
335.16pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy
335.17that distributes controlled substances for inpatient hospital care.
335.18    (e) "Prescriber" means a licensed health care professional who is authorized to
335.19prescribe a controlled substance under section 152.12, subdivision 1.
335.20    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.
335.21    Subd. 2. Prescription electronic reporting system. (a) By January 1, 2009,
335.22or upon enactment of legislation that implements the recommendations of the Board
335.23of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall
335.24establish an electronic system for reporting the information required under subdivision
335.254 for all controlled substances dispensed within the state. Data for controlled substance
335.26prescriptions that are dispensed in a quantity small enough to provide treatment to a
335.27patient for a period of 48 hours or less need not be reported.
335.28    (b) The board may contract with a vendor for the purpose of obtaining technical
335.29assistance in the design, implementation, and maintenance of the electronic reporting
335.30system. The vendor's role shall be limited to providing technical support to the board
335.31concerning the software, databases, and computer systems required to interface with the
335.32existing systems currently used by pharmacies to dispense prescriptions and transmit
335.33prescription data to other third parties.
335.34    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing
335.35information by electronic means. The waiver may permit the dispenser to submit
336.1dispensing information by paper form or other means, provided all information required
336.2by subdivision 4 is submitted in this alternative format.
336.3    Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The
336.4board shall convene an advisory committee. The committee must include at least one
336.5representative of:
336.6    (1) the Department of Health;
336.7    (2) the Department of Human Services;
336.8    (3) each health-related licensing board that licenses prescribers;
336.9    (4) a professional medical association, which may include an association of pain
336.10management and chemical dependency specialists;
336.11    (5) a professional pharmacy association;
336.12    (6) a consumer privacy or security advocate; and
336.13    (7) a consumer or patient rights organization.
336.14    (b) The advisory committee shall advise the board on the development and operation
336.15of the electronic reporting system, including, but not limited to:
336.16    (1) technical standards for electronic prescription drug reporting;
336.17    (2) proper analysis and interpretation of prescription monitoring data; and
336.18    (3) an evaluation process for the program.
336.19    (c) The Board of Pharmacy, after consultation with the advisory committee, shall
336.20present recommendations and draft legislation on the issues addressed by the advisory
336.21committee under paragraph (b), to the legislature by December 15, 2007.
336.22    Subd. 4. Reporting requirements and notice. (a) Each dispenser must submit the
336.23following data to the board or its designated vendor, subject to the notice required under
336.24paragraph (d):
336.25    (1) prescriber DEA number;
336.26    (2) dispenser DEA number;
336.27    (3) name of the patient for whom the prescription was written;
336.28    (4) date of birth of the patient for whom the prescription was written;
336.29    (5) date the prescription was written;
336.30    (6) date the prescription was filled;
336.31    (7) NDC code for drug dispensed; and
336.32    (8) quantity of controlled substance dispensed.
336.33    (b) The dispenser must submit the required information according to the format and
336.34protocols specified in the "ASAP Telecommunications Format for Controlled Substances,"
336.35May 1995 edition, published by the American Society for Automation in Pharmacy, which
336.36is hereby adopted by reference, by a procedure established by the board.
337.1    (c) A dispenser is not required to submit this data for those controlled substance
337.2prescriptions dispensed for:
337.3    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
337.4    (2) individuals receiving assisted living services under chapter 144G or through a
337.5medical assistance home and community-based waiver;
337.6    (3) individuals receiving medication intravenously;
337.7    (4) individuals receiving hospice and other palliative or end-of-life care; and
337.8    (5) individuals receiving services from a home care provider regulated under chapter
337.9144A.
337.10    (d) A dispenser must not submit data under this subdivision unless a conspicuous
337.11notice of the reporting requirements of this section is given to the patient for whom the
337.12prescription was written.
337.13    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
337.14of the data reported under subdivision 4. The board shall maintain data that could identify
337.15an individual prescriber or dispenser in encrypted form. The database may be used by
337.16permissible users identified under subdivision 6 for the identification of:
337.17    (1) individuals receiving prescriptions for controlled substances from prescribers
337.18who subsequently obtain controlled substances from dispensers in quantities or with a
337.19frequency inconsistent with generally recognized standards of dosage for those controlled
337.20substances; and
337.21    (2) individuals presenting forged or otherwise false or altered prescriptions for
337.22controlled substances to dispensers.
337.23    (b) No permissible user identified under subdivision 6 may access the database
337.24for the sole purpose of identifying prescribers of controlled substances for unusual or
337.25excessive prescribing patterns without a valid search warrant or court order.
337.26    (c) No personnel of a state or federal occupational licensing board or agency may
337.27access the database for the purpose of obtaining information to be used to initiate or
337.28substantiate a disciplinary action against a prescriber.
337.29    (d) Data reported under subdivision 4 shall be retained by the board in the database
337.30for a six-month period, and shall be removed from the database six months from the
337.31date the data was received.
337.32    Subd. 6. Access to reporting system data. (a) Except as indicated in this
337.33subdivision, the data submitted to the board under subdivision 4 is private data on
337.34individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
337.35    (b) Except as specified in subdivision 5, the following persons shall be considered
337.36permissible users and may access the data submitted under subdivision 4 in the same or
338.1similar manner, and for the same or similar purposes, as those persons who are authorized
338.2to access similar private data on individuals under federal and state law:
338.3    (1) a prescriber, to the extent the information relates specifically to a current patient
338.4of the prescriber, to whom the practitioner is prescribing or considering prescribing any
338.5controlled substance;
338.6    (2) a dispenser to the extent the information relates specifically to a current patient to
338.7whom that dispenser is dispensing or considering dispensing any controlled substance;
338.8    (3) an individual who is the recipient of a controlled substance prescription for
338.9which data was submitted under subdivision 4;
338.10    (4) personnel of the board specifically assigned to conduct a bona fide investigation
338.11of a specific board licensee;
338.12    (5) personnel of the board engaged in the collection of controlled substance
338.13prescription information as part of the assigned duties and responsibilities under this
338.14section;
338.15    (6) authorized personnel of a vendor under contract with the board who are engaged
338.16in the design, implementation, and maintenance of the electronic reporting system as part
338.17of the assigned duties and responsibilities of their employment, provided that access to data
338.18is limited to the minimum amount necessary to test and maintain the system databases;
338.19    (7) federal, state, and local law enforcement authorities engaged in a bona fide
338.20investigation of a specific person; and
338.21    (8) personnel of the medical assistance program assigned to use the data collected
338.22under this section to identify recipients whose usage of controlled substances may warrant
338.23restriction to a single primary care physician, a single outpatient pharmacy, or a single
338.24hospital.
338.25    (c) Any permissible user identified in paragraph (b), who directly accesses
338.26the data electronically, shall implement and maintain a comprehensive information
338.27security program that contains administrative, technical, and physical safeguards that
338.28are appropriate to the user's size and complexity, and the sensitivity of the personal
338.29information obtained. The permissible user shall identify reasonably foreseeable internal
338.30and external risks to the security, confidentiality, and integrity of personal information
338.31that could result in the unauthorized disclosure, misuse, or other compromise of the
338.32information and assess the sufficiency of any safeguards in place to control the risks.
338.33    (d) The board shall not release data submitted under this section unless it is provided
338.34with evidence, satisfactory to the board, that the person requesting the information is
338.35entitled to receive the data. Access to the data by law enforcement authorities must be
338.36accompanied by a valid search warrant.
339.1    (e) The board shall not release the name of a prescriber without the written consent
339.2of the prescriber or a valid search warrant or court order. The board shall provide a
339.3mechanism for a prescriber to submit to the board a signed consent authorizing the release
339.4of the prescriber's name when data containing the prescriber's name is requested.
339.5    (f) The board shall maintain a log of all persons who access the data and shall ensure
339.6that any permissible user complies with paragraph (c) prior to attaining direct access to
339.7the data.
339.8    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
339.9the board as required under this section is subject to disciplinary action by the appropriate
339.10health-related licensing board.
339.11    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
339.12the data in violation of state or federal laws relating to the privacy of health care data
339.13shall be subject to disciplinary action by the appropriate health-related licensing board,
339.14and appropriate civil penalties.
339.15    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
339.16electronic reporting system to determine if the system is cost-effective and whether it is
339.17negatively impacting appropriate prescribing practices of controlled substances. The
339.18board may contract with a vendor to design and conduct the evaluation.
339.19    (b) The board shall submit the evaluation of the system to the legislature by January
339.2015, 2010.
339.21    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
339.22pharmacist, prescriber, or other dispenser making a report to the program in good faith
339.23under this section is immune from any civil, criminal, or administrative liability, which
339.24might otherwise be incurred or imposed as a result of the report, or on the basis that the
339.25pharmacist or prescriber did or did not seek or obtain or use information from the program.
339.26    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
339.27to obtain information about a patient from the program, and the pharmacist, prescriber,
339.28or other dispenser, if acting in good faith, is immune from any civil, criminal, or
339.29administrative liability that might otherwise be incurred or imposed for requesting,
339.30receiving, or using information from the program.
339.31EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving
339.32sufficient nonstate funds to implement the prescription electronic reporting program,
339.33whichever is later. In the event that nonstate funds are not secured by the Board of
339.34Pharmacy to adequately fund the implementation of the prescription electronic reporting
339.35program, the board is not required to implement this section without a subsequent
339.36appropriation from the legislature.

340.1    Sec. 10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:
340.2    Subd. 7. Essential employee. "Essential employee" means firefighters, peace
340.3officers subject to licensure under sections 626.84 to 626.863, 911 system and police and
340.4fire department public safety dispatchers, guards at correctional facilities, confidential
340.5employees, supervisory employees, assistant county attorneys, assistant city attorneys,
340.6principals, and assistant principals. However, for state employees, "essential employee"
340.7means all employees, except for nonprofessional employees employed by the Department
340.8of Human Services in mental health facilities for the treatment of psychopathic
340.9personalities, sexual predators, and the criminally insane, in law enforcement, public
340.10safety radio communications operators, health care professionals, correctional guards,
340.11professional engineering, and supervisory collective bargaining units, irrespective of
340.12severance, and no other employees. For University of Minnesota employees, "essential
340.13employee" means all employees in law enforcement, nursing professional and supervisory
340.14units, irrespective of severance, and no other employees. "Firefighters" means salaried
340.15employees of a fire department whose duties include, directly or indirectly, controlling,
340.16extinguishing, preventing, detecting, or investigating fires. Employees for whom the state
340.17court administrator is the negotiating employer are not essential employees. For Hennepin
340.18Healthcare System, Inc. employees, "essential employees" means all employees.
340.19EFFECTIVE DATE.This section is effective the day following final enactment.

340.20    Sec. 11. Minnesota Statutes 2006, section 245.4874, is amended to read:
340.21245.4874 DUTIES OF COUNTY BOARD.
340.22    (a) The county board must:
340.23    (1) develop a system of affordable and locally available children's mental health
340.24services according to sections 245.487 to 245.4887;
340.25    (2) establish a mechanism providing for interagency coordination as specified in
340.26section 245.4875, subdivision 6;
340.27    (3) consider the assessment of unmet needs in the county as reported by the local
340.28children's mental health advisory council under section 245.4875, subdivision 5, paragraph
340.29(b), clause (3). The county shall provide, upon request of the local children's mental health
340.30advisory council, readily available data to assist in the determination of unmet needs;
340.31    (4) assure that parents and providers in the county receive information about how to
340.32gain access to services provided according to sections 245.487 to 245.4887;
340.33    (5) coordinate the delivery of children's mental health services with services
340.34provided by social services, education, corrections, health, and vocational agencies to
341.1improve the availability of mental health services to children and the cost-effectiveness of
341.2their delivery;
341.3    (6) assure that mental health services delivered according to sections 245.487
341.4to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
341.5assessment and individual treatment plan;
341.6    (7) provide the community with information about predictors and symptoms of
341.7emotional disturbances and how to access children's mental health services according to
341.8sections 245.4877 and 245.4878;
341.9    (8) provide for case management services to each child with severe emotional
341.10disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
341.11subdivisions 1, 3, and 5 ;
341.12    (9) provide for screening of each child under section 245.4885 upon admission
341.13to a residential treatment facility, acute care hospital inpatient treatment, or informal
341.14admission to a regional treatment center;
341.15    (10) prudently administer grants and purchase-of-service contracts that the county
341.16board determines are necessary to fulfill its responsibilities under sections 245.487 to
341.17245.4887 ;
341.18    (11) assure that mental health professionals, mental health practitioners, and case
341.19managers employed by or under contract to the county to provide mental health services
341.20are qualified under section 245.4871;
341.21    (12) assure that children's mental health services are coordinated with adult mental
341.22health services specified in sections 245.461 to 245.486 so that a continuum of mental
341.23health services is available to serve persons with mental illness, regardless of the person's
341.24age;
341.25    (13) assure that culturally informed mental health consultants are used as necessary
341.26to assist the county board in assessing and providing appropriate treatment for children of
341.27cultural or racial minority heritage; and
341.28    (14) consistent with section 245.486, arrange for or provide a children's mental
341.29health screening to a child receiving child protective services or a child in out-of-home
341.30placement, a child for whom parental rights have been terminated, a child found to be
341.31delinquent, and a child found to have committed a juvenile petty offense for the third
341.32or subsequent time, unless a screening or diagnostic assessment has been performed
341.33within the previous 180 days, or the child is currently under the care of a mental health
341.34professional. The court or county agency must notify a parent or guardian whose
341.35parental rights have not been terminated of the potential mental health screening and the
341.36option to prevent the screening by notifying the court or county agency in writing. The
342.1screening shall be conducted with a screening instrument approved by the commissioner
342.2of human services according to criteria that are updated and issued annually to ensure
342.3that approved screening instruments are valid and useful for child welfare and juvenile
342.4justice populations, and shall be conducted by a mental health practitioner as defined in
342.5section 245.4871, subdivision 26, or a probation officer or local social services agency
342.6staff person who is trained in the use of the screening instrument. Training in the use of the
342.7instrument shall include training in the administration of the instrument, the interpretation
342.8of its validity given the child's current circumstances, the state and federal data practices
342.9laws and confidentiality standards, the parental consent requirement, and providing respect
342.10for families and cultural values. If the screen indicates a need for assessment, the child's
342.11family, or if the family lacks mental health insurance, the local social services agency,
342.12in consultation with the child's family, shall have conducted a diagnostic assessment,
342.13including a functional assessment, as defined in section 245.4871. The administration of
342.14the screening shall safeguard the privacy of children receiving the screening and their
342.15families and shall comply with the Minnesota Government Data Practices Act, chapter
342.1613, and the federal Health Insurance Portability and Accountability Act of 1996, Public
342.17Law 104-191. Screening results shall be considered private data and the commissioner
342.18shall not collect individual screening results.
342.19    (b) When the county board refers clients to providers of children's therapeutic
342.20services and supports under section 256B.0943, the county board must clearly identify
342.21the desired services components not covered under section 256B.0943 and identify the
342.22reimbursement source for those requested services, the method of payment, and the
342.23payment rate to the provider.

342.24    Sec. 12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:
342.25    Subd. 2. Transfer to correctional facility. (a) If a person has been committed
342.26under this section and later is committed to the custody of the commissioner of corrections
342.27for any reason, including but not limited to, being sentenced for a crime or revocation of
342.28the person's supervised release or conditional release under section 244.05, 609.108,
342.29subdivision 6 , or 609.109, subdivision 7, the person shall be transferred to a facility
342.30designated by the commissioner of corrections without regard to the procedures provided
342.31in section 253B.18.
342.32    (b) If a person is committed under this section after a commitment to the
342.33commissioner of corrections, the person shall first serve the sentence in a facility
342.34designated by the commissioner of corrections. After the person has served the sentence,
343.1the person shall be transferred to a treatment program designated by the commissioner
343.2of human services.

343.3    Sec. 13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:
343.4    Subd. 3. Rules for chemical dependency care. The commissioner of human
343.5services shall establish by rule criteria to be used in determining the appropriate level
343.6of chemical dependency care, whether outpatient, inpatient or short-term treatment
343.7programs, for each recipient of public assistance seeking treatment for alcohol or other
343.8drug dependency and abuse problems. The criteria shall address, at least, the family
343.9relationship, past treatment history, medical or physical problems, arrest record, and
343.10employment situation.

343.11    Sec. 14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:
343.12    Subd. 2. Program and service guidelines. (a) The commissioner shall provide
343.13program and service guidelines and technical assistance to the county boards in carrying
343.14out services authorized under sections section 254A.08, 254A.12, 254A.14, and their
343.15responsibilities under chapter 256E.
343.16    (b) The commissioner shall recommend to the governor means of improving
343.17the efficiency and effectiveness of comprehensive program services in the state and
343.18maximizing the use of nongovernmental funds for providing comprehensive programs.

343.19    Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT
343.20OF INTEREST.
343.21    (a) Except as provided in paragraph (b), an assessor conducting a chemical use
343.22assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any
343.23direct or shared financial interest or referral relationship resulting in shared financial
343.24interest or referral relationship resulting in shared financial gain with a treatment provider.
343.25    (b) A county may contract with an assessor having a conflict described in paragraph
343.26(a) if the county documents that:
343.27    (1) the assessor is employed by a culturally specific service provider or a service
343.28provider with a program designed to treat individuals of a specific age, sex, or sexual
343.29preference;
343.30    (2) the county does not employ a sufficient number of qualified assessors and the
343.31only qualified assessors available in the county have a direct or shared financial interest or
343.32a referral relationship resulting in shared financial gain with a treatment provider; or
344.1    (3) the county social service agency has an existing relationship with an assessor
344.2or service provider and elects to enter into a contract with that assessor to provide both
344.3assessment and treatment under circumstances specified in the county's contract, provided
344.4the county retains responsibility for making placement decisions.
344.5EFFECTIVE DATE.This section is effective the day following final enactment.

344.6    Sec. 16. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:
344.7    Subdivision 1. Chemical dependency treatment allocation. The chemical
344.8dependency funds appropriated for allocation shall be placed in a special revenue account.
344.9The commissioner shall annually transfer funds from the chemical dependency fund to pay
344.10for operation of the drug and alcohol abuse normative evaluation system and to pay for all
344.11costs incurred by adding two positions for licensing of chemical dependency treatment
344.12and rehabilitation programs located in hospitals for which funds are not otherwise
344.13appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall
344.14allocate funds to the American Indian chemical dependency tribal account for treatment
344.15of American Indians by eligible vendors under section 254B.05, equal to the amount
344.16allocated in fiscal year 1997. Six percent of the remaining money must be reserved for
344.17tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall
344.18annually divide the money available in the chemical dependency fund that is not held
344.19in reserve by counties from a previous allocation, or allocated to the American Indian
344.20chemical dependency tribal account. Six percent of the remaining money must be
344.21reserved for the nonreservation American Indian chemical dependency allocation for
344.22treatment of American Indians by eligible vendors under section 254B.05, subdivision
344.231 . The remainder of the money must be allocated among the counties according to the
344.24following formula, using state demographer data and other data sources determined by
344.25the commissioner:
344.26    (a) For purposes of this formula, American Indians and children under age 14 are
344.27subtracted from the population of each county to determine the restricted population.
344.28    (b) The amount of chemical dependency fund expenditures for entitled persons for
344.29services not covered by prepaid plans governed by section 256B.69 in the previous year is
344.30divided by the amount of chemical dependency fund expenditures for entitled persons for
344.31all services to determine the proportion of exempt service expenditures for each county.
344.32    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
344.33service expenditures to determine the adjusted prepaid plan months of eligibility for
344.34each county.
345.1    (d) The adjusted prepaid plan months of eligibility is added to the number of
345.2restricted population fee for service months of eligibility for the Minnesota family
345.3investment program, general assistance, and medical assistance and divided by the county
345.4restricted population to determine county per capita months of covered service eligibility.
345.5    (e) The number of adjusted prepaid plan months of eligibility for the state is added
345.6to the number of fee for service months of eligibility for the Minnesota family investment
345.7program, general assistance, and medical assistance for the state restricted population and
345.8divided by the state restricted population to determine state per capita months of covered
345.9service eligibility.
345.10    (f) The county per capita months of covered service eligibility is divided by the
345.11state per capita months of covered service eligibility to determine the county welfare
345.12caseload factor.
345.13    (g) The median married couple income for the most recent three-year period
345.14available for the state is divided by the median married couple income for the same period
345.15for each county to determine the income factor for each county.
345.16    (h) The county restricted population is multiplied by the sum of the county welfare
345.17caseload factor and the county income factor to determine the adjusted population.
345.18    (i) $15,000 shall be allocated to each county.
345.19    (j) The remaining funds shall be allocated proportional to the county adjusted
345.20population.

345.21    Sec. 17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:
345.22    Subd. 5. Administrative adjustment. The commissioner may make payments to
345.23local agencies from money allocated under this section to support administrative activities
345.24under sections 254B.03 and 254B.04. The administrative payment must not exceed
345.25five percent of the first $50,000, four percent of the next $50,000, and three percent of
345.26the remaining payments for services from the allocation. Twenty-five percent of the
345.27administrative allowance shall be advanced at the beginning of each quarter, based on
345.28the payments for services made in the most recent quarter for which data is available.
345.29Adjustment of any overestimate or underestimate based on actual expenditures shall be
345.30made by the state agency by adjusting the administrative allowance for any succeeding
345.31quarter.

345.32    Sec. 18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:
345.33    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
345.34dependency services to persons residing within its jurisdiction who meet criteria
346.1established by the commissioner for placement in a chemical dependency residential or
346.2nonresidential treatment service. Chemical dependency money must be administered
346.3by the local agencies according to law and rules adopted by the commissioner under
346.4sections 14.001 to 14.69.
346.5    (b) In order to contain costs, the county board shall, with the approval of the
346.6commissioner of human services, select eligible vendors of chemical dependency services
346.7who can provide economical and appropriate treatment. Unless the local agency is a social
346.8services department directly administered by a county or human services board, the local
346.9agency shall not be an eligible vendor under section 254B.05. The commissioner may
346.10approve proposals from county boards to provide services in an economical manner or to
346.11control utilization, with safeguards to ensure that necessary services are provided. If a
346.12county implements a demonstration or experimental medical services funding plan, the
346.13commissioner shall transfer the money as appropriate. If a county selects a vendor located
346.14in another state, the county shall ensure that the vendor is in compliance with the rules
346.15governing licensure of programs located in the state.
346.16    (c) The calendar year 2002 rate for vendors may not increase more than three
346.17percent above the rate approved in effect on January 1, 2001. The calendar year 2003
346.18rate for vendors may not increase more than three percent above the rate in effect on
346.19January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in
346.20effect on January 1, 2003.
346.21    (d) (c) A culturally specific vendor that provides assessments under a variance under
346.22Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
346.23persons not covered by the variance.

346.24    Sec. 19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:
346.25    Subd. 3. Local agencies to pay state for county share. Local agencies shall submit
346.26invoices to the state on forms supplied by the commissioner and according to procedures
346.27established by the commissioner. Local agencies shall pay the state for the county share
346.28of the invoiced services authorized by the local agency. Payments shall be made at the
346.29beginning of each month for services provided in the previous month. The commissioner
346.30shall bill the county monthly for services, based on the most recent month for which
346.31expenditure information is available. Adjustment of any overestimate or underestimate
346.32based on actual expenditures shall be made by the state agency by adjusting the estimate
346.33for any succeeding month.

346.34    Sec. 20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:
347.1    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for
347.2placements made by local agencies under section 254B.03, subdivision 1, and placements
347.3by tribal designated agencies according to section 254B.09. The commissioner may
347.4reduce or deny payment of the state share when services are not provided according to the
347.5placement criteria established by the commissioner. The commissioner may pay for all or
347.6a portion of improper county chemical dependency placements and bill the county for the
347.7entire payment made when the placement did not comply with criteria established by the
347.8commissioner. The commissioner may make payments to vendors and charge the county
347.9100 percent of the payments if documentation of a county approved placement is received
347.10more than 30 working days, exclusive of weekends and holidays, after the date services
347.11began; or if the county approved invoice is received by the commissioner more than 120
347.12days after the last date of service provided. The commissioner shall not pay vendors until
347.13private insurance company claims have been settled.

347.14    Sec. 21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
347.15to read:
347.16    Subd. 25. Base budget detail. The commissioner shall provide the commissioner
347.17of finance with the information necessary to provide base budget detail to the legislature
347.18under section 16A.10, subdivision 2a.

347.19    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
347.20read:
347.21    Subd. 23. Day treatment services. Medical assistance covers day treatment
347.22services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
347.23are provided under contract with the county board. Notwithstanding Minnesota Rules,
347.24part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
347.25treatment for adults according to section 256B.0625, subdivision 25. Notwithstanding
347.26Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance
347.27covers day treatment services for children as specified under section 256B.0943.

347.28    Sec. 23. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES;
347.29ABUSE PREVENTION.
347.30    The commissioner shall develop and implement a plan to:
347.31    (1) monitor the prescribing of controlled substances listed in section 152.02,
347.32subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
348.1section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract
348.2with participating managed care plans;
348.3    (2) require enrolled providers and providers under contract with participating
348.4managed care plans to report information related to potential patient abuse of the
348.5controlled substances to the commissioner, and the Board of Pharmacy; and
348.6    (3) provide education to Minnesota health care program enrollees on the proper use
348.7of controlled substances.

348.8    Sec. 24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to
348.9read:
348.10    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be
348.11an eligible provider entity under this section, a provider entity must have a clinical
348.12infrastructure that utilizes diagnostic assessment, an individualized treatment plan,
348.13service delivery, and individual treatment plan review that are culturally competent,
348.14child-centered, and family-driven to achieve maximum benefit for the client. The provider
348.15entity must review and update the clinical policies and procedures every three years and
348.16must distribute the policies and procedures to staff initially and upon each subsequent
348.17update.
348.18    (b) The clinical infrastructure written policies and procedures must include policies
348.19and procedures for:
348.20    (1) providing or obtaining a client's diagnostic assessment that identifies acute and
348.21chronic clinical disorders, co-occurring medical conditions, sources of psychological and
348.22environmental problems, and a functional assessment. The functional assessment must
348.23clearly summarize the client's individual strengths and needs;
348.24    (2) developing an individual treatment plan that is:
348.25    (i) based on the information in the client's diagnostic assessment;
348.26    (ii) developed no later than the end of the first psychotherapy session after the
348.27completion of the client's diagnostic assessment by the mental health professional who
348.28provides the client's psychotherapy;
348.29    (iii) developed through a child-centered, family-driven planning process that
348.30identifies service needs and individualized, planned, and culturally appropriate
348.31interventions that contain specific treatment goals and objectives for the client and the
348.32client's family or foster family;
348.33    (iv) reviewed at least once every 90 days and revised, if necessary; and
348.34    (v) signed by the client or, if appropriate, by the client's parent or other person
348.35authorized by statute to consent to mental health services for the client;
349.1    (3) developing an individual behavior plan that documents services to be provided
349.2by the mental health behavioral aide. The individual behavior plan must include:
349.3    (i) detailed instructions on the service to be provided;
349.4    (ii) time allocated to each service;
349.5    (iii) methods of documenting the child's behavior;
349.6    (iv) methods of monitoring the child's progress in reaching objectives; and
349.7    (v) goals to increase or decrease targeted behavior as identified in the individual
349.8treatment plan;
349.9    (4) clinical supervision of the mental health practitioner and mental health behavioral
349.10aide. A mental health professional must document the clinical supervision the professional
349.11provides by cosigning individual treatment plans and making entries in the client's record
349.12on supervisory activities. Clinical supervision does not include the authority to make or
349.13terminate court-ordered placements of the child. A clinical supervisor must be available
349.14for urgent consultation as required by the individual client's needs or the situation. Clinical
349.15supervision may occur individually or in a small group to discuss treatment and review
349.16progress toward goals. The focus of clinical supervision must be the client's treatment
349.17needs and progress and the mental health practitioner's or behavioral aide's ability to
349.18provide services;
349.19    (4a) CTSS certified provider entities providing day treatment programs must meet
349.20the conditions in items (i) to (iii):
349.21    (i) the provider supervisor must be present and available on the premises more
349.22than 50 percent of the time in a five-working-day period during which the supervisee is
349.23providing a mental health service;
349.24    (ii) the diagnosis and the client's individual treatment plan or a change in the
349.25diagnosis or individual treatment plan must be made by or reviewed, approved, and signed
349.26by the provider supervisor; and
349.27    (iii) every 30 days, the supervisor must review and sign the record of the client's care
349.28for all activities in the preceding 30-day period;
349.29    (4b) for all other services provided under CTSS, clinical supervision standards
349.30provided in items (i) to (iii) must be used:
349.31    (i) medical assistance shall reimburse a mental health practitioner who maintains a
349.32consulting relationship with a mental health professional who accepts full professional
349.33responsibility and is present on site for at least one observation during the first 12 hours
349.34in which the mental health practitioner provides the individual, family, or group skills
349.35training to the child or the child's family;
350.1    (ii) thereafter, the mental health professional is required to be present on site for
350.2observation as clinically appropriate when the mental health practitioner is providing
350.3individual, family, or group skills training to the child or the child's family; and
350.4    (iii) the observation must be a minimum of one clinical unit. The on-site presence of
350.5the mental health professional must be documented in the child's record and signed by the
350.6mental health professional who accepts full professional responsibility;
350.7    (5) providing direction to a mental health behavioral aide. For entities that employ
350.8mental health behavioral aides, the clinical supervisor must be employed by the provider
350.9entity or other certified children's therapeutic supports and services provider entity to
350.10ensure necessary and appropriate oversight for the client's treatment and continuity
350.11of care. The mental health professional or mental health practitioner giving direction
350.12must begin with the goals on the individualized treatment plan, and instruct the mental
350.13health behavioral aide on how to construct therapeutic activities and interventions that
350.14will lead to goal attainment. The professional or practitioner giving direction must also
350.15instruct the mental health behavioral aide about the client's diagnosis, functional status,
350.16and other characteristics that are likely to affect service delivery. Direction must also
350.17include determining that the mental health behavioral aide has the skills to interact with
350.18the client and the client's family in ways that convey personal and cultural respect and
350.19that the aide actively solicits information relevant to treatment from the family. The aide
350.20must be able to clearly explain the activities the aide is doing with the client and the
350.21activities' relationship to treatment goals. Direction is more didactic than is supervision
350.22and requires the professional or practitioner providing it to continuously evaluate the
350.23mental health behavioral aide's ability to carry out the activities of the individualized
350.24treatment plan and the individualized behavior plan. When providing direction, the
350.25professional or practitioner must:
350.26    (i) review progress notes prepared by the mental health behavioral aide for accuracy
350.27and consistency with diagnostic assessment, treatment plan, and behavior goals and the
350.28professional or practitioner must approve and sign the progress notes;
350.29    (ii) identify changes in treatment strategies, revise the individual behavior plan,
350.30and communicate treatment instructions and methodologies as appropriate to ensure
350.31that treatment is implemented correctly;
350.32    (iii) demonstrate family-friendly behaviors that support healthy collaboration among
350.33the child, the child's family, and providers as treatment is planned and implemented;
350.34    (iv) ensure that the mental health behavioral aide is able to effectively communicate
350.35with the child, the child's family, and the provider; and
351.1    (v) record the results of any evaluation and corrective actions taken to modify the
351.2work of the mental health behavioral aide;
351.3    (6) providing service delivery that implements the individual treatment plan and
351.4meets the requirements under subdivision 9; and
351.5    (7) individual treatment plan review. The review must determine the extent to which
351.6the services have met the goals and objectives in the previous treatment plan. The review
351.7must assess the client's progress and ensure that services and treatment goals continue to
351.8be necessary and appropriate to the client and the client's family or foster family. Revision
351.9of the individual treatment plan does not require a new diagnostic assessment unless the
351.10client's mental health status has changed markedly. The updated treatment plan must be
351.11signed by the client, if appropriate, and by the client's parent or other person authorized by
351.12statute to give consent to the mental health services for the child.

351.13    Sec. 25. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to
351.14read:
351.15    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
351.16certified provider entity must ensure that:
351.17    (1) each individual provider's caseload size permits the provider to deliver services
351.18to both clients with severe, complex needs and clients with less intensive needs. The
351.19provider's caseload size should reasonably enable the provider to play an active role in
351.20service planning, monitoring, and delivering services to meet the client's and client's
351.21family's needs, as specified in each client's individual treatment plan;
351.22    (2) site-based programs, including day treatment and preschool programs, provide
351.23staffing and facilities to ensure the client's health, safety, and protection of rights, and that
351.24the programs are able to implement each client's individual treatment plan;
351.25    (3) a day treatment program is provided to a group of clients by a multidisciplinary
351.26team under the clinical supervision of a mental health professional. The day treatment
351.27program must be provided in and by: (i) an outpatient hospital accredited by the Joint
351.28Commission on Accreditation of Health Organizations and licensed under sections
351.29144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii)
351.30an entity that is under contract with the county board to operate a program that meets
351.31the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2,
351.32and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must
351.33stabilize the client's mental health status while developing and improving the client's
351.34independent living and socialization skills. The goal of the day treatment program must be
351.35to reduce or relieve the effects of mental illness and provide training to enable the client
352.1to live in the community. The program must be available at least one day a week for a
352.2minimum three-hour time block. The three-hour time block must include at least one
352.3hour, but no more than two hours, of individual or group psychotherapy. The remainder
352.4of the three-hour time block may include recreation therapy, socialization therapy, or
352.5independent living skills therapy, but only if the therapies are included in the client's
352.6individual treatment plan. Day treatment programs are not part of inpatient or residential
352.7treatment services; and
352.8    (4) a preschool program is a structured treatment program offered to a child who
352.9is at least 33 months old, but who has not yet reached the first day of kindergarten, by a
352.10preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts
352.119503.0005 to 9503.0175. The program must be available at least one day a week for a
352.12minimum two-hour time block. The structured treatment program may include individual
352.13or group psychotherapy and recreation therapy, socialization therapy, or independent
352.14living skills therapy, if included in the client's individual treatment plan.
352.15    (b) A provider entity must deliver the service components of children's therapeutic
352.16services and supports in compliance with the following requirements:
352.17    (1) individual, family, and group psychotherapy must be delivered as specified in
352.18Minnesota Rules, part 9505.0323;
352.19    (2) individual, family, or group skills training must be provided by a mental health
352.20professional or a mental health practitioner who has a consulting relationship with a
352.21mental health professional who accepts full professional responsibility for the training;
352.22    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
352.23through arrangements for direct intervention and support services to the child and the
352.24child's family. Crisis assistance must utilize resources designed to address abrupt or
352.25substantial changes in the functioning of the child or the child's family as evidenced by
352.26a sudden change in behavior with negative consequences for well being, a loss of usual
352.27coping mechanisms, or the presentation of danger to self or others;
352.28    (4) medically necessary services that are provided by a mental health behavioral
352.29aide must be designed to improve the functioning of the child and support the family in
352.30activities of daily and community living. A mental health behavioral aide must document
352.31the delivery of services in written progress notes. The mental health behavioral aide
352.32must implement goals in the treatment plan for the child's emotional disturbance that
352.33allow the child to acquire developmentally and therapeutically appropriate daily living
352.34skills, social skills, and leisure and recreational skills through targeted activities. These
352.35activities may include:
353.1    (i) assisting a child as needed with skills development in dressing, eating, and
353.2toileting;
353.3    (ii) assisting, monitoring, and guiding the child to complete tasks, including
353.4facilitating the child's participation in medical appointments;
353.5    (iii) observing the child and intervening to redirect the child's inappropriate behavior;
353.6    (iv) assisting the child in using age-appropriate self-management skills as related
353.7to the child's emotional disorder or mental illness, including problem solving, decision
353.8making, communication, conflict resolution, anger management, social skills, and
353.9recreational skills;
353.10    (v) implementing deescalation techniques as recommended by the mental health
353.11professional;
353.12    (vi) implementing any other mental health service that the mental health professional
353.13has approved as being within the scope of the behavioral aide's duties; or
353.14    (vii) assisting the parents to develop and use parenting skills that help the child
353.15achieve the goals outlined in the child's individual treatment plan or individual behavioral
353.16plan. Parenting skills must be directed exclusively to the child's treatment; and
353.17    (5) direction of a mental health behavioral aide must include the following:
353.18    (i) a total of one hour of on-site observation by a mental health professional during
353.19the first 12 hours of service provided to a child;
353.20    (ii) ongoing on-site observation by a mental health professional or mental health
353.21practitioner for at least a total of one hour during every 40 hours of service provided
353.22to a child; and
353.23    (iii) immediate accessibility of the mental health professional or mental health
353.24practitioner to the mental health behavioral aide during service provision.

353.25    Sec. 26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to
353.26read:
353.27    Subd. 11. Documentation and billing. (a) A provider entity must document the
353.28services it provides under this section. The provider entity must ensure that the entity's
353.29documentation standards meet the requirements of federal and state laws. Services billed
353.30under this section that are not documented according to this subdivision shall be subject to
353.31monetary recovery by the commissioner. The provider entity may not bill for anything
353.32other than direct service time.
353.33    (b) An individual mental health provider must promptly document the following
353.34in a client's record after providing services to the client:
354.1    (1) each occurrence of the client's mental health service, including the date, type,
354.2length, and scope of the service;
354.3    (2) the name of the person who gave the service;
354.4    (3) contact made with other persons interested in the client, including representatives
354.5of the courts, corrections systems, or schools. The provider must document the name
354.6and date of each contact;
354.7    (4) any contact made with the client's other mental health providers, case manager,
354.8family members, primary caregiver, legal representative, or the reason the provider did
354.9not contact the client's family members, primary caregiver, or legal representative, if
354.10applicable; and
354.11    (5) required clinical supervision, as appropriate.

354.12    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to
354.13read:
354.14    Subd. 12. Excluded services. The following services are not eligible for medical
354.15assistance payment as children's therapeutic services and supports:
354.16    (1) service components of children's therapeutic services and supports
354.17simultaneously provided by more than one provider entity unless prior authorization is
354.18obtained;
354.19    (2) children's therapeutic services and supports provided in violation of medical
354.20assistance policy in Minnesota Rules, part 9505.0220;
354.21    (3) mental health behavioral aide services provided by a personal care assistant who
354.22is not qualified as a mental health behavioral aide and employed by a certified children's
354.23therapeutic services and supports provider entity;
354.24    (4) service components of CTSS that are the responsibility of a residential or
354.25program license holder, including foster care providers under the terms of a service
354.26agreement or administrative rules governing licensure; and
354.27    (5) adjunctive activities that may be offered by a provider entity but are not
354.28otherwise covered by medical assistance, including:
354.29    (i) a service that is primarily recreation oriented or that is provided in a setting that
354.30is not medically supervised. This includes sports activities, exercise groups, activities
354.31such as craft hours, leisure time, social hours, meal or snack time, trips to community
354.32activities, and tours;
354.33    (ii) a social or educational service that does not have or cannot reasonably be
354.34expected to have a therapeutic outcome related to the client's emotional disturbance;
355.1    (iii) consultation with other providers or service agency staff about the care or
355.2progress of a client;
355.3    (iv) prevention or education programs provided to the community; and
355.4    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and
355.5    (6) activities that are not direct service time.

355.6    Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
355.7    Effective for services rendered on or after July 1, 2007, payment rates for family
355.8planning services shall be increased by 25 percent over the rates in effect July 30, 2007,
355.9when these services are provided by a community clinic as defined in section 145.9268,
355.10subdivision 1.

355.11    Sec. 29. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:
355.12    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
355.13    (b) "Family asset account" means a savings account opened by a household
355.14participating in the Minnesota family assets for independence initiative.
355.15    (c) "Fiduciary organization" means:
355.16    (1) a community action agency that has obtained recognition under section 268.53
355.17256E.31 ;
355.18    (2) a federal community development credit union serving the seven-county
355.19metropolitan area; or
355.20    (3) a women-oriented economic development agency serving the seven-county
355.21metropolitan area.
355.22    (d) "Financial institution" means a bank, bank and trust, savings bank, savings
355.23association, or credit union, the deposits of which are insured by the Federal Deposit
355.24Insurance Corporation or the National Credit Union Administration.
355.25    (e) "Permissible use" means:
355.26    (1) postsecondary educational expenses at an accredited public postsecondary
355.27institution including books, supplies, and equipment required for courses of instruction;
355.28    (2) acquisition costs of acquiring, constructing, or reconstructing a residence,
355.29including any usual or reasonable settlement, financing, or other closing costs;
355.30    (3) business capitalization expenses for expenditures on capital, plant, equipment,
355.31working capital, and inventory expenses of a legitimate business pursuant to a business
355.32plan approved by the fiduciary organization; and
355.33    (4) acquisition costs of a principal residence within the meaning of section 1034 of
355.34the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
356.1purchase price applicable to the residence determined according to section 143(e)(2) and
356.2(3) of the Internal Revenue Code of 1986.
356.3    (f) "Household" means all individuals who share use of a dwelling unit as primary
356.4quarters for living and eating separate from other individuals.

356.5    Sec. 30. [525A.01] SHORT TITLE.
356.6    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical
356.7Gift Act."

356.8    Sec. 31. [525A.02] DEFINITIONS.
356.9    Subdivision 1. Scope. The definitions in this section apply to this chapter.
356.10    Subd. 2. Adult. "Adult" means an individual who is at least 18 years of age.
356.11    Subd. 3. Agent. "Agent" means an individual who is:
356.12    (1) authorized to make health care decisions on the principal's behalf by a power of
356.13attorney for health care; or
356.14    (2) expressly authorized to make an anatomical gift on the principal's behalf by
356.15any other record signed by the principal.
356.16    Subd. 4. Anatomical gift. "Anatomical gift" means a donation of all or part of
356.17a human body to take effect after the donor's death for the purpose of transplantation,
356.18therapy, research, or education.
356.19    Subd. 5. Decedent. "Decedent" means a deceased individual and includes a stillborn
356.20infant or an embryo or fetus that has died of natural causes in utero.
356.21    Subd. 6. Disinterested witness. "Disinterested witness" means a witness other than
356.22the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual
356.23who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who
356.24exhibited special care and concern for the individual. The term does not include a person
356.25to which an anatomical gift could pass under section 525A.11.
356.26    Subd. 7. Document of gift. "Document of gift" means a donor card or other record
356.27used to make an anatomical gift. The term includes a statement or symbol on a driver's
356.28license, identification card, or donor registry.
356.29    Subd. 8. Donor. "Donor" means an individual whose body or part is the subject of
356.30an anatomical gift.
356.31    Subd. 9. Donor registry. "Donor registry" means a database that contains records
356.32of anatomical gifts and amendments to or revocations of anatomical gifts.
357.1    Subd. 10. Driver's license. "Driver's license" means a license or permit issued
357.2under chapter 171 to operate a vehicle, whether or not conditions are attached to the
357.3license or permit.
357.4    Subd. 11. Eye bank. "Eye bank" means a person that is licensed, accredited,
357.5or regulated under federal or state law to engage in the recovery, screening, testing,
357.6processing, storage, or distribution of human eyes or portions of human eyes.
357.7    Subd. 12. Guardian. "Guardian" means a person appointed by a court to make
357.8decisions regarding the support, care, education, health, or welfare of an individual. The
357.9term does not include a guardian ad litem.
357.10    Subd. 13. Hospital. "Hospital" means a facility licensed as a hospital under the
357.11law of any state or a facility operated as a hospital by the United States, a state, or a
357.12subdivision of a state.
357.13    Subd. 14. Identification card. "Identification card" means a Minnesota
357.14identification card issued under chapter 171.
357.15    Subd. 15. Know. "Know" means to have actual knowledge.
357.16    Subd. 16. Medical examiner. "Medical examiner" includes coroner.
357.17    Subd. 17. Minor. "Minor" means an individual who is under 18 years of age.
357.18    Subd. 18. Organ procurement organization. "Organ procurement organization"
357.19means a person designated by the secretary of the United States Department of Health and
357.20Human Services as an organ procurement organization.
357.21    Subd. 19. Parent. "Parent" means a parent whose parental rights have not been
357.22terminated.
357.23    Subd. 20. Part. "Part" means an organ, an eye, or tissue of a human being. The term
357.24does not include the whole body.
357.25    Subd. 21. Person. "Person" means an individual, corporation, business trust, estate,
357.26trust, partnership, limited liability company, association, joint venture, public corporation,
357.27government or governmental subdivision, agency, or instrumentality, or any other legal or
357.28commercial entity.
357.29    Subd. 22. Physician. "Physician" means an individual authorized to practice
357.30medicine or osteopathy under the law of any state.
357.31    Subd. 23. Procurement organization. "Procurement organization" means an eye
357.32bank, organ procurement organization, or tissue bank.
357.33    Subd. 24. Prospective donor. "Prospective donor" means an individual who is dead
357.34or near death and has been determined by a procurement organization to have a part that
357.35could be medically suitable for transplantation, therapy, research, or education. The term
357.36does not include an individual who has made a refusal.
358.1    Subd. 25. Reasonably available. "Reasonably available" means able to be
358.2contacted by a procurement organization without undue effort and willing and able to act
358.3in a timely manner consistent with existing medical criteria necessary for the making of
358.4an anatomical gift.
358.5    Subd. 26. Recipient. "Recipient" means an individual into whose body a decedent's
358.6part has been or is intended to be transplanted.
358.7    Subd. 27. Record. "Record" means information that is inscribed on a tangible
358.8medium or that is stored in an electronic or other medium and is retrievable in perceivable
358.9form.
358.10    Subd. 28. Refusal. "Refusal" means a record created under section 525A.07 that
358.11expressly states an intent to bar other persons from making an anatomical gift of an
358.12individual's body or part.
358.13    Subd. 29. Sign. "Sign" means, with the present intent to authenticate or adopt
358.14a record:
358.15    (1) to execute or adopt a tangible symbol; or
358.16    (2) to attach to or logically associate with the record an electronic symbol, sound,
358.17or process.
358.18    Subd. 30. State. "State" means a state of the United States, the District of Columbia,
358.19Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject
358.20to the jurisdiction of the United States.
358.21    Subd. 31. Technician. "Technician" means an individual determined to be qualified
358.22to remove or process parts by an appropriate organization that is licensed, accredited, or
358.23regulated under federal or state law. The term includes an enucleator.
358.24    Subd. 32. Tissue. "Tissue" means a portion of the human body other than an organ
358.25or an eye. The term does not include blood unless the blood is donated for the purpose
358.26of research or education.
358.27    Subd. 33. Tissue bank. "Tissue bank" means a person that is licensed, accredited,
358.28or regulated under federal or state law to engage in the recovery, screening, testing,
358.29processing, storage, or distribution of tissue.
358.30    Subd. 34. Transplant hospital. "Transplant hospital" means a hospital that
358.31furnishes organ transplants and other medical and surgical specialty services required
358.32for the care of transplant patients.

358.33    Sec. 32. [525A.03] APPLICABILITY.
358.34    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal
358.35to make an anatomical gift, whenever made.

359.1    Sec. 33. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE
359.2DONOR'S DEATH.
359.3    Subject to section 525A.08, an anatomical gift of a donor's body or part may be
359.4made during the life of the donor for the purpose of transplantation, therapy, research, or
359.5education in the manner provided in section 525A.05 by:
359.6    (1) the donor, if the donor is an adult or if the donor is a minor and is:
359.7    (i) emancipated; or
359.8    (ii) authorized under state law to apply for a driver's license because the donor is
359.9at least 16 years of age;
359.10    (2) an agent of the donor, unless the power of attorney for health care or other record
359.11prohibits the agent from making an anatomical gift;
359.12    (3) a parent of the donor, if the donor is an unemancipated minor; or
359.13    (4) the donor's guardian.

359.14    Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE
359.15DONOR'S DEATH.
359.16    (a) A donor may make an anatomical gift:
359.17    (1) by authorizing a statement or symbol indicating that the donor has made an
359.18anatomical gift to be imprinted on the donor's driver's license or identification card;
359.19    (2) in a will;
359.20    (3) during a terminal illness or injury of the donor, by any form of communication
359.21addressed to at least two adults, at least one of whom is a disinterested witness; or
359.22    (4) as provided in paragraph (b).
359.23    (b) A donor or other person authorized to make an anatomical gift under section
359.24525A.04 may make a gift by a donor card or other record signed by the donor or other
359.25person making the gift or by authorizing that a statement or symbol indicating that the
359.26donor has made an anatomical gift be included on a donor registry. If the donor or
359.27other person is physically unable to sign a record, the record may be signed by another
359.28individual at the direction of the donor or other person and must:
359.29    (1) be witnessed by at least two adults, at least one of whom is a disinterested
359.30witness, who have signed at the request of the donor or the other person; and
359.31    (2) state that it has been signed and witnessed as provided in clause (1).
359.32    (c) Revocation, suspension, expiration, or cancellation of a driver's license or
359.33identification card upon which an anatomical gift is indicated does not invalidate the gift.
360.1    (d) An anatomical gift made by will takes effect upon the donor's death whether or
360.2not the will is probated. Invalidation of the will after the donor's death does not invalidate
360.3the gift.
360.4    (e) The making of an anatomical gift shall not itself authorize or direct the denial
360.5of health care.

360.6    Sec. 35. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT
360.7BEFORE DONOR'S DEATH.
360.8    (a) Subject to section 525A.08, a donor or other person authorized to make an
360.9anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:
360.10    (1) a record signed by:
360.11    (i) the donor;
360.12    (ii) the other person; or
360.13    (iii) subject to paragraph (b), another individual acting at the direction of the donor
360.14or the other person if the donor or other person is physically unable to sign; or
360.15    (2) a later-executed document of gift that amends or revokes a previous anatomical
360.16gift or portion of an anatomical gift, either expressly or by inconsistency.
360.17    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:
360.18    (1) be witnessed by at least two adults, at least one of whom is a disinterested
360.19witness, who have signed at the request of the donor or the other person; and
360.20    (2) state that it has been signed and witnessed as provided in clause (1).
360.21    (c) Subject to section 525A.08, a donor or other person authorized to make an
360.22anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or
360.23cancellation of the document of gift, or the portion of the document of gift used to make
360.24the gift, with the intent to revoke the gift.
360.25    (d) A donor may amend or revoke an anatomical gift that was not made in a will
360.26by any form of communication during a terminal illness or injury addressed to at least
360.27two adults, at least one of whom is a disinterested witness.
360.28    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in
360.29the manner provided for amendment or revocation of wills or as provided in paragraph (a).

360.30    Sec. 36. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF
360.31REFUSAL.
360.32    (a) An individual may refuse to make an anatomical gift of the individual's body
360.33or part by:
360.34    (1) a record signed by:
361.1    (i) the individual; or
361.2    (ii) subject to paragraph (b), another individual acting at the direction of the
361.3individual if the individual is physically unable to sign;
361.4    (2) the individual's will, whether or not the will is admitted to probate or invalidated
361.5after the individual's death; or
361.6    (3) any form of communication made by the individual during the individual's
361.7terminal illness or injury addressed to at least two adults, at least one of whom is a
361.8disinterested witness.
361.9    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:
361.10    (1) be witnessed by at least two adults, at least one of whom is a disinterested
361.11witness, who have signed at the request of the individual; and
361.12    (2) state that it has been signed and witnessed as provided in clause (1).
361.13    (c) An individual who has made a refusal may amend or revoke the refusal:
361.14    (1) in the manner provided in paragraph (a) for making a refusal;
361.15    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is
361.16inconsistent with the refusal; or
361.17    (3) by destroying or canceling the record evidencing the refusal, or the portion of the
361.18record used to make the refusal, with the intent to revoke the refusal.
361.19    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence
361.20of an express, contrary indication by the individual set forth in the refusal, an individual's
361.21unrevoked refusal to make an anatomical gift of the individual's body or part bars all other
361.22persons from making an anatomical gift of the individual's body or part.

361.23    Sec. 37. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT,
361.24AMENDMENT, OR REVOCATION.
361.25    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the
361.26absence of an express, contrary indication by the donor, a person other than the donor is
361.27barred from making, amending, or revoking an anatomical gift of a donor's body or part if
361.28the donor made an anatomical gift of the donor's body or part under section 525A.05 or an
361.29amendment to an anatomical gift of the donor's body or part under section 525A.06. An
361.30anatomical gift made in a will, a designation on a driver's license or identification card, or
361.31a health care directive under chapter 145C, and not revoked, establishes the intent of the
361.32person making the designation and may not be overridden by any other person.
361.33    (b) A donor's revocation of an anatomical gift of the donor's body or part under
361.34section 525A.06 is not a refusal and does not bar another person specified in section
362.1525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under
362.2section 525A.05 or 525A.10.
362.3    (c) If a person other than the donor makes an unrevoked anatomical gift of the
362.4donor's body or part under section 525A.05 or an amendment to an anatomical gift of the
362.5donor's body or part under section 525A.06, another person may not make, amend, or
362.6revoke the gift of the donor's body or part under section 525A.10.
362.7    (d) A revocation of an anatomical gift of a donor's body or part under section
362.8525A.06 by a person other than the donor does not bar another person from making an
362.9anatomical gift of the body or part under section 525A.05 or 525A.10.
362.10    (e) In the absence of an express, contrary indication by the donor or other person
362.11authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part
362.12is neither a refusal to give another part nor a limitation on the making of an anatomical gift
362.13of another part at a later time by the donor or another person.
362.14    (f) In the absence of an express, contrary indication by the donor or other person
362.15authorized to make an anatomical gift under section 525A.04, an anatomical gift of a
362.16part for one or more of the purposes set forth in section 525A.04 is not a limitation on
362.17the making of an anatomical gift of the part for any of the other purposes by the donor
362.18or any other person under section 525A.05 or 525A.10.
362.19    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is
362.20reasonably available may revoke or amend an anatomical gift of the donor's body or part.
362.21    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who
362.22is reasonably available may revoke the minor's refusal.

362.23    Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S
362.24BODY OR PART.
362.25    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or
362.26525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation,
362.27therapy, research, or education may be made by any member of the following classes of
362.28persons who is reasonably available, in the order of priority listed:
362.29    (1) an agent of the decedent at the time of death who could have made an anatomical
362.30gift under section 525A.04, clause (2), immediately before the decedent's death;
362.31    (2) the spouse of the decedent;
362.32    (3) adult children of the decedent;
362.33    (4) parents of the decedent;
362.34    (5) adult siblings of the decedent;
362.35    (6) adult grandchildren of the decedent;
363.1    (7) grandparents of the decedent;
363.2    (8) an adult who exhibited special care and concern for the decedent;
363.3    (9) the persons who were acting as the guardians of the person of the decedent
363.4at the time of death; and
363.5    (10) any other person having the authority to dispose of the decedent's body.
363.6    (b) If there is more than one member of a class listed in paragraph (a), clause (1),
363.7(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may
363.8be made by a member of the class unless that member or a person to which the gift may
363.9pass under section 525A.11 knows of an objection by another member of the class. If
363.10an objection is known, the gift may be made only by a majority of the members of the
363.11class who are reasonably available.
363.12    (c) A person may not make an anatomical gift if, at the time of the decedent's death,
363.13a person in a prior class under paragraph (a) is reasonably available to make or to object to
363.14the making of an anatomical gift.

363.15    Sec. 39. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING
363.16ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.
363.17    (a) A person authorized to make an anatomical gift under section 525A.09 may
363.18make an anatomical gift by a document of gift signed by the person making the gift or by
363.19that person's oral communication that is electronically recorded or is contemporaneously
363.20reduced to a record and signed by the individual receiving the oral communication.
363.21    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section
363.22525A.09 may be amended or revoked orally or in a record by any member of a prior class
363.23who is reasonably available. If more than one member of the prior class is reasonably
363.24available, the gift made by a person authorized under section 525A.09 may be:
363.25    (1) amended only if a majority of the reasonably available members agree to the
363.26amending of the gift; or
363.27    (2) revoked only if a majority of the reasonably available members agree to the
363.28revoking of the gift or if they are equally divided as to whether to revoke the gift.
363.29    (c) A revocation under paragraph (b) is effective only if, before an incision has been
363.30made to remove a part from the donor's body or before invasive procedures have begun to
363.31prepare the recipient, the procurement organization, transplant hospital, or physician or
363.32technician knows of the revocation.

363.33    Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT;
363.34PURPOSE OF ANATOMICAL GIFT.
364.1    (a) An anatomical gift may be made to the following persons named in the document
364.2of gift:
364.3    (1) a hospital; accredited medical school, dental school, college, or university; organ
364.4procurement organization; or nonprofit organization in medical education or research,
364.5for research or education;
364.6    (2) subject to paragraph (b), an individual designated by the person making the
364.7anatomical gift if the individual is the recipient of the part; and
364.8    (3) an eye bank or tissue bank.
364.9    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be
364.10transplanted into the individual, the part passes in accordance with paragraph (g) in the
364.11absence of an express, contrary indication by the person making the anatomical gift.
364.12    (c) If an anatomical gift of one or more specific parts or of all parts is made in a
364.13document of gift that does not name a person described in paragraph (a) but identifies the
364.14purpose for which an anatomical gift may be used, the following rules apply:
364.15    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy,
364.16the gift passes to the appropriate eye bank;
364.17    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the
364.18gift passes to the appropriate tissue bank;
364.19    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy,
364.20the gift passes to the appropriate organ procurement organization as custodian of the
364.21organ; and
364.22    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research
364.23or education, the gift passes to the appropriate procurement organization.
364.24    (d) For the purpose of paragraph (c), if there is more than one purpose of an
364.25anatomical gift set forth in the document of gift but the purposes are not set forth in any
364.26priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot
364.27be used for transplantation or therapy, the gift may be used for research or education.
364.28    (e) If an anatomical gift of one or more specific parts is made in a document of gift
364.29that does not name a person described in paragraph (a) and does not identify the purpose
364.30of the gift, the gift may be used only for transplantation or therapy, and the gift passes in
364.31accordance with paragraph (g).
364.32    (f) If a document of gift specifies only a general intent to make an anatomical gift
364.33by words such as "donor," "organ donor," or "body donor," or by a symbol or statement
364.34of similar import, the gift may be used only for transplantation or therapy, and the gift
364.35passes in accordance with paragraph (g).
364.36    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:
365.1    (1) if the part is an eye, the gift passes to the appropriate eye bank;
365.2    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and
365.3    (3) if the part is an organ, the gift passes to the appropriate organ procurement
365.4organization as custodian of the organ.
365.5    (h) An anatomical gift of an organ for transplantation or therapy, other than
365.6an anatomical gift under paragraph (a), clause (2), passes to the organ procurement
365.7organization as custodian of the organ.
365.8    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the
365.9decedent's body or part is not used for transplantation, therapy, research, or education,
365.10custody of the body or part passes to the person under obligation to dispose of the body or
365.11part.
365.12    (j) A person may not accept an anatomical gift if the person knows that the gift was
365.13not effectively made under section 525A.05 or 525A.10 or if the person knows that the
365.14decedent made a refusal under section 525A.07 that was not revoked. For purposes of
365.15this paragraph, if a person knows that an anatomical gift was made on a document of gift,
365.16the person is deemed to know of any amendment or revocation of the gift or any refusal
365.17to make an anatomical gift on the same document of gift.
365.18    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter
365.19affects the allocation of organs for transplantation or therapy.

365.20    Sec. 41. [525A.12] SEARCH AND NOTIFICATION.
365.21    (a) The following persons shall make a reasonable search of an individual who
365.22the person reasonably believes is dead or near death for a document of gift or other
365.23information identifying the individual as a donor or as an individual who made a refusal:
365.24    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer
365.25finding the individual; and
365.26    (2) if no other source of the information is immediately available, a hospital, as soon
365.27as practical after the individual's arrival at the hospital.
365.28    (b) If a document of gift or a refusal to make an anatomical gift is located by the
365.29search required by paragraph (a), clause (1), and the individual or deceased individual to
365.30whom it relates is taken to a hospital, the person responsible for conducting the search
365.31shall send the document of gift or refusal to the hospital. If a body is transferred to
365.32the custody of the medical examiner, the person who discovered the body must notify
365.33the person's dispatcher. A dispatcher notified under this section must notify the state's
365.34federally designated organ procurement organization and inform the organization of the
365.35deceased's name, donor status, and location.
366.1    (c) A person is not subject to criminal or civil liability for failing to discharge the
366.2duties imposed by this section but may be subject to administrative sanctions.

366.3    Sec. 42. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED;
366.4RIGHT TO EXAMINE.
366.5    (a) A document of gift need not be delivered during the donor's lifetime to be
366.6effective.
366.7    (b) Upon or after an individual's death, a person in possession of a document of
366.8gift or a refusal to make an anatomical gift with respect to the individual shall allow
366.9examination and copying of the document of gift or refusal by a person authorized to
366.10make or object to the making of an anatomical gift with respect to the individual or by a
366.11person to which the gift could pass under section 525A.11.

366.12    Sec. 43. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT
366.13ORGANIZATION AND OTHERS.
366.14    (a) When a hospital refers an individual at or near death to a procurement
366.15organization, the organization shall make a reasonable search of the records of the
366.16Department of Public Safety and any donor registry that it knows exists for the
366.17geographical area in which the individual resides to ascertain whether the individual has
366.18made an anatomical gift.
366.19    (b) A procurement organization must be allowed reasonable access to information
366.20in the records of the Department of Public Safety to ascertain whether an individual at
366.21or near death is a donor.
366.22    (c) When a hospital refers an individual at or near death to a procurement
366.23organization, the organization may conduct any reasonable examination necessary to
366.24ensure the medical suitability of a part that is or could be the subject of an anatomical gift
366.25for transplantation, therapy, research, or education from a donor or a prospective donor.
366.26During the examination period, measures necessary to ensure the medical suitability of the
366.27part may not be withdrawn unless the hospital or procurement organization knows that
366.28the individual expressed a contrary intent.
366.29    (d) Unless prohibited by law other than this chapter, at any time after a donor's death,
366.30the person to which a part passes under section 525A.11 may conduct any reasonable
366.31examination necessary to ensure the medical suitability of the body or part for its intended
366.32purpose.
367.1    (e) Unless prohibited by law other than this chapter, an examination under paragraph
367.2(c) or (d) may include an examination of all medical and dental records of the donor or
367.3prospective donor.
367.4    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a
367.5procurement organization knows the minor is emancipated, the procurement organization
367.6shall conduct a reasonable search for the parents of the minor and provide the parents with
367.7an opportunity to revoke or amend the anatomical gift or revoke the refusal.
367.8    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall
367.9make a reasonable search for any person listed in section 525A.09 having priority to make
367.10an anatomical gift on behalf of a prospective donor. If a procurement organization receives
367.11information that an anatomical gift to any other person was made, amended, or revoked, it
367.12shall promptly advise the other person of all relevant information.
367.13    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person
367.14to which a part passes under section 525A.11 are superior to the rights of all others with
367.15respect to the part. The person may accept or reject an anatomical gift in whole or in part.
367.16Subject to the terms of the document of gift and this chapter, a person that accepts an
367.17anatomical gift of an entire body may allow embalming, burial, or cremation, and use of
367.18remains in a funeral service. If the gift is of a part, the person to which the part passes
367.19under section 525A.11, upon the death of the donor and before embalming, burial, or
367.20cremation, shall cause the part to be removed without unnecessary mutilation.
367.21    (i) Neither the physician who attends the decedent at death nor the physician who
367.22determines the time of the decedent's death may participate in the procedures for removing
367.23or transplanting a part from the decedent.
367.24    (j) A physician or technician may remove a donated part from the body of a donor
367.25that the physician or technician is qualified to remove.

367.26    Sec. 44. [525A.15] COORDINATION OF PROCUREMENT AND USE.
367.27    Each hospital in this state shall enter into agreements or affiliations with procurement
367.28organizations for coordination of procurement and use of anatomical gifts.

367.29    Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.
367.30    (a) Except as otherwise provided in paragraph (b), a person that, for valuable
367.31consideration, knowingly purchases or sells a part for transplantation or therapy if removal
367.32of a part from an individual is intended to occur after the individual's death, commits a
367.33felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment
367.34not exceeding five years, or both.
368.1    (b) A person may charge a reasonable amount for the removal, processing,
368.2preservation, quality control, storage, transportation, implantation, or disposal of a part.

368.3    Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.
368.4    A person that, in order to obtain a financial gain, intentionally falsifies, forges,
368.5conceals, defaces, or obliterates a document of gift, an amendment or revocation of a
368.6document of gift, or a refusal commits a felony and upon conviction is subject to a fine not
368.7exceeding $10,000 or imprisonment not exceeding five years, or both.

368.8    Sec. 47. [525A.18] IMMUNITY.
368.9    (a) A person that acts in accordance with this chapter or with the applicable
368.10anatomical gift law of another state, or attempts in good faith to do so, is not liable for the
368.11act in a civil action, criminal prosecution, or administrative proceeding.
368.12    (b) Neither the person making an anatomical gift nor the donor's estate is liable for
368.13any injury or damage that results from the making or use of the gift.
368.14    (c) In determining whether an anatomical gift has been made, amended, or revoked
368.15under this chapter, a person may rely upon representations of an individual listed in
368.16section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the
368.17individual's relationship to the donor or prospective donor unless the person knows that
368.18the representation is untrue.
368.19    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined
368.20in section 336.2-105, paragraph (1), or the sale of a product.

368.21    Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO
368.22EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.
368.23    (a) A document of gift is valid if executed in accordance with:
368.24    (1) this chapter;
368.25    (2) the laws of the state or country where it was executed; or
368.26    (3) the laws of the state or country where the person making the anatomical gift
368.27was domiciled, has a place of residence, or was a national at the time the document of
368.28gift was executed.
368.29    (b) If a document of gift is valid under this section, the law of this state governs
368.30the interpretation of the document of gift.
368.31    (c) A person may presume that a document of gift or amendment of an anatomical
368.32gift is valid unless that person knows that it was not validly executed or was revoked.

369.1    Sec. 49. [525A.20] DONOR REGISTRY.
369.2    (a) The Department of Health may establish or contract for the establishment of a
369.3donor registry.
369.4    (b) The Department of Public Safety shall cooperate with a person that administers
369.5any donor registry that this state establishes, contracts for, or recognizes for the purpose
369.6of transferring to the donor registry all relevant information regarding a donor's making,
369.7amendment to, or revocation of an anatomical gift.
369.8    (c) A donor registry must:
369.9    (1) allow a donor or other person authorized under section 525A.04 to include on
369.10the donor registry a statement or symbol that the donor has made, amended, or revoked
369.11an anatomical gift;
369.12    (2) be accessible to a procurement organization to allow it to obtain relevant
369.13information on the donor registry to determine, at or near death of the donor or a
369.14prospective donor, whether the donor or prospective donor has made, amended, or revoked
369.15an anatomical gift; and
369.16    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a
369.1724-hour basis.
369.18    (d) Personally identifiable information on a donor registry about a donor or
369.19prospective donor may not be used or disclosed without the express consent of the donor,
369.20prospective donor, or person that made the anatomical gift for any purpose other than
369.21to determine, at or near death of the donor or prospective donor, whether the donor or
369.22prospective donor has made, amended, or revoked an anatomical gift.
369.23    (e) This section does not prohibit any person from creating or maintaining a donor
369.24registry that is not established by or under contract with the state. Any such registry
369.25must comply with paragraphs (c) and (d).

369.26    Sec. 50. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH
369.27CARE DIRECTIVE.
369.28    (a) In this section:
369.29    (1) "advance health care directive" means a power of attorney for health care
369.30or a record signed by a prospective donor containing the prospective donor's direction
369.31concerning a health care decision for the prospective donor;
369.32    (2) "declaration" means a record signed by a prospective donor specifying the
369.33circumstances under which a life support system may be withheld or withdrawn from
369.34the prospective donor; and
370.1    (3) "health care decision" means any decision made regarding the health care of the
370.2prospective donor.
370.3    (b) If a prospective donor has a declaration or advance health care directive,
370.4measures necessary to ensure the medical suitability of an organ for transplantation
370.5or therapy may not be withheld or withdrawn from the prospective donor, unless the
370.6declaration expressly provides to the contrary.

370.7    Sec. 51. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND
370.8PROCUREMENT ORGANIZATION.
370.9    (a) A medical examiner shall cooperate with procurement organizations to maximize
370.10the opportunity to recover anatomical gifts for the purpose of transplantation, therapy,
370.11research, or education.
370.12    (b) If a medical examiner receives notice from a procurement organization that an
370.13anatomical gift might be available or was made with respect to a decedent whose body is
370.14under the jurisdiction of the medical examiner and a postmortem examination is going to
370.15be performed, unless the medical examiner denies recovery in accordance with section
370.16525A.23, the medical examiner or designee shall conduct a postmortem examination of
370.17the body or the part in a manner and within a period compatible with its preservation for
370.18the purposes of the gift.
370.19    (c) A part may not be removed from the body of a decedent under the jurisdiction
370.20of a medical examiner for transplantation, therapy, research, or education unless the part
370.21is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the
370.22medical examiner may not be delivered to a person for research or education unless the
370.23body is the subject of an anatomical gift. This paragraph does not preclude a medical
370.24examiner from performing the medicolegal investigation upon the body or parts of a
370.25decedent under the jurisdiction of the medical examiner.

370.26    Sec. 52. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM
370.27DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL
370.28EXAMINER.
370.29    (a) Upon request of a procurement organization, a medical examiner shall release to
370.30the procurement organization the name, contact information, and available medical and
370.31social history of a decedent whose body is under the jurisdiction of the medical examiner.
370.32If the decedent's body or part is medically suitable for transplantation, therapy, research,
370.33or education, the medical examiner shall release postmortem examination results to
370.34the procurement organization. The procurement organization may make a subsequent
371.1disclosure of the postmortem examination results or other information received from the
371.2medical examiner only if relevant to transplantation or therapy.
371.3    (b) The medical examiner may conduct a medicolegal examination by reviewing
371.4all medical records, laboratory test results, x-rays, other diagnostic results, and other
371.5information that any person possesses about a donor or prospective donor whose body is
371.6under the jurisdiction of the medical examiner which the medical examiner determines
371.7may be relevant to the investigation.
371.8    (c) A person that has any information requested by a medical examiner pursuant
371.9to paragraph (b) shall provide that information as expeditiously as possible to allow the
371.10medical examiner to conduct the medicolegal investigation within a period compatible
371.11with the preservation of parts for the purpose of transplantation, therapy, research, or
371.12education.
371.13    (d) If an anatomical gift has been or might be made of a part of a decedent whose
371.14body is under the jurisdiction of the medical examiner and a postmortem examination
371.15is not required, or the medical examiner determines that a postmortem examination is
371.16required but that the recovery of the part that is the subject of an anatomical gift will
371.17not interfere with the examination, the medical examiner and procurement organization
371.18shall cooperate in the timely removal of the part from the decedent for the purpose of
371.19transplantation, therapy, research, or education.
371.20    (e) If an anatomical gift of a part from the decedent under the jurisdiction of
371.21the medical examiner has been or might be made, but the medical examiner initially
371.22believes that the recovery of the part could interfere with the postmortem investigation
371.23into the decedent's cause or manner of death, the medical examiner shall consult with
371.24the procurement organization or physician or technician designated by the procurement
371.25organization about the proposed recovery. After consultation, the medical examiner may
371.26allow the recovery.
371.27    (f) Following the consultation under paragraph (e), in the absence of mutually
371.28agreed-upon protocols to resolve conflict between the medical examiner and the
371.29procurement organization, if the medical examiner intends to deny recovery of an organ
371.30for transplantation, the medical examiner or designee, at the request of the procurement
371.31organization, shall attend the removal procedure for the part before making a final
371.32determination not to allow the procurement organization to recover the part. During
371.33the removal procedure, the medical examiner or designee may allow recovery by the
371.34procurement organization to proceed, or, if the medical examiner or designee reasonably
371.35believes that the part may be involved in determining the decedent's cause or manner of
371.36death, deny recovery by the procurement organization.
372.1    (g) If the medical examiner or designee denies recovery under paragraph (f), the
372.2medical examiner or designee shall:
372.3    (1) explain in a record the specific reasons for not allowing recovery of the part;
372.4    (2) include the specific reasons in the records of the medical examiner; and
372.5    (3) provide a record with the specific reasons to the procurement organization.
372.6    (h) If the medical examiner or designee allows recovery of a part under paragraph
372.7(d), (e), or (f), the procurement organization, upon request, shall cause the physician
372.8or technician who removes the part to provide the medical examiner with a record
372.9describing the condition of the part, a biopsy, a photograph, and any other information and
372.10observations that would assist in the postmortem examination.
372.11    (i) If a medical examiner or designee is required to be present at a removal procedure
372.12under paragraph (f), upon request the procurement organization requesting the recovery
372.13of the part shall reimburse the medical examiner or designee for the additional costs
372.14incurred in complying with paragraph (f).

372.15    Sec. 53. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL
372.16AND NATIONAL COMMERCE ACT.
372.17    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and
372.18National Commerce Act, United States Code, title 15, section 7001 et seq., but does not
372.19modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section
372.207001, or authorize electronic delivery of any of the notices described in section 103(b)
372.21of that act, United States Code, title 15, section 7003(b).

372.22    Sec. 54. Laws 2005, chapter 98, article 3, section 25, is amended to read:
372.23    Sec. 25. REPEALER.
372.24    Minnesota Statutes 2004, sections 245.713, subdivisions 2 and subdivision 4;
372.25245.716 ; and 626.5551, subdivision 4, are repealed.
372.26EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.

372.27    Sec. 55. SOBER HOUSES.
372.28    Subdivision 1. Sober house defined. For purposes of this section, a "sober house"
372.29means a cooperative living residence that:
372.30    (1) provides temporary housing to persons with alcohol or other drug dependency
372.31and abuse problems in exchange for compensation;
372.32    (2) stipulates residents must abstain from using alcohol or drugs and meet other
372.33requirements as a condition of living in the residence; and
373.1    (3) does not provide counseling or treatment services to those residents within the
373.2meaning of Minnesota Statutes, chapter 148C or 254A.
373.3    Subd. 2. Work group creation; membership. The commissioner of human services
373.4shall convene a sober house work group which is comprised of the following members:
373.5    (1) sober house landlords;
373.6    (2) sober house residents;
373.7    (3) community members with knowledge of sober housing;
373.8    (4) representatives of cities and counties;
373.9    (5) a representative from the Department of Human Services, Chemical Health
373.10Division;
373.11    (6) a representative from the Department of Human Services, Licensing Division;
373.12    (7) a representative of chemical dependency treatment providers; and
373.13    (8) a representative from the Department of Health.
373.14    Subd. 3. Report. The work group created in subdivision 2 is directed to study the
373.15issue of sober houses in the state and determine whether state licensing or other regulation
373.16of sober houses is appropriate. Based on findings of the work group, the commissioner of
373.17human services shall submit a report of recommendations to the legislature by January
373.181, 2008.

373.19    Sec. 56. INTERPRETER SERVICES WORK GROUP.
373.20    (a) The commissioner of health shall, in consultation with the commissioners of
373.21commerce, human services, and employee relations, convene a work group to study the
373.22provision of interpreter services to patients in medical and dental care settings. The work
373.23group shall include one representative from each of the following groups:
373.24    (1) consumers;
373.25    (2) interpreters;
373.26    (3) interpreter service providers or agencies;
373.27    (4) health plan companies;
373.28    (5) self-insured purchasers;
373.29    (6) hospitals;
373.30    (7) health care providers;
373.31    (8) dental providers;
373.32    (9) clinic administrators;
373.33    (10) state agency staff from the Departments of Health, Human Services, and
373.34Employee Relations;
373.35    (11) Minnesota Registry of Interpreters for the Deaf;
374.1    (12) local county social services agencies;
374.2    (13) local public health agencies;
374.3    (14) interpreting stakeholders group;
374.4    (15) one interpreter trainer; and
374.5    (16) one interpreter certification examiner.
374.6    (b) The work group shall develop findings and recommendations on the following:
374.7    (1) assuring access to interpreter services;
374.8    (2) compliance with requirements of federal law and guidance;
374.9    (3) developing a quality assurance program to ensure the quality of health care
374.10interpreting services, including requirements for training and establishing a certification
374.11process; and
374.12    (4) identifying broad-based funding mechanisms for interpreter services.
374.13    (c) Based on the discussions of the work group, the commissioner shall make
374.14recommendations to the chairs of the health policy and finance committees in the house
374.15and senate by January 15, 2008, on how to ensure high quality interpreter services for
374.16patients in medical and dental settings, and for a broad-based funding mechanism for
374.17delivering these services.
374.18EFFECTIVE DATE.This section is effective the day following final enactment.

374.19    Sec. 57. FEDERAL GRANTS.
374.20    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate
374.21funds to establish and fully implement the prescription electronic reporting system.
374.22EFFECTIVE DATE.This section is effective the day following final enactment.

374.23    Sec. 58. BOARD OF PHARMACY.
374.24    The Board of Pharmacy shall not increase the license fees of pharmacists or
374.25pharmacies in order to adequately fund the prescription electronic reporting system under
374.26Minnesota Statutes, section 152.126, without specific authority from the legislature.
374.27EFFECTIVE DATE.This section is effective the day following final enactment.

374.28    Sec. 59. BOARD OF MEDICAL PRACTICE.
374.29    The Board of Medical Practice shall convene a work group to discuss the appropriate
374.30prescribing of controlled substances listed in Minnesota Statutes, section 152.02,
374.31subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
375.1Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and
375.2shall report to the legislature by December 15, 2007.

375.3    Sec. 60. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.
375.4    Subdivision 1. Pilot project requirements. The commissioner of commerce shall
375.5authorize a joint self-insurance pilot project administered by a trust sponsored by one
375.6or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A,
375.7or under a federal charter for the purpose of offering health coverage to members of
375.8the cooperatives and their families, provided the project satisfies the requirements of
375.9Minnesota Statutes, chapter 62H, except as follows:
375.10    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;
375.11    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph
375.12(e), is 90 days;
375.13    (3) the commissioner shall grant necessary waivers and approve an alternative
375.14arrangement that fully funds the plan's liability or incurred but unpaid claims under
375.15Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides
375.16evidence demonstrating that the insolvency protection proposed is substantially less than
375.17that typically provided by self-insured group plans of a similar size in Minnesota;
375.18    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint
375.19self-insurance plan shall be considered a large group and not subject to the small group
375.20insurance requirements in Minnesota Statutes, chapter 62L, even if some employer
375.21groups enrolled in the plan would be defined as small employers, except that the joint
375.22self-insurance plan may elect to treat the sale of a health plan to or for an employer that
375.23has only one eligible employee who has not waived coverage as the sale of an individual
375.24health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;
375.25    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not
375.26apply; and
375.27    (6) the trust must pay the assessment for the Minnesota comprehensive health
375.28association as provided under Minnesota Statutes, section 62E.11.
375.29    Subd. 2. Evaluation and renewal. The pilot project authorized under this section
375.30is for a period of four years from the date of initial enrollment. The commissioner shall
375.31grant an extension of four additional years if the trust provides evidence that it remains in
375.32compliance with the requirements of this section and other applicable laws and rules. If the
375.33commissioner determines that the operation of the trust has not improved access, expanded
375.34health plan choices, or improved affordability of health coverage for farm families, or
375.35that it has significantly damaged access, choice, or affordability for other consumers not
376.1enrolled in the trust, the commissioner shall provide at least 180 days' advance written
376.2notice to the trust and to the chairs of the senate and house finance and policy committees
376.3with jurisdiction over health and insurance matters of the commissioner's intention not to
376.4renew the pilot project at the expiration of a four-year period.
376.5EFFECTIVE DATE.This section is effective the day following final enactment.

376.6    Sec. 61. HEALTH PLAN PURCHASING POOL STUDY GROUP.
376.7    Subdivision 1. Creation; membership. A health care purchasing pool study group
376.8is created to study and make recommendations regarding the creation of a voluntary,
376.9statewide health care purchasing pool that would contract directly with providers to
376.10provide affordable health coverage to eligible Minnesota residents. The study group is
376.11composed of:
376.12    (1) the chief house and senate authors of this act;
376.13    (2) the chairs of the senate Committee on Health, Housing, and Family Security and
376.14the Health and Human Services Budget Division;
376.15    (3) the chairs of the house Health Care and Human Services Committee and the
376.16Health Care and Human Services Division;
376.17    (4) the attorney general or the attorney general's designated representative;
376.18    (5) three representatives of health care providers appointed as follows:
376.19    (i) one member appointed by the governor;
376.20    (ii) one member appointed by the speaker of the house; and
376.21    (iii) one member appointed by the Subcommittee on Committees of the senate
376.22Committee on Rules and Administration; and
376.23    (6) two consumers of health care appointed by the governor.
376.24    All appointments to be made under this subdivision must be made within 30 days
376.25of the effective date of this act.
376.26    Subd. 2. Study; report. The study group shall study and make recommendations
376.27on the following issues related to the creation, maintenance, and funding of a voluntary,
376.28statewide health plan purchasing pool to provide comprehensive, cost-effective, and
376.29medically appropriate health coverage to all public and private employees in Minnesota
376.30and all Minnesota residents:
376.31    (1) the creation of an independent public entity to administer the pool;
376.32    (2) eligibility and participation requirements for existing public and private health
376.33care purchasing pools, public and private employers, and residents of this state;
376.34    (3) how to contract directly with providers to provide comprehensive coverage for
376.35preventive, mental health, dental and other medical services, and comprehensive drug
377.1benefits to enrollees and maximize the cost savings and other efficiencies that a large
377.2purchasing pool would be expected to generate without the need for a public subsidy;
377.3    (4) provisions that allow the pool to contract directly with health care providers
377.4to provide coverage to enrollees;
377.5    (5) incentives designed to attract and retain the maximum number of enrollees;
377.6    (6) recommendations for the administration of the pool and the plans that will be
377.7available to enrollees including, but not limited to, recommendations to keep the pool
377.8solvent and profitable so that public subsidies are not necessary; and
377.9    (7) other elements the study group concludes are necessary or desirable for the
377.10pool to possess.
377.11    The study group shall submit its report and the draft legislation necessary to
377.12implement its recommendations to the chairs of the legislative committees and divisions
377.13with jurisdiction over health care policy and finance, the Health Care Access Commission,
377.14and the governor by February 1, 2008.
377.15    Subd. 3. Staffing. State agencies shall assist the study group with any requests for
377.16information the study group considers necessary to complete the study and report under
377.17subdivision 2.
377.18    Subd. 4. Removal; vacancies; expenses. Removal of members, vacancies, and
377.19expenses for members shall be as provided in Minnesota Statutes, section 15.059.
377.20    Subd. 5. Expiration. This section expires after the submission of the report as
377.21required in subdivision 2.
377.22EFFECTIVE DATE.This section is effective the day following final enactment.

377.23    Sec. 62. REPEALER.
377.24(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16;
377.25254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
377.26254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.
377.27(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.
377.28(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213;
377.29525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222;
377.30525.9223; and 525.9224, are repealed.

377.31ARTICLE 8

377.32CHILDREN'S HEALTH SECURITY PROGRAM

377.33    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.
378.1    A children's health security account is created in a special revenue fund in the
378.2state treasury. The commissioner shall deposit to the credit of the account money made
378.3available to the account. Notwithstanding section 11A.20, any investment income
378.4attributable to the investment of the children's health security account not currently needed
378.5shall be credited to the children's health security account.

378.6    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:
378.7    Subd. 8. Children under age two. Medical assistance may be paid for a child under
378.8two years of age whose countable family income is above 275 300 percent of the federal
378.9poverty guidelines for the same size family but less than or equal to 280 305 percent of the
378.10federal poverty guidelines for the same size family.
378.11EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
378.12approval, whichever is later.

378.13    Sec. 3. [256N.01] CITATION.
378.14    This chapter may be cited as the "Children's Health Security Act."

378.15    Sec. 4. [256N.02] DEFINITIONS.
378.16    Subdivision 1. Applicability. The terms used in this chapter have the following
378.17meanings unless otherwise provided for by text.
378.18    Subd. 2. Child. "Child" means an individual under age 21.
378.19    Subd. 3. Commissioner. "Commissioner" means the commissioner of human
378.20services.
378.21    Subd. 4. Dependent child. "Dependent child" means an unmarried child under
378.22age 25 who is claimed as a dependent for federal income tax purposes by a parent,
378.23grandparent, foster parent, relative caretaker, or legal guardian.

378.24    Sec. 5. [256N.03] ESTABLISHMENT.
378.25    The commissioner shall establish the children's health security program. The
378.26commissioner shall begin implementation of the program on October 1, 2008, or upon
378.27federal approval, whichever is later. The children's health security program must comply
378.28with title XIX of the federal Social Security Act, and waivers granted under title XIX.

378.29    Sec. 6. [256N.05] ELIGIBILITY.
378.30    Subdivision 1. General requirements. Children meeting the eligibility
378.31requirements of this section are eligible for the children's health security program.
379.1    Subd. 2. Income limit. (a) Effective October 1, 2008, children in families with
379.2gross household incomes equal to or less than 225 percent of the federal poverty
379.3guidelines are eligible for the children's health security program. In determining gross
379.4income, the commissioner shall use the income methodology applied to children under the
379.5MinnesotaCare program.
379.6    (b) Effective October 1, 2008, a dependent child who meets the program income
379.7limits under paragraph (a) and all other program eligibility requirements is eligible for
379.8state-funded benefits under this section.
379.9    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children
379.10in families with household incomes equal to or less than 300 percent of the federal poverty
379.11guidelines must be included in the children's health security program.
379.12    (d) The Legislative Task Force On Children's Health Care Coverage established
379.13under section 19 shall develop recommendations on options for extending health insurance
379.14coverage to children in families with household incomes in excess of 300 percent of the
379.15federal poverty guidelines.
379.16    Subd. 3. Residency. Program participants must meet the residency requirements of
379.17section 256B.056, subdivision 1.
379.18    Subd. 4. Enrollment voluntary. Enrollment in the children's health security
379.19program is voluntary. Parents or guardians may retain private sector or Medicare coverage
379.20for a child as the sole source of coverage. Parents or guardians who have private sector or
379.21Medicare coverage for children may also enroll children in the children's health security
379.22program. If private sector or Medicare coverage is available, coverage under the children's
379.23health security program is secondary to the private sector or Medicare coverage.
379.24    Subd. 5. Emergency services. Payment must be made for care and services that
379.25are furnished to noncitizens, regardless of immigration status, who otherwise meet the
379.26eligibility requirements of this chapter, if the care and services are necessary for the
379.27treatment of an emergency medical condition, except for organ transplants and related
379.28care and services and routine prenatal care. For purposes of this subdivision, "emergency
379.29medical condition" means a medical condition that meets the requirements of United
379.30States Code, title 42, section 1396b(v).
379.31    Subd. 6. Medical assistance standards and procedures. (a) Unless otherwise
379.32specified in this chapter, the commissioner shall use medical assistance procedures and
379.33methodology when determining initial eligibility and redetermining eligibility for the
379.34children's health security program.
380.1    (b) The procedures and income standard specified in section 256B.056, subdivisions
380.25 and 5c, paragraph (a), apply to children who would be eligible for the children's health
380.3security program, except for excess income.
380.4    (c) Retroactive coverage for the children's health security program must be provided
380.5as specified in section 256B.056, subdivision 7.

380.6    Sec. 7. [256N.07] COVERED SERVICES.
380.7    Covered services under the children's health security program must consist of all
380.8covered services under chapter 256B.

380.9    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.
380.10    In order to ensure broad access to coverage, the children's health security program
380.11has no enrollee premium or cost-sharing requirements.

380.12    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY
380.13DETERMINATION.
380.14    Subdivision 1. Application procedure. The application form for the program
380.15must be easily understandable and must not exceed two pages in length. Applications for
380.16the program must be made available to provider offices, local human services agencies,
380.17school districts, schools, community health offices, and other sites willing to cooperate in
380.18program outreach. These sites may accept applications and forward applications to the
380.19commissioner, and counties where applicable. Applications may also be made directly to
380.20the commissioner and to counties that determine eligibility.
380.21    Subd. 2. Eligibility determination. Counties that determine eligibility for
380.22MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health
380.23security program. The commissioner, and counties where applicable, shall determine an
380.24applicant's eligibility for the program within 30 days of the date the application is received,
380.25according to the procedures in Code of Federal Regulations, title 42, section 435.911.
380.26    Subd. 3. Presumptive eligibility. Coverage under the program is available during a
380.27presumptive eligibility period for children under age 19 whose family income does not
380.28exceed the applicable income standard. The presumptive eligibility period begins on the
380.29date on which a health care provider enrolled in the program, or other entity designated by
380.30the commissioner, determines, based on preliminary information, that the child's family
380.31income does not exceed the applicable income standard. The presumptive eligibility period
380.32ends the earlier of the day on which a determination is made of eligibility under this section
380.33or the last day of the month following the month presumptive eligibility was determined.
381.1    Subd. 4. Renewal of eligibility. The commissioner shall require enrollees to renew
381.2eligibility every 12 months.
381.3    Subd. 5. Continuous eligibility. Children under the age of 19 who are eligible
381.4under this section shall be continuously eligible until the earlier of the next renewal period,
381.5or the time that a child exceeds age 19.

381.6    Sec. 10. [256N.12] COUNTY ROLE.
381.7    Counties not required to determine eligibility under section 256N.11, subdivision
381.82, may choose to determine eligibility under that section. Counties may also choose
381.9to provide assistance to applicants under section 256N.17, subdivision 1, and provide
381.10ombudsperson services under section 256N.17, subdivision 2. This must not limit the
381.11ability of the commissioner to establish reasonable staffing standards that relate to the
381.12number of persons served, and that provide a county option to hire part-time staff or pursue
381.13multicounty implementation models. If a county chooses not to deliver these services, they
381.14must be delivered by the commissioner. State and federal funding to support these services
381.15must be the same, whether delivered by the state or by a county or group of counties.

381.16    Sec. 11. [256N.13] SERVICE DELIVERY.
381.17    Subdivision 1. Contracts for service delivery. The commissioner, within each
381.18county, may contract with managed care organizations, including health maintenance
381.19organizations licensed under chapter 62D, community integrated service networks licensed
381.20under chapter 62N, accountable provider networks licensed under chapter 62T, and
381.21county-based purchasing plans established under section 256B.692, to provide covered
381.22health care services to program enrollees under a managed care system, and may contract
381.23with health care and social service providers to provide services on a fee-for-service basis.
381.24Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In
381.25determining the method for service delivery, the commissioner shall consider the cost and
381.26quality of health care services; the breadth of services offered, including medical, dental
381.27and mental health services; the breadth of choice of medical providers for enrollees; the
381.28ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of
381.29service delivery; and the integration of best medical practice standards into the children's
381.30health security program.
381.31    Subd. 2. Managed care organization requirements. (a) Managed care
381.32organizations under contract are responsible for coordinating covered health care services
381.33provided to eligible individuals. Managed care organizations under contract:
382.1    (1) shall authorize and arrange for the provision of all needed covered health
382.2services under chapter 256B, with the exception of services available only under a medical
382.3assistance home and community-based waiver, in order to ensure appropriate health care
382.4is delivered to enrollees;
382.5    (2) shall comply with the requirements of section 256B.69, subdivision 26;
382.6    (3) shall accept the prospective, per capita payment from the commissioner in return
382.7for the provision of comprehensive and coordinated health care services for enrollees;
382.8    (4) may contract with health care and social service providers to provide covered
382.9services to enrollees; and
382.10    (5) shall institute enrollee grievance procedures according to the method established
382.11by the commissioner, utilizing applicable requirements of chapter 62D and Code of
382.12Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to
382.13the commissioner using the procedures in section 256.045.
382.14    (b) Upon implementation of the children's health security program, the commissioner
382.15shall withhold five percent of managed care organization payments pending completion
382.16of performance targets, including lead screening, well child services, immunizations,
382.17vision screening, and customer service performance targets. Effective January 1, 2011,
382.18the commissioner shall add treatment of asthma and screening for mental health as new
382.19performance targets. Each performance target must apply uniformly to all managed care
382.20organizations, and be qualitative, objective, measurable, and reasonably attainable, except
382.21in the case of a performance target based on federal or state law or rule. Criteria for
382.22assessment of each performance target must be outlined in writing prior to the contract
382.23effective date. The withhold funds must be returned no sooner than July of the following
382.24year if performance targets in the contract are achieved. The success of each managed care
382.25organization in reaching performance targets must be reported to the legislature annually.
382.26    Subd. 3. Fee-for-service delivery. Disputes related to services provided under
382.27the fee-for-service system may be appealed to the commissioner using the procedures
382.28in section 256.045.
382.29    Subd. 4. Contracts for waiver services. The commissioner, when services
382.30are delivered through managed care, may contract with health care and social service
382.31providers on a fee-for-service basis to provide program enrollees with covered services
382.32available only under a medical assistance home and community-based waiver. The
382.33commissioner shall determine eligibility for home and community-based waiver services
382.34using the criteria and procedures in chapter 256B. Disputes related to services provided
382.35on a fee-for-service basis may be appealed to the commissioner using the procedures
382.36in section 256.045.
383.1    Subd. 5. Service delivery for Minnesota disabilities health option recipient.
383.2    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO),
383.3established under section 256B.69, subdivision 23, shall continue to receive their home
383.4and community-based waiver services through MnDHO.
383.5    Subd. 6. Disabled or blind children. Children eligible for medical assistance due
383.6to blindness or disability as determined by the Social Security Administration or the state
383.7medical review team are exempt from enrolling in a managed care organization and shall
383.8be provided health benefits on a fee-for-service basis.

383.9    Sec. 12. [256N.15] PAYMENT RATES.
383.10    Subdivision 1. Establishment. The commissioner, in consultation with a health
383.11care actuary, shall establish the method and amount of payments for services. The
383.12commissioner shall annually contract with eligible entities to provide services to program
383.13enrollees. The commissioner, in consultation with the Risk Adjustment Association
383.14established under section 62Q.03, subdivision 6, shall develop and implement a risk
383.15adjustment system for the program.
383.16    Subd. 2. Provider rates. In establishing the payment amount under subdivision
383.171, the commissioner shall ensure that fee-for-service payment rates for preventative
383.18care services provided on or after October 1, 2008, are at least five percent above the
383.19medical assistance rates for preventative services in effect on September 30, 2008, and
383.20shall ensure that fee-for-service payment rates for all other services provided on or after
383.21October 1, 2008, are at least three percent above the medical assistance rates for those
383.22services in effect on September 30, 2008. The commissioner shall adjust managed care
383.23capitation rates to reflect these increases, and shall require managed care organizations, as
383.24a condition of contract, to pass these increases on to providers under contract.

383.25    Sec. 13. [256N.17] CONSUMER ASSISTANCE.
383.26    Subdivision 1. Assistance to applicants. The commissioner shall assist applicants
383.27in choosing a managed care organization or fee-for-service provider by:
383.28    (1) establishing a Web site to provide information about managed care organizations
383.29and fee-for-service providers and to allow online enrollment;
383.30    (2) make information on managed care organizations and fee-for-service providers
383.31available at the sites specified in section 256N.11, subdivision 1;
383.32    (3) make applications and information on managed care organizations and
383.33fee-for-service providers available to applicants and enrollees according to Title VI of the
384.1Civil Rights Act and federal regulations adopted under that law or any guidance from the
384.2United States Department of Health and Human Services; and
384.3    (4) make benefit educators available to assist applicants in choosing a managed care
384.4organization or fee-for-service provider.
384.5    Subd. 2. Ombudsperson. The commissioner shall designate an ombudsperson
384.6to advocate for children enrolled in the children's health security program. The
384.7ombudsperson shall assist enrollees in understanding and making use of complaint and
384.8appeal procedures and ensure that necessary medical services are provided to enrollees. At
384.9the time of enrollment, the commissioner shall inform enrollees about the ombudsperson
384.10program, the right to a resolution of the enrollee's complaint by the managed care
384.11organization if the enrollee experiences a problem with the managed care organization
384.12or its providers, and appeal rights under section 256.045.

384.13    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND
384.14COSTS.
384.15    (a) The commissioner, as a condition of contract, shall require each participating
384.16managed care organization and participating provider to submit, in the form and manner
384.17specified by the commissioner, data required for assessing enrollee satisfaction, quality
384.18of care, cost, and utilization of services. The commissioner shall evaluate this data, in
384.19order to:
384.20    (1) make summary information on the quality of care across managed care
384.21organizations, medical clinics, and providers available to consumers;
384.22    (2) require managed care organizations and providers, as a condition of contract, to
384.23implement quality improvement plans; and
384.24    (3) compare the cost and quality of services under the program to the cost and
384.25quality of services provided to private sector enrollees.
384.26    (b) The commissioner shall implement this section to the extent allowed by federal
384.27and state laws on data privacy.

384.28    Sec. 15. [256N.21] FEDERAL APPROVAL.
384.29    The commissioner shall seek all federal waivers and approvals necessary to
384.30implement this chapter including, but not limited to, waivers and approvals necessary to:
384.31    (1) coordinate medical assistance and MinnesotaCare coverage for children with the
384.32children's health security program;
384.33    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care
384.34services under the children's health security program;
385.1    (3) maximize receipt of the federal medical assistance match for covered children,
385.2by increasing income standards through the use of more liberal income methodologies as
385.3provided under United States Code, title 42, sections 1396a and 1396u-1;
385.4    (4) extend presumptive eligibility and continuous eligibility to children under age
385.521; and
385.6    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to
385.7dependent children.

385.8    Sec. 16. [256N.23] RULEMAKING.
385.9    The commissioner shall adopt rules to implement this chapter.

385.10    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM
385.11OUTREACH.
385.12    Subdivision 1. Grant awards. The commissioner shall award grants to public or
385.13private organizations to:
385.14    (1) provide information, in areas of the state with high uninsured populations, on the
385.15importance of maintaining insurance coverage and on how to obtain coverage through
385.16the children's health security program; and
385.17    (2) monitor and provide ongoing support to ensure enrolled children remain covered.
385.18    Subd. 2. Criteria. In awarding the grants, the commissioner shall consider the
385.19following:
385.20    (1) geographic areas and populations with high uninsured rates;
385.21    (2) the ability to raise matching funds;
385.22    (3) the ability to contact, effectively communicate with, or serve eligible populations;
385.23and
385.24    (4) the applicant's plan to monitor and provide support to ensure enrolled children
385.25remain covered.
385.26    Subd. 3. Monitoring and termination. The commissioner shall monitor the grants
385.27and may terminate a grant if the outreach effort does not increase enrollment in the
385.28children's health security program.

385.29    Sec. 18. IMPLEMENTATION PLAN.
385.30    The commissioner of human services shall develop an implementation plan for the
385.31children's health security program, which includes a health delivery plan based on the
385.32criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner
385.33shall present this plan, any necessary draft legislation, and a draft of proposed rules
386.1to the legislature by December 15, 2007. The plan must include recommendations
386.2for any additional legislative changes necessary to coordinate medical assistance and
386.3MinnesotaCare coverage for children with the children's health security program. The
386.4commissioner shall evaluate the provision of services under the program to children with
386.5disabilities and shall present recommendations to the legislature by December 15, 2009,
386.6for any program changes necessary to ensure the quality and continuity of care.

386.7    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE
386.8COVERAGE.
386.9    Subdivision 1. Establishment; membership. (a) The Legislative Task Force on
386.10Children's Health Care Coverage is established. The task force is made up of 12 voting
386.11members and six nonvoting members.
386.12    (b) The voting members are:
386.13    (1) six members of the house of representatives appointed by the speaker, three from
386.14the majority party and three from the minority party; and
386.15    (2) six members of the senate appointed by the Subcommittee on Committees of the
386.16senate Committee on Rules and Administration, three from the majority party and three
386.17from the minority party.
386.18    (c) The nonvoting members are one representative selected by each of the following
386.19organizations:
386.20    (1) the American Academy of Pediatrics, Minnesota chapter;
386.21    (2) the Minnesota Nurses Association;
386.22    (3) the Minnesota Council of Health Plans;
386.23    (4) the Minnesota Children's Platform Coalition;
386.24    (5) the Minnesota Universal Health Care Coalition; and
386.25    (6) the Minnesota Business Partnership.
386.26    (d) The task force members must be appointed by September 1, 2007. The majority
386.27leader of the senate and the speaker of the house of representatives must each designate
386.28a chair from their appointments. The chair appointed by the speaker of the house of
386.29representatives shall convene and chair the first meeting of the task force. The chair
386.30appointed by the majority leader of the senate shall chair the next meeting of the task
386.31force. The chairs shall then alternate for the duration of the task force.
386.32    Subd. 2. Study; staff support. (a) The task force shall study viable options to extend
386.33coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision
386.342, paragraph (d), and provide recommendations to the legislature. The study must:
387.1    (1) evaluate methods to achieve universal coverage for children, including, but not
387.2limited to, changes to the employer-based coverage system and an expansion of eligibility
387.3for the children's health security program established under Minnesota Statutes, chapter
387.4256N;
387.5    (2) examine health care reform and cost containment methods that will contain costs
387.6and increase access and improve health outcomes;
387.7    (3) examine how to increase access to preventive care and health care services; and
387.8    (4) examine how to reduce health disparities among minority populations.
387.9    (b) The task force, through the Legislative Coordinating Commission, may hire staff
387.10or contract for staff support for the study.
387.11    (c) The task force, in developing recommendations, shall hold meetings to hear
387.12public testimony at locations throughout the state, including locations outside of the
387.13seven-county metropolitan area.
387.14    Subd. 3. Recommendations. The task force shall report its recommendations to
387.15the legislature by December 15, 2009. Recommendations must be consistent with the
387.16following criteria:
387.17    (1) health care coverage must include preventive care and all other medically
387.18necessary services;
387.19    (2) health care coverage must be affordable for families, with the family share of
387.20premium costs and cost-sharing in total not exceeding five percent of family income;
387.21    (3) the system of coverage must give priority to ensuring access to and the quality
387.22and continuity of care; and
387.23    (4) enrollment must be simple and seamless for families.
387.24    Subd. 4. Expiration. This section expires December 16, 2009.

387.25ARTICLE 9

387.26HEALTH CARE REFORM

387.27    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:
387.28    Subd. 3. Premium rate restrictions. No individual health plan may be offered,
387.29sold, issued, or renewed to a Minnesota resident unless the premium rate charged is
387.30determined in accordance with the following requirements:
387.31    (a) Premium rates must be no more than 25 percent above and no more than 25
387.32percent below the index rate charged to individuals for the same or similar coverage,
387.33adjusted pro rata for rating periods of less than one year. The premium variations
387.34permitted by this paragraph must be based only upon health status, claims experience,
387.35and occupation. For purposes of this paragraph, health status includes refraining from
388.1tobacco use or other actuarially valid lifestyle factors associated with good health,
388.2provided that the lifestyle factor and its effect upon premium rates have been determined
388.3by the commissioner to be actuarially valid and have been approved by the commissioner.
388.4Variations permitted under this paragraph must not be based upon age or applied
388.5differently at different ages. This paragraph does not prohibit use of a constant percentage
388.6adjustment for factors permitted to be used under this paragraph.
388.7    (b) Premium rates may vary based upon the ages of covered persons only as
388.8provided in this paragraph. In addition to the variation permitted under paragraph (a),
388.9each health carrier may use an additional premium variation based upon age for adults
388.10aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for
388.11children under the age of 19 may not vary based on age, regardless of whether the child is
388.12covered as a dependent or as a primary insured.
388.13    (c) A health carrier may request approval by the commissioner to establish separate
388.14geographic regions determined by the health carrier and to establish separate index rates
388.15for each such region. The commissioner shall grant approval if the following conditions
388.16are met:
388.17    (1) the geographic regions must be applied uniformly by the health carrier;
388.18    (2) each geographic region must be composed of no fewer than seven counties that
388.19create a contiguous region; and
388.20    (3) the health carrier provides actuarial justification acceptable to the commissioner
388.21for the proposed geographic variations in index rates, establishing that the variations are
388.22based upon differences in the cost to the health carrier of providing coverage.
388.23    (d) Health carriers may use rate cells and must file with the commissioner the rate
388.24cells they use. Rate cells must be based upon the number of adults or children covered
388.25under the policy and may reflect the availability of Medicare coverage. The rates for
388.26different rate cells must not in any way reflect generalized differences in expected costs
388.27between principal insureds and their spouses.
388.28    (e) In developing its index rates and premiums for a health plan, a health carrier shall
388.29take into account only the following factors:
388.30    (1) actuarially valid differences in rating factors permitted under paragraphs (a)
388.31and (b); and
388.32    (2) actuarially valid geographic variations if approved by the commissioner as
388.33provided in paragraph (c).
388.34    (f) All premium variations must be justified in initial rate filings and upon request of
388.35the commissioner in rate revision filings. All rate variations are subject to approval by
388.36the commissioner.
389.1    (g) The loss ratio must comply with the section 62A.021 requirements for individual
389.2health plans.
389.3    (h) The rates must not be approved, unless the commissioner has determined that the
389.4rates are reasonable. In determining reasonableness, the commissioner shall consider the
389.5growth rates applied under section 62J.04, subdivision 1, paragraph (b), to the calendar
389.6year or years that the proposed premium rate would be in effect, actuarially valid changes
389.7in risks associated with the enrollee populations, and actuarially valid changes as a result
389.8of statutory changes in Laws 1992, chapter 549.
389.9    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under
389.10section 62A.02, subdivision 3a, include a rating practices guarantee as provided in this
389.11paragraph. The rating practices guarantee must be in writing and must guarantee that
389.12the policy form will be offered, sold, issued, and renewed only with premium rates and
389.13premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices
389.14guarantee must be accompanied by an actuarial memorandum that demonstrates that the
389.15premium rates and premium rating system used in connection with the policy form will
389.16satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to
389.17policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4,
389.18or 5. An insurer that complies with this paragraph in connection with a policy form is
389.19exempt from the requirement of prior approval by the commissioner under paragraphs
389.20(c), (f), and (h).

389.21    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.
389.22    Subdivision 1. Title; citation. This section may be cited as the "Minnesota Health
389.23Insurance Exchange."
389.24    Subd. 2. Creation; tax exemption. The Minnesota Health Insurance Exchange
389.25is created for the limited purpose of providing individuals with greater access, choice,
389.26portability, and affordability of health insurance products. The Minnesota Health
389.27Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c)
389.28of the Internal Revenue Code.
389.29    Subd. 3. Definitions. The following terms have the meanings given them unless
389.30otherwise provided in text.
389.31    (a) "Board" means the board of directors of the Minnesota Health Insurance
389.32Exchange under subdivision 13.
389.33    (b) "Commissioner" means:
389.34    (1) the commissioner of commerce for health insurers subject to the jurisdiction
389.35of the Department of Commerce;
390.1    (2) the commissioner of health for health insurers subject to the jurisdiction of the
390.2Department of Health; or
390.3    (3) either commissioner's designated representative.
390.4    (c) "Exchange" means the Minnesota Health Insurance Exchange.
390.5    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.
390.6    (e) "Individual market health plans," unless otherwise specified, means individual
390.7market health plans defined in section 62A.011.
390.8    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of
390.9the Internal Revenue Code that allows employees to pay for health insurance premiums
390.10with pretax dollars.
390.11    Subd. 4. Insurer and health plan participation. All health plans as defined in
390.12section 62A.011, subdivision 3, issued or renewed in the individual market shall participate
390.13in the exchange. No health plans in the individual market may be issued or renewed
390.14outside of the exchange. Group health plans as defined in section 62A.10 shall not be
390.15offered through the exchange. Health plans offered through the Minnesota Comprehensive
390.16Health Association as defined in section 62E.10 are offered through the exchange to
390.17eligible enrollees as determined by the Minnesota Comprehensive Health Association.
390.18Health plans offered through MinnesotaCare under chapter 256L are offered through the
390.19exchange to eligible enrollees as determined by the commissioner of human services.
390.20    Subd. 5. Approval of health plans. No health plan may be offered through the
390.21exchange unless the commissioner has first certified that:
390.22    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in
390.23the state; and
390.24    (2) the health plan meets the requirements of this section, and the health plan and the
390.25insurer are in compliance with all other applicable health insurance laws.
390.26    Subd. 6. Individual market health plans. Individual market health plans offered
390.27through the exchange continue to be regulated by the commissioner as specified in
390.28chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions
390.29that apply to all health plans issued or renewed through the exchange:
390.30    (1) premiums for children under the age of 19 shall not vary by age in the exchange;
390.31and
390.32    (2) premiums for children under the age of 19 must be excluded from rating factors
390.33under section 62A.65, subdivision 3, paragraph (b).
390.34    Subd. 7. Individual participation and eligibility. Individuals are eligible to
390.35purchase health plans directly through the exchange or through an employer Section
390.36125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of
391.1individual market health plans offered through the exchange. Individuals are eligible to
391.2purchase individual market health plans through the exchange by meeting one or more
391.3of the following qualifications:
391.4    (1) the individual is a Minnesota resident, meaning the individual is physically
391.5residing on a permanent basis in a place that is the person's principal residence and from
391.6which the person is absent only for temporary purposes;
391.7    (2) the individual is a student attending an institution outside of Minnesota and
391.8maintains Minnesota residency;
391.9    (3) the individual is not a Minnesota resident but is employed by an employer
391.10physically located within the state and the individual's employer is required to offer a
391.11Section 125 Plan under section 62A.68;
391.12    (4) the individual is not a Minnesota resident but is self-employed and the
391.13individual's principal place of business is in the state; or
391.14    (5) the individual is a dependent as defined in section 62L.02, of another individual
391.15who is eligible to participate in the exchange.
391.16    Subd. 8. Continuation of coverage. Enrollment in a health plan may be canceled
391.17for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under
391.18chapter 256L. Enrollment in an individual market health plan may not be canceled or
391.19nonrenewed because of any change in employer or employment status, marital status,
391.20health status, age, residence, or any other change that does not affect eligibility as defined
391.21in this section.
391.22    Subd. 9. Responsibilities of the exchange. The exchange shall serve as the sole
391.23entity for enrollment and collection and transfer of premium payments for health plans
391.24sold to individuals through the exchange. The exchange shall be responsible for the
391.25following functions:
391.26    (1) publicize the exchange, including but not limited to its functions, eligibility
391.27rules, and enrollment procedures;
391.28    (2) provide assistance to employers to establish Section 125 Plans under section
391.2962A.68;
391.30    (3) provide education and assistance to employers to help them understand the
391.31requirements of Section 125 Plans and compliance with applicable regulations;
391.32    (4) create a system to allow individuals to compare and enroll in health plans offered
391.33through the exchange;
391.34    (5) create a system to collect and transmit to the applicable plans all premium
391.35payments made by individuals, including developing mechanisms to receive and process
392.1automatic payroll deductions for individuals who purchase coverage through employer
392.2Section 125 Plans;
392.3    (6) not accept premium payments for individual market health plans from an
392.4employer Section 125 Plan if the employer offers a group health plan as defined in section
392.562A.10, or if the employer is a self-insurer as defined in section 62E.02;
392.6    (7) provide jointly with health insurers a cancellation notice directly to the primary
392.7insured at least ten days prior to termination of coverage for nonpayment of premium;
392.8    (8) bill the employer for the premiums payable by an employee, provided that the
392.9employer is not liable for payment except from payroll deductions for that purpose;
392.10    (9) refer individuals interested in MinnesotaCare under chapter 256L to the
392.11Department of Human Services to determine eligibility;
392.12    (10) establish a mechanism with the Department of Human Services to transfer
392.13premiums and subsidies for MinnesotaCare to qualify for federal matching payments;
392.14    (11) upon request, issue certificates of previous coverage according to the provisions
392.15of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be
392.16covered by a participating health plan through the exchange;
392.17    (12) establish procedures to account for all funds received and disbursed by the
392.18exchange for individual participants of the exchange;
392.19    (13) make available to the public, at the end of each calendar year, a report of an
392.20independent audit of the exchange's accounts; and
392.21    (14) provide copies of written and signed statements from employers stating that
392.22the employer is not contributing to the employee's premiums for health plans purchased
392.23by an employee through the exchange to all health insurers with enrolled employees of
392.24the employer.
392.25    Health insurers may rely on the employer's statement in clause (4) provided by the
392.26Minnesota Health Insurance Exchange and are not required to guarantee-issue individual
392.27health plans to the employer's employees.
392.28    Subd. 10. State not liable. The state of Minnesota shall not be liable for the actions
392.29of the Minnesota Health Insurance Exchange.
392.30    Subd. 11. Powers of the exchange. The exchange shall have the power to:
392.31    (1) contract with insurance producers licensed in accident and health insurance
392.32under chapter 60K and vendors to perform one or more of the functions specified in
392.33subdivision 10;
392.34    (2) contract with employers to collect premiums through a Section 125 Plan for
392.35eligible individuals who purchase an individual market health plan through the exchange;
393.1    (3) establish and assess fees on health plan premiums of health plans purchased
393.2through the exchange to fund the cost of administering the exchange;
393.3    (4) seek and directly receive grant funding from government agencies or private
393.4philanthropic organizations to defray the costs of operating the exchange;
393.5    (5) establish and administer rules and procedures governing the operations of the
393.6exchange;
393.7    (6) establish one or more service centers within Minnesota;
393.8    (7) sue or be sued or otherwise take any necessary or proper legal action;
393.9    (8) establish bank accounts and borrow money; and
393.10    (9) enter into agreements with the commissioners of commerce, health, human
393.11services, revenue, employment and economic development, and other state agencies as
393.12necessary for the exchange to implement the provisions of this section.
393.13    Subd. 12. Dispute resolution. The exchange shall establish procedures for
393.14resolving disputes with respect to the eligibility of an individual to participate in the
393.15exchange. The exchange does not have the authority or responsibility to intervene in or
393.16resolve disputes between an individual and a health plan or health insurer. The exchange
393.17shall refer complaints from individuals participating in the exchange to the commissioner
393.18to be resolved according to sections 62Q.68 to 62Q.73.
393.19    Subd. 13. Governance. The exchange shall be governed by a board of directors
393.20with 11 members. The board shall convene on or before July 1, 2007, after the initial board
393.21members have been selected. The initial board membership consists of the following:
393.22    (1) the commissioner of commerce;
393.23    (2) the commissioner of human services;
393.24    (3) the commissioner of health;
393.25    (4) four members appointed by a joint committee of the Minnesota senate and the
393.26Minnesota house of representatives to serve three-year terms; and
393.27    (5) four members appointed by the governor to serve three-year terms.
393.28    Subd. 14. Subsequent board membership. Ongoing membership of the exchange
393.29consists of the following effective July 1, 2010:
393.30    (1) the commissioner of commerce;
393.31    (2) the commissioner of human services;
393.32    (3) the commissioner of health;
393.33    (4) two members appointed by the governor with the approval of a joint committee
393.34of the senate and house of representatives to serve two-year terms; and
394.1    (5) six members elected by the membership of the exchange of which three
394.2are elected to serve a two-year term and three are elected to serve a three-year term.
394.3Appointed and elected members may serve more than one term.
394.4    Subd. 15. Operations of the board. Officers of the board of directors are elected by
394.5members of the board and serve one-year terms. Six members of the board constitutes a
394.6quorum, and the affirmative vote of six members of the board is necessary and sufficient
394.7for any action taken by the board. Board members serve without pay, but are reimbursed
394.8for actual expenses incurred in the performance of their duties.
394.9    Subd. 16. Operations of the exchange. The board of directors shall appoint an
394.10exchange director who shall:
394.11    (1) be a full-time employee of the exchange;
394.12    (2) administer all of the activities and contracts of the exchange; and
394.13    (3) hire and supervise the staff of the exchange.
394.14    Subd. 17. Insurance producers. An individual has the right to choose any
394.15insurance producer licensed in accident and health insurance under chapter 60K to assist
394.16them in purchasing an individual market health plan through the exchange. When a
394.17producer licensed in accident and health insurance under chapter 60K enrolls an eligible
394.18individual in the exchange, the health plan chosen by an individual may pay the producer
394.19a commission.
394.20    Subd. 18. Implementation. Health plan coverage through the exchange begins on
394.21January 1, 2009. The exchange must be operational to assist employers and individuals
394.22by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees
394.23of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive
394.24Health Association as of December 2, 2008, are automatically enrolled in the exchange
394.25on January 1, 2009, in the same health plan and at the same premium that they were
394.26enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1,
394.272009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota
394.28Comprehensive Health Association shall make premium payments to the exchange.

394.29    Sec. 3. [62A.68] SECTION 125 PLANS.
394.30    Subdivision 1. Definitions. The following terms have the meanings given unless
394.31otherwise provided in text:
394.32    (a) "Current employee" means an employee currently on an employer's payroll other
394.33than a retiree or disabled former employee.
395.1    (b) "Employer" means a person, firm, corporation, partnership, association, business
395.2trust, or other entity employing one or more persons, including a political subdivision of
395.3the state, filing payroll tax information on such employed person or persons.
395.4    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125
395.5of the Internal Revenue Code that allows employees to purchase health insurance with
395.6pretax dollars.
395.7    (d) "Exchange" means the Minnesota Health Insurance Exchange under section
395.862A.67.
395.9    (e) "Exchange director" means the appointed director under section 62A.67,
395.10subdivision 16.
395.11    Subd. 2. Section 125 Plan requirement. (a) Effective January 1, 2009, all
395.12employers with 11 or more current employees shall establish a Section 125 Plan to
395.13allow their employees to purchase individual market health plan coverage with pretax
395.14dollars. Nothing in this section requires or mandates employers to offer or purchase
395.15health insurance coverage for their employees. The following employers are exempt
395.16from the Section 125 Plan requirement:
395.17    (1) employers that offer a group health insurance plan as defined in 62A.10;
395.18    (2) employers that are self-insurers as defined in section 62E.02; and
395.19    (3) employers with fewer than 11 current employees, except that employers under
395.20this clause may voluntarily offer a Section 125 Plan.
395.21    (b) Employers that offer a Section 125 Plan may enter into an agreement with the
395.22exchange to administer the employer's Section 125 Plan.
395.23    Subd. 3. Tracking compliance. By July 1, 2008, the exchange, in consultation with
395.24the commissioners of commerce, health, employment and economic development, and
395.25revenue shall establish a method for tracking employer compliance with the Section 125
395.26Plan requirement.
395.27    Subd. 4. Employer requirements. Employers that are required to offer or choose
395.28to offer a Section 125 Plan shall:
395.29    (1) allow employees to purchase any individual market health plan for themselves
395.30and their dependents through the exchange;
395.31    (2) allow employees to choose any insurance producer licensed in accident and
395.32health insurance under chapter 60K to assist them in purchasing an individual market
395.33health plan through the exchange;
395.34    (3) provide a written and signed statement to the exchange stating that the employer
395.35is not contributing to the employee's premiums for health plans purchased by an employee
395.36through the exchange;
396.1    (4) upon an employee's request, deduct premium amounts on a pretax basis in an
396.2amount not to exceed an employee's wages, and remit these employee payments to the
396.3exchange; and
396.4    (5) provide notice to employees that individual market health plans purchased
396.5through the exchange are not employer-sponsored or administered. Employers shall be
396.6held harmless from any and all liability claims related to the individual market health
396.7plans purchased through the exchange by employees under a Section 125 Plan.
396.8    Subd. 5. Section 125 eligible health plans. Individuals who are eligible to use
396.9an employer Section 125 Plan to pay for health insurance coverage purchased through
396.10the exchange may enroll in any health plan offered through the exchange for which the
396.11individual is eligible including individual market health plans, MinnesotaCare, and the
396.12Minnesota Comprehensive Health Association.

396.13    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:
396.1462E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.
396.15    No employee of an employer that offers a group health plan, under which the
396.16employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in
396.17the comprehensive health association, except for enrollment or continued enrollment
396.18necessary to cover conditions that are subject to an unexpired preexisting condition
396.19limitation, preexisting condition exclusion, or exclusionary rider under the employer's
396.20health plan. This section does not apply to persons enrolled in the Comprehensive Health
396.21Association as of June 30, 1993. With respect to persons eligible to enroll in the health
396.22plan of an employer that has more than 29 current employees, as defined in section
396.2362L.02 , this section does not apply to persons enrolled in the Comprehensive Health
396.24Association as of December 31, 1994.

396.25    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:
396.26    Subd. 3. Cost containment duties. The commissioner shall:
396.27    (1) establish statewide and regional cost containment goals for total health care
396.28spending under this section and, collect data as described in sections 62J.38 to 62J.41 to
396.29monitor statewide achievement of the cost containment goals, and annually report to the
396.30legislature on whether the goals were achieved and, if not, what action should be taken to
396.31ensure that goals are achieved in the future;
396.32    (2) divide the state into no fewer than four regions, with one of those regions being
396.33the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
396.34Wright, and Sherburne Counties, for purposes of fostering the development of regional
397.1health planning and coordination of health care delivery among regional health care
397.2systems and working to achieve the cost containment goals;
397.3    (3) monitor the quality of health care throughout the state and take action as
397.4necessary to ensure an appropriate level of quality;
397.5    (4) issue recommendations regarding uniform billing forms, uniform electronic
397.6billing procedures and data interchanges, patient identification cards, and other uniform
397.7claims and administrative procedures for health care providers and private and public
397.8sector payers. In developing the recommendations, the commissioner shall review the
397.9work of the work group on electronic data interchange (WEDI) and the American National
397.10Standards Institute (ANSI) at the national level, and the work being done at the state and
397.11local level. The commissioner may adopt rules requiring the use of the Uniform Bill
397.1282/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
397.13version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
397.14forms or procedures;
397.15    (5) undertake health planning responsibilities;
397.16    (6) authorize, fund, or promote research and experimentation on new technologies
397.17and health care procedures;
397.18    (7) within the limits of appropriations for these purposes, administer or contract for
397.19statewide consumer education and wellness programs that will improve the health of
397.20Minnesotans and increase individual responsibility relating to personal health and the
397.21delivery of health care services, undertake prevention programs including initiatives to
397.22improve birth outcomes, expand childhood immunization efforts, and provide start-up
397.23grants for worksite wellness programs;
397.24    (8) undertake other activities to monitor and oversee the delivery of health care
397.25services in Minnesota with the goal of improving affordability, quality, and accessibility of
397.26health care for all Minnesotans; and
397.27    (9) make the cost containment goal data available to the public in a
397.28consumer-oriented manner.
397.29EFFECTIVE DATE.This section is effective July 1, 2007.

397.30    Sec. 6. Minnesota Statutes 2006, section 62J.495, is amended to read:
397.3162J.495 HEALTH INFORMATION TECHNOLOGY AND
397.32INFRASTRUCTURE ADVISORY COMMITTEE.
397.33    Subdivision 1. Establishment; members; duties Implementation. By January
397.341, 2012, all hospitals and health care providers must have in place an interoperable
398.1electronic health records system within their hospital system or clinical practice setting.
398.2The commissioner of health, in consultation with the Health Information Technology and
398.3Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal,
398.4including the adoption of uniform standards to be used for the interoperable system for
398.5sharing and synchronizing patient data across systems. The standards must be compatible
398.6with federal efforts. The uniform standards must be refined and adopted for use when
398.7a standard development organization accredited by the American National Standards
398.8Institute completes the development of a standard for sharing and synchronizing patient
398.9data across systems.
398.10    Subd. 2. Health Information Technology and Infrastructure Advisory
398.11Committee. (a) The commissioner shall establish a Health Information Technology
398.12and Infrastructure Advisory Committee governed by section 15.059 to advise the
398.13commissioner on the following matters:
398.14    (1) assessment of the use of health information technology by the state, licensed
398.15health care providers and facilities, and local public health agencies;
398.16    (2) recommendations for implementing a statewide interoperable health information
398.17infrastructure, to include estimates of necessary resources, and for determining standards
398.18for administrative data exchange, clinical support programs, patient privacy requirements,
398.19and maintenance of the security and confidentiality of individual patient data; and
398.20    (3) other related issues as requested by the commissioner.
398.21    (b) The members of the Health Information Technology and Infrastructure Advisory
398.22Committee shall include the commissioners, or commissioners' designees, of health,
398.23human services, administration, and commerce and additional members to be appointed
398.24by the commissioner to include persons representing Minnesota's local public health
398.25agencies, licensed hospitals and other licensed facilities and providers, private purchasers,
398.26the medical and nursing professions, health insurers and health plans, the state quality
398.27improvement organization, academic and research institutions, consumer advisory
398.28organizations with an interest and expertise in health information technology, and other
398.29stakeholders as identified by the Health Information Technology and Infrastructure
398.30Advisory Committee.
398.31    Subd. 2. Annual report. (c) The commissioner shall prepare and issue an annual
398.32report not later than January 30 of each year outlining progress to date in implementing a
398.33statewide health information infrastructure and recommending future projects.
398.34    Subd. 3. Expiration. (d) Notwithstanding section 15.059, this section subdivision
398.35expires June 30, 2009 2012.

399.1    Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
399.2ACCOUNT AND LOAN PROGRAM.
399.3    Subdivision 1. Account establishment. The commissioner of finance shall establish
399.4and implement a revolving account in the state government special revenue fund to
399.5provide loans to eligible borrowers to assist in financing the installation or support of
399.6an interoperable health record system. The system must provide for the interoperable
399.7exchange of health care information between the applicant and, at a minimum, a hospital
399.8system, pharmacy, and a health care clinic or other physician group.
399.9    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
399.10    (1) community clinics, as defined under section 145.9268;
399.11    (2) hospitals eligible for rural hospital capital improvement grants, as defined
399.12in section 144.148;
399.13    (3) physician clinics located in a community with a population of less than 50,000
399.14according to United States Census Bureau statistics and outside the seven-county
399.15metropolitan area;
399.16    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and
399.17    (5) other providers of health or health care services approved by the commissioner
399.18for which interoperable electronic health record capability would improve quality of
399.19care, patient safety, or community health.
399.20    (b) To be eligible for a loan under this section, the applicant must submit a loan
399.21application to the commissioner of health on forms prescribed by the commissioner. The
399.22application must include, at a minimum:
399.23    (1) the amount of the loan requested and a description of the purpose or project
399.24for which the loan proceeds will be used;
399.25    (2) a quote from a vendor;
399.26    (3) a description of the health care entities and other groups participating in the
399.27project;
399.28    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
399.29    (5) a description of how the system to be financed interconnects or plans in the
399.30future to interconnect with other health care entities and provider groups located in the
399.31same geographical area.
399.32    Subd. 3. Loans. (a) The commissioner of health may make a no interest loan
399.33to a provider or provider group who is eligible under subdivision 2 on a first-come,
399.34first-served basis provided that the applicant is able to comply with this section. The total
399.35accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of
399.36health has discretion over the size and number of loans made.
400.1    (b) The commissioner of health may prescribe forms and establish an application
400.2process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
400.3application fee to cover the cost of administering the loan program.
400.4    (c) The borrower must begin repaying the principal no later than two years from the
400.5date of the loan. Loans must be amortized no later than six years from the date of the loan.
400.6    (d) Repayments must be credited to the account.
400.7    Subd. 4. Data classification. Data collected by the commissioner of health on the
400.8application to determine eligibility under subdivision 2 and to monitor borrowers' default
400.9risk or collect payments owed under subdivision 3 are (1) private data on individuals as
400.10defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
400.1113.02, subdivision 9. The names of borrowers and the amounts of the loans granted are
400.12public data.

400.13    Sec. 8. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND
400.14IMPLEMENTATION GUIDE STANDARDS.
400.15    Subdivision 1. Electronic claims and eligibility transactions required. (a)
400.16Beginning January 15, 2009, all group purchasers must accept from health care providers
400.17the eligibility for a health plan transaction described under Code of Federal Regulations,
400.18title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept
400.19from health care providers the health care claims or equivalent encounter information
400.20transaction described under Code of Federal Regulations, title 45, part 162, subpart K.
400.21    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the
400.22eligibility for a health plan transaction described under Code of Federal Regulations, title
400.2345, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit
400.24to providers the health care payment and remittance advice transaction described under
400.25Code of Federal Regulations, title 45, part 162, subpart P.
400.26    (c) Beginning January 15, 2009, all health care providers must submit to group
400.27purchasers the eligibility for a health plan transaction described under Code of Federal
400.28Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care
400.29providers must submit to group purchasers the health care claims or equivalent encounter
400.30information transaction described under Code of Federal Regulations, title 45, part 162,
400.31subpart K.
400.32    (d) Beginning January 15, 2009, all health care providers must accept from group
400.33purchasers the eligibility for a health plan transaction described under Code of Federal
400.34Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care
400.35providers must accept from group purchasers the health care payment and remittance
401.1advice transaction described under Code of Federal Regulations, title 45, part 162, subpart
401.2P.
401.3    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use
401.4of a single, uniform companion guide to the implementation guides described under
401.5Code of Federal Regulations, title 45, part 162. The companion guides will be developed
401.6pursuant to subdivision 2.
401.7    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group
401.8purchasers and health care providers must exchange claims and eligibility information
401.9electronically using the transactions, companion guides, implementation guides, and
401.10timelines required under this subdivision. Group purchasers may not impose any fee on
401.11providers for the use of the transactions prescribed in this subdivision.
401.12    (g) Nothing in this subdivision shall prohibit group purchasers and health care
401.13providers from using a direct data entry, Web-based methodology for complying with
401.14the requirements of this subdivision. Any direct data entry method for conducting
401.15the transactions specified in this subdivision must be consistent with the data content
401.16component of the single, uniform companion guides required in paragraph (e) and the
401.17implementation guides described under Code of Federal Regulations, title 45, part 162.
401.18    Subd. 2. Establishing uniform, standard companion guides. (a) At least 12
401.19months prior to the timelines required in subdivision 1, the commissioner of health shall
401.20promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers
401.21and health care providers to use the transactions and the uniform, standard companion
401.22guides required under subdivision 1, paragraph (e).
401.23    (b) The commissioner of health must consult with the Minnesota Administrative
401.24Uniformity Committee on the development of the single, uniform companion guides
401.25required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1.
401.26The single uniform companion guides required under subdivision 1, paragraph (e), must
401.27specify uniform billing and coding standards. The commissioner of health shall base the
401.28companion guides required under subdivision 1, paragraph (e), billing and coding rules,
401.29and standards on the Medicare program, with modifications that the commissioner deems
401.30appropriate after consulting the Minnesota Administrative Uniformity Committee.
401.31    (c) No group purchaser or health care provider may add to or modify the single,
401.32uniform companion guides defined in subdivision 1, paragraph (e), through additional
401.33companion guides or other requirements.
401.34    (d) In promulgating the rules in paragraph (a), the commissioner shall not require
401.35data content that is not essential to accomplish the purpose of the transactions in
401.36subdivision 1.

402.1    Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:
402.2    Subdivision 1. Definitions. For purposes of this section, the following definitions
402.3apply:
402.4    (a) "Accredited clinical training" means the clinical training provided by a
402.5medical education program that is accredited through an organization recognized by the
402.6Department of Education, the Centers for Medicare and Medicaid Services, or another
402.7national body who reviews the accrediting organizations for multiple disciplines and
402.8whose standards for recognizing accrediting organizations are reviewed and approved by
402.9the commissioner of health in consultation with the Medical Education and Research
402.10Advisory Committee.
402.11    (b) "Commissioner" means the commissioner of health.
402.12    (c) "Clinical medical education program" means the accredited clinical training of
402.13physicians (medical students and residents), doctor of pharmacy practitioners, doctors
402.14of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
402.15registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
402.16physician assistants.
402.17    (d) "Sponsoring institution" means a hospital, school, or consortium located in
402.18Minnesota that sponsors and maintains primary organizational and financial responsibility
402.19for a clinical medical education program in Minnesota and which is accountable to the
402.20accrediting body.
402.21    (e) "Teaching institution" means a hospital, medical center, clinic, or other
402.22organization that conducts a clinical medical education program in Minnesota.
402.23    (f) "Trainee" means a student or resident involved in a clinical medical education
402.24program.
402.25    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
402.26equivalent counts, that are at training sites located in Minnesota with a currently
402.27active medical assistance provider number enrollment status and a National Provider
402.28Identification (NPI) number where training occurs in either an inpatient or ambulatory
402.29patient care setting and where the training is funded, in part, by patient care revenues.

402.30    Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:
402.31    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute
402.3290 percent of available medical education funds transferred according to section
402.33256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a
402.34distribution formula that reflects a summation of two factors:
403.1    (1) an education factor, which is determined by the total number of eligible trainee
403.2FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
403.3medical education program; and
403.4    (2) a public program volume factor, which is determined by the total volume of
403.5public program revenue received by each training site as a percentage of all public
403.6program revenue received by all training sites in the fund pool.
403.7    In this formula, the education factor is weighted at 67 percent and the public program
403.8volume factor is weighted at 33 percent.
403.9    Public program revenue for the distribution formula includes revenue from medical
403.10assistance, prepaid medical assistance, general assistance medical care, and prepaid
403.11general assistance medical care. Training sites that receive no public program revenue
403.12are ineligible for funds available under this paragraph. Total statewide average costs per
403.13trainee for medical residents is based on audited clinical training costs per trainee in
403.14primary care clinical medical education programs for medical residents. Total statewide
403.15average costs per trainee for dental residents is based on audited clinical training costs
403.16per trainee in clinical medical education programs for dental students. Total statewide
403.17average costs per trainee for pharmacy residents is based on audited clinical training costs
403.18per trainee in clinical medical education programs for pharmacy students.
403.19    (b) The commissioner shall annually distribute ten percent of total available medical
403.20education funds transferred according to section 256B.69, subdivision 5c, paragraph (a),
403.21clause (1), to all qualifying applicants based on the percentage received by each applicant
403.22under paragraph (a). These funds are to be used to offset clinical education costs at
403.23eligible clinical training sites based on criteria developed by the clinical medical education
403.24program. Applicants may choose to distribute funds allocated under this paragraph based
403.25on the distribution formula described in paragraph (a).
403.26    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated
403.27to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal
403.28financial participation on these funds and on funds transferred under subdivision 10, to all
403.29qualifying applicants based on a distribution formula that gives 100 percent weight to a
403.30public program volume factor, which is determined by the total volume of public program
403.31revenue received by each training site as a percentage of all public program revenue
403.32received by all training sites in the fund pool. If federal approval is not obtained for
403.33federal financial participation on any portion of funds distributed under this paragraph,
403.3490 percent of the unmatched funds shall be distributed by the commissioner based on
403.35the formula described in paragraph (a) and ten percent of the unmatched funds shall be
403.36distributed by the commissioner based on the formula described in paragraph (b).
404.1    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the
404.2commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving
404.3100 percent weight to an education factor, which is determined by the total number of
404.4eligible trainee full-time equivalents and the total statewide average costs per trainee, by
404.5type of trainee, in each clinical medical education program. If no matching funds are
404.6received on funds distributed under paragraph (c), funds distributed under this paragraph
404.7shall be distributed by the commissioner based on the formula described in paragraph (a).
404.8    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the
404.9commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants
404.10based on the percentage received by each applicant under paragraph (a). These funds are
404.11to be used to offset clinical education costs at eligible clinical training sites based on
404.12criteria developed by the clinical medical education program. Applicants may choose to
404.13distribute funds allocated under this paragraph based on the distribution formula described
404.14in paragraph (a). If no matching funds are received on funds distributed under paragraph
404.15(c), funds distributed under this paragraph shall be distributed by the commissioner based
404.16on the formula described in paragraph (b).
404.17    (c) (f) Funds distributed shall not be used to displace current funding appropriations
404.18from federal or state sources.
404.19    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount
404.20to be distributed to each of the sponsor's clinical medical education programs based on
404.21the criteria in this subdivision and in accordance with the commissioner's approval letter.
404.22Each clinical medical education program must distribute funds allocated under paragraph
404.23(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
404.24institutions, which are accredited through an organization recognized by the Department
404.25of Education or the Centers for Medicare and Medicaid Services, may contract directly
404.26with training sites to provide clinical training. To ensure the quality of clinical training,
404.27those accredited sponsoring institutions must:
404.28    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
404.29training conducted at sites; and
404.30    (2) take necessary action if the contract requirements are not met. Action may
404.31include the withholding of payments under this section or the removal of students from
404.32the site.
404.33    (e) (h) Any funds not distributed in accordance with the commissioner's approval
404.34letter must be returned to the medical education and research fund within 30 days of
404.35receiving notice from the commissioner. The commissioner shall distribute returned funds
404.36to the appropriate training sites in accordance with the commissioner's approval letter.
405.1    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to
405.2the funds transferred under subdivision 10, plus five percent interest to the University of
405.3Minnesota Board of Regents for the instructional costs of health professional programs
405.4at the Academic Health Center and for interdisciplinary academic initiatives within the
405.5Academic Health Center.
405.6    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner
405.7under section 297F.10, subdivision 1, paragraph (b), clause (2), may be used by the
405.8commissioner for administrative expenses associated with implementing this section.

405.9    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:
405.10    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
405.11shall award grants to teaching institutions and clinical training sites for projects that
405.12increase dental access for underserved populations and promote innovative clinical
405.13training of dental professionals.
405.14    (b) The commissioner shall award grants to teaching institutions and clinical training
405.15sites for projects that increase mental health access for underserved populations, promote
405.16innovative clinical training of mental health professionals, increase the number of mental
405.17health providers in rural or underserved areas, and promote the incorporation of patient
405.18safety principles into clinical medical education programs.
405.19    (c) In awarding the grants, the commissioner, in consultation with the commissioner
405.20of human services, shall consider the following:
405.21    (1) potential to successfully increase access to an underserved population;
405.22    (2) the long-term viability of the project to improve access beyond the period
405.23of initial funding;
405.24    (3) evidence of collaboration between the applicant and local communities;
405.25    (4) the efficiency in the use of the funding; and
405.26    (5) the priority level of the project in relation to state clinical education, access,
405.27patient safety, and workforce goals.; and
405.28    (6) the potential of the project to impact the number or distribution of the health
405.29care workforce.
405.30    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the
405.31innovations grants in order to ensure that the priorities meet the changing workforce
405.32needs of the state.

405.33    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:
406.1    Subd. 8. Federal financial participation. (a) The commissioner of human
406.2services shall seek to maximize federal financial participation in payments for medical
406.3education and research costs. If the commissioner of human services determines that
406.4federal financial participation is available for the medical education and research, the
406.5commissioner of health shall transfer to the commissioner of human services the amount
406.6of state funds necessary to maximize the federal funds available. The amount transferred
406.7to the commissioner of human services, plus the amount of federal financial participation,
406.8shall be distributed to medical assistance providers in accordance with the distribution
406.9methodology described in subdivision 4.
406.10    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic
406.11rates where possible to maximize federal financial participation.

406.12    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:
406.13    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the
406.14Academic Health Center under section 297F.10, subdivision 1, clause (1), $4,850,000
406.15shall be transferred annually to the commissioner of health no later than April 15 of each
406.16year for distribution under subdivision 4, paragraph (f) (i).

406.17    Sec. 14. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:
406.18    Subdivision 1. Required disclosure of estimated payment. (a) A health care
406.19provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
406.20to by that designee, shall, at the request of a consumer, provide that consumer with a good
406.21faith estimate of the reimbursement allowable payment the provider expects to receive
406.22from the health plan company in which the consumer is enrolled has agreed to accept from
406.23the consumer's health plan company for the services specified by the consumer, specifying
406.24the amount of the allowable payment due from the health plan company. Health plan
406.25companies must allow contracted providers, or their designee, to release this information.
406.26A good faith estimate must also be made available at the request of a consumer who
406.27is not enrolled in a health plan company. If a consumer has no applicable public or
406.28private coverage, the health care provider must give the consumer a good faith estimate
406.29of the average allowable reimbursement the provider accepts as payment from private
406.30third-party payers for the services specified by the consumer and the estimated amount
406.31the noncovered consumer will be required to pay. Payment information provided by a
406.32provider, or by the provider's designee as agreed to by that designee, to a patient pursuant
406.33to this subdivision does not constitute a legally binding estimate of the allowable charge
406.34for or cost to the consumer of services.
407.1    (b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at
407.2the request of an enrollee or the enrollee's designee, provide that enrollee with a good
407.3faith estimate of the reimbursement allowable amount the health plan company would
407.4expect to pay to has contracted for with a specified provider within the network as total
407.5payment for a health care service specified by the enrollee and the portion of the allowable
407.6amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the
407.7enrollee, the health plan company shall also provide to the enrollee a good faith estimate
407.8of the enrollee's out-of-pocket cost for the health care service. An estimate provided to
407.9an enrollee under this paragraph is not a legally binding estimate of the reimbursement
407.10allowable amount or enrollee's out-of-pocket cost.
407.11EFFECTIVE DATE.This section is effective August 1, 2007.

407.12    Sec. 15. Minnesota Statutes 2006, section 62J.82, is amended to read:
407.1362J.82 HOSPITAL CHARGE INFORMATION REPORTING DISCLOSURE.
407.14    Subdivision 1. Required information. The Minnesota Hospital Association shall
407.15develop a Web-based system, available to the public free of charge, for reporting charge
407.16information the following, for Minnesota residents,:
407.17    (1) hospital-specific performance on the measures of care developed under section
407.18256B.072 for acute myocardial infarction, heart failure, and pneumonia;
407.19    (2) by January 1, 2009, hospital-specific performance on the public reporting
407.20measures for hospital-acquired infections as published by the National Quality Forum
407.21and collected by the Minnesota Hospital Association and Stratis Health in collaboration
407.22with infection control practitioners; and
407.23    (3) charge information, including, but not limited to, number of discharges, average
407.24length of stay, average charge, average charge per day, and median charge, for each of the
407.2550 most common inpatient diagnosis-related groups and the 25 most common outpatient
407.26surgical procedures as specified by the Minnesota Hospital Association.
407.27    Subd. 2. Web site. The Web site must provide information that compares
407.28hospital-specific data to hospital statewide data. The Web site must be established by
407.29October 1, 2006, and must be updated annually. The commissioner shall provide a link to
407.30this reporting information on the department's Web site.
407.31    Subd. 3. Enforcement. The commissioner shall provide a link to this information
407.32on the department's Web site. If a hospital does not provide this information to the
407.33Minnesota Hospital Association, the commissioner of health may require the hospital to
408.1do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a
408.2link to this information on the department's Web site.

408.3    Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.
408.4    Subdivision 1. Task force. The governor shall convene a health care transformation
408.5task force to advise and assist the governor and the Minnesota legislature. The task force
408.6shall consist of:
408.7    (1) four legislators from the house of representatives appointed by the speaker, two
408.8from the majority party and two from the minority party, and four legislators from the
408.9senate appointed by the Subcommittee on Committees of the senate Committee on Rules
408.10and Administration, two from the majority party and two from the minority party;
408.11    (2) four representatives of the governor and state agencies appointed by the governor;
408.12    (3) at least four persons appointed by the governor who have demonstrated
408.13leadership in health care organizations, health improvement initiatives, health care trade or
408.14professional associations, or other collaborative health system improvement activities; and
408.15    (4) at least two persons appointed by the governor who have demonstrated leadership
408.16in employer and group purchaser activities related to health system improvement, at least
408.17one of which must be from a labor organization.
408.18    Subd. 2. Public input. The commissioner of health shall review available research,
408.19and conduct statewide, regional, and local surveys, focus groups, and other activities as
408.20needed to fill gaps in existing research, to determine Minnesotans' values, preferences,
408.21opinions, and perceptions related to health care and to the issues confronting the task
408.22force, and shall report the findings to the task force.
408.23    Subd. 3. Inventory and assessment of existing activities; action plan. The task
408.24force shall complete an inventory and assessment of all public and private organized
408.25activities, coalitions, and collaboratives working on tasks relating to health system
408.26improvement including, but not limited to, patient safety, quality measurement and
408.27reporting, evidence-based practice, adoption of health information technology, disease
408.28management and chronic care coordination, medical homes, access to health care,
408.29cultural competence, prevention and public health, consumer incentives, price and cost
408.30transparency, nonprofit organization community benefits, education, research, and health
408.31care workforce.
408.32    Subd. 4. Action plan. By December 15, 2007, the governor, with the advice
408.33and assistance of the task force, shall develop and present to the legislature a statewide
408.34action plan for transforming the health care system to improve affordability, quality,
408.35and access. The plan shall include draft legislation needed to implement the plan. The
409.1plan may consist of legislative actions, administrative actions of governmental entities,
409.2collaborative actions, and actions of individuals and individual organizations. Among
409.3other things, the action plan must include the following, with specific and measurable
409.4goals and deadlines for each:
409.5    (1) proposed actions that will slow the rate of increase in health care costs to a rate
409.6that does not exceed the increase in the Consumer Price Index for urban consumers for the
409.7preceding calendar year plus two percentage points, plus an additional percentage based
409.8on the added costs necessary to implement legislation enacted in 2007;
409.9    (2) actions that will increase the affordable health coverage options for uninsured
409.10and underinsured Minnesotans and other strategies that will ensure that all Minnesotans
409.11will have health coverage by January 2011;
409.12    (3) actions to improve the quality and safety of health care and reduce racial and
409.13ethnic disparities in access and quality;
409.14    (4) actions that will reduce the rate of preventable chronic illness through prevention
409.15and public health and wellness initiatives; and
409.16    (5) proposed changes to state health care purchasing and payment strategies used for
409.17state health care programs and state employees that will promote higher quality, lower
409.18cost health care through incentives that reward prevention and early intervention, use
409.19of cost-effective primary care, effective care coordination, and management of chronic
409.20disease;
409.21    (6) actions that will promote the appropriate and cost-effective investment in new
409.22facilities, technologies, and drugs;
409.23    (7) actions to reduce administrative costs; and
409.24    (8) the results of the inventory completed under subdivision 3 and recommendations
409.25for how these activities can be coordinated and improved.
409.26    Subd. 5. Options for small employers. The task force shall study and report back
409.27to the legislature by December 15, 2007, on options for serving small employers and their
409.28employees, and self-employed individuals.

409.29    Sec. 17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:
409.30    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual
409.31conversion policies to eligible employees otherwise eligible for conversion coverage under
409.32section 62D.104 as a result of leaving a health maintenance organization's service area.
409.33    (b) A health carrier may sell, issue, or renew individual conversion policies to
409.34eligible employees otherwise eligible for conversion coverage as a result of the expiration
410.1of any continuation of group coverage required under sections 62A.146, 62A.17, 62A.21,
410.262C.142 , 62D.101, and 62D.105.
410.3    (c) A health carrier may sell, issue, or renew conversion policies under section
410.462E.16 to eligible employees.
410.5    (d) A health carrier may sell, issue, or renew individual continuation policies to
410.6eligible employees as required.
410.7    (e) A health carrier may sell, issue, or renew individual health plans if the coverage
410.8is appropriate due to an unexpired preexisting condition limitation or exclusion applicable
410.9to the person under the employer's group health plan or due to the person's need for health
410.10care services not covered under the employer's group health plan.
410.11    (f) A health carrier may sell, issue, or renew an individual health plan, if the
410.12individual has elected to buy the individual health plan not as part of a general plan to
410.13substitute individual health plans for a group health plan nor as a result of any violation of
410.14subdivision 3 or 4.
410.15    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide
410.16continuation or conversion coverage otherwise required under federal or state law.
410.17    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage
410.18issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or policies or
410.19contracts that supplement Medicare issued by health maintenance organizations, or those
410.20contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social
410.21Security Act, United States Code, title 42, section 1395 et seq., as amended.
410.22    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
410.23health plans necessary to comply with a court order.
410.24    (j) A health carrier may offer, issue, sell, or renew an individual health plan to
410.25persons eligible for an employer group health plan, if the individual health plan is a high
410.26deductible health plan for use in connection with an existing health savings account, in
410.27compliance with the Internal Revenue Code, section 223. In that situation, the same or
410.28a different health carrier may offer, issue, sell, or renew a group health plan to cover
410.29the other eligible employees in the group.
410.30    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one
410.31or more employees of a small employer if the individual health plan is marketed directly
410.32through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to
410.33all employees of the small employer and the small employer does not contribute directly
410.34or indirectly to the premiums or facilitate the administration of the individual health
410.35plan. The requirement to market an individual health plan to all employees through the
410.36Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require
411.1the health carrier to offer or issue an individual health plan to any employee. For purposes
411.2of this paragraph, an employer is not contributing to the premiums or facilitating the
411.3administration of the individual health plan if the employer does not contribute to the
411.4premium and merely collects the premiums from an employee's wages or salary through
411.5payroll deductions and submits payment for the premiums of one or more employees in a
411.6lump sum to the health carrier to the Minnesota Health Insurance Exchange under section
411.762A.67 or 62A.68. Except for coverage under section 62A.65, subdivision 5, paragraph
411.8(b), or 62E.16, at the request of an employee, the health carrier Minnesota Health Insurance
411.9Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums
411.10payable by the employee, provided that the employer is not liable for payment except
411.11from payroll deductions for that purpose. If an employer is submitting payments under
411.12this paragraph, the health carrier and the Minnesota Health Insurance Exchange under
411.13section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary
411.14insured at least ten days prior to termination of coverage for nonpayment of premium.
411.15Individual coverage under this paragraph may be offered only if the small employer has
411.16not provided coverage under section 62L.03 to the employees within the past 12 months.
411.17    The employer must provide a written and signed statement to the health carrier
411.18Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer
411.19is not contributing directly or indirectly to the employee's premiums. The Minnesota
411.20Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health
411.21carriers with enrolled employees of the employer with a copy of the employer's statement.
411.22The health carrier may rely on the employer's statement provided by the Minnesota Health
411.23Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue
411.24individual health plans to the employer's other current or future employees.

411.25    Sec. 18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:
411.26    Subd. 4. Employer prohibition. A small employer offering a health benefit plan
411.27shall not encourage or direct an employee or applicant to:
411.28    (1) refrain from filing an application for health coverage when other similarly
411.29situated employees may file an application for health coverage;
411.30    (2) file an application for health coverage during initial eligibility for coverage,
411.31the acceptance of which is contingent on health status, when other similarly situated
411.32employees may apply for health coverage, the acceptance of which is not contingent on
411.33health status;
411.34    (3) seek coverage from another health carrier, including, but not limited to, MCHA;
411.35or
412.1    (4) cause coverage to be issued on different terms because of the health status or
412.2claims experience of that person or the person's dependents.

412.3    Sec. 19. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
412.4    Subdivision 1. Definition. It is the commitment of the state to achieve universal
412.5health coverage for all Minnesotans by the year 2011. Universal coverage is achieved
412.6when:
412.7    (1) every Minnesotan has access to a full range of quality health care services;
412.8    (2) every Minnesotan is able to obtain affordable health coverage which pays for the
412.9full range of services, including preventive and primary care; and
412.10    (3) every Minnesotan pays into the health care system according to that person's
412.11ability.
412.12EFFECTIVE DATE.This section is effective July 1, 2007.

412.13    Sec. 20. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
412.14    Subd. 2. Goal. It is the goal of the state to make continuous progress toward
412.15reducing the number of Minnesotans who do not have health coverage so that by January
412.161, 2000, fewer than four percent of the state's population will be without health coverage
412.172011, all Minnesota residents have access to affordable health care. The goal will be
412.18achieved by improving access to private health coverage through insurance reforms and
412.19market reforms, by making health coverage more affordable for low-income Minnesotans
412.20through purchasing pools and state subsidies, and by reducing the cost of health coverage
412.21through cost containment programs and methods of ensuring that all Minnesotans are
412.22paying into the system according to their ability.
412.23EFFECTIVE DATE.This section is effective July 1, 2007.

412.24    Sec. 21. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
412.25    Subd. 3. Approval. (a) Prior to the operation of a community-based health care
412.26coverage program, a community-based health initiative shall submit to the commissioner
412.27of health for approval the community-based health care coverage program developed by
412.28the initiative. The commissioner shall only approve a program that has been awarded
412.29a community access program grant from the United States Department of Health and
412.30Human Services. The commissioner shall ensure that the program meets the federal grant
412.31requirements and any requirements described in this section and is actuarially sound based
412.32on a review of appropriate records and methods utilized by the community-based health
413.1initiative in establishing premium rates for the community-based health care coverage
413.2program.
413.3    (b) Prior to approval, the commissioner shall also ensure that:
413.4    (1) the benefits offered comply with subdivision 8 and that there are adequate
413.5numbers of health care providers participating in the community-based health network to
413.6deliver the benefits offered under the program;
413.7    (2) the activities of the program are limited to activities that are exempt under this
413.8section or otherwise from regulation by the commissioner of commerce;
413.9    (3) the complaint resolution process meets the requirements of subdivision 10; and
413.10    (4) the data privacy policies and procedures comply with state and federal law.

413.11    Sec. 22. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
413.12    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval
413.13by the commissioner of health a community-based health care coverage program. The
413.14operational structure established by the initiative shall include, but is not limited to:
413.15    (1) establishing a process for enrolling eligible individuals and their dependents;
413.16    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
413.17    (3) providing payment to participating providers;
413.18    (4) establishing a benefit set according to subdivision 8 and establishing premium
413.19rates and cost-sharing requirements;
413.20    (5) creating incentives to encourage primary care and wellness services; and
413.21    (6) initiating disease management services, as appropriate.
413.22    (b) The payments collected under paragraph (a), clause (2), may be used to capture
413.23available federal funds.

413.24    Sec. 23. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
413.25    Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the
413.26commissioner of health on January 15, April 15, July 15, and October 15 of each year,
413.27with the first report due January 15, 2007 2008. The status report shall include:
413.28    (1) the financial status of the program, including the premium rates, cost per member
413.29per month, claims paid out, premiums received, and administrative expenses;
413.30    (2) a description of the health care benefits offered and the services utilized;
413.31    (3) the number of employers participating, the number of employees and dependents
413.32covered under the program, and the number of health care providers participating;
413.33    (4) a description of the health outcomes to be achieved by the program and a status
413.34report on the performance measurements to be used and collected; and
414.1    (5) any other information requested by the commissioner of health or commerce or
414.2the legislature.
414.3    (b) The initiative shall contract with an independent entity to conduct an evaluation
414.4of the program to be submitted to the commissioners of health and commerce and the
414.5legislature by January 15, 2009 2010. The evaluation shall include:
414.6    (1) an analysis of the health outcomes established by the initiative and the
414.7performance measurements to determine whether the outcomes are being achieved;
414.8    (2) an analysis of the financial status of the program, including the claims to
414.9premiums loss ratio and utilization and cost experience;
414.10    (3) the demographics of the enrollees, including their age, gender, family income,
414.11and the number of dependents;
414.12    (4) the number of employers and employees who have been denied access to the
414.13program and the basis for the denial;
414.14    (5) specific analysis on enrollees who have aggregate medical claims totaling over
414.15$5,000 per year, including data on the enrollee's main diagnosis and whether all the
414.16medical claims were covered by the program;
414.17    (6) number of enrollees referred to state public assistance programs;
414.18    (7) a comparison of employer-subsidized health coverage provided in a comparable
414.19geographic area to the designated community-based geographic area served by the
414.20program, including, to the extent available:
414.21    (i) the difference in the number of employers with 50 or fewer employees offering
414.22employer-subsidized health coverage;
414.23    (ii) the difference in uncompensated care being provided in each area; and
414.24    (iii) a comparison of health care outcomes and measurements established by the
414.25initiative; and
414.26    (8) any other information requested by the commissioner of health or commerce.

414.27    Sec. 24. Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:
414.28    Subd. 14. Sunset. This section expires December 31, 2011 2012.

414.29    Sec. 25. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:
414.30    Subdivision 1. Yearly reports. (a) Each hospital and each outpatient surgical center,
414.31which has not filed the financial information required by this section with a voluntary,
414.32nonprofit reporting organization pursuant to section 144.702, shall file annually with the
414.33commissioner of health after the close of the fiscal year:
415.1    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or
415.2outpatient surgical center;
415.3    (2) a detailed statement of income and expenses;
415.4    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of
415.5Title XVIII of the United States Social Security Act;
415.6    (4) a copy of all changes to articles of incorporation or bylaws;
415.7    (5) information on services provided to benefit the community, including services
415.8provided at no cost or for a reduced fee to patients unable to pay, teaching and research
415.9activities, or other community or charitable activities;
415.10    (6) information required on the revenue and expense report form set in effect on
415.11July 1, 1989, or as amended by the commissioner in rule;
415.12    (7) information on changes in ownership or control; and
415.13    (8) other information required by the commissioner in rule.;
415.14    (9) information on the number of available hospital beds that are dedicated to certain
415.15specialized services, as designated by the commissioner, and annual occupancy rates for
415.16those beds, separately for adult and pediatric care;
415.17    (10) from outpatient surgical centers, the total number of surgeries; and
415.18    (11) a report on health care capital expenditures during the previous year, as required
415.19by section 62J.17.
415.20    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on
415.21community benefits under paragraph (a), clause (5). "Community benefit" means the costs
415.22of community care, underpayment for services provided under state health care programs,
415.23research costs, community health services costs, financial and in-kind contributions, costs
415.24of community building activities, costs of community benefit operations, education, and
415.25the cost of operating subsidized services. The cost of bad debts and underpayment for
415.26Medicare services are not included in the calculation of community benefit.

415.27    Sec. 26. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision
415.28to read:
415.29    Subd. 5. Annual reports on community benefit, community care amounts,
415.30and state program underfunding. (a) For each hospital reporting health care cost
415.31information under section 144.698 or 144.702, the commissioner shall report annually
415.32on the hospital's community benefit, community care, and underpayment for state public
415.33health care programs.
415.34    (b) For purposes of this subdivision, "community benefits" has the definition given
415.35in section 144.698, paragraph (b).
416.1    (c) For purposes of this subdivision, "community care" means the costs for medical
416.2care for which a hospital has determined is charity care, as defined under Minnesota Rules,
416.3part 4650.0115, or for which the hospital determines after billing for the services that there
416.4is a demonstrated inability to pay. Any costs forgiven under a hospital's community care
416.5plan or under section 62J.83 may be counted in the hospital's calculation of community
416.6care. Bad debt expenses and discounted charges available to the uninsured shall not be
416.7included in the calculation of community care. The amount of community care is the value
416.8of costs incurred and not the charges made for services.
416.9    (d) For purposes of this subdivision, underpayment for services provided by state
416.10public health care programs is the difference between hospital costs and public program
416.11payments. The information shall be reported in terms of total dollars and as a percentage
416.12of total operating costs for each hospital.

416.13    Sec. 27. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
416.14    Subd. 2b. Performance payments. (a) The commissioner shall develop and
416.15implement a pay-for-performance system to provide performance payments to:
416.16    (1) eligible medical groups and clinics that demonstrate optimum care in serving
416.17individuals with chronic diseases who are enrolled in health care programs administered
416.18by the commissioner under chapters 256B, 256D, and 256L.;
416.19    (2) medical groups that implement effective medical home models of patient care
416.20that improve quality and reduce costs through effective primary and preventive care, care
416.21coordination, and management of chronic conditions; and
416.22    (3) eligible medical groups and clinics that evaluate medical provider usage patterns
416.23and provide feedback to individual medical providers on that provider's practice patterns
416.24relative to peer medical providers.
416.25    (b) The commissioner shall also develop and implement a patient incentive health
416.26program to provide incentives and rewards to patients who are enrolled in health care
416.27programs administered by the commissioner under chapters 256B, 256D, and 256L, and
416.28who have agreed to and meet personal health goals established with their primary care
416.29provider to manage a chronic disease or condition including, but not limited to, diabetes,
416.30high blood pressure, and coronary artery disease.
416.31    (c) The commissioner may receive any federal matching money that is made
416.32available through the medical assistance program for managed care oversight contracted
416.33through vendors including consumer surveys, studies, and external quality reviews as
416.34required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations,
416.35title 42, part 438, subpart E. Any federal money received for managed care oversight is
417.1appropriated to the commissioner for this purpose. The commissioner may expend the
417.2federal money received in either year of the biennium.
417.3EFFECTIVE DATE.This section is effective July 1, 2007.

417.4    Sec. 28. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
417.5subdivision to read:
417.6    Subd. 49. Provider-directed care coordination services. The commissioner
417.7shall develop and implement a provider-directed care coordination program for medical
417.8assistance recipients who are not enrolled in the prepaid medical assistance program and
417.9who are receiving services on a fee-for-service basis. This program provides payment
417.10to primary care clinics for care coordination for people who have complex and chronic
417.11medical conditions. Clinics must meet certain criteria such as the capacity to develop care
417.12plans; have a dedicated care coordinator; and have an adequate number of fee-for-service
417.13clients, evaluation mechanisms, and quality improvement processes to qualify for
417.14reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic
417.15designated as the patient's first point of contact for medical care, available 24 hours a
417.16day, seven days a week, that provides or arranges for the patient's comprehensive health
417.17care needs, and provides overall integration, coordination and continuity over time and
417.18referrals for specialty care.

417.19    Sec. 29. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
417.20    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross
417.21family income" for nonfarm self-employed means income calculated for the six-month
417.22period of eligibility using the net profit or loss reported on the applicant's federal income
417.23tax form for the previous year and using the medical assistance families with children
417.24methodology for determining allowable and nonallowable self-employment expenses and
417.25countable income.
417.26    (b) "Gross individual or gross family income" for farm self-employed means income
417.27calculated for the six-month period of eligibility using as the baseline the adjusted gross
417.28income reported on the applicant's federal income tax form for the previous year and
417.29adding back in reported depreciation amounts that apply to the business in which the
417.30family is currently engaged.
417.31    (c) "Gross individual or gross family income" means the total income for all family
417.32members, calculated for the six-month period of eligibility.
417.33EFFECTIVE DATE.This section is effective July 1, 2007.

418.1    Sec. 30. HEALTH CARE PAYMENT SYSTEM REFORM.
418.2    Subdivision 1. Payment reform plan. The commissioners of employee relations,
418.3human services, commerce, and health shall develop a plan for promoting and facilitating
418.4changes in payment rates and methods for paying for health care services, drugs, devices,
418.5supplies, and equipment in order to:
418.6    (1) reward the provision of cost-effective primary and preventive care;
418.7    (2) reward the use of evidence-based care;
418.8    (3) discourage underutilization, overuse, and misuse;
418.9    (4) reward the use of the most cost-effective settings, drugs, devices, providers,
418.10and treatments; and
418.11    (5) encourage consumers to maintain good health and use the health care system
418.12appropriately.
418.13    In developing the plan, the commissioners shall analyze existing data to determine
418.14specific services and health conditions for which changes in payment rates and methods
418.15would lead to significant improvements in quality of care.
418.16    Subd. 2. Report. The commissioners shall submit a report to the legislature by
418.17December 15, 2007, describing the payment reform plan. The report must include
418.18proposed legislation for implementing those components of the plan requiring legislative
418.19action or appropriations of money.
418.20EFFECTIVE DATE.This section is effective July 1, 2007.

418.21    Sec. 31. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER
418.22THE UNINSURED.
418.23    Subdivision 1. Community collaboratives. The commissioner of human services
418.24shall provide grants to and authorization for up to three community collaboratives that
418.25satisfy the requirements in this section. To be eligible to receive a grant and authorization
418.26under this section, a community collaborative must include:
418.27    (1) one or more counties;
418.28    (2) one or more local hospitals;
418.29    (3) one or more local employers who collectively provide at least 300 jobs in the
418.30community;
418.31    (4) one or more health care clinics or physician groups; and
418.32    (5) a third-party payer, which may be a county-based purchasing plan operating
418.33under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan
418.34company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.
419.1    Subd. 2. Pilot project requirements. (a) Community collaborative pilot projects
419.2must:
419.3    (1) identify and enroll persons in the community who are uninsured, and who have,
419.4or are at risk of developing, one of the following chronic conditions: mental illness,
419.5diabetes, asthma, hypertension, or other chronic condition designated by the project;
419.6    (2) assist uninsured persons to obtain private-sector health insurance coverage if
419.7possible or to enroll in any public health care programs for which they are eligible. If the
419.8uninsured individual is unable to obtain health coverage, the community collaborative
419.9must enroll the individual in a local health care assistance program that provides specified
419.10services to prevent or effectively manage the chronic condition;
419.11    (3) include components to help uninsured persons retain employment or to become
419.12employable, if currently unemployed;
419.13    (4) ensure that each uninsured person enrolled in the program has a medical home
419.14responsible for providing, or arranging for, health care services and assisting in the
419.15effective management of the chronic condition;
419.16    (5) coordinate services between all providers and agencies serving an enrolled
419.17individual; and
419.18    (6) be coordinated with the state's Q-Care initiative and improve the use of
419.19evidence-based treatments and effective disease management programs in the broader
419.20community, beyond those individuals enrolled in the project.
419.21    (b) Projects established under this section are not insurance and are not subject to
419.22state-mandated benefit requirements or insurance regulations.
419.23    Subd. 3. Criteria. Proposals must be evaluated by actuarial, financial, and clinical
419.24experts based on the likelihood that the project would produce a positive return on
419.25investment for the community. In awarding grants, the commissioner of human services
419.26shall give preference to proposals that:
419.27    (1) have broad community support from local businesses, provider counties, and
419.28other public and private organizations;
419.29    (2) would provide services to uninsured persons who have, or are at risk of
419.30developing, multiple, co-occurring chronic conditions;
419.31    (3) integrate or coordinate resources from multiple sources, such as employer
419.32contributions, county funds, social service programs, and provider financial or in-kind
419.33support;
419.34    (4) provide continuity of treatment and services when uninsured individuals in
419.35the program become eligible for public or private health insurance or when insured
419.36individuals lose their coverage;
420.1    (5) demonstrate how administrative costs for health plan companies and providers
420.2can be reduced through greater simplification, coordination, consolidation, standardization,
420.3reducing billing errors, or other methods; and
420.4    (6) involve local contributions to the cost of the pilot projects.
420.5    Subd. 4. Grants. The commissioner of human services shall provide
420.6implementation grants of up to one-half of the community collaborative's costs for
420.7planning, administration, and evaluation. The commissioner shall also provide grants to
420.8community collaboratives to develop a fund to pay up to 50 percent of the cost of the
420.9services provided to uninsured individuals. The remaining costs must be paid for through
420.10other sources or by agreement of a health care provider to contribute the cost as charity
420.11care.
420.12    Subd. 5. Evaluation. The commissioner of human services shall evaluate the
420.13effectiveness of each community collaborative project awarded a grant, by comparing
420.14actual costs for serving the identified uninsured persons to the predicted costs that would
420.15have been incurred in the absence of early intervention and consistent treatment to manage
420.16the chronic condition, including the costs to medical assistance, MinnesotaCare, and
420.17general assistance medical care. The commissioner shall require community collaborative
420.18projects, as a condition of receipt of a grant award, to provide the commissioner with all
420.19information necessary for this evaluation.
420.20EFFECTIVE DATE.This section is effective July 1, 2007.

420.21    Sec. 32. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.
420.22    Subdivision 1. Pilot projects. (a) The commissioners of health, human services,
420.23and employee relations shall develop and administer payment reform pilot projects for
420.24state employees and persons enrolled in medical assistance, MinnesotaCare, or general
420.25assistance medical care, to the extent permitted by federal requirements. The purpose of
420.26the projects is to promote and facilitate changes in payment rates and methods for paying
420.27for health care services, drugs, devices, supplies, and equipment in order to:
420.28    (1) reward the provision of cost-effective primary and preventive care;
420.29    (2) reward the use of evidence-based care;
420.30    (3) reward coordination of care for patients with chronic conditions;
420.31    (4) discourage overuse and misuse;
420.32    (5) reward the use of the most cost-effective settings, drugs, devices, providers,
420.33and treatments;
420.34    (6) encourage consumers to maintain good health and use the health care system
420.35appropriately.
421.1    (b) The pilot projects must involve the use of designated care professionals or
421.2clinics to serve as a patient's medical home and be responsible for coordinating health
421.3care services across the continuum of care. The pilot projects must evaluate different
421.4payment reform models and must be coordinated with the Minnesota senior health options
421.5program and the Minnesota disability health options program. To the extent possible, the
421.6commissioners shall coordinate state purchasing activities with other public employers
421.7and with private purchasers, self-insured groups, and health plan companies to promote
421.8the use of pilot projects encompassing both public and private purchasers and markets.
421.9    Subd. 2. Payment methods and incentives. The commissioners shall modify
421.10existing payment methods and rates for those enrollees and health care providers
421.11participating in the pilot project in order to provide incentives for care management,
421.12team-based care, and practice redesign, and increase resources for primary care, chronic
421.13condition care, and care provided to complex patients. The commissioners may create
421.14financial incentives for patients to select a medical home under the pilot project by
421.15reducing, modifying, or eliminating deductibles and co-payments for certain services, or
421.16through other incentives. The commissioners may require patients to remain with their
421.17designated medical home for a specified period of time. Alternative payment methods
421.18may include complete or partial capitation, fee-for-service payments, or other payment
421.19methodologies. The payment methods may provide for the payment of bonuses to medical
421.20home providers or other providers, or to patients, for the achievement of performance
421.21goals. The payment methods may include allocating a portion of the payment that
421.22would otherwise be paid to health plans under state prepaid health care programs to the
421.23designated medical home for specified services.
421.24    Subd. 3. Requirements. In order to be designated a medical home under the pilot
421.25project, health care professionals or clinics must demonstrate their ability to:
421.26    (1) be the patient's first point of contact by telephone or other means, 24 hours a
421.27day, seven days a week;
421.28    (2) provide or arrange for patients' comprehensive health care needs, including the
421.29ability to structure planned chronic disease visits and to manage chronic disease through
421.30the use of disease registries;
421.31    (3) coordinate patients' care when care must be provided outside the medical home;
421.32    (4) provide longitudinal care, not just episodic care, including meeting long-term
421.33and unique personal needs;
421.34    (5) utilize an electronic health record and incorporate a plan to develop and make
421.35available to patients that choose a medical home an electronic personal health record that
422.1is prepopulated with the patient's data, consumer-directed, connected to the provider,
422.224-hour accessible, and owned and controlled by the patient;
422.3    (6) systematically improve quality of care using, among other inputs, patient
422.4feedback; and
422.5    (7) create a provider network that provides for increased reimbursement for a
422.6medical home in a cost-neutral manner.
422.7    Subd. 4. Evaluation. Pilot projects must be evaluated based on patient satisfaction,
422.8provider satisfaction, clinical process and outcome measures, program costs and savings,
422.9and economic impact on health care providers. Pilot projects must be evaluated based
422.10on the extent to which the medical home:
422.11    (1) coordinated health care services across the continuum of care and thereby
422.12reduced duplication of services and enhanced communication across providers;
422.13    (2) provided safe and high-quality care by increasing utilization of effective
422.14treatments, reduced use of ineffective treatments, reduced barriers to essential care and
422.15services, and eliminated barriers to access;
422.16    (3) reduced unnecessary hospitalizations and emergency room visits and increased
422.17use of cost-effective care and settings;
422.18    (4) encouraged long-term patient and provider relationships by shifting from
422.19episodic care to consistent, coordinated communication and care with a specified team of
422.20providers or individual providers;
422.21    (5) engaged and educated consumers by encouraging shared patient and provider
422.22responsibility and accountability for disease prevention, health promotion, chronic
422.23disease management, acute care, and overall well-being, encouraging informed medical
422.24decision-making, ensuring the availability of accurate medical information, and facilitated
422.25the transfer of accurate medical information;
422.26    (6) encouraged innovation in payment methodologies by using patient and provider
422.27incentives to coordinate care and utilize medical home services and fostering the
422.28expansion of a technology infrastructure that supports collaboration; and
422.29    (7) reduced overall health care costs as compared to conventional payment methods
422.30for similar patient populations.
422.31    Subd. 5. Rulemaking. The commissioners are exempt from administrative
422.32rulemaking under chapter 14 for purposes of developing, administering, contracting
422.33for, and evaluating pilot projects under this section. The commissioner shall publish a
422.34proposed request for proposals in the State Register and allow 30 days for comment
422.35before issuing the final request for proposals.
423.1    Subd. 6. Regulatory and payment barriers. The commissioners shall study state
423.2and federal statutory and regulatory barriers to the creation of medical homes and provide
423.3a report and recommendations to the legislature by December 15, 2007.

423.4    Sec. 33. HEALTH CARE SYSTEM CONSOLIDATION.
423.5    (a) The commissioner of health shall study the effect of health care provider and
423.6health plan company consolidation in the four metropolitan statistical areas in Minnesota
423.7on: health care costs, including provider payment rates; quality of care; and access to care.
423.8The commissioner shall separately consider hospitals, specialty groups, and primary care
423.9groups. The commissioner shall present findings and recommendations to the legislature
423.10by December 15, 2007.
423.11    (b) For purposes of this study, health carriers, provider networks, and other health
423.12care providers shall provide data on network participation, contracted payment rates,
423.13charges, costs, payments received, patient referrals, and other information requested by
423.14the commissioner, in the form and manner specified by the commissioner. Provider-level
423.15information on contracted payment rates and payments from health plans provided to the
423.16commissioner of health for the purposes of this study are (1) private data on individuals as
423.17defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as
423.18defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not
423.19collect patient-identified data for purposes of this study. Data collected for purposes of
423.20this study may not be used for any other purposes.

423.21    Sec. 34. REPEALER.
423.22Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective
423.23August 1, 2007.

423.24ARTICLE 10

423.25PUBLIC HEALTH

423.26    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a
423.27subdivision to read:
423.28    Subd. 21. Birth defects registry system. Data on individuals collected by the
423.29birth defects registry system are private data on individuals and classified pursuant to
423.30section 144.2215.

423.31    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision
423.32to read:
424.1    Subd. 3b. Window fall prevention device code. The commissioner of labor and
424.2industry shall adopt rules for window fall prevention devices as part of the state Building
424.3Code. Window fall prevention devices include, but are not limited to, safety screens,
424.4hardware, guards, and other devices that comply with the standards established by the
424.5commissioner of labor and industry. The rules must require compliance with standards
424.6for window fall prevention devices developed by ASTM International, contained in the
424.7International Building Code as the model language with amendments deemed necessary to
424.8coordinate with the other adopted building codes in Minnesota. The rules must establish a
424.9scope that includes the applicable building occupancies, and the types, locations, and sizes
424.10of windows that will require the installation of fall devices. The rules will be effective July
424.111, 2009. The commissioner shall report to the legislature on the status of the rulemaking
424.12on or before February 15, 2008.

424.13    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:
424.14    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable
424.15application fee of $175 $215 to cover the administrative cost of processing a request for a
424.16variance or modification of rules adopted by the commissioner under this chapter.
424.17EFFECTIVE DATE.This section is effective July 1, 2008.

424.18    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:
424.19    Subdivision 1. Well notification fee. The well notification fee to be paid by a
424.20property owner is:
424.21    (1) for a new water supply well, $175 $215, which includes the state core function
424.22fee;
424.23    (2) for a well sealing, $35 $50 for each well, which includes the state core function
424.24fee, except that for monitoring wells constructed on a single property, having depths
424.25within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
424.26$35 $50; and
424.27    (3) for construction of a dewatering well, $175 $215, which includes the state core
424.28function fee, for each dewatering well except a dewatering project comprising five or
424.29more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering
424.30wells recorded on the notification.
424.31EFFECTIVE DATE.This section is effective July 1, 2008.

424.32    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:
425.1    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
425.2    (1) for a water supply well that is not in use under a maintenance permit, $150 $175
425.3annually;
425.4    (2) for construction of a monitoring well, $175 $215, which includes the state
425.5core function fee;
425.6    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175
425.7annually;
425.8    (4) for monitoring wells used as a leak detection device at a single motor fuel retail
425.9outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
425.10chemical facility site, the construction permit fee is $175 $215, which includes the state
425.11core function fee, per site regardless of the number of wells constructed on the site, and
425.12the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per
425.13site regardless of the number of monitoring wells located on site;
425.14    (5) for a groundwater thermal exchange device, in addition to the notification fee for
425.15water supply wells, $175 $215, which includes the state core function fee;
425.16    (6) for a vertical heat exchanger, $175 $215;
425.17    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175
425.18annually for each dewatering well, except a dewatering project comprising more than five
425.19dewatering wells shall be issued a single permit for $750 $875 annually for dewatering
425.20wells recorded on the permit; and
425.21    (8) for an elevator boring, $175 $215 for each boring.
425.22EFFECTIVE DATE.This section is effective July 1, 2008.

425.23    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:
425.24    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to
425.25sell or transfer real property, the seller must disclose in writing to the buyer information
425.26about the status and location of all known wells on the property, by delivering to the buyer
425.27either a statement by the seller that the seller does not know of any wells on the property,
425.28or a disclosure statement indicating the legal description and county, and a map drawn
425.29from available information showing the location of each well to the extent practicable.
425.30In the disclosure statement, the seller must indicate, for each well, whether the well is in
425.31use, not in use, or sealed.
425.32    (b) At the time of closing of the sale, the disclosure statement information, name and
425.33mailing address of the buyer, and the quartile, section, township, and range in which each
425.34well is located must be provided on a well disclosure certificate signed by the seller or a
425.35person authorized to act on behalf of the seller.
426.1    (c) A well disclosure certificate need not be provided if the seller does not know
426.2of any wells on the property and the deed or other instrument of conveyance contains
426.3the statement: "The Seller certifies that the Seller does not know of any wells on the
426.4described real property."
426.5    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
426.6required by this subdivision shall be signed by the buyer or a person authorized to act on
426.7behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
426.8certificate is not required if the following statement appears on the deed followed by the
426.9signature of the grantee or, if there is more than one grantee, the signature of at least one
426.10of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
426.11described real property." The statement and signature of the grantee may be on the front
426.12or back of the deed or on an attached sheet and an acknowledgment of the statement by
426.13the grantee is not required for the deed to be recordable.
426.14    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:
426.15    (1) that consists solely of a sale or transfer of severed mineral interests; or
426.16    (2) that consists of an individual condominium unit as described in chapters 515
426.17and 515B.
426.18    (f) For an area owned in common under chapter 515 or 515B the association or other
426.19responsible person must report to the commissioner by July 1, 1992, the location and
426.20status of all wells in the common area. The association or other responsible person must
426.21notify the commissioner within 30 days of any change in the reported status of wells.
426.22    (g) For real property sold by the state under section 92.67, the lessee at the time of
426.23the sale is responsible for compliance with this subdivision.
426.24    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or
426.25a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
426.26based on the information provided on the disclosure statement required by this section
426.27or based on other available information.
426.28    (i) A county recorder or registrar of titles may not record a deed or other instrument
426.29of conveyance dated after October 31, 1990, for which a certificate of value is required
426.30under section 272.115, or any deed or other instrument of conveyance dated after October
426.3131, 1990, from a governmental body exempt from the payment of state deed tax, unless
426.32the deed or other instrument of conveyance contains the statement made in accordance
426.33with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
426.34the information required by paragraph (b) or (d). The county recorder or registrar of titles
426.35must not accept a certificate unless it contains all the required information. The county
426.36recorder or registrar of titles shall note on each deed or other instrument of conveyance
427.1accompanied by a well disclosure certificate that the well disclosure certificate was
427.2received. The notation must include the statement "No wells on property" if the disclosure
427.3certificate states there are no wells on the property. The well disclosure certificate shall not
427.4be filed or recorded in the records maintained by the county recorder or registrar of titles.
427.5After noting "No wells on property" on the deed or other instrument of conveyance, the
427.6county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
427.7certificate. The county recorder or registrar of titles shall collect from the buyer or the
427.8person seeking to record a deed or other instrument of conveyance, a fee of $40 $45
427.9for receipt of a completed well disclosure certificate. By the tenth day of each month,
427.10the county recorder or registrar of titles shall transmit the well disclosure certificates
427.11to the commissioner of health. By the tenth day after the end of each calendar quarter,
427.12the county recorder or registrar of titles shall transmit to the commissioner of health
427.13$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter.
427.14The commissioner shall maintain the well disclosure certificate for at least six years. The
427.15commissioner may store the certificate as an electronic image. A copy of that image
427.16shall be as valid as the original.
427.17    (j) No new well disclosure certificate is required under this subdivision if the buyer
427.18or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
427.19or other instrument of conveyance that the status and number of wells on the property
427.20have not changed since the last previously filed well disclosure certificate. The following
427.21statement, if followed by the signature of the person making the statement, is sufficient
427.22to comply with the certification requirement of this paragraph: "I am familiar with the
427.23property described in this instrument and I certify that the status and number of wells on
427.24the described real property have not changed since the last previously filed well disclosure
427.25certificate." The certification and signature may be on the front or back of the deed or on
427.26an attached sheet and an acknowledgment of the statement is not required for the deed or
427.27other instrument of conveyance to be recordable.
427.28    (k) The commissioner in consultation with county recorders shall prescribe the form
427.29for a well disclosure certificate and provide well disclosure certificate forms to county
427.30recorders and registrars of titles and other interested persons.
427.31    (l) Failure to comply with a requirement of this subdivision does not impair:
427.32    (1) the validity of a deed or other instrument of conveyance as between the parties
427.33to the deed or instrument or as to any other person who otherwise would be bound by
427.34the deed or instrument; or
427.35    (2) the record, as notice, of any deed or other instrument of conveyance accepted for
427.36filing or recording contrary to the provisions of this subdivision.
428.1EFFECTIVE DATE.This section is effective July 1, 2008.

428.2    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:
428.3144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES;
428.4EXCEPTIONS.
428.5    Subdivision 1. Who must pay. Except for the limitation contained in this section,
428.6the commissioner of health shall charge a handling fee for each specimen submitted to
428.7the Department of Health for analysis for diagnostic purposes by any hospital, private
428.8laboratory, private clinic, or physician. No fee shall be charged to any entity which
428.9receives direct or indirect financial assistance from state or federal funds administered by
428.10the Department of Health, including any public health department, nonprofit community
428.11clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar
428.12entity. No fee will be charged for any biological materials submitted to the Department
428.13of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
428.14materials requested by the department to gather information for disease prevention or
428.15control purposes. The commissioner of health may establish by rule other exceptions to
428.16the handling fee as may be necessary to gather information for epidemiologic purposes
428.17protect the public's health. All fees collected pursuant to this section shall be deposited in
428.18the state treasury and credited to the state government special revenue fund.
428.19    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate
428.20rules, in accordance with chapter 14, which shall specify the amount of the charge a
428.21handling fee prescribed in subdivision 1. The fee shall approximate the costs to the
428.22department of handling specimens including reporting, postage, specimen kit preparation,
428.23and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen
428.24until the commissioner promulgates rules pursuant to this subdivision.

428.25    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:
428.26144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL
428.27DISORDERS.
428.28    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
428.29officer or other person in charge of each institution caring for infants 28 days or less
428.30of age, (2) the person required in pursuance of the provisions of section 144.215, to
428.31register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
428.32birth, to arrange to have administered to every infant or child in its care tests for heritable
428.33and congenital disorders according to subdivision 2 and rules prescribed by the state
428.34commissioner of health. Testing and the recording and reporting of test results shall be
429.1performed at the times and in the manner prescribed by the commissioner of health. The
429.2commissioner shall charge laboratory service fees a fee so that the total of fees collected
429.3will approximate the costs of conducting the tests and implementing and maintaining
429.4a system to follow-up infants with heritable or congenital disorders. The laboratory
429.5service fee is $61 $101 per specimen. Costs associated with capital expenditures and
429.6the development of new procedures may be prorated over a three-year period when
429.7calculating the amount of the fees.
429.8    Subd. 2. Determination of tests to be administered. The commissioner shall
429.9periodically revise the list of tests to be administered for determining the presence of a
429.10heritable or congenital disorder. Revisions to the list shall reflect advances in medical
429.11science, new and improved testing methods, or other factors that will improve the public
429.12health. In determining whether a test must be administered, the commissioner shall take
429.13into consideration the adequacy of laboratory analytical methods to detect the heritable
429.14or congenital disorder, the ability to treat or prevent medical conditions caused by the
429.15heritable or congenital disorder, and the severity of the medical conditions caused by the
429.16heritable or congenital disorder. The list of tests to be performed may be revised if the
429.17changes are recommended by the advisory committee established under section 144.1255,
429.18approved by the commissioner, and published in the State Register. The revision is
429.19exempt from the rulemaking requirements in chapter 14, and sections 14.385 and 14.386
429.20do not apply.
429.21    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
429.22subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to
429.23perform testing thereunder as well as the results of such testing may be retained by the
429.24Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that
429.25the following options are available to them with respect to the testing: (i) to decline to
429.26have the tests, or (ii) to elect to have the tests but to require that all blood samples and
429.27records of test results be destroyed within 24 months of the testing. If the parents of
429.28an infant object in writing to testing for heritable and congenital disorders or elect to
429.29require that blood samples and test results be destroyed, the objection or election shall
429.30be recorded on a form that is signed by a parent or legal guardian and made part of the
429.31infant's medical record. A written objection exempts an infant from the requirements of
429.32this section and section 144.128.

429.33    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:
429.34    Subdivision 1. Establishment. Within the limits of available appropriations, the
429.35commissioner of health shall establish and maintain an information system containing data
430.1on the cause, treatment, prevention, and cure of major birth defects. The commissioner
430.2shall consult with representatives and experts in epidemiology, medicine, insurance,
430.3health maintenance organizations, genetics, consumers, and voluntary organizations in
430.4developing the system and may phase in the implementation of the system. After the
430.5parents have provided informed consent under section 144.2216, subdivision 4, the
430.6commissioner shall offer the parents with their informed consent a visit by a trained health
430.7care worker to interview the parents about:
430.8    (1) all previous home addresses, occupations, and places of work including from
430.9childhood;
430.10    (2) the time and place of any military service; and
430.11    (3) known occasions or sites of toxic exposures.

430.12    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:
430.13    Subdivision 1. Rule authority. The commissioner of health shall collect cancer
430.14incidence information, analyze the information, and conduct special studies designed to
430.15determine the potential public health significance of an increase in cancer incidence.
430.16    The commissioner shall adopt rules to administer the system, collect information,
430.17and distribute data. The rules must include, but not be limited to, the following:
430.18    (1) the type of data to be reported, which must include current and previous
430.19occupational data;
430.20    (2) standards for reporting specific types of data;
430.21    (3) payments allowed to hospitals, pathologists, and registry systems to defray their
430.22costs in providing information to the system;
430.23    (4) criteria relating to contracts made with outside entities to conduct studies using
430.24data collected by the system. The criteria may include requirements for a written protocol
430.25outlining the purpose and public benefit of the study, the description, methods, and
430.26projected results of the study, peer review by other scientists, the methods and facilities
430.27to protect the privacy of the data, and the qualifications of the researcher proposing to
430.28undertake the study; and
430.29    (5) specification of fees to be charged under section 13.03, subdivision 3, for all
430.30out-of-pocket expenses for data summaries or specific analyses of data requested by
430.31public and private agencies, organizations, and individuals, and which are not otherwise
430.32included in the commissioner's annual summary reports. Fees collected are appropriated
430.33to the commissioner to offset the cost of providing the data.

430.34    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:
431.1    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical
431.2clinic, medical laboratory, other facility, or individual performing blood lead analysis
431.3shall report the results after the analysis of each specimen analyzed, for both capillary
431.4and venous specimens, and epidemiologic information required in this section to the
431.5commissioner of health, within the time frames set forth in clauses (1) and (2):
431.6    (1) within two working days by telephone, fax, or electronic transmission, with
431.7written or electronic confirmation within one month, for a venous blood lead level equal to
431.8or greater than 15 ten micrograms of lead per deciliter of whole blood; or
431.9    (2) within one month in writing or by electronic transmission, for any capillary
431.10result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of
431.11whole blood.
431.12    (b) If a blood lead analysis is performed outside of Minnesota and the facility
431.13performing the analysis does not report the blood lead analysis results and epidemiological
431.14information required in this section to the commissioner, the provider who collected the
431.15blood specimen must satisfy the reporting requirements of this section. For purposes of
431.16this section, "provider" has the meaning given in section 62D.02, subdivision 9.
431.17    (c) The commissioner shall coordinate with hospitals, medical clinics, medical
431.18laboratories, and other facilities performing blood lead analysis to develop a universal
431.19reporting form and mechanism.

431.20    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:
431.21    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk
431.22assessment of a residence according to the venous blood lead level and time frame set
431.23forth in clauses (1) to (4) for purposes of secondary prevention:
431.24    (1) within 48 hours of a child or pregnant female in the residence being identified to
431.25the agency as having a venous blood lead level equal to or greater than 60 45 micrograms
431.26of lead per deciliter of whole blood;
431.27    (2) within five working days of a child or pregnant female in the residence being
431.28identified to the agency as having a venous blood lead level equal to or greater than 45 15
431.29micrograms of lead per deciliter of whole blood;
431.30    (3) within ten working days of a child in the residence being identified to the agency
431.31as having a venous blood lead level equal to or greater than 15 ten micrograms of lead
431.32per deciliter of whole blood; or
431.33    (4) within ten working days of a pregnant female in the residence being identified to
431.34the agency as having a venous blood lead level equal to or greater than ten micrograms of
431.35lead per deciliter of whole blood.
432.1    (b) Within the limits of available local, state, and federal appropriations, an assessing
432.2agency may also conduct a lead risk assessment for children with any elevated blood
432.3lead level.
432.4    (c) In a building with two or more dwelling units, an assessing agency shall assess
432.5the individual unit in which the conditions of this section are met and shall inspect all
432.6common areas accessible to a child. If a child visits one or more other sites such as another
432.7residence, or a residential or commercial child care facility, playground, or school, the
432.8assessing agency shall also inspect the other sites. The assessing agency shall have one
432.9additional day added to the time frame set forth in this subdivision to complete the lead
432.10risk assessment for each additional site.
432.11    (d) Within the limits of appropriations, the assessing agency shall identify the
432.12known addresses for the previous 12 months of the child or pregnant female with venous
432.13blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten
432.14micrograms per deciliter for the pregnant female; notify the property owners, landlords,
432.15and tenants at those addresses that an elevated blood lead level was found in a person
432.16who resided at the property; and give them primary prevention information. Within the
432.17limits of appropriations, the assessing agency may perform a risk assessment and issue
432.18corrective orders in the properties, if it is likely that the previous address contributed to
432.19the child's or pregnant female's blood lead level. The assessing agency shall provide the
432.20notice required by this subdivision without identifying the child or pregnant female with
432.21the elevated blood lead level. The assessing agency is not required to obtain the consent of
432.22the child's parent or guardian or the consent of the pregnant female for purposes of this
432.23subdivision. This information shall be classified as private data on individuals as defined
432.24under section 13.02, subdivision 12.
432.25    (e) The assessing agency shall conduct the lead risk assessment according to rules
432.26adopted by the commissioner under section 144.9508. An assessing agency shall have
432.27lead risk assessments performed by lead risk assessors licensed by the commissioner
432.28according to rules adopted under section 144.9508. If a property owner refuses to allow
432.29a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry
432.30to the property and the time frame for conducting a lead risk assessment set forth in this
432.31subdivision no longer applies. A lead risk assessor or assessing agency may observe the
432.32performance of lead hazard reduction in progress and shall enforce the provisions of this
432.33section under section 144.9509. Deteriorated painted surfaces, bare soil, and dust must be
432.34tested with appropriate analytical equipment to determine the lead content, except that
432.35deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to
432.36engage in lead hazard reduction on those surfaces. The lead content of drinking water
433.1must be measured if another probable source of lead exposure is not identified. Within a
433.2standard metropolitan statistical area, an assessing agency may order lead hazard reduction
433.3of bare soil without measuring the lead content of the bare soil if the property is in a
433.4census tract in which soil sampling has been performed according to rules established by
433.5the commissioner and at least 25 percent of the soil samples contain lead concentrations
433.6above the standard in section 144.9508.
433.7    (f) Each assessing agency shall establish an administrative appeal procedure which
433.8allows a property owner to contest the nature and conditions of any lead order issued by
433.9the assessing agency. Assessing agencies must consider appeals that propose lower cost
433.10methods that make the residence lead safe. The commissioner shall use the authority and
433.11appeal procedure granted under sections 144.989 to 144.993.
433.12    (g) Sections 144.9501 to 144.9509 neither authorize nor prohibit an assessing agency
433.13from charging a property owner for the cost of a lead risk assessment.

433.14    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a
433.15subdivision to read:
433.16    Subd. 6. Medical assistance. Medical assistance reimbursement for lead risk
433.17assessment services under section 256B.0625, subdivision 49, shall not be used to replace
433.18or decrease existing state or local funding for lead services and lead-related activities.

433.19    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:
433.20144.9512 LEAD ABATEMENT PROGRAM.
433.21    Subdivision 1. Definitions. (a) The definitions in section 144.9501 and in this
433.22subdivision apply to this section.
433.23    (b) "Eligible organization" means a lead contractor, city, board of health, community
433.24health department, community action agency as defined in section 256E.30, or community
433.25development corporation.
433.26    (c) "Commissioner" means the commissioner of health, or the commissioner of the
433.27Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.
433.28    Subd. 2. Grants; administration. Within the limits of the available appropriation,
433.29the commissioner must develop a swab team services program which may shall make
433.30demonstration and training grants to eligible organizations a nonprofit organization
433.31currently operating the CLEARCorps lead hazard reduction project to train workers to
433.32provide swab team services and swab team services for residential property. Grants may
433.33be awarded to nonprofit organizations to provide technical assistance and training to
433.34ensure quality and consistency within the statewide program. Grants must be awarded to
434.1help ensure full-time employment to workers providing swab team services and must be
434.2awarded for a two-year period.
434.3    Grants awarded under this section must be made in consultation with the
434.4commissioner of the Housing Finance Agency and representatives of neighborhood
434.5groups from areas at high risk for toxic lead exposure, a labor organization, the lead
434.6coalition, community action agencies, and the legal aid society. The consulting team must
434.7review grant applications and recommend awards to eligible organizations that meet
434.8requirements for receiving a grant under this section.
434.9    Subd. 3. Applicants. (a) Interested eligible organizations may apply to the
434.10commissioner for grants under this section. Two or more eligible organizations may
434.11jointly apply for a grant. Priority shall be given to community action agencies in greater
434.12Minnesota and to either community action agencies or neighborhood based nonprofit
434.13organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may
434.14be used for administrative purposes. The commissioner may deviate from this percentage
434.15if a grantee can justify the need for a larger administrative allowance. Of this amount,
434.16up to five percent may be used by the commissioner for state administrative purposes.
434.17Applications must provide information requested by the commissioner, including at least
434.18the information required to assess the factors listed in paragraph (d).
434.19    (b) The commissioner must consult with boards of health to provide swab team
434.20services for purposes of secondary prevention. The priority for swab teams created
434.21by grants to eligible organizations under this section must be work assigned by the
434.22commissioner of health, or by a board of health if so designated by the commissioner of
434.23health, to provide secondary prevention swab team services to fulfill the requirements
434.24of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned
434.25work under this section by the commissioner, that are not engaged daily in fulfilling the
434.26requirements of section 144.9504, subdivision 6, must deliver swab team services in
434.27response to elevated blood lead levels as defined in section 144.9501, subdivision 9,
434.28where lead orders were not issued, and for purposes of primary prevention in census
434.29tracts known to be in areas at high risk for toxic lead exposure as described in section
434.30144.9503, subdivision 2.
434.31    (c) Any additional money must be used for grants to establish swab teams for
434.32primary prevention under section 144.9503, in census tracts in areas at high risk for toxic
434.33lead exposure as determined under section 144.9503, subdivision 2.
434.34    (d) In evaluating grant applications, the commissioner must consider the following
434.35criteria:
434.36    (1) the use of lead contractors and lead workers for residential swab team services;
435.1    (2) the participation of neighborhood groups and individuals, as swab team workers,
435.2in areas at high risk for toxic lead exposure;
435.3    (3) plans for the provision of swab team services for primary and secondary
435.4prevention as required under subdivision 4;
435.5    (4) plans for supervision, training, career development, and postprogram placement
435.6of swab team members;
435.7    (5) plans for resident and property owner education on lead safety;
435.8    (6) plans for distributing cleaning supplies to area residents and educating residents
435.9and property owners on cleaning techniques;
435.10    (7) sources of other funding and cost estimates for training, lead inspections, swab
435.11team services, equipment, monitoring, testing, and administration;
435.12    (8) measures of program effectiveness;
435.13    (9) coordination of program activities with other federal, state, and local public
435.14health, job training, apprenticeship, and housing renovation programs including programs
435.15under sections 116L.86 to 116L.881; and
435.16    (10) prior experience in providing swab team services.
435.17    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible
435.18organizations and lead supervisors or certified firms may participate in the swab team
435.19program. An eligible organization The nonprofit receiving a grant under this section
435.20must assure ensure that all participating lead supervisors or certified firms are licensed
435.21and that all swab team workers are certified by the Department of Health under section
435.22144.9505 . Eligible organizations and lead supervisors or certified firms may distinguish
435.23between interior and exterior services in assigning duties and The nonprofit organization
435.24may participate in the program by:
435.25    (1) providing on-the-job training for swab team workers;
435.26    (2) providing swab team services to meet the requirements of sections 144.9503,
435.27subdivision 4 , and 144.9504, subdivision 6;
435.28    (3) providing a removal and replacement component using skilled craft workers
435.29under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501,
435.30subdivision 17;
435.31    (4) providing lead testing according to subdivision 8;
435.32    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as
435.33described in section 144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or
435.34    (6) (5) having a swab team worker instruct residents and property owners on
435.35appropriate lead control techniques, including the lead-safe directives developed by the
435.36commissioner of health.;
436.1    (6) conducting blood lead testing events including screening children and pregnant
436.2women according to Department of Health screening guidelines;
436.3    (7) performing case management services according to Department of Health case
436.4management guidelines; or
436.5    (8) conducting mandated risk assessments under Minnesota Statutes, section
436.6144.9504, subdivision 2.
436.7    (b) Participating lead supervisors or certified firms must:
436.8    (1) demonstrate proof of workers' compensation and general liability insurance
436.9coverage;
436.10    (2) be knowledgeable about lead abatement requirements established by the
436.11Department of Housing and Urban Development and the Occupational Safety and Health
436.12Administration and lead hazard reduction requirements and lead-safe directives of the
436.13commissioner of health;
436.14    (3) demonstrate experience with on-the-job training programs;
436.15    (4) demonstrate an ability to recruit employees from areas at high risk for toxic
436.16lead exposure; and
436.17    (5) demonstrate experience in working with low-income clients.
436.18    Subd. 5. Swab team workers. Each worker engaged in swab team services
436.19established under this section must have blood lead concentrations below 15 micrograms
436.20of lead per deciliter of whole blood as determined by a baseline blood lead screening.
436.21Any The nonprofit organization receiving a grant under this section is responsible for lead
436.22screening and must assure ensure that all swab team workers meet the standards established
436.23in this subdivision. Grantees The nonprofit organization must use appropriate workplace
436.24procedures including following the lead-safe directives developed by the commissioner of
436.25health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization
436.26and participating contractors must report all employee blood lead levels that exceed 15
436.27micrograms of lead per deciliter of whole blood to the commissioner of health.
436.28    Subd. 6. On-the-job training component. (a) Programs established under this
436.29section must provide on-the-job training for swab team workers.
436.30    (b) Swab team workers must receive monetary compensation equal to the prevailing
436.31wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed
436.32contractor's principal business.
436.33    Subd. 7. Removal and replacement component. (a) Within the limits of the
436.34available appropriation and if a need is identified by a lead inspector, the commissioner
436.35may establish a component for removal and replacement of deteriorated paint in residential
436.36properties according to the following criteria:
437.1    (1) components within a residence must have both deteriorated lead-based paint and
437.2substrate damage beyond repair or rotting wooden framework to be eligible for removal
437.3and replacement;
437.4    (2) all removal and replacement must be done using least-cost methods and
437.5following lead-safe directives;
437.6    (3) whenever windows and doors or other components covered with deteriorated
437.7lead-based paint have sound substrate or are not rotting, those components should be
437.8repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or
437.9covered with protective guards instead of being replaced, provided that such an activity is
437.10the least-cost method of providing the swab team service;
437.11    (4) removal and replacement or repair must be done by lead contractors using skilled
437.12craft workers or trained swab team members; and
437.13    (5) all craft work that requires a state license must be supervised by a person with
437.14a state license in the craft work being supervised. The grant recipient may contract for
437.15this supervision.
437.16    (b) The program design must:
437.17    (1) identify the need for on-the-job training of swab team workers to be removal and
437.18replacement workers; and
437.19    (2) describe plans to involve appropriate groups in designing methods to meet the
437.20need for training swab team workers.
437.21    Subd. 8. Testing and evaluation. (a) Testing of the environment is not necessary
437.22by swab teams whose work is assigned by the commissioner of health or a designated
437.23board of health under section 144.9504. The commissioner of health or designated board
437.24of health must share the analytical testing data collected on each residence for purposes
437.25of secondary prevention under section 144.9504 with the swab team workers in order to
437.26provide constructive feedback on their work and to the commissioner for the purposes
437.27set forth in paragraph (c).
437.28    (b) For purposes of primary prevention evaluation, the following samples must be
437.29collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a
437.30notation of the extent and location of bare soil and of deteriorated lead-based paint. The
437.31analytical testing data collected on each residence for purposes of primary prevention
437.32under section 144.9503 must be shared with the swab team workers in order to provide
437.33constructive feedback on their work and to the commissioner for the purposes set forth in
437.34paragraph (c).
437.35    (c) The commissioner of health must establish a program to collect appropriate data
437.36as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of
438.1swab team services for primary and secondary prevention. Within the limits of available
438.2appropriations, the commissioner of health must conduct on up to 1,000 residences which
438.3have received primary or secondary prevention swab team services, a postremediation
438.4evaluation, on at least a quarterly basis for a period of at least two years for each residence.
438.5The evaluation must note the condition of the paint within the residence, the extent of bare
438.6soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample.
438.7The data collected must be evaluated to determine the efficacy of providing swab team
438.8services as a method of reducing lead exposure in young children. In evaluating this data,
438.9the commissioner of health must consider city size, community location, historic traffic
438.10flow, soil lead level of the property by area or census tract, distance to industrial point
438.11sources that emit lead, season of the year, age of the housing, age and number of children
438.12living at the residence, the presence of pets that move in and out of the residence, and
438.13other relevant factors as the commissioner of health may determine.
438.14    Subd. 9. Program benefits. As a condition of providing swab team services under
438.15this section, an the nonprofit organization may require a property owner to not increase
438.16rents on a property solely as a result of a substantial improvement made with public
438.17funds under the programs in this section.
438.18    Subd. 10. Requirements of organizations receiving grants the nonprofit
438.19organization. An eligible The nonprofit organization that is awarded a training and
438.20demonstration grant under this section must prepare and submit a quarterly progress report
438.21to the commissioner beginning three months after receipt of the grant.

438.22    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION
438.23ACT.
438.24    Subdivision 1. Definitions. (a) "Child" means a person 18 years of age or younger.
438.25    (b) "False positive rate" means the proportion of infants identified as having a
438.26significant hearing loss by the screening process who are ultimately found to not have a
438.27significant hearing loss.
438.28    (c) "False negative rate" means the proportion of infants not identified as having
438.29a significant hearing loss by the screening process who are ultimately found to have a
438.30significant hearing loss.
438.31    (d) "Hearing screening test" means automated auditory brain stem response,
438.32otoacoustic emissions, or another appropriate screening test approved by the Department
438.33of Health.
438.34    (e) "Hospital" means a birthing health care facility or birthing center licensed in
438.35this state that provides obstetrical services.
439.1    (f) "Infant" means a child who is not a newborn and has not attained the age of
439.2one year.
439.3    (g) "Newborn" means an infant 28 days old or younger.
439.4    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or
439.5custodian of a newborn or infant.
439.6    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
439.7commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee
439.8to advise and assist the Department of Health and the Department of Education in:
439.9    (1) developing protocols and timelines for screening, rescreening, and diagnostic
439.10audiological assessment and early medical, audiological, and educational intervention
439.11services for children who are deaf or hard-of-hearing;
439.12    (2) designing protocols for tracking children from birth through age three that may
439.13have passed newborn screening but are at risk for delayed or late onset of permanent
439.14hearing loss;
439.15    (3) designing a technical assistance program to support facilities implementing the
439.16screening program and facilities conducting rescreening and diagnostic audiological
439.17assessment;
439.18    (4) designing implementation and evaluation of a system of follow-up and tracking;
439.19and
439.20    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
439.21culturally appropriate services for children with a confirmed hearing loss and their families.
439.22    (b) Membership of the committee shall include at least one member from each of the
439.23following groups with no less than two of the members being deaf or hard-of-hearing:
439.24    (1) a representative from a consumer organization representing culturally deaf
439.25persons;
439.26    (2) a parent with a child with hearing loss representing a parent organization;
439.27    (3) a consumer from an organization representing oral communication options;
439.28    (4) a consumer from an organization representing cued speech communication
439.29options;
439.30    (5) an audiologist who has experience in evaluation and intervention of infants
439.31and young children;
439.32    (6) a speech-language pathologist who has experience in evaluation and intervention
439.33of infants and young children;
439.34    (7) two primary care providers who have experience in the care of infants and young
439.35children, one of which shall be a pediatrician;
439.36    (8) a representative from the early hearing detection intervention teams;
440.1    (9) a representative from the Department of Education resource center for the deaf
440.2and hard-of-hearing or their designee;
440.3    (10) a representative of the Minnesota Commission Serving Deaf and Hard of
440.4Hearing People;
440.5    (11) a representative from the Department of Human Services Deaf and Hard of
440.6Hearing Services Division;
440.7    (12) one or more of the Part C coordinators from the Department of Education, the
440.8Department of Health, or the Department of Human Services or their designee;
440.9    (13) the Department of Health early hearing detection and intervention coordinator;
440.10    (14) two birth hospital representatives from one rural and one urban hospital;
440.11    (15) a pediatric geneticist;
440.12    (16) an otolaryngologist;
440.13    (17) a representative from the Newborn Screening Advisory Committee under
440.14this subdivision; and
440.15    (18) a representative of the Department of Education regional low-incidence
440.16facilitators.
440.17    The Department of Health member shall chair the first meeting of the committee.
440.18At the first meeting, the committee shall elect a chairperson from its membership. The
440.19committee shall meet at the call of the chairperson, at least four times a year. The
440.20committee shall adopt written bylaws to govern its activities. The Department of Health
440.21shall provide technical and administrative support services as required by the committee.
440.22These services shall include technical support from individuals qualified to administer
440.23infant hearing screening, rescreening, and diagnostic audiological assessments.
440.24    Members of the committee shall receive no compensation for their service, but
440.25shall be reimbursed for expenses incurred as a result of their duties as members of the
440.26committee.
440.27    Subd. 3. Newborn and infant hearing screening programs. All hospitals shall
440.28establish a Universal Newborn Hearing and Infant Screening (UNHS) program. Each
440.29UNHS program shall:
440.30    (1) in advance of any hearing screening testing, provide to the newborn's or infant's
440.31parents information concerning the nature of the screening procedure, applicable costs of
440.32the screening procedure, the potential risks and effects of hearing loss, and the benefits of
440.33early detection and intervention;
440.34    (2) comply with parental consent under section 144.125, subdivision 3;
440.35    (3) develop policies and procedures for screening and rescreening based on
440.36Department of Health recommendations;
441.1    (4) provide appropriate training and monitoring of individuals responsible for
441.2performing hearing screening tests as recommended by the Department of Health;
441.3    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to
441.4remain in the hospital for a prolonged period, testing shall be performed prior to three
441.5months of age, or when medically feasible;
441.6    (6) develop and implement procedures for documenting the results of all hearing
441.7screening tests;
441.8    (7) inform the baby's parents or parent, primary care physician, and the Department
441.9of Health according to recommendations of the Department of Health of the results of the
441.10hearing screening test or rescreening if conducted, or if the newborn or infant was not
441.11successfully tested. The hospital that discharges the baby to home is responsible for
441.12the screening; and
441.13    (8) collect performance data specified by the Department of Health.
441.14    Subd. 4. Notification and information. (a) Notification to the parents, primary
441.15care provider, and Department of Health shall occur prior to discharge or no later than ten
441.16days following the date of testing. Notification shall include information recommended by
441.17the Department of Health.
441.18    (b) A physician, nurse, midwife, or other health professional attending a birth outside
441.19a hospital or institution shall provide information, orally and in writing, as established by
441.20the Department of Health, to parents regarding places where the parents may have their
441.21infants' hearing screened and the importance of such screening.
441.22    (c) The professional conducting the diagnostic procedure to confirm the hearing loss
441.23must report the results to the parents, primary care provider, and Department of Health
441.24according to the Department of Health recommendations.
441.25    Subd. 5. Oversight responsibility. The Department of Health shall exercise
441.26oversight responsibility for UNHS programs, including establishing a performance data
441.27set and reviewing performance data collected by each hospital.
441.28    Subd. 6. Civil and criminal immunity and penalties. (a) No physician or hospital
441.29shall be civilly or criminally liable for failure to conduct hearing screening testing.
441.30    (b) No physician, midwife, nurse, other health professional, or hospital acting in
441.31compliance with this section shall be civilly or criminally liable for any acts conforming
441.32with this section, including furnishing information required according to this section.
441.33    Subd. 7. Laboratory service fees. The commissioner shall charge laboratory
441.34service fees according to section 16A.1285 so that the total of fees collected will
441.35approximate the costs of implementing and maintaining a system to follow up infants,
441.36provide technical assistance, a tracking system, data management, and evaluation.
442.1EFFECTIVE DATE.This section is effective the day following final enactment.

442.2    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.
442.3    Subdivision 1. Arsenic health risk standard established. The commissioner of
442.4health in cooperation with the commissioners of agriculture and the Pollution Control
442.5Agency responsible for monitoring land and water cleanup and soil contamination
442.6information shall determine a health risk standard for human exposure to arsenic. The
442.7commissioner of health shall ensure that the established arsenic health risk standard is
442.8included in all information provided to the public.
442.9    Subd. 2. Information. The commissioner of health, in consultation with the
442.10commissioners of agriculture and the Pollution Control Agency with jurisdiction over
442.11soil and water contamination, shall establish a central information source available to
442.12the public to provide accurate information on arsenic soil and water contamination in
442.13residential areas.
442.14    Subd. 3. Testing for arsenic. (a) The commissioner of health shall ensure access
442.15to medical testing for arsenical pesticide exposure to persons living within one mile of
442.16the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or
442.17medical assistance.
442.18    (b) Through an agreement with the United States Environmental Protection Agency,
442.19the commissioner shall ensure soil testing is available to households within one mile of the
442.20CMC Heartland Lite Yard Superfund site at no cost to the residents.
442.21    Subd. 4. Evaluation. The commissioner of health shall evaluate the cumulative
442.22health impact burdens of environmental toxins in the residential communities impacted by
442.23arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first
442.24priority shall be to evaluate health burdens to those communities experiencing health
442.25disparities as documented by the Minority and Multicultural Health Division of the
442.26Minnesota Department of Health.

442.27    Sec. 17. [144.995] DEFINITIONS.
442.28    (a) For purposes of sections 144.995 to 144.998, the terms in this section have
442.29the meanings given.
442.30    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring
442.31Advisory Panel established under section 144.998.
442.32    (c) "Biomonitoring" means the process by which chemicals and their metabolites are
442.33identified and measured within a biospecimen.
443.1    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably
443.2available as a medium to measure the presence and concentration of chemicals or their
443.3metabolites in a human body.
443.4    (e) "Commissioner" means the commissioner of the Department of Health.
443.5    (f) "Community" means geographically or nongeographically-based populations
443.6that may participate in the biomonitoring program. A "nongeographical community"
443.7includes, but is not limited to, populations that may share a common chemical exposure
443.8through similar occupations, populations experiencing a common health outcome that
443.9may be linked to chemical exposures, or populations that may experience similar chemical
443.10exposures because of comparable consumption, lifestyle, product use, or subpopulations
443.11that share ethnicity, age, or gender.
443.12    (g) "Department" means the Department of Health.
443.13    (h) "Designated chemicals" means those chemicals that are known to, or strongly
443.14suspected of, adversely impacting human health or development, based upon scientific,
443.15peer-reviewed animal, human, or in vitro studies, and baseline human exposure data,
443.16and consists of chemical families or metabolites that are included in the federal Centers
443.17for Disease Control and Prevention studies that are known collectively as the National
443.18Reports on Human Exposure to Environmental Chemicals program and any substances
443.19specified under section 144.998, subdivision 3, clause (6).
443.20    (i) "Environmental hazard" means a chemical, metal, or other substance for which
443.21scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the
443.22chemical is known or reasonably anticipated to adversely impact human health.
443.23    (j) "Environmental health tracking" means collection, integration, analysis, and
443.24dissemination of data on human exposures to chemicals in the environment and on
443.25diseases potentially caused or aggravated by those chemicals.

443.26    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING;
443.27BIOMONITORING.
443.28    Subdivision 1. Environmental health tracking. In cooperation with the
443.29commissioner of the Pollution Control Agency, the commissioner shall establish an
443.30environmental health tracking program to:
443.31    (1) coordinate data collection activities with the Pollution Control Agency,
443.32Department of Agriculture, University of Minnesota, and any other relevant state agency
443.33and work to promote the sharing of and access to health and environmental databases
443.34in order to develop an environmental health tracking system for Minnesota, consistent
443.35with applicable data practices laws;
444.1    (2) facilitate the dissemination of public health tracking data to the public and
444.2researchers in accessible format and provide technical assistance on interpreting the data;
444.3    (3) develop written data sharing agreements with the Minnesota Pollution Control
444.4Agency, Department of Agriculture, and other relevant state agencies and organizations,
444.5and develop additional procedures as needed to protect individual privacy;
444.6    (4) develop a strategic plan that includes a mission statement, the identification of
444.7core priorities for research and epidemiologic surveillance, the identification of internal
444.8and external stakeholders, and a work plan describing future program development;
444.9    (5) organize, analyze, and interpret available data, in order to:
444.10    (i) characterize statewide and localized trends and geographic patterns of prevalence
444.11and incidence of chronic diseases, including, but not limited to, cancer, respiratory
444.12diseases, reproductive problems, birth defects, neurologic diseases, and developmental
444.13disorders;
444.14    (ii) recommend to the commissioner methods to improve data collection on
444.15statewide population rates of chronic diseases and the occurrence of environmental
444.16hazards and exposures;
444.17    (iii) characterize statewide and localized trends and geographic patterns in the
444.18occurrence of environmental hazards and exposures;
444.19    (iv) assess the level of correlation with disease rate data and indicators of exposure
444.20such as biomonitoring data, and other health and environmental data;
444.21    (v) incorporate newly collected and existing health tracking and biomonitoring
444.22data into efforts to identify communities with elevated rates of chronic disease, higher
444.23likelihood of exposure to environmental pollutants, or both;
444.24    (vi) analyze occurrence of environmental hazards, exposures, and diseases with
444.25relation to socioeconomic status, race, and ethnicity;
444.26    (vii) develop and implement targeted plans to conduct more intensive health tracking
444.27and biomonitoring among communities;
444.28    (viii) work with the Pollution Control Agency, the Department of Agriculture, and
444.29other relevant state agency personnel and organizations to develop, implement, and
444.30evaluate preventive measures to reduce elevated rates of diseases and exposures identified
444.31through activities performed under sections 144.995 to 144.998; and
444.32    (ix) provide baseline data and present descriptive information relevant to policy
444.33formation that are consistent with existing goals of the department; and
444.34    (6) submit a biennial report to the legislature by January 15, beginning January
444.3515, 2009, on the status of environmental health tracking activities and related research
445.1programs, and making recommendations regarding the continuation and improvement of
445.2the programs.
445.3    Subd. 2. Biomonitoring. The commissioner shall:
445.4    (1) conduct biomonitoring of communities on a voluntary basis by collecting and
445.5analyzing biospecimens, as appropriate, to assess environmental exposures to designated
445.6chemicals;
445.7    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis,
445.8when scientifically appropriate;
445.9    (3) communicate findings to the public, and plan ensuing stages of biomonitoring
445.10and disease tracking work to further develop and refine the integrated analysis;
445.11    (4) share analytical results with the advisory panel and work with the panel
445.12to interpret results, communicate findings to the public, and plan ensuing stages of
445.13biomonitoring work; and
445.14    (5) submit a biennial report to the legislature by January 15, beginning January
445.1515, 2009, on the status of the biomonitoring program and any recommendations for
445.16improvement.
445.17    Subd. 3. Health data. Data collected under the biomonitoring program are health
445.18data under section 13.3805.

445.19    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.
445.20    Subdivision 1. Pilot program. With advice from the advisory panel, the
445.21commissioner shall develop a biomonitoring pilot program. The program shall collect
445.22one biospecimen from each of the voluntary participants. The biospecimen selected must
445.23be the biospecimen that most accurately represents body concentration of the chemical
445.24of interest. Each biospecimen from the voluntary participants must be analyzed for one
445.25type or class of related chemicals or metals, based on recommendations from the advisory
445.26panel. The panel shall determine the chemical or class of chemicals that community
445.27members were most likely exposed to. The program shall collect and assess biospecimens
445.28in accordance with the following:
445.29    (1) 30 voluntary participants from each of three communities that the advisory panel
445.30identifies as likely to have been exposed to a designated chemical;
445.31    (2) 100 voluntary participants from each of two communities: (i) that the advisory
445.32panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel
445.33identifies as likely to have been exposed to mercury; and
445.34    (3) 100 voluntary participants from each of two communities that the advisory panel
445.35identifies as likely to have been exposed to perfluorinated chemicals.
446.1    Subd. 2. Base program. Following the conclusion of the pilot program and within
446.2the appropriations available, the program shall:
446.3    (1) collect and assess biospecimens from at least as many voluntary participants and
446.4communities as identified in subdivision 1, clause (1); and
446.5    (2) work with the advisory panel to assess the usefulness of continuing biomonitoring
446.6among members of communities assessed during the initial phase of the program,
446.7and to identify other communities and other designated chemicals to be assessed via
446.8biomonitoring.
446.9    Subd. 3. Participation. (a) Participation in the biomonitoring program by providing
446.10biospecimens is voluntary and requires written, informed consent. Minors may participate
446.11in the program if a written consent is signed by the minor's parent or legal guardian.
446.12The written consent must include the information required to be provided under this
446.13subdivision to all voluntary participants.
446.14    (b) All participants shall be evaluated for the presence of the designated chemical
446.15of interest as a component of the biomonitoring process. Participants shall be provided
446.16with information and fact sheets about the program's activities and its findings.
446.17Individual participants shall, if requested, receive their complete results. Any results
446.18provided to participants shall be subject to the Department of Health Institutional
446.19Review Board protocols and guidelines. When either physiological or chemical data
446.20obtained from a participant indicate a significant known health risk, program staff
446.21experienced in communicating biomonitoring results shall consult with the individual
446.22and recommend follow-up steps, as appropriate. Program administrators shall receive
446.23training in administering the program in an ethical, culturally sensitive, participatory,
446.24and community-based manner.
446.25    Subd. 4. Program guidelines. (a) The commissioner, in consultation with the
446.26advisory panel, shall develop:
446.27    (1) protocols or program guidelines that address the science and practice of
446.28biomonitoring to be utilized and procedures for changing those protocols to incorporate
446.29new and more accurate or efficient technologies as they become available. The protocols
446.30shall be developed utilizing a peer-review process in a manner that is participatory and
446.31community-based in design, implementation, and evaluation;
446.32    (2) guidelines for ensuring the privacy of information; informed consent; follow-up
446.33counseling and support; and communicating findings to participants, communities, and
446.34the general public. The informed consent used for the program must meet the informed
446.35consent protocols developed by the National Institutes of Health;
447.1    (3) educational and outreach materials that are culturally appropriate for
447.2dissemination to program participants and communities. Priority shall be given to the
447.3development of materials specifically designed to ensure that parents are informed about
447.4all of the benefits of breastfeeding so that the program does not result in an unjustified fear
447.5of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding.
447.6The materials shall communicate relevant scientific findings; data on the accumulation
447.7of pollutants to community health; and the required responses by local, state, and other
447.8governmental entities in regulating toxicant exposures;
447.9    (4) a training program that is culturally sensitive specifically for health care
447.10providers, health educators, and other program administrators;
447.11    (5) a designation process for state and private laboratories that are qualified to
447.12analyze biospecimens and report the findings; and
447.13    (6) a method for informing affected communities and local governments representing
447.14those communities concerning biomonitoring activities and for receiving comments from
447.15citizens concerning those activities.
447.16    (b) The commissioner may enter into contractual agreements with health clinics,
447.17community-based organizations, or experts in a particular field to perform any of the
447.18activities described under this section.

447.19    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND
447.20BIOMONITORING ADVISORY PANEL.
447.21    Subdivision 1. Creation. The commissioner shall establish the Environmental
447.22Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint,
447.23from the panel's membership, a chair. The panel shall meet as often as it deems necessary
447.24but, at a minimum, on a quarterly basis. Members of the panel shall serve without
447.25compensation but shall be reimbursed for travel and other necessary expenses incurred
447.26through performance of their duties. Members appointed under this subdivision are
447.27appointed for a three-year term and may be reappointed.
447.28    Subd. 2. Members. The commissioner shall appoint eight members, none of whom
447.29may be lobbyists registered under chapter 10A, who have backgrounds or training in
447.30designing, implementing, and interpreting health tracking and biomonitoring studies or
447.31in related fields of science, including epidemiology, biostatistics, environmental health,
447.32laboratory sciences, occupational health, industrial hygiene, toxicology, and public health,
447.33including:
448.1    (1) two scientists who represent nongovernmental organizations with a focus on
448.2environmental health, environmental justice, children's health, or on specific chronic
448.3diseases; and
448.4    (2) one scientist who is a representative of the University of Minnesota.
448.5    In addition, the commissioner shall appoint one member representing each of the
448.6following departments or divisions: the department's health promotion and chronic disease
448.7division, the Pollution Control Agency, and the Department of Agriculture.
448.8    Subd. 3. Duties. The advisory panel shall make recommendations to the
448.9commissioner and the legislature on:
448.10    (1) priorities for health tracking;
448.11    (2) priorities for biomonitoring that are based on sound science and practice, and
448.12that will advance the state of public health in Minnesota;
448.13    (3) specific chronic diseases to study under the environmental health tracking system;
448.14    (4) specific environmental pollutant exposures to study under the environmental
448.15health tracking system, with the agreement of at least seven of the advisory panel members;
448.16    (5) specific communities and geographic areas on which to focus environmental
448.17health tracking and biomonitoring efforts;
448.18    (6) specific chemicals and metals to study under the biomonitoring program that meet
448.19the following criteria, with the agreement of at least seven of the advisory panel members:
448.20    (i) the degree of potential exposure to the public or specific subgroups, including,
448.21but not limited to, occupational;
448.22    (ii) the likelihood of a chemical being a carcinogen or toxicant based on
448.23peer-reviewed health data, the chemical structure, or the toxicology of chemically related
448.24compounds;
448.25    (iii) the limits of laboratory detection for the chemical, including the ability to detect
448.26the chemical at low enough levels that could be expected in the general population;
448.27    (iv) exposure or potential exposure to the public or specific subgroups;
448.28    (v) the known or suspected health effects resulting from the same level of exposure
448.29based on peer-reviewed scientific studies;
448.30    (vi) the need to assess the efficacy of public health actions to reduce exposure to a
448.31chemical;
448.32    (vii) the availability of a biomonitoring analytical method with adequate accuracy,
448.33precision, sensitivity, specificity, and speed;
448.34    (viii) the availability of adequate biospecimen samples; and
448.35    (ix) other criteria that the panel may agree to; and
449.1    (7) other aspects of the design, implementation, and evaluation of the environmental
449.2health tracking and biomonitoring system, including, but not limited to:
449.3    (i) identifying possible community partners and sources of additional public or
449.4private funding;
449.5    (ii) developing outreach and educational methods and materials; and
449.6    (iii) disseminating environmental health tracking and biomonitoring findings to
449.7the public.
449.8    Subd. 4. Liability. No member of the panel shall be held civilly or criminally liable
449.9for an act or omission by that person if the act or omission was in good faith and within
449.10the scope of the member's responsibilities under sections 144.995 to 144.998.

449.11    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:
449.12    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life
449.13support ambulance shall be staffed by at least two ambulance service personnel, at least
449.14one of which must be an EMT, who provide a level of care so as to ensure that:
449.15    (1) life-threatening situations and potentially serious injuries are recognized;
449.16    (2) patients are protected from additional hazards;
449.17    (3) basic treatment to reduce the seriousness of emergency situations is administered;
449.18and
449.19    (4) patients are transported to an appropriate medical facility for treatment.
449.20    (b) A basic life support service shall provide basic airway management.
449.21    (c) By January 1, 2001, a basic life support service shall provide automatic
449.22defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).
449.23    (d) A basic life support service licensee's medical director may authorize the
449.24ambulance service personnel to carry and to use medical antishock trousers and to perform
449.25intravenous infusion if the ambulance service personnel have been properly trained.
449.26    (e) Upon application from an ambulance service that includes evidence
449.27demonstrating hardship, the board may grant a temporary variance from the staff
449.28requirements in paragraph (a) and may authorize a basic life support ambulance to be
449.29staffed by one EMT and one first responder. The variance shall apply to basic life support
449.30ambulances operated by the ambulance service for up to one year from the date of the
449.31variance's issuance until the ambulance service renews its license. When a variance
449.32expires, an ambulance service may apply for a new variance under this paragraph. For
449.33purposes of this paragraph, "ambulance service" means either an ambulance service whose
449.34primary service area is located outside the metropolitan counties listed in section 473.121,
450.1subdivision 4 , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
450.2Cloud; or an ambulance service based in a community with a population of less than 1,000.

450.3    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:
450.4144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.
450.5    Subdivision 1. Interhospital transfers. When transporting a patient from one
450.6licensed hospital to another, a licensee may substitute for one of the required ambulance
450.7service personnel, a physician, a registered nurse, or physician's assistant who has been
450.8trained to use the equipment in the ambulance and is knowledgeable of the licensee's
450.9ambulance service protocols.
450.10    Subd. 2. Interfacility transfers. In an interfacility transport, a licensee whose
450.11primary service area is located outside the metropolitan counties listed in section 473.121,
450.12subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
450.13Cloud; or an ambulance service based in a community with a population of less than 1,000,
450.14may substitute one EMT with a registered first responder if an EMT or EMT-paramedic,
450.15physician, registered nurse, or physician's assistant is in the patient compartment. If using
450.16a physician, registered nurse, or physician's assistant as the sole provider in the patient
450.17compartment, the individual must be trained to use the equipment in the ambulance and be
450.18knowledgeable of the ambulance service protocols.

450.19    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:
450.20    Subdivision 1. Repayment for volunteer training. Any political subdivision, or
450.21nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall
450.22be reimbursed by the board for the necessary expense of the initial training of a volunteer
450.23ambulance attendant upon successful completion by the attendant of a basic emergency
450.24care course, or a continuing education course for basic emergency care, or both, which has
450.25been approved by the board, pursuant to section 144E.285. Reimbursement may include
450.26tuition, transportation, food, lodging, hourly payment for the time spent in the training
450.27course, and other necessary expenditures, except that in no instance shall a volunteer
450.28ambulance attendant be reimbursed more than $450 $600 for successful completion of a
450.29basic course, and $225 $275 for successful completion of a continuing education course.

450.30    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.
450.31    Subdivision. 1. Bisphenol-A and phthalates committee. The commissioner of
450.32health shall create a committee under the direction of the environmental health division of
450.33the Department of Health to study the scientific literature and make recommendations to
451.1the legislature on the health impact of bisphenol-A and phthalates on children in products
451.2intended for use by young children, including, but not limited to, toys, pacifiers, baby
451.3bottles, and teethers, and report back by January 15, 2008. The committee shall also
451.4identify least harmful alternatives. Of the seven committee members at least one shall be a
451.5representative of the Department of Health, one shall be a representative of environmental
451.6health sciences research, one shall be a representative of the Minnesota Nurses
451.7Association, one shall be a representative of environmental health consumer advocates,
451.8one shall be a member of a children's product manufacturer's association, and one shall be
451.9a representative of the University of Minnesota, chemical plastics research department.
451.10    Subd. 2. Definitions. For the purposes of this section, the following terms have
451.11the meanings given them:
451.12    (a) "Toy" means all products designed or intended by the manufacturer to be used by
451.13children when they play.
451.14    (b) "Child care article" means all products designed or intended by the manufacturer
451.15to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or
451.16teething.

451.17    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:
451.18145A.17 FAMILY HOME VISITING PROGRAMS.
451.19    Subdivision 1. Establishment; goals. The commissioner shall establish a program
451.20to fund family home visiting programs designed to foster a healthy beginning for children
451.21in families at or below 200 percent of the federal poverty guidelines beginnings, improve
451.22pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
451.23juvenile delinquency, promote positive parenting and resiliency in children, and promote
451.24family health and economic self-sufficiency for children and families. The commissioner
451.25shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
451.26professionals and paraprofessionals from the fields of public health nursing, social work,
451.27and early childhood education. A program funded under this section must serve families
451.28at or below 200 percent of the federal poverty guidelines, and other families determined
451.29to be at risk, including but not limited to being at risk for child abuse, child neglect, or
451.30juvenile delinquency. Programs must give priority for services to families considered to
451.31be in need of services, including but not limited to begin prenatally whenever possible and
451.32must be targeted to families with:
451.33    (1) adolescent parents;
451.34    (2) a history of alcohol or other drug abuse;
451.35    (3) a history of child abuse, domestic abuse, or other types of violence;
452.1    (4) a history of domestic abuse, rape, or other forms of victimization;
452.2    (5) reduced cognitive functioning;
452.3    (6) a lack of knowledge of child growth and development stages;
452.4    (7) low resiliency to adversities and environmental stresses; or
452.5    (8) insufficient financial resources to meet family needs;
452.6    (9) a history of homelessness;
452.7    (10) a risk of long-term welfare dependence or family instability due to employment
452.8barriers; or
452.9    (11) other risk factors as determined by the commissioner.
452.10    Subd. 3. Requirements for programs; process. (a) Before a community health
452.11board or tribal government may receive an allocation under subdivision 2, a community
452.12health board or tribal government must submit a proposal to the commissioner that
452.13includes identification, based on a community assessment, of the populations at or below
452.14200 percent of the federal poverty guidelines that will be served and the other populations
452.15that will be served. Each program that receives funds must Community health boards
452.16and tribal governments that receive funding under this section must submit a plan to
452.17the commissioner describing a multidisciplinary approach to targeted home visiting for
452.18families. The plan must be submitted on forms provided by the commissioner. At a
452.19minimum, the plan must include the following:
452.20    (1) a description of outreach strategies to families prenatally or at birth;
452.21    (2) provisions for the seamless delivery of health, safety, and early learning services;
452.22    (3) methods to promote continuity of services when families move within the state;
452.23    (4) a description of the community demographics;
452.24    (5) a plan for meeting outcome measures; and
452.25    (6) a proposed work plan that includes:
452.26    (i) coordination to ensure nonduplication of services for children and families;
452.27    (ii) a description of the strategies to ensure that children and families at greatest risk
452.28receive appropriate services; and
452.29    (iii) collaboration with multidisciplinary partners including public health,
452.30ECFE, Head Start, community health workers, social workers, community home
452.31visiting programs, school districts, and other relevant partners. Letters of intent from
452.32multidisciplinary partners must be submitted with the plan.
452.33    (b) Each program that receives funds must accomplish the following program
452.34requirements:
452.35    (1) use either a broad community-based or selective community-based strategy to
452.36provide preventive and early intervention home visiting services;
453.1    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
453.2home visit must occur prenatally or as soon after birth as possible and must include a
453.3public health nursing assessment by a public health nurse;
453.4    (3) offer, at a minimum, information on infant care, child growth and development,
453.5positive parenting, preventing diseases, preventing exposure to environmental hazards,
453.6and support services available in the community;
453.7    (4) provide information on and referrals to health care services, if needed, including
453.8information on and assistance in applying for health care coverage for which the child or
453.9family may be eligible; and provide information on preventive services, developmental
453.10assessments, and the availability of public assistance programs as appropriate;
453.11    (5) provide youth development programs when appropriate;
453.12    (6) recruit home visitors who will represent, to the extent possible, the races,
453.13cultures, and languages spoken by families that may be served;
453.14    (7) train and supervise home visitors in accordance with the requirements established
453.15under subdivision 4;
453.16    (8) maximize resources and minimize duplication by coordinating activities or
453.17contracting with local social and human services organizations, education organizations,
453.18and other appropriate governmental entities and community-based organizations and
453.19agencies; and
453.20    (9) utilize appropriate racial and ethnic approaches to providing home visiting
453.21services; and
453.22    (10) connect eligible families, as needed, to additional resources available in the
453.23community, including, but not limited to, early care and education programs, health or
453.24mental health services, family literacy programs, employment agencies, social services,
453.25and child care resources and referral agencies.
453.26    (c) When available, programs that receive funds under this section must offer or
453.27provide the family with a referral to center-based or group meetings that meet at least
453.28once per month for those families identified with additional needs. The meetings must
453.29focus on further enhancing the information, activities, and skill-building addressed during
453.30home visitation; offering opportunities for parents to meet with and support each other;
453.31and offering infants and toddlers a safe, nurturing, and stimulating environment for
453.32socialization and supervised play with qualified teachers.
453.33    (b) (d) Funds available under this section shall not be used for medical services. The
453.34commissioner shall establish an administrative cost limit for recipients of funds. The
453.35outcome measures established under subdivision 6 must be specified to recipients of
453.36funds at the time the funds are distributed.
454.1    (c) (e) Data collected on individuals served by the home visiting programs must
454.2remain confidential and must not be disclosed by providers of home visiting services
454.3without a specific informed written consent that identifies disclosures to be made.
454.4Upon request, agencies providing home visiting services must provide recipients with
454.5information on disclosures, including the names of entities and individuals receiving the
454.6information and the general purpose of the disclosure. Prospective and current recipients
454.7of home visiting services must be told and informed in writing that written consent for
454.8disclosure of data is not required for access to home visiting services.
454.9    Subd. 4. Training. The commissioner shall establish training requirements for
454.10home visitors and minimum requirements for supervision by a public health nurse. The
454.11requirements for nurses must be consistent with chapter 148. The commissioner must
454.12provide training for home visitors. Training must include child development, positive
454.13parenting techniques, screening and referrals for child abuse and neglect, and diverse
454.14cultural practices in child rearing and family systems the following:
454.15    (1) effective relationships for engaging and retaining families and ensuring family
454.16health, safety, and early learning;
454.17    (2) effective methods of implementing parent education, conducting home visiting,
454.18and promoting quality early childhood development;
454.19    (3) early childhood development from birth to age five;
454.20    (4) diverse cultural practices in child rearing and family systems;
454.21    (5) recruiting, supervising, and retaining qualified staff;
454.22    (6) increasing services for underserved populations; and
454.23    (7) relevant issues related to child welfare and protective services, with information
454.24provided being consistent with state child welfare agency training.
454.25    Subd. 5. Technical assistance. The commissioner shall provide administrative
454.26and technical assistance to each program, including assistance in data collection and
454.27other activities related to conducting short- and long-term evaluations of the programs
454.28as required under subdivision 7. The commissioner may request research and evaluation
454.29support from the University of Minnesota.
454.30    Subd. 6. Outcome and performance measures. The commissioner shall establish
454.31outcomes measures to determine the impact of family home visiting programs funded
454.32under this section on the following areas:
454.33    (1) appropriate utilization of preventive health care;
454.34    (2) rates of substantiated child abuse and neglect;
454.35    (3) rates of unintentional child injuries;
454.36    (4) rates of children who are screened and who pass early childhood screening; and
455.1    (5) rates of children accessing early care and educational services;
455.2    (6) program retention rates;
455.3    (7) number of home visits provided compared to the number of home visits planned;
455.4    (8) participant satisfaction;
455.5    (9) rates of at-risk populations reached; and
455.6    (10) any additional qualitative goals and quantitative measures established by the
455.7commissioner.
455.8    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and
455.9performance measures established under subdivisions 1 and 6, the commissioner shall
455.10conduct ongoing evaluations of the programs funded under this section. Community
455.11health boards and tribal governments shall cooperate with the commissioner in the
455.12evaluations and shall provide the commissioner with the information necessary to conduct
455.13the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact
455.14of the programs on the outcome measures listed in subdivision 6, and shall periodically
455.15determine whether home visiting programs are the best way to achieve the qualitative
455.16goals established under subdivisions 1 and 6. If the commissioner determines that home
455.17visiting programs are not the best way to achieve these goals, the commissioner shall
455.18provide the legislature with alternative methods for achieving them.
455.19    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered
455.20year thereafter, the commissioner shall submit a report to the legislature on the family
455.21home visiting programs funded under this section and on the results of the evaluations
455.22conducted under subdivision 7.
455.23    Subd. 9. No supplanting of existing funds. Funding available under this section
455.24may be used only to supplement, not to replace, nonstate funds being used for home
455.25visiting services as of July 1, 2001.

455.26    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision
455.27to read:
455.28    Subd. 10a. Program for the Assessment of Veterinary Education Equivalence;
455.29PAVE certificate. A "Program for the Assessment of Veterinary Education Equivalence"
455.30or "PAVE" certificate is issued by the American Association of Veterinary State Boards,
455.31indicating that the holder has demonstrated knowledge and skill equivalent to that
455.32possessed by a graduate of an accredited or approved college of veterinary medicine.

455.33    Sec. 27. [156.015] FEES.
456.1    Subdivision 1. Verification of licensure. The board may charge a fee of $25 per
456.2license verification to a licensee for verification of licensure status provided to other
456.3veterinary licensing boards.
456.4    Subd. 2. Continuing education review. The board may charge a fee of $50 per
456.5submission to a sponsor for review and approval of individual continuing education
456.6seminars, courses, wet labs, and lectures. This fee does not apply to continuing education
456.7sponsors that already meet the criteria for preapproval under Minnesota Rules, part
456.89100.1000, subpart 3, item A.

456.9    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:
456.10    Subdivision 1. License application. Application for a license to practice veterinary
456.11medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a
456.12form furnished by the board, accompanied by satisfactory evidence that the applicant is at
456.13least 18 years of age, is of good moral character, and has one of the following:
456.14    (1) a diploma conferring the degree of doctor of veterinary medicine, or an
456.15equivalent degree, from an accredited or approved college of veterinary medicine;
456.16    (2) an ECFVG or PAVE certificate; or
456.17    (3) a certificate from the dean of an accredited or approved college of veterinary
456.18medicine stating that the applicant is a student in good standing expecting to be graduated
456.19at the completion of the current academic year of the college in which the applicant is
456.20enrolled.
456.21    The application shall contain the information and material required by subdivision
456.222 and any other information that the board may, in its sound judgment, require. The
456.23application shall be filed with the board at least 60 days before the date of the examination.
456.24If the board deems it advisable, it may require that such application be verified by the
456.25oath of the applicant.

456.26    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:
456.27    Subd. 2. Required with application. Every application shall contain the following
456.28information and material:
456.29    (1) the application fee set by the board in the form of a check or money order payable
456.30to the board, which fee is not returnable in the event permission to take the examination
456.31is denied for good cause;
456.32    (2) a copy of a diploma from an accredited or approved college of veterinary
456.33medicine or a certificate from the dean or secretary of an accredited or approved college of
456.34veterinary medicine showing the time spent in the school and the date when the applicant
457.1was duly and regularly graduated or will duly and regularly graduate or verification of
457.2ECFVG or PAVE certification;
457.3    (3) affidavits of at least two veterinarians and three adults who are not related to
457.4the applicant setting forth how long a time, when, and under what circumstances they
457.5have known the applicant, and any other facts as may be proper to enable the board to
457.6determine the qualifications of the applicant; and
457.7    (4) if the applicant has served in the armed forces, a copy of discharge papers.

457.8    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:
457.9156.04 BOARD TO ISSUE LICENSE.
457.10    The Board of Veterinary Medicine shall issue to every applicant who has successfully
457.11passed the required examination, who has received a diploma conferring the degree of
457.12doctor of veterinary medicine or an equivalent degree from an accredited or approved
457.13college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been
457.14adjudged to be duly qualified to practice veterinary medicine, a license to practice.

457.15    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:
457.16    Subd. 2. Required with application. Such doctor of veterinary medicine shall
457.17accompany the application by the following:
457.18    (1) a copy of a diploma from an accredited or approved college of veterinary
457.19medicine or certification from the dean, registrar, or secretary of an accredited or approved
457.20college of veterinary medicine attesting to the applicant's graduation from an accredited
457.21or approved college of veterinary medicine, or a certificate of satisfactory completion of
457.22the ECFVG or PAVE program.
457.23    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in
457.24the United States or Canadian licensing jurisdiction in which the applicant is currently
457.25practicing, attesting that they are well acquainted with the applicant, that the applicant is a
457.26person of good moral character, and has been actively engaged in practicing or teaching in
457.27such jurisdiction for the period above prescribed;
457.28    (3) a certificate from the regulatory agency having jurisdiction over the conduct of
457.29practice of veterinary medicine that such applicant is in good standing and is not the
457.30subject of disciplinary action or pending disciplinary action;
457.31    (4) a certificate from all other jurisdictions in which the applicant holds a currently
457.32active license or held a license within the past ten years, stating that the applicant is and
457.33was in good standing and has not been subject to disciplinary action;
458.1    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information
458.2Verification Agency that the applicant's licensure is in good standing;
458.3    (6) a fee as set by the board in form of check or money order payable to the board,
458.4no part of which shall be refunded should the application be denied;
458.5    (7) score reports on previously taken national examinations in veterinary medicine,
458.6certified by the Veterinary Information Verification Agency; and
458.7    (8) if requesting waiver of examination, provide evidence of meeting licensure
458.8requirements in the state of the applicant's original licensure that were substantially equal
458.9to the requirements for licensure in Minnesota in existence at that time.

458.10    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:
458.11156.073 TEMPORARY PERMIT.
458.12    The board may issue without examination a temporary permit to practice veterinary
458.13medicine in this state to a person who has submitted an application approved by the
458.14board for license pending examination, and holds a doctor of veterinary medicine degree
458.15or an equivalent degree from an approved or accredited college of veterinary medicine
458.16or an ECFVG or PAVE certification. The temporary permit shall expire the day after
458.17publication of the notice of results of the first examination given after the permit is
458.18issued. No temporary permit may be issued to any applicant who has previously failed
458.19the national examination and is currently not licensed in any licensing jurisdiction of the
458.20United States or Canada or to any person whose license has been revoked or suspended
458.21or who is currently subject to a disciplinary order in any licensing jurisdiction of the
458.22United States or Canada.

458.23    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:
458.24    Subd. 2. Authorized activities. No provision of this chapter shall be construed to
458.25prohibit:
458.26    (a) a person from rendering necessary gratuitous assistance in the treatment of any
458.27animal when the assistance does not amount to prescribing, testing for, or diagnosing,
458.28operating, or vaccinating and when the attendance of a licensed veterinarian cannot be
458.29procured;
458.30    (b) a person who is a regular student in an accredited or approved college of
458.31veterinary medicine from performing duties or actions assigned by instructors or
458.32preceptors or working under the direct supervision of a licensed veterinarian;
458.33    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a
458.34licensed veterinarian in this state;
459.1    (d) the owner of an animal and the owner's regular employee from caring for and
459.2administering to the animal belonging to the owner, except where the ownership of the
459.3animal was transferred for purposes of circumventing this chapter;
459.4    (e) veterinarians who are in compliance with subdivision 6 and who are employed by
459.5the University of Minnesota from performing their duties with the College of Veterinary
459.6Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension
459.7Service, Medical School, School of Public Health, or other unit within the university; or
459.8a person from lecturing or giving instructions or demonstrations at the university or in
459.9connection with a continuing education course or seminar to veterinarians or pathologists
459.10at the University of Minnesota Veterinary Diagnostic Laboratory;
459.11    (f) any person from selling or applying any pesticide, insecticide or herbicide;
459.12    (g) any person from engaging in bona fide scientific research or investigations which
459.13reasonably requires experimentation involving animals;
459.14    (h) any employee of a licensed veterinarian from performing duties other than
459.15diagnosis, prescription or surgical correction under the direction and supervision of the
459.16veterinarian, who shall be responsible for the performance of the employee;
459.17    (i) a graduate of a foreign college of veterinary medicine from working under the
459.18direct personal instruction, control, or supervision of a veterinarian faculty member of
459.19the College of Veterinary Medicine, University of Minnesota in order to complete the
459.20requirements necessary to obtain an ECFVG or PAVE certificate.

459.21    Sec. 34. Minnesota Statutes 2006, section 156.12, subdivision 4, is amended to read:
459.22    Subd. 4. Titles. It is unlawful for a person who has not received a professional
459.23degree from an accredited or approved college of veterinary medicine, or ECFVG or PAVE
459.24certification, to use any of the following titles or designations: Veterinary, veterinarian,
459.25animal doctor, animal surgeon, animal dentist, animal chiropractor, animal acupuncturist,
459.26or any other title, designation, word, letter, abbreviation, sign, card, or device tending to
459.27indicate that the person is qualified to practice veterinary medicine.

459.28    Sec. 35. Minnesota Statutes 2006, section 156.12, subdivision 6, is amended to read:
459.29    Subd. 6. Faculty licensure. (a) Veterinary Medical Center clinicians at the College
459.30of Veterinary Medicine, University of Minnesota, who are engaged in the practice of
459.31veterinary medicine as defined in subdivision 1 and who treat animals owned by clients of
459.32the Veterinary Medical Center must possess the same license required by other veterinary
459.33practitioners in the state of Minnesota except for persons covered by paragraphs (b) and (c).
460.1    (b) A specialty practitioner in a hard-to-fill faculty position who has been employed
460.2at the College of Veterinary Medicine, University of Minnesota, for five years or
460.3more prior to 2003 or is specialty board certified by the American Veterinary Medical
460.4Association or the European Board of Veterinary Specialization may be granted a specialty
460.5faculty Veterinary Medical Center clinician license which will allow the licensee to
460.6practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's
460.7training and only within the scope of employment at the Veterinary Medical Center.
460.8    (c) A specialty practitioner in a hard-to-fill faculty position at the College of
460.9Veterinary Medicine, University of Minnesota, who has graduated from a board-approved
460.10foreign veterinary school may be granted a temporary faculty Veterinary Medical Center
460.11clinician license. The temporary faculty Veterinary Medical Center clinician license
460.12expires in two years and allows the licensee to practice veterinary medicine as defined
460.13in subdivision 1 and treat animals owned by clients of the Veterinary Medical Center.
460.14The temporary faculty Veterinary Medical Center clinician license allows the licensee to
460.15practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's
460.16training and only within the scope of employment at the Veterinary Medical Center while
460.17under the direct supervision of a veterinarian currently licensed and actively practicing
460.18veterinary medicine in Minnesota, as defined in section 156.04. The direct supervising
460.19veterinarian shall not have any current or past conditions, restrictions, or probationary
460.20status imposed on the veterinarian's license by the board within the past five years. The
460.21holder of a temporary faculty Veterinary Medical Center clinician license who is enrolled
460.22in a PhD program may apply for up to two additional consecutive two-year extensions
460.23of an expiring temporary faculty Veterinary Medical Center clinician license. Any other
460.24holder of a temporary faculty Veterinary Medical Center clinician license may apply for
460.25one two-year extension of the expiring temporary faculty Veterinary Medical Center
460.26clinician license. Temporary faculty Veterinary Medical Center clinician licenses that are
460.27allowed to expire may not be renewed. The board shall grant an extension to a licensee
460.28who demonstrates suitable progress toward completing the requirements of their academic
460.29program, specialty board certification, or full licensure in Minnesota by a graduate of a
460.30foreign veterinary college.
460.31    (d) Temporary and specialty faculty Veterinary Medical Center clinician licensees
460.32must abide by all the laws governing the practice of veterinary medicine in the state
460.33of Minnesota and are subject to the same disciplinary action as any other veterinarian
460.34licensed in the state of Minnesota.
461.1    (e) The fee for a license issued under this subdivision is the same as for a regular
461.2license to practice veterinary medicine in Minnesota. License payment deadlines, late
461.3payment fees, and other license requirements are also the same as for regular licenses.

461.4    Sec. 36. Minnesota Statutes 2006, section 156.15, subdivision 2, is amended to read:
461.5    Subd. 2. Service. Service of an order under this section is effective if the order is
461.6served on the person or counsel of record personally or by certified United States mail to
461.7the most recent address provided to the board for the person or counsel of record.

461.8    Sec. 37. Minnesota Statutes 2006, section 156.16, subdivision 3, is amended to read:
461.9    Subd. 3. Dispensing. "Dispensing" means distribution of veterinary prescription
461.10drugs or over-the-counter drugs for extra-label use or human drugs for extra-label use by a
461.11person licensed as a pharmacist by the Board of Pharmacy or a person licensed by the
461.12Board of Veterinary Medicine.

461.13    Sec. 38. Minnesota Statutes 2006, section 156.16, subdivision 10, is amended to read:
461.14    Subd. 10. Prescription. "Prescription" means an order from a veterinarian to a
461.15pharmacist or another veterinarian authorizing the dispensing of a veterinary prescription
461.16drug drugs, human drugs for extra-label use, or over-the-counter drugs for extra-label use
461.17to a client for use on or in a patient.

461.18    Sec. 39. Minnesota Statutes 2006, section 156.18, subdivision 1, is amended to read:
461.19    Subdivision 1. Prescription. (a) A person may not dispense a veterinary
461.20prescription drug to a client without a prescription or other veterinary authorization. A
461.21person may not make extra-label use of an animal or human drug for an animal without a
461.22prescription from a veterinarian. A veterinarian or the veterinarian's authorized employee
461.23may dispense a veterinary prescription drug to drugs, human drugs for extra-label use, or
461.24an over-the-counter drug for extra-label use by a client or oversee the extra-label use of
461.25a veterinary drug directly by a client without a separate written prescription, providing
461.26there is documentation of the prescription in the medical record and there is an existing
461.27veterinarian-client-patient relationship. The prescribing veterinarian must monitor the use
461.28of veterinary prescription drugs, human drugs for extra-label use, or over-the-counter
461.29drugs for extra-label use by a client.
461.30    (b) A veterinarian may dispense prescription veterinary drugs and prescribe and
461.31dispense extra-label use drugs to a client without personally examining the animal if
462.1a bona fide veterinarian-client-patient relationship exists and in the judgment of the
462.2veterinarian the client has sufficient knowledge to use the drugs properly.
462.3    (c) A veterinarian may issue a prescription or other veterinary authorization by oral or
462.4written communication to the dispenser, or by computer connection. If the communication
462.5is oral, the veterinarian must enter it into the patient's record. The dispenser must record
462.6the veterinarian's prescription or other veterinary authorization within 72 hours.
462.7    (d) A prescription or other veterinary authorization must include:
462.8    (1) the name, address, and, if written, the signature of the prescriber;
462.9    (2) the name and address of the client;
462.10    (3) identification of the species for which the drug is prescribed or ordered;
462.11    (4) the name, strength, and quantity of the drug;
462.12    (5) the date of issue;
462.13    (6) directions for use; and
462.14    (7) withdrawal time., if applicable; and
462.15    (8) number of authorized refills.
462.16    (e) A veterinarian may, in the course of professional practice and an existing
462.17veterinarian-client-patient relationship, prepare medicaments that combine drugs approved
462.18by the United States Food and Drug Administration and other legally obtained ingredients
462.19with appropriate vehicles.
462.20    (f) A veterinarian or a bona fide employee of a veterinarian may dispense veterinary
462.21prescription drugs to a person on the basis of a prescription issued by a licensed
462.22veterinarian. The provisions of paragraphs (c) and (d) apply.
462.23    (g) This section does not limit the authority of the Minnesota Racing Commission to
462.24regulate veterinarians providing services at a licensed racetrack.

462.25    Sec. 40. Minnesota Statutes 2006, section 156.18, subdivision 2, is amended to read:
462.26    Subd. 2. Label of dispensed veterinary drugs. (a) A veterinarian or the
462.27veterinarian's authorized agent or employee dispensing a veterinary prescription drug
462.28or prescribing the extra-label use of an over-the-counter drug, an over-the-counter drug
462.29for extra-label use, or a human drug for extra-label use must provide written information
462.30which includes the name and address of the veterinarian, date of filling, species of patient,
462.31name or names of drug, strength of drug or drugs, directions for use, withdrawal time,
462.32and cautionary statements, if any, appropriate for the drug.
462.33    (b) If the veterinary drug has been prepared, mixed, formulated, or packaged by the
462.34dispenser, all of the information required in paragraph (a) must be provided on a label
462.35affixed to the container.
463.1    (c) If the veterinary drug is in the manufacturer's original package, the information
463.2required in paragraph (a) must be supplied in writing but need not be affixed to the
463.3container. Information required in paragraph (a) that is provided by the manufacturer on
463.4the original package does not need to be repeated in the separate written information.
463.5Written information required by this paragraph may be written on the sales invoice.

463.6    Sec. 41. Minnesota Statutes 2006, section 156.19, is amended to read:
463.7156.19 EXTRA-LABEL USE.
463.8    A person, other than a veterinarian or a person working under the control an
463.9employee of a veterinarian, must not make extra-label use of a veterinary drug in or
463.10on a food-producing animal, unless permitted by the prescription of a veterinarian. A
463.11veterinarian may prescribe the extra-label use of a veterinary drug if:
463.12    (1) the veterinarian makes a careful medical diagnosis within the context of a valid
463.13veterinarian-client-patient relationship;
463.14    (2) the veterinarian determines that there is no marketed drug specifically labeled to
463.15treat the condition diagnosed, or that drug therapy as recommended by the labeling has, in
463.16the judgment of the attending veterinarian, been found to be clinically ineffective;
463.17    (3) the veterinarian recommends procedures to ensure that the identity of the treated
463.18animal will be carefully maintained; and
463.19    (4) the veterinarian prescribes a significantly extended time period for drug
463.20withdrawal before marketing meat, milk, or eggs.; and
463.21    (5) the veterinarian has met the criteria established in Code of Federal Regulations,
463.22title 21, part 530, which define the extra-label use of medication in or on animals.

463.23    Sec. 42. Minnesota Statutes 2006, section 198.075, is amended to read:
463.24198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED
463.25FROM COMMISSARY PRIVILEGES.
463.26    Except as provided in this section, no commissary privileges including food, laundry
463.27service, janitorial service, and household supplies shall be furnished to any employee of
463.28the Minnesota veterans homes. An employee of the Minnesota veterans homes who works
463.29a second shift that is consecutive with a regularly scheduled shift may be allowed one free
463.30meal at the veterans home on the day of that extra shift.

463.31    Sec. 43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to
463.32read:
464.1    Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance
464.2covers diagnostic, screening, and preventive services.
464.3    (b) "Preventive services" include services related to pregnancy, including:
464.4    (1) services for those conditions which may complicate a pregnancy and which may
464.5be available to a pregnant woman determined to be at risk of poor pregnancy outcome;
464.6    (2) prenatal HIV risk assessment, education, counseling, and testing; and
464.7    (3) alcohol abuse assessment, education, and counseling on the effects of alcohol
464.8usage while pregnant. Preventive services available to a woman at risk of poor pregnancy
464.9outcome may differ in an amount, duration, or scope from those available to other
464.10individuals eligible for medical assistance.
464.11    (c) "Screening services" include, but are not limited to, blood lead tests. Screening
464.12services also include, for children with blood lead levels equal to or greater than five
464.13micrograms of lead per deciliter of whole blood, environmental investigations to
464.14determine the source of lead exposure. Reimbursement is limited to a health professional's
464.15time and activities during an on-site investigation of a child's home or primary residence.

464.16    Sec. 44. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
464.17subdivision to read:
464.18    Subd. 49. Lead risk assessments. (a) Effective October 1, 2007, or six months after
464.19federal approval, whichever is later, medical assistance covers lead risk assessments
464.20provided by a lead risk assessor who is licensed by the commissioner of health under
464.21section 144.9505 and employed by an assessing agency as defined in section 144.9501.
464.22Medical assistance covers a onetime on-site investigation of a recipient's home or primary
464.23residence to determine the existence of lead so long as the recipient is under the age
464.24of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2,
464.25paragraph (a).
464.26    (b) Medical assistance reimbursement covers the lead risk assessor's time to
464.27complete the following activities:
464.28    (1) gathering samples;
464.29    (2) interviewing family members;
464.30    (3) gathering data, including meter readings; and
464.31    (4) providing a report with the results of the investigation and options for reducing
464.32lead-based paint hazards.
464.33    Medical assistance coverage of lead risk assessment does not include testing of
464.34environmental substances such as water, paint, or soil or any other laboratory services.
464.35Medical assistance coverage of lead risk assessments is not included in the capitated
465.1services for children enrolled in health plans through the prepaid medical assistance
465.2program and the MinnesotaCare program.
465.3    (c) Payment for lead risk assessment must be cost-based and must meet the criteria
465.4for federal financial participation under the Medicaid program. The rate must be based
465.5on allowable expenditures from cost information gathered. Under section 144.9507,
465.6subdivision 5, federal medical assistance funds may not replace existing funding for
465.7lead-related activities. The nonfederal share of costs for services provided under this
465.8subdivision must be from state or local funds and is the responsibility of the agency
465.9providing the risk assessment. Eligible expenditures for the nonfederal share of costs may
465.10not be made from federal funds or funds used to match other federal funds. Any federal
465.11disallowances are the responsibility of the agency providing risk assessment services.

465.12    Sec. 45. [325E.385] PRODUCTS CONTAINING POLYBROMINATED
465.13DIPHENYL ETHER.
465.14    Subdivision 1. Definitions. For the purposes of sections 325E.386 to 325E.388,
465.15the terms in this section have the meanings given them.
465.16    Subd. 2. Commercial decabromodiphenyl ether. "Commercial
465.17decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl ether,
465.18including associated polybrominated diphenyl ether impurities not intentionally added.
465.19    Subd. 3. Commissioner. "Commissioner" means the commissioner of the Pollution
465.20Control Agency.
465.21    Subd. 4. Manufacturer. "Manufacturer" means any person, firm, association,
465.22partnership, corporation, governmental entity, organization, or joint venture that produces
465.23a product containing polybrominated diphenyl ethers or an importer or domestic
465.24distributor of a noncomestible product containing polybrominated diphenyl ethers.
465.25    Subd. 5. Polybrominated diphenyl ethers or PBDE's. "Polybrominated diphenyl
465.26ethers" or "PBDE's" means chemical forms that consist of diphenyl ethers bound with
465.27bromine atoms. Polybrominated diphenyl ethers include, but are not limited to, the
465.28three primary forms of the commercial mixtures known as pentabromodiphenyl ether,
465.29octabromodiphenyl ether, and decabromodiphenyl ether.
465.30    Subd. 6. Retailer. "Retailer" means a person who offers a product for sale at retail
465.31through any means, including, but not limited to, remote offerings such as sales outlets,
465.32catalogs, or the Internet, but does not include a sale that is a wholesale transaction with a
465.33distributor or a retailer.
466.1    Subd. 7. Used product. "Used product" means any product that has been previously
466.2owned, purchased, or sold in commerce. Used product does not include any product
466.3manufactured after January 1, 2008.

466.4    Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN
466.5POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.
466.6    Subdivision 1. Penta- and octabromodiphenyl ethers. Except as provided in
466.7subdivision 3, beginning January 1, 2008, a person may not manufacture, process, or
466.8distribute in commerce a product or flame-retardant part of a product containing more
466.9than one-tenth of one percent of pentabromodiphenyl ether or octabromodiphenyl ether
466.10by mass.
466.11    Subd. 2. Exemptions. The following products containing polybrominated diphenyl
466.12ethers are exempt from subdivision 1:
466.13    (1) the sale or distribution of any used transportation vehicle with component parts
466.14containing polybrominated diphenyl ethers;
466.15    (2) the sale or distribution of any used transportation vehicle parts or new
466.16transportation vehicle parts manufactured before January 1, 2008, that contain
466.17polybrominated diphenyl ethers;
466.18    (3) the manufacture, sale, repair, distribution, maintenance, refurbishment, or
466.19modification of equipment containing polybrominated diphenyl ethers and used primarily
466.20for military or federally funded space program applications. This exemption does not
466.21cover consumer-based goods with broad applicability;
466.22    (4) the sale or distribution by a business, charity, public entity, or private party of
466.23any used product containing polybrominated diphenyl ethers;
466.24    (5) the manufacture, sale, or distribution of new carpet cushion made from recycled
466.25foam containing more than one-tenth of one percent penta polybrominated diphenyl
466.26ether; or
466.27    (6) medical devices.
466.28    In-state retailers in possession of products on January 1, 2008, that are banned for
466.29sale under subdivision 1 may exhaust their stock through sales to the public. Nothing in
466.30this section restricts the ability of a manufacturer, importer, or distributor from transporting
466.31products containing polybrominated diphenyl ethers through the state, or storing such
466.32products in the state for later distribution outside the state.

466.33    Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL ETHER.
467.1    Subdivision 1. Commissioner duties. The commissioner in consultation
467.2with the commissioners of health and public safety shall review uses of commercial
467.3decabromodiphenyl ether, availability of technically feasible and safer alternatives, fire
467.4safety and any evidence regarding the potential harm to public health and the environment
467.5posed by commercial decabromodiphenyl ether and the alternatives. The commissioner
467.6must consult with key stakeholders. The commissioner must also review the findings from
467.7similar state and federal agencies and must report their findings and recommendations to
467.8the appropriate committees of the legislature no later than January 15, 2008.
467.9    Subd. 2. State procurement. By January 1, 2008, the commissioner of
467.10administration shall make available for purchase and use by all state agencies only
467.11equipment, supplies, and other products that do not contain polybrominated diphenyl
467.12ethers, unless exempted under section 325E.386, subdivision 2.

467.13    Sec. 48. [325E.388] PENALTIES.
467.14    A manufacturer who violates sections 325E.386 to 325E.388 is subject to a
467.15civil penalty not to exceed $1,000 for each violation in the case of a first offense. A
467.16manufacturer is subject to a civil penalty not to exceed $5,000 for each repeat offense.
467.17Penalties collected under this section must be deposited in an account in the special
467.18revenue fund and are appropriated in fiscal years 2008 and 2009 to the commissioner to
467.19implement and enforce this section.

467.20    Sec. 49. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2,
467.21is amended to read:

467.22 467.23

Subd. 2.Community and Family Health Improvement

467.24	Summary by Fund
467.25	General	40,413,000	40,382,000
467.26 467.27	State Government Special Revenue	141,000	128,000
467.28	Health Care Access	3,510,000	3,516,000
467.29	Federal TANF	6,000,000	6,000,000

467.30Family Planning Base Reduction. Base
467.31level funding for the family planning
467.32special projects grant program is reduced
467.33by $1,877,000 each year of the biennium
467.34beginning July 1, 2007, provided that
467.35this reduction shall only take place
468.1upon full implementation of the family
468.2planning project section of the 1115 waiver.
468.3Notwithstanding Minnesota Statutes, section
468.4145.925, the commissioner shall give priority
468.5to community health care clinics providing
468.6family planning services that either serve a
468.7high number of women who do not qualify
468.8for medical assistance or are unable to
468.9participate in the medical assistance program
468.10as a medical assistance provider when
468.11allocating the remaining appropriations.
468.12Notwithstanding section 15, this paragraph
468.13shall not expire.
468.14Shaken Baby Video. Of the state
468.15government special revenue fund
468.16appropriation, $13,000 in 2006 is
468.17appropriated to the commissioner of health
468.18to provide a video to hospitals on shaken
468.19baby syndrome. The commissioner of health
468.20shall assess a fee to hospitals to cover the
468.21cost of the approved shaken baby video and
468.22the revenue received is to be deposited in the
468.23state government special revenue fund.

468.24    Sec. 50. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.
468.25    The commissioner of health, in conjunction with the commissioner of the Pollution
468.26Control Agency, shall establish an environmental justice mapping program and shall
468.27apply for federal funding to renew and expand the state's environmental justice mapping
468.28capacity in order to promote public health tracking. The commissioner shall coordinate
468.29the project with the Pollution Control Agency and the Department of Agriculture in order
468.30to explore possible links between environmental health and toxic exposures and to help
468.31create a system for environmental public health tracking. The commissioner shall also
468.32make recommendations to the legislature for additional sources of funding within the state.
468.33EFFECTIVE DATE.This section is effective the day following final enactment.

469.1    Sec. 51. LEGISLATIVE FINDINGS AND PURPOSE.
469.2    The legislature hereby finds that hearing loss occurs in newborn infants more
469.3frequently than any other health condition for which newborn infant screening is required.
469.4Early detection of hearing loss in a child and early intervention and treatment has been
469.5demonstrated to be highly effective in facilitating a child's healthy development in a
469.6manner consistent with the child's age, language acquisition, and cognitive ability.
469.7Without early hearing detection and intervention, children with hearing loss experience
469.8serious delays in language acquisition and social and cognitive development. With
469.9appropriate testing and identification of newborn infants, hearing loss screening will
469.10facilitate early intervention and treatment and will serve the public purpose of promoting
469.11the healthy development of children.
469.12    For these reasons, the legislature hereby determines that it is beneficial and in the
469.13best interests of the development of the children of the state of Minnesota that newborn
469.14infants' hearing be screened.

469.15    Sec. 52. INFORMATION SHARING.
469.16    By August 1, 2007, the commissioner of health, the Pollution Control Agency, the
469.17commissioner of agriculture, and the University of Minnesota are requested to jointly
469.18develop and sign a memorandum of understanding declaring their intent to share new
469.19and existing environmental hazard, exposure, and health outcome data, consistent with
469.20applicable data practices laws, and to cooperate and communicate effectively to ensure
469.21sufficient clarity and understanding of the data between these organizations.

469.22    Sec. 53. COMMISSIONER OF HEALTH REPORT; ROUTINE RADIATION
469.23EMISSIONS.
469.24    The commissioner of health, within the limits of available appropriations, in
469.25cooperation with the utilities that own the Monticello and Prairie Island nuclear plants,
469.26shall issue a report detailing where routine radiation releases go and the health impacts of
469.27the radiation emissions on affected communities. By April 1, 2008, the report must be
469.28distributed to house and senate committees having jurisdiction over public health and to
469.29all communities that are part of the emergency response planning.

469.30    Sec. 54. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.
469.31    Subdivision 1. Purpose. Recognizing that scented products may trigger asthma or
469.32chemical sensitivity reactions in students and school staff, which can contribute to learning
470.1and breathing problems, the commissioner of health shall develop a fragrance-free schools
470.2education pilot project.
470.3    Subd. 2. Education. The commissioner of health, in collaboration with the
470.4commissioner of education and the Minneapolis Board of Education, shall establish a
470.5working group composed of at least three students, two teachers, one school administrator,
470.6and one member of the Minneapolis Board of Education to recommend an education
470.7campaign in Minneapolis public schools to inform students and parents about the
470.8potentially harmful effects of the use of fragrance products on sensitive students and
470.9school personnel in Minneapolis schools. The commissioner shall report findings to the
470.10legislature by February 1, 2008.
470.11EFFECTIVE DATE.This section is effective the day following final enactment.

470.12    Sec. 55. LINDANE COMMITTEE.
470.13    The commissioner of health shall create a committee of stakeholders, including
470.14at least one environmental health research scientist and at least one parent consumer
470.15advocate, to review the scientific literature and make recommendations to the legislature
470.16on the health impact of Lindane on children and report back by January 15, 2008.

470.17    Sec. 56. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.
470.18    The commissioner of human services shall ensure that testing for arsenic under
470.19Minnesota Statutes, section 144.967, is covered under medical assistance.

470.20    Sec. 57. BLOOD LEAD TESTING STUDY.
470.21    The commissioner of health, in consultation with the Department of Human
470.22Services; cities of the first class; health care providers; and other interested parties shall
470.23conduct a study to evaluate blood lead testing methods used to confirm elevated blood
470.24lead status. The study shall examine and/or develop:
470.25    (1) the false positive rate of capillary tests for children less than 72 months old;
470.26    (2) current protocols for conducting capillary testing, including filter paper
470.27methodology;
470.28    (3) existing guidelines and regulations from other states and federal agencies
470.29regarding lead testing;
470.30    (4) recommendations regarding the use of capillary tests to initiate environmental
470.31investigations and case management, including number and timing of tests and fiscal
470.32implications for state and local lead programs; and
471.1    (5) recommendations regarding reducing the state mandatory intervention to ten
471.2micrograms of lead per deciliter of whole blood.
471.3    The commissioner shall submit the results of the study and any recommendations,
471.4including any necessary legislative changes, to the legislature by February 15, 2008.

471.5    Sec. 58. WINDOW SAFETY EDUCATION.
471.6    The commissioner of health shall create in the department's current educational
471.7safety program a component targeted at parents and caregivers of young children to
471.8provide awareness of the need to take precautions to prevent children from falling
471.9through open windows. The commissioner of health shall consult with representatives
471.10of the residential building industry, the window products industry, the child safety
471.11advocacy community, and the Department of Labor and Industry to create the window
471.12safety program component. The program must include the gathering of data about
471.13falls from windows that result in severe injury in order to measure the effectiveness of
471.14the safety program. The commissioner of health may consult with other child safety
471.15advocacy groups, experts, and interested parties in the development and implementation
471.16of the window safety program. The commissioner of health shall prepare and submit
471.17a final report on the window safety program to the legislature by March 1, 2011. The
471.18commissioner shall prepare and submit a yearly progress report to the legislature by
471.19March 1 of each year beginning in 2008 until the submission of the final report. The
471.20final report must include a summary of the safety program, the impact of the program on
471.21children falling from windows, and any recommendations for further study or action.

471.22    Sec. 59. REVISOR'S INSTRUCTION.
471.23    The revisor of statutes shall change the range reference "144.9501 to 144.9509"
471.24to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and
471.25Minnesota Rules.

471.26    Sec. 60. REPEALER.
471.27Laws 2004, chapter 288, article 6, section 27, is repealed.

471.28ARTICLE 11

471.29HUMAN SERVICES FORECAST ADJUSTMENTS

471.30 471.31

Section 1. SUMMARY OF APPROPRIATIONS; DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.

472.1    The dollar amounts shown are added to or, if shown in parentheses, are subtracted
472.2from the appropriations in Laws 2006, chapter 282, from the general fund, or any other
472.3fund named, to the Department of Human Services for the purposes specified in this
472.4article, to be available for the fiscal year indicated for each purpose. The figure "2007"
472.5used in this article means that the appropriation or appropriations listed are available
472.6for the fiscal year ending June 30, 2007.

472.7							2007
472.8	General Fund					$	(25,226,000)
472.9	Health Care Access					$	(53,980,000)
472.10	TANF					$	(24,805,000)
472.11	Total					$	(104,011,000)

472.12 472.13

Sec. 2. COMMISSIONER OF HUMAN SERVICES

472.14

Subdivision 1.Total Appropriation

$

(104,011,000)

472.15	Appropriations by Fund
472.16			2007
472.17	General		(25,226,000)
472.18	Health Care Access		(53,980,000)
472.19	TANF		(24,805,000)

472.20

Subd. 2.Revenue and Pass Through

472.21

TANF

(106,000)

472.22 472.23

Subd. 3.Children and Economic Assistance Grants

472.24	General						3,221,000
472.25	TANF						(24,699,000)

472.26The amounts that may be spent from this
472.27appropriation for each purpose are as follows:

472.28	(a) MFIP/DWP Grants
472.29	General						13,827,000
472.30	TANF						(24,699,000)

472.31	(b) MFIP Child Care Assistance Grants
472.32	General						(4,733,000)

472.33	(c) General Assistance Grants
472.34	General						1,081,000

473.1	(d) Minnesota Supplemental Aid Grants
473.2	General						(1,099,000)

473.3	(e) Group Residential Housing Grants
473.4	General						(5,855,000)

473.5

Subd. 4.Basic Health Care Grants

473.6	General						17,592,000
473.7	Health Care Access						(53,980,000)

473.8The amounts that may be spent from this
473.9appropriation for each purpose are as follows:

473.10

(a) MinnesotaCare Health Care Access

(53,980,000)

473.11	(b) MA Basic Health Care - Families and Children
473.12	General						15,729,000

473.13	(c) MA Basic Health Care - Elderly and Disabled
473.14	General						(4,540,000)

473.15	(d) General Assistance Medical Care
473.16	General						6,403,000

473.17

Subd. 5.Continuing Care Grants

473.18

General

(46,039,000)

473.19The amounts that may be spent from this
473.20appropriation for each purpose are as follows:

473.21	(a) MA Long-Term Care Facilities
473.22	General						(15,028,000)

473.23	(b) MA Long-Term Care Waivers
473.24	General						(20,677,000)

473.25	(c) Chemical Dependency Entitlement Grants
473.26	General						(10,334,000)

473.27    Sec. 3. EFFECTIVE DATE.
473.28    Sections 1 and 2 are effective the day following final enactment.

473.29ARTICLE 12

473.30HUMAN SERVICES APPROPRIATIONS

473.31

Section 1. SUMMARY OF APPROPRIATIONS.

474.1    The amounts shown in this section summarize direct appropriations, by fund, made
474.2in this article.

474.3			2008		2009		Total
474.4	General	$	4,559,985,000	$	4,920,502,000	$	9,480,487,000
474.5 474.6	State Government Special Revenue		13,854,000		13,864,000		27,718,000
474.7	Health Care Access		432,115,000		536,076,000		968,191,000
474.8	Federal TANF		244,463,000		252,899,000		497,362,000
474.9	Lottery Prize Fund		2,184,000		1,787,000		3,971,000
474.10	Total	$	5,252,601,000	$	5,730,508,000	$	10,983,109,000

474.11

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

474.12    The sums shown in the columns marked "Appropriations" are appropriated to the
474.13agencies and for the purposes specified in this article. The appropriations are from the
474.14general fund, or another named fund, and are available for the fiscal years indicated
474.15for each purpose. The figures "2008" and "2009" used in this article mean that the
474.16appropriations listed under them are available for the fiscal year ending June 30, 2008, or
474.17June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal
474.18year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal
474.19year ending June 30, 2007, are effective the day following final enactment.

474.20				APPROPRIATIONS
474.21				Available for the Year
474.22				Ending June 30
474.23					2008		2009

474.24

Sec. 3. HUMAN SERVICES

474.25

Subdivision 1.Total Appropriation

$

5,198,244,000

$

5,684,723,000

474.26	Appropriations by Fund
474.27		2008	2009
474.28	General	4,341,800,000	4,904,289,000
474.29 474.30	State Government Special Revenue	545,000	555,000
474.31	Health Care Access	409,252,000	519,813,000
474.32	Federal TANF	244,463,000	252,899,000
474.33	Lottery Prize Fund	2,184,000	1,787,000

474.34The amounts that may be spent for each
474.35purpose are specified in the following
474.36subdivisions.
475.1Receipts for Systems Projects.
475.2Appropriations and federal receipts for
475.3information system projects for MAXIS,
475.4PRISM, MMIS, and SSIS must be deposited
475.5in the state system account authorized in
475.6Minnesota Statutes, section 256.014. Money
475.7appropriated for computer projects approved
475.8by the Minnesota Office of Enterprise
475.9Technology, funded by the legislature, and
475.10approved by the commissioner of finance,
475.11may be transferred from one project to
475.12another and from development to operations
475.13as the commissioner of human services
475.14considers necessary. Any unexpended
475.15balance in the appropriation for these
475.16projects does not cancel but is available for
475.17ongoing development and operations.
475.18Systems Continuity. In the event of
475.19disruption of technical systems or computer
475.20operations, the commissioner may use
475.21available grant appropriations to ensure
475.22continuity of payments for maintaining the
475.23health, safety, and well-being of clients
475.24served by programs administered by the
475.25Department of Human Services. Grant funds
475.26must be used in a manner consistent with the
475.27original intent of the appropriation.
475.28Nonfederal Share Transfers. The
475.29nonfederal share of activities for which
475.30federal administrative reimbursement is
475.31appropriated to the commissioner may be
475.32transferred to the special revenue fund.
475.33Gifts. Notwithstanding Minnesota
475.34Statutes, sections 16A.013 to 16A.016, the
475.35commissioner may accept, on behalf of the
476.1state, additional funding from sources other
476.2than state funds for the purpose of financing
476.3the cost of assistance program grants or
476.4nongrant administration. All additional
476.5funding is appropriated to the commissioner
476.6for use as designated by the grantor of
476.7funding.
476.8TANF Funds Appropriated to Other
476.9Entities. Any expenditures from the TANF
476.10block grant shall be expended according
476.11to the requirements and limitations of part
476.12A of title IV of the Social Security Act, as
476.13amended, and any other applicable federal
476.14requirement or limitation. Prior to any
476.15expenditure of these funds, the commissioner
476.16shall ensure that funds are expended in
476.17compliance with the requirements and
476.18limitations of federal law and that any
476.19reporting requirements of federal law are
476.20met. It shall be the responsibility of any entity
476.21to which these funds are appropriated to
476.22implement a memorandum of understanding
476.23with the commissioner that provides the
476.24necessary assurance of compliance prior to
476.25any expenditure of funds. The commissioner
476.26shall receipt TANF funds appropriated
476.27to other state agencies and coordinate all
476.28related interagency accounting transactions
476.29necessary to implement these appropriations.
476.30Unexpended TANF funds appropriated to
476.31any state, local, or nonprofit entity cancel
476.32at the end of the state fiscal year unless
476.33appropriating or statutory language permits
476.34otherwise.
476.35TANF Block Grant. Of this amount,
476.36$750,000 the first year and $750,000 the
477.1second year are onetime appropriations
477.2from the state's federal TANF block grant
477.3under Title I of Public Law 104-193. If the
477.4appropriation in either year is insufficient, the
477.5appropriation for the other year is available.
477.6TANF Maintenance of Effort. (a) In
477.7order to meet the basic maintenance of
477.8effort (MOE) requirements of the TANF
477.9block grant specified under Code of Federal
477.10Regulations, title 45, section 263.1, the
477.11commissioner may only report nonfederal
477.12money expended for allowable activities
477.13listed in the following clauses as TANF/MOE
477.14expenditures:
477.15(1) MFIP cash, diversionary work program,
477.16and food assistance benefits under Minnesota
477.17Statutes, chapter 256J;
477.18(2) the child care assistance programs
477.19under Minnesota Statutes, sections 119B.03
477.20and 119B.05, and county child care
477.21administrative costs under Minnesota
477.22Statutes, section 119B.15;
477.23(3) state and county MFIP administrative
477.24costs under Minnesota Statutes, chapters
477.25256J and 256K;
477.26(4) state, county, and tribal MFIP
477.27employment services under Minnesota
477.28Statutes, chapters 256J and 256K;
477.29(5) expenditures made on behalf of
477.30noncitizen MFIP recipients who qualify
477.31for the medical assistance without federal
477.32financial participation program under
477.33Minnesota Statutes, section 256B.06,
477.34subdivision 4, paragraphs (d), (e), and (j);
477.35and
478.1(6) qualifying working family credit
478.2expenditures under Minnesota Statutes,
478.3section 290.0671.
478.4(b) The commissioner shall ensure that
478.5sufficient qualified nonfederal expenditures
478.6are made each year to meet the state's
478.7TANF/MOE requirements. For the activities
478.8listed in paragraph (a), clauses (2) to
478.9(6), the commissioner may only report
478.10expenditures that are excluded from the
478.11definition of assistance under Code of
478.12Federal Regulations, title 45, section 260.31.
478.13(c) The commissioner shall ensure that
478.14the maintenance of effort used by the
478.15commissioner of finance for the February
478.16and November forecasts required under
478.17Minnesota Statutes, section 16A.103,
478.18contains expenditures under paragraph (a),
478.19clause (1), equal to at least 25 percent of
478.20the total required under Code of Federal
478.21Regulations, title 45, section 263.1.
478.22(d) Minnesota Statutes, section 256.011,
478.23subdivision 3, which requires that federal
478.24grants or aids secured or obtained under that
478.25subdivision be used to reduce any direct
478.26appropriations provided by law, does not
478.27apply if the grants or aids are federal TANF
478.28funds.
478.29(e) Notwithstanding section 13, this rider
478.30expires June 30, 2011.
478.31Working Family Credit Expenditures
478.32as TANF/MOE. The commissioner may
478.33claim as TANF maintenance of effort up
478.34to $6,707,000 per year for fiscal year 2008
479.1through fiscal year 2011. Notwithstanding
479.2section 13, this rider expires June 30, 2011.
479.3Additional Working Family Credit
479.4Expenditures to be Claimed for
479.5TANF/MOE. In addition to the amounts
479.6provided in this section, the commissioner
479.7may count the following amounts of working
479.8family credit expenditure as TANF/MOE:
479.9(1) fiscal year 2008, $4,269,000; and
479.10(2) fiscal year 2009, $4,889,000.
479.11Notwithstanding section 13, this rider expires
479.12June 30, 2011.
479.13Capitation Rate Increase. Of the health care
479.14access fund appropriations to the University
479.15of Minnesota in the higher education
479.16omnibus appropriation bill, $2,157,000 in
479.17fiscal year 2008 and $2,157,000 in fiscal year
479.182009 are to be used to increase the capitation
479.19payments under Minnesota Statutes, section
479.20256B.69.
479.21Health Care Access Fund Transfer.
479.22Notwithstanding Minnesota Statutes, section
479.23295.581, in addition to the transfers in
479.24Minnesota Statutes, section 16A.724,
479.25subdivision 2, the commissioner of finance
479.26shall transfer up to the following amounts
479.27from the health care access fund to the
479.28general fund on June 30 of each fiscal year:
479.29(1) fiscal year 2008, $6,416,000;
479.30(2) fiscal year 2009, $5,643,000;
479.31(3) fiscal year 2010, $6,677,000; and
479.32(4) fiscal year 2011, $7,866,000.
480.1Notwithstanding section 13, this rider expires
480.2June 30, 2011.

480.3

Subd. 2.Agency Management

57,495,000

57,696,000

480.4	Appropriations by Fund
480.5	General	48,181,000	48,417,000
480.6 480.7	State Government Special Revenue	424,000	432,000
480.8	Health Care Access	8,018,000	7,975,000
480.9	Federal TANF	222,000	222,000

480.10The amounts that may be spent from the
480.11appropriation for each purpose are as follows:

480.12

(a) Financial Operations

480.13	Appropriations by Fund
480.14	General	7,102,000	7,523,000
480.15	Health Care Access	889,000	880,000
480.16	Federal TANF	122,000	122,000

480.17

(b) Legal and Regulation Operations

480.18	Appropriations by Fund
480.19	General	12,805,000	12,673,000
480.20 480.21	State Government Special Revenue	424,000	432,000
480.22	Health Care Access	891,000	908,000
480.23	Federal TANF	100,000	100,000

480.24Base Adjustment. The general fund base is
480.25decreased by $177,000 in fiscal year 2010
480.26and $353,000 in fiscal year 2011 for legal
480.27and regulatory.
480.28Child Care Licensing. $697,000 is
480.29appropriated from the general fund to
480.30the commissioner of human services for
480.31the biennium beginning July 1, 2007, for
480.32purposes of completing background studies
480.33for family and group family child care
480.34providers under Minnesota Statutes, chapter
480.35245C. This appropriation will be $288,000 in
481.1fiscal year 2010 and $112,000 in fiscal year
481.22011.

481.3

(c) Management Operations

481.4	Appropriations by Fund
481.5	General	4,390,000	4,433,000
481.6	Health Care Access	234,000	238,000

481.7

(d) Information Technology Operations

481.8	Appropriations by Fund
481.9	General	23,884,000	23,788,000
481.10	Health Care Access	6,004,000	5,949,000

481.11 481.12

Subd. 3.Revenue and Pass-Through Expenditures

56,509,000

56,897,000

481.13

Federal TANF

56,509,000

56,897,000

481.14TANF Transfer to Federal Child Care
481.15and Development Fund. The following
481.16TANF fund amounts are appropriated to
481.17the commissioner for the purposes of MFIP
481.18transition year child care under MFIP,
481.19Minnesota Statutes, section 119B.05:
481.20(1) fiscal year 2008, $9,478,000
481.21(2) fiscal year 2009, $13,022,000
481.22(3) fiscal year 2010, $3,332,000 and
481.23(4) fiscal year 2011, $4,668,000.
481.24The commissioner shall authorize transfer
481.25of sufficient TANF funds to the federal
481.26child care and development fund to meet
481.27this appropriation and shall ensure that all
481.28transferred funds are expended according
481.29the federal child care and development fund
481.30regulations.

481.31 481.32

Subd. 4.Children and Economic Assistance Grants

603,305,000

581,714,000

481.33	Appropriations by Fund
481.34	General	416,519,000	387,330,000
482.1	Federal TANF	186,536,000	194,584,000
482.2	Health Care Access	250,000	-0-

482.3The amounts that may be spent from this
482.4appropriation for each purpose are as follows:

482.5

(a) MFIP/DWP Grants

482.6	Appropriations by Fund
482.7	General	62,000,000	61,911,000
482.8	Federal TANF	82,532,000	90,003,000

482.9

(b) Support Services Grants

482.10	Appropriations by Fund
482.11	General	8,815,000	9,465,000
482.12	Federal TANF	103,382,000	103,382,000

482.13TANF Prior Appropriation Cancellation.
482.14Notwithstanding Laws 2001, First Special
482.15Session chapter 9, article 17, section
482.162, subdivision 11, paragraph (b), any
482.17unexpended TANF funds appropriated to the
482.18commissioner to contract with the Board of
482.19Trustees of Minnesota State Colleges and
482.20Universities, to provide tuition waivers to
482.21employees of health care and human service
482.22providers that are members of qualifying
482.23consortia operating under Minnesota
482.24Statutes, sections 116L.10 to 116L.15, must
482.25cancel at the end of fiscal year 2007.
482.26MFIP Pilot Program. Of the general fund
482.27appropriation, $100,000 in fiscal year 2008
482.28and $750,000 in fiscal year 2009 are for a
482.29grant to the Stearns-Benton Employment and
482.30Training Council for the Workforce U pilot
482.31program.
482.32Work Study. $750,000 in fiscal year
482.332008 and $750,000 in fiscal year 2009 are
482.34appropriated from the TANF reserve account
483.1to the Minnesota Office of Higher Education
483.2for work study grants under Minnesota
483.3Statutes, section 136A.233, specifically
483.4for low-income individuals who receive
483.5assistance under Minnesota Statutes, chapter
483.6256J.

483.7

(c) MFIP Child Care Assistance Grants

483.8	General	337,000	553,000
483.9	Federal TANF	32,000	609,000

483.10

(d) Child Support Enforcement Grants

483.11

General

11,705,000

3,705,000

483.12Child Support Enforcement. $8,000,000
483.13for fiscal year 2008 is to make grants to
483.14counties for child support enforcement
483.15programs to make up for the loss under the
483.162006 federal Deficit Reduction Act of federal
483.17matching funds for federal incentive funds
483.18passed on to the counties by the state.
483.19This appropriation is available until spent.

483.20 483.21

(e) Basic Sliding Fee Child Care Assistance Grants

483.22

General

43,012,000

45,432,000

483.23Base Adjustment. The general fund base is
483.24increased by $3,583,000 in fiscal year 2010
483.25and $1,334,000 in fiscal year 2011 for basic
483.26sliding fee child care assistance grants.

483.27

(f) Child Care Development Grants

483.28

General

5,865,000

5,865,000

483.29Child Care Services Grants. $5,000,000
483.30is appropriated from the general fund to
483.31the commissioner of human services for
483.32the biennium beginning July 1, 2007, for
483.33purposes of providing child care services
484.1grants under Minnesota Statutes, section
484.2119B.21, subdivision 5. This appropriation
484.3is for the 2008-2009 biennium only, and does
484.4not increase the base funding.
484.5Early Childhood Professional
484.6Development System. $2,000,000 is
484.7appropriated from the general fund to
484.8the commissioner of human services for
484.9the biennium beginning July 1, 2007, for
484.10purposes of the early childhood professional
484.11development system, which increases the
484.12quality and continuum of professional
484.13development opportunities for child care
484.14practitioners. This appropriation is for the
484.152008-2009 biennium only, and does not
484.16increase the base funding.
484.17Family, Friend, and Neighbor Grant
484.18Program. $750,000 in fiscal year 2008 and
484.19$750,000 in fiscal year 2009 are appropriated
484.20from the general fund to the commissioner
484.21of human services for the family, friend,
484.22and neighbor grant program in section 31.
484.23Any balance in the first year does not cancel
484.24but is available in the second year. This
484.25appropriation is for the 2008-2009 biennium
484.26only, and does not increase the base funding.
484.27(g) Increased Child Care Provider
484.28Connections. (1) $200,000 is appropriated
484.29from the general fund to the commissioner of
484.30human services for the biennium beginning
484.31July 1, 2007, for the following purposes:
484.32$100,000 each year is for a grant to Hennepin
484.33County, and $100,000 each year is for a grant
484.34to Ramsey County. The two counties shall
484.35each contract with a nonprofit organization
485.1to work with the contracting county
485.2and county-based licensed family child
485.3care providers to facilitate county-based
485.4information regarding family and children's
485.5resources and to make training and peer
485.6support available to licensed family child
485.7care providers consistent with clause (2).
485.8These appropriations are available until
485.9June 30, 2009, and shall not become part
485.10of base-level funding for the biennium
485.11beginning July 1, 2009.
485.12(2) Programs to improve child care provider
485.13connections to county services shall be
485.14established in Hennepin and Ramsey
485.15counties to:
485.16(i) improve county contact activities
485.17with county-licensed family child care
485.18providers that facilitate utilization of county
485.19educational, social service, public health,
485.20and economic assistance services by eligible
485.21families, parents, and children using licensed
485.22family child care; and
485.23(ii) support licensed family child care
485.24providers to qualify as quality-rated child
485.25care providers through peer support and
485.26coaching networks.
485.27Hennepin and Ramsey Counties shall
485.28contract with a nonprofit organization under
485.29clause (1) that utilizes licensed family child
485.30care providers as contacts for families using
485.31licensed family child care and to provide
485.32peer support to licensed family child care
485.33providers.
485.34(3) Hennepin and Ramsey Counties must
485.35report back on successful strategies for
486.1increasing contact with county-based
486.2licensed family child care providers and
486.3report their findings to the appropriate
486.4legislative committees by February 15, 2010.

486.5

(h) Children's Services Grants

486.6	Appropriations by Fund
486.7	General	62,745,000	73,133,000
486.8	Health Care Access	250,000	-0-

486.9Base Adjustment. The general fund base
486.10is decreased by $673,000 in fiscal year
486.112010 and $670,000 in fiscal year 2011 for
486.12children's services grants.
486.13Privatized Adoption Grants. Federal
486.14reimbursement for privatized adoption grant
486.15and foster care recruitment grant expenditures
486.16is appropriated to the commissioner for
486.17adoption grants and foster care and adoption
486.18administrative purposes.
486.19Adoption Assistance Incentive Grants.
486.20Federal funds available during fiscal year
486.212008 and fiscal year 2009 for the adoption
486.22incentive grants are appropriated to the
486.23commissioner for these purposes.
486.24Adoption Assistance and Relative Custody
486.25Assistance. The commissioner may transfer
486.26unencumbered appropriation balances for
486.27adoption assistance and relative custody
486.28assistance between fiscal years and between
486.29programs.
486.30Adoption Assistance and Relative
486.31Custody Assistance Subsidy Payment
486.32Increase. Notwithstanding Minnesota
486.33Rules, part 9560.0083, subparts 5 and 6, the
486.34commissioner shall increase the payment
486.35schedules for basic and supplemental
487.1maintenance needs subsidies by 3.95 percent
487.2effective July 1, 2007. The commissioner
487.3may make cost-neutral adjustments between
487.4schedules and between brackets within
487.5schedules to allow for whole-dollar bracket
487.6levels and account for differential cost
487.7increases in caring for children with special
487.8needs. Counties have until December 31,
487.92007, to implement the relative custody
487.10assistance payment increases and shall make
487.11payment adjustments retroactive to July 1,
487.122007.
487.13Crisis Nurseries. $1,100,000 in fiscal year
487.142008 and $1,100,000 in fiscal year 2009 are
487.15appropriated from the general fund for the
487.16crisis nurseries program. Of this amount,
487.17$100,000 each year is to be made available
487.18for capacity development and technical
487.19support for crisis nurseries.
487.20Respite Care. Of the general fund
487.21appropriation, $1,250,000 in fiscal year
487.222008 and $2,500,000 in fiscal year 2009 are
487.23to the commissioner of human services to
487.24fund respite care for children who have a
487.25diagnosis of emotional disturbance or severe
487.26emotional disturbance.
487.27Childhood Trauma; Grants. Of the general
487.28fund appropriation, $125,000 in fiscal year
487.292008 and $250,000 in fiscal year 2009 are
487.30to the commissioner of human services to
487.31make grants for the purpose of maintaining
487.32and expanding evidence-based practices that
487.33support children and youth who have been
487.34exposed to violence or who are refugees.
488.1Collaborative Services for High-Risk
488.2Children. Of the general fund appropriation,
488.3$2,632,000 in fiscal year 2008 and
488.4$6,150,000 in fiscal year 2009 are to the
488.5commissioner of human services to fund
488.6early intervention collaborative programs.
488.7Evidence-Based Practice. Of the general
488.8fund appropriation, $2,175,000 in fiscal year
488.92008 and $4,350,000 in fiscal year 2009
488.10are to the commissioner of human services
488.11to develop and implement evidence-based
488.12practice in children's mental health care and
488.13treatment.
488.14MFIP and Children's Mental Health Pilot
488.15Project. Of the general fund appropriation,
488.16$100,000 in fiscal year 2008 and $200,000
488.17in fiscal year 2009 are to the commissioner
488.18of human services to fund the MFIP and
488.19children's mental health pilot project.
488.20Regional Children's Mental Health
488.21Initiative. $700,000 in fiscal year 2008 and
488.22$700,000 in fiscal year 2009 are appropriated
488.23to the commissioner of human services to
488.24fund the Regional Children's Mental Health
488.25Initiative pilot project. This is a onetime
488.26appropriation.
488.27Child Safety Efforts. $1,000,000 in fiscal
488.28year 2008 and $1,000,000 in fiscal year 2009
488.29are appropriated to counties based on their
488.30population of residents under age 18. Funds
488.31are to be used to maintain and improve child
488.32safety services. By February 1, 2008, each
488.33county shall submit a report regarding current
488.34child safety efforts, child safety funding, and
488.35unmet needs including investments needed.
489.1The report shall also include methods and
489.2community partners available to ensure
489.3early identification of at-risk families. The
489.4Association of Minnesota Counties and
489.5county agencies shall develop a uniform
489.6report structure so that statewide data can
489.7be easily summarized. This is a onetime
489.8appropriation.
489.9Fetal Alcohol Syndrome. Of the general
489.10fund appropriation, $75,000 in fiscal year
489.112008 and $75,000 in fiscal year 2009 are
489.12for three programs that provide services
489.13to reduce fetal alcohol syndrome under
489.14Minnesota Statutes, section 145.9266. The
489.15three program grantees are the University
489.16of Minnesota, the Meeker-McLeod-Sibley
489.17Community, and the American Indian Family
489.18Center. This appropriation shall become part
489.19of the base appropriation.
489.20Base Adjustment. The general fund base is
489.21increased by $366,000 in fiscal year 2010 and
489.22$369,000 in fiscal year 2011 for children's
489.23services grants.

489.24

(i) Children and Community Services Grants

489.25

General

110,802,000

69,567,000

489.26Base Adjustment. The general fund base is
489.27increased by $99,000 in each of fiscal years
489.282010 and 2011 for children and community
489.29services grants.
489.30Targeted Case Management Temporary
489.31Funding. Of the general fund appropriation,
489.32$40,000,000 in fiscal year 2008 is allocated to
489.33counties and tribes affected by reductions in
489.34targeted case management federal Medicaid
489.35revenue as a result of the provisions in
490.1the federal Deficit Reduction Act of 2005,
490.2Public Law 109-171. The commissioner
490.3shall distribute the funds proportionate
490.4to each affected county or tribe's targeted
490.5case management federal earnings for
490.6calendar year 2005. Prior to distribution
490.7of funds, the commissioner shall estimate
490.8and certify the amount by which the federal
490.9regulations will reduce case management
490.10revenue over the 2008-2009 biennium. The
490.11commissioner may provide grants up to the
490.12amount of the estimated reduction, not to
490.13exceed $40,000,000 for the biennium. The
490.14commissioner may determine the timing and
490.15frequency of payments to counties. These
490.16funds are available in either year of the
490.17biennium. Counties shall use these funds to
490.18pay for social service-related costs, but the
490.19funds are not subject to provisions of the
490.20Children and Community Services Act grant
490.21under Minnesota Statutes, chapter 256M.
490.22Child Welfare Project. Of the general fund
490.23appropriation, $2,000,000 for the biennium
490.24beginning July 1, 2007, is for expanding
490.25the American Indian chid welfare project
490.26under Minnesota Statutes, section 256.01,
490.27subdivision 14b, to include the Red Lake
490.28Band of Chippewa Indians Tribe, provided
490.29the tribe meets the criteria in Minnesota
490.30Statutes, section 256.01, subdivision 14b.

490.31

(j) General Assistance Grants

490.32

General

37,876,000

38,253,000

490.33General Assistance Standard. The
490.34commissioner shall set the monthly standard
490.35of assistance for general assistance units
491.1consisting of an adult recipient who is
491.2childless and unmarried or living apart
491.3from parents or a legal guardian at $203.
491.4The commissioner may reduce this amount
491.5according to Laws 1997, chapter 85, article
491.63, section 54.
491.7Emergency General Assistance. The
491.8amount appropriated for emergency general
491.9assistance funds is limited to no more
491.10than $7,889,812 in fiscal year 2008 and
491.11$7,889,812 in fiscal year 2009. Funds
491.12to counties must be allocated by the
491.13commissioner using the allocation method
491.14specified in Minnesota Statutes, section
491.15256D.06.

491.16

(k) Minnesota Supplemental Aid Grants

491.17

General

30,798,000

31,439,000

491.18Emergency Minnesota Supplemental
491.19Aid Funds. The amount appropriated for
491.20emergency Minnesota supplemental aid
491.21funds is limited to no more than $1,100,000
491.22in fiscal year 2008 and $1,100,000 in fiscal
491.23year 2009. Funds to counties must be
491.24allocated by the commissioner using the
491.25allocation method specified in Minnesota
491.26Statutes, section 256D.46.

491.27

(l) Group Residential Housing Grants

491.28

General

91,441,000

99,304,000

491.29Base Adjustment. The general fund base is
491.30increased by $6,665,000 in fiscal year 2010
491.31and $13,419,000 in fiscal year 2011.
491.32People Incorporated. $460,000 in fiscal
491.33year 2008 and $460,000 in fiscal year 2009
491.34are appropriated from the general fund to the
492.1commissioner of human services to augment
492.2community support and mental health
492.3services provided to individuals residing in
492.4facilities under Minnesota Statutes, section
492.5256I.05, subdivision 1h.

492.6 492.7

(m) Other Children and Economic Assistance Grants

492.8

Federal TANF

590,000

590,000

492.9New Chance. $140,000 in fiscal year
492.102008 and $140,000 in fiscal year 2009 are
492.11appropriated from federal TANF funds to the
492.12Hennepin County new chance program.
492.13Mothers First. Of the TANF appropriation,
492.14$450,000 in fiscal year 2008 and $450,000
492.15in fiscal year 2009 are to fund the Ramsey
492.16County mothers first program. The
492.17appropriations are available until spent and
492.18are a onetime appropriation.
492.19Homeless and Runaway Youth. $3,500,000
492.20in the first year and $3,500,000 in the second
492.21year are for the Runaway and Homeless
492.22Youth Act under Minnesota Statutes, section
492.23256K.45. Funds shall be spent in each area
492.24of the continuum of care to ensure that
492.25programs are meeting the greatest need. The
492.26base is decreased by $2,000,000 each year in
492.27fiscal year 2010 and fiscal year 2011.
492.28Transitional Housing and Emergency
492.29Services.
492.30(1) $750,000 each year from the federal
492.31TANF fund is for transitional housing
492.32programs under Minnesota Statutes, section
492.33256E.33. The TANF appropriations
492.34are onetime. The general fund base for
492.35transitional housing is increased by $422,000
493.1each year for the fiscal 2010-2011 biennium.
493.2Up to ten percent of this appropriation may
493.3be used for housing and services which
493.4extend beyond 24 months. $300,000 in each
493.5year of this amount is for grants for safe
493.6housing pilot projects for battered women
493.7and families in Anoka County, Houston
493.8County, and Beltrami County; and
493.9(2) $527,000 each year is added to the
493.10base for emergency services grants under
493.11Laws 1997, chapter 162, article 3, section
493.127. The base for emergency services grants
493.13is decreased each year by $300,000 in fiscal
493.14year 2010 and fiscal year 2011.
493.15Foodshelf Programs. $575,000 each year
493.16is added to the base for foodshelf programs
493.17under Minnesota Statutes, section 256E.34.
493.18The base is decreased by $250,000 each year
493.19in fiscal year 2010 and fiscal year 2011.
493.20Long-term Homeless Services. $2,440,000
493.21each year is added to the base for the
493.22long-term homeless services under
493.23Minnesota Statutes, section 256K.26. The
493.24base is decreased by $1,000,000 each year in
493.25fiscal year 2010 and fiscal year 2011.
493.26Minnesota Community Action Grants.
493.27$1,500,000 each year is added to the base for
493.28the purposes of Minnesota community action
493.29grants under Minnesota Statutes, sections
493.30256E.30 to 256E.32. The base is reduced by
493.31$500,000 each year in fiscal year 2010 and
493.32fiscal year 2011.
493.33Tenant Hotline Services Program. $50,000
493.34each year is added to the base for a grant to
494.1HOME Line for the tenant hotline services
494.2program. This is a onetime appropriation.

494.3 494.4

Subd. 5.Children and Economic Assistance Management

46,507,000

46,590,000

494.5	Appropriations by Fund
494.6	General	44,964,000	45,040,000
494.7	Health Care Access	347,000	354,000
494.8	Federal TANF	1,196,000	1,196,000

494.9The amounts that may be spent from the
494.10appropriation for each purpose are as follows:

494.11 494.12

(a) Children and Economic Assistance Administration

494.13	Appropriations by Fund
494.14	General	9,321,000	9,318,000
494.15	Federal TANF	1,196,000	1,196,000

494.16 494.17

(b) Children and Economic Assistance Operations

494.18	Appropriations by Fund
494.19	General	35,643,000	35,722,000
494.20	Health Care Access	347,000	354,000

494.21Spending Authority for Food Stamps
494.22Bonus Awards. In the event that Minnesota
494.23qualifies for the United States Department
494.24of Agriculture Food and Nutrition Services
494.25Food Stamp Program performance bonus
494.26awards, the funding is appropriated to the
494.27commissioner. The commissioner shall
494.28retain 25 percent of the funding, with the
494.29other 75 percent divided among the counties
494.30according to a formula that takes into account
494.31each county's impact on state performance in
494.32the applicable bonus categories.
494.33Child Support Payment Center. Payments
494.34to the commissioner from other governmental
494.35units, private enterprises, and individuals
494.36for services performed by the child support
495.1payment center must be deposited in the state
495.2systems account authorized under Minnesota
495.3Statutes, section 256.014. These payments
495.4are appropriated to the commissioner for the
495.5operation of the child support payment center
495.6or system, according to Minnesota Statutes,
495.7section 256.014.
495.8Financial Institution Data Match and
495.9Payment of Fees. The commissioner is
495.10authorized to allocate up to $310,000 each
495.11year in fiscal years 2008 and 2009 from the
495.12PRISM special revenue account to make
495.13payments to financial institutions in exchange
495.14for performing data matches between account
495.15information held by financial institutions
495.16and the public authority's database of child
495.17support obligors as authorized by Minnesota
495.18Statutes, section 13B.06, subdivision 7.

495.19

Subd. 6.Basic Health Care Grants

2,396,290,000

2,738,179,000

495.20	Appropriations by Fund
495.21	General	2,618,815,000	2,250,170,000
495.22	Health Care Access	377,475,000	487,989,000

495.23The amounts that may be spent from the
495.24appropriation for each purpose are as follows:

495.25

(a) MinnesotaCare Grants

495.26

Health Care Access

376,588,000

455,429,000

495.27MinnesotaCare Federal Receipts. Receipts
495.28received as a result of federal participation
495.29in administering costs of the Minnesota
495.30health care reform waiver must be deposited
495.31as nondedicated revenue in the health care
495.32access fund. Receipts received as a result of
495.33federal participation in making grants must
495.34be deposited in the federal fund and must
496.1offset health care access funds for payments
496.2to providers.
496.3MinnesotaCare Funding. The
496.4commissioner may expend money
496.5appropriated from the health care access fund
496.6for MinnesotaCare in either fiscal year of the
496.7biennium.
496.8HealthMatch Delay. Of this appropriation,
496.9$2,560,000 in fiscal year 2008 and
496.10$25,508,000 in fiscal year 2009 are for
496.11MinnesotaCare program costs related to
496.12implementation of the HealthMatch program.

496.13 496.14

(b) MA Basic Health Care - Families and Children

496.15	Appropriations by Fund
496.16	General	759,866,000	853,680,000
496.17	Health Care Access	-0-	31,661,000

496.18 496.19

(c) MA Basic Health Care - Elderly and Disabled

496.20

General

1,017,023,000

1,142,719,000

496.21Provider-Directed Care Coordination. In
496.22addition to medical assistance reimbursement
496.23under Minnesota Statutes, sections
496.24256B.0625 and 256B.76, clinics participating
496.25in provider-directed care coordination under
496.26Minnesota Statutes, section 256B.0625, also
496.27receive a monthly payment per client when
496.28the clinic serves an eligible client. The
496.29payments across the program must average
496.30$50 per month per client.
496.31Services for Developmentally Disabled.
496.32The commissioner must serve: an additional
496.33200 persons in the MR/RC waiver program;
496.34an additional 200 persons in the family
496.35support grant program under Minnesota
497.1Statutes, section 252.32; and an additional
497.2200 persons in the semi-independent living
497.3services program under Minnesota Statutes,
497.4section 252.275.
497.5Transfer of Funds. (1) The commissioner
497.6of human services shall transfer to qualifying
497.7counties medical assistance funds for
497.8fiscal year 2007 equal to the difference
497.9between the state allocation for community
497.10alternatives for disabled individuals (CADI)
497.11and actual county spending for persons who
497.12have been receiving personal care assistant
497.13services but were transferred to the CADI
497.14waivered services program according to
497.15Laws 2006, chapter 282, article 20, section
497.1635. The medical assistance funds shall be
497.17transferred from appropriations for personal
497.18care assistant services that went unspent
497.19as a result of the provisions of Laws 2006,
497.20chapter 282, article 20, section 35.
497.21(2) Counties that qualify under paragraph (a)
497.22shall provide to the commissioner by June 10,
497.232007, all necessary information regarding the
497.24funding amount to which they are entitled.
497.25The commissioner shall transfer funds to
497.26qualifying counties by June 25, 2007.
497.27(3) The amounts provided to counties
497.28under this section shall become part of each
497.29county's base level state allocation for CADI
497.30for the biennium beginning July 1, 2007.
497.31(4) The provisions in paragraphs (a) to (c)
497.32shall apply to persons who transferred to
497.33the elderly waiver as a result of Laws 2006,
497.34chapter 282, article 20, section 35.
498.1(5) This rider is effective the day following
498.2final enactment.

498.3

(d) General Assistance Medical Care Grants

498.4

General

238,887,000

251,082,000

498.5

(e) Other Health Care Grants

498.6	General	3,039,000	2,709,000
498.7	Health Care Access	887,000	899,000

498.8Care Coordination. Of the general fund
498.9appropriation, $500,000 in fiscal year 2008
498.10and $1,000,000 in fiscal year 2009 are for
498.11the commissioner of human services for
498.12contracting for care coordination with the
498.13U special kids program under Minnesota
498.14Statutes, section 256B.0751.
498.15Community-Based Health Care. Of the
498.16general fund appropriation, $1,050,000
498.17for the biennium beginning July 1, 2007,
498.18is to the commissioner of human services
498.19for the demonstration project grant
498.20described in Minnesota Statutes, section
498.2162Q.80, subdivision 1a. This is a onetime
498.22appropriation and is available until June 30,
498.232012.
498.24Community Collaboratives. Of the general
498.25fund appropriation, $330,000 in fiscal year
498.262008 and $850,000 in fiscal year 2009 are to
498.27provide grants to community collaboratives
498.28to cover the uninsured. These are onetime
498.29appropriations.
498.30Health Care Payment Reform Pilot. Of
498.31the general fund appropriation, $1,018,000
498.32in fiscal year 2008 and $1,027,000 in fiscal
498.33year 2009 are for the health care payment
499.1reform pilot project. These are onetime
499.2appropriations.
499.3Patient Incentive Programs. Of the general
499.4fund appropriation, $500,000 in fiscal year
499.52008 and $500,000 in fiscal year 2009 are
499.6for patient incentive programs.
499.7State Health Policies Grant. Of the general
499.8fund appropriation, $300,000 in fiscal year
499.92008 is to provide a grant to a research center
499.10associated with a safety net hospital and
499.11county-affiliated health system to develop
499.12the capabilities necessary for evaluating the
499.13effects of changes in state health policies
499.14on low-income and uninsured individuals,
499.15including the impact on state health care
499.16program costs, health outcomes, cost-shifting
499.17to different units and levels of government,
499.18and utilization patterns including use of
499.19emergency room care and hospitalization
499.20rates.
499.21Neighborhood Health Care Network. Of
499.22the general fund appropriation, $150,000 in
499.23fiscal year 2008 and $150,000 in fiscal year
499.242009 are for a grant to the Neighborhood
499.25Health Care Network to maintain and staff a
499.26toll-free health care access telephone number.

499.27

Subd. 7.Health Care Management

54,536,000

58,696,000

499.28	Appropriations by Fund
499.29	General	32,416,000	30,589,000
499.30	Health Care Access	22,120,000	28,125,000

499.31The amounts that may be spent from the
499.32appropriation for each purpose are as follows:

499.33

(a) Health Care Policy Administration

500.1	Appropriations by Fund
500.2	General	10,236,000	8,813,000
500.3	Health Care Access	2,323,000	10,074,000

500.4Minnesota Senior Health Options
500.5Reimbursement. Federal administrative
500.6reimbursement resulting from the Minnesota
500.7senior health options project is appropriated
500.8to the commissioner for this activity.
500.9Utilization Review. Federal administrative
500.10reimbursement resulting from prior
500.11authorization and inpatient admission
500.12certification by a professional review
500.13organization is dedicated to the commissioner
500.14for these purposes. A portion of these funds
500.15must be used for activities to decrease
500.16unnecessary pharmaceutical costs in medical
500.17assistance.
500.18Dental Access for Persons with Disabilities.
500.19Of the general fund appropriation, $82,000
500.20in fiscal year 2008 is for a study on access to
500.21dental services for persons with disabilities.
500.22Base Adjustment. The health care access
500.23fund base is $10,716,000 in fiscal year 2010
500.24and $8,870,000 in fiscal year 2011, for health
500.25care administration.

500.26

(b) Health Care Operations

500.27	Appropriations by Fund
500.28	General	22,180,000	21,776,000
500.29	Health Care Access	19,797,000	18,051,000

500.30Base Adjustment. The general fund base is
500.31decreased by $214,000 in fiscal year 2010
500.32for health care operations.

500.33

Subd. 8.Continuing Care Grants

1,697,359,000

1,858,283,000

501.1	Appropriations by Fund
501.2	General	1,694,876,000	1,855,900,000
501.3	Health Care Access	750,000	750,000
501.4	Lottery Prize	1,733,000	1,633,000

501.5The amounts that may be spent from the
501.6appropriation for each purpose are as follows:

501.7

(a) Aging and Adult Services Grants

501.8

General

15,986,000

16,605,000

501.9Information and Assistance
501.10Reimbursement. Federal administrative
501.11reimbursement obtained from information
501.12and assistance services provided by the
501.13Senior LinkAge Line to people who are
501.14identified as eligible for medical assistance
501.15are appropriated to the commissioner for this
501.16activity.
501.17Senior Companion Program. Of the
501.18general fund appropriation, $191,000 in
501.19fiscal year 2008 and $191,000 in fiscal year
501.202009 are for the senior companion program
501.21under Minnesota Statutes, section 256.977.
501.22Volunteer Senior Citizens. Of the general
501.23fund appropriation, $192,000 in fiscal year
501.242008 and $192,000 in fiscal year 2009 are
501.25for the volunteer programs for retired senior
501.26citizens under Minnesota Statutes, section
501.27256.9753.
501.28Foster Grandparent Program. Of the
501.29general fund appropriation, $192,000 in
501.30fiscal year 2008 and $192,000 in fiscal year
501.312009 are for the foster grandparent program
501.32in Minnesota Statutes, section 256.976.
501.33Senior Nutrition. Of the general fund
501.34appropriation, $250,000 in fiscal year
502.12008 and $250,000 in fiscal year 2009 are
502.2for the senior nutrition programs under
502.3Minnesota Statutes, section 256.9752.
502.4The commissioner shall give priority to
502.5increase services to: (1) persons facing
502.6language or cultural barriers, (2) persons with
502.7special diets, (3) persons living in isolated
502.8rural areas, and (4) other hard-to-serve
502.9populations.
502.10Living At Home/Block Nurse Program. Of
502.11the general fund appropriation, $580,000 in
502.12fiscal year 2008 and $655,000 in fiscal year
502.132009 are for the living at home/block nurse
502.14program. The purpose of the appropriation is
502.15to increase base funding levels to $25,000
502.16per program year, provide base funding for
502.17nine programs currently operating without
502.18base funding, provide base funding for five
502.19new programs beginning July 1, 2007, and
502.20provide base funding for six additional
502.21programs beginning July 1, 2008.
502.22$76,000 in fiscal year 2008 and $62,000 in
502.23fiscal year 2009 are for increased staff for
502.24the ombudsman for older Minnesotans and
502.25related costs.
502.26$150,000 in fiscal year 2008 and $150,000 in
502.27fiscal year 2009 are to increase the base of
502.28the Senior LinkAge line program.
502.29Minnesota Kinship Caregivers
502.30Association. (1) Of the general fund
502.31appropriation, $175,000 in fiscal year
502.322008 and $175,000 in fiscal year 2009
502.33are transferred to a nonprofit organization
502.34experienced in kinship caregiver programs,
502.35with at least 50 percent of its board
503.1composed of kinship caregivers for purposes
503.2of providing support to grandparents or
503.3relatives who are raising kinship children.
503.4(2) The demonstration grant sites must
503.5include the Minnesota Kinship Caregivers
503.6Association central site in the metropolitan
503.7area and another site in the Bemidji region.
503.8The support must provide a one-stop services
503.9program. The services that may be provided
503.10include but are not limited to legal services,
503.11education, information, family activities,
503.12support groups, mental health access,
503.13advocacy, mentors, and information related
503.14to foster care licensing. The funds may also
503.15be used for a media campaign to inform
503.16kinship families about available information
503.17and services, support sites, and other program
503.18development. The general fund base for the
503.19program shall be $160,000 in fiscal year
503.202010 and $160,000 in fiscal year 2011.
503.21Base Adjustment. The general fund base
503.22is increased by $72,000 in fiscal year 2010
503.23and $72,000 in fiscal year 2011 for aging and
503.24adult services grants.

503.25

(b) Alternative Care Grants

503.26

General

50,063,000

52,511,000

503.27Alternative Care Transfer. Any money
503.28allocated to the alternative care program that
503.29is not spent for the purposes indicated does
503.30not cancel but is transferred to the medical
503.31assistance account.
503.32Base Adjustment. The general fund base is
503.33increased by $547,000 in fiscal year 2010 and
503.34$784,000 in fiscal year 2011 for alternative
503.35care grants.

504.1 504.2

(c) Medical Assistance Grants - Long-Term Care Facilities

504.3

General

499,278,000

513,016,000

504.4New Nursing Facility Reimbursement
504.5System Delay. Notwithstanding Minnesota
504.6Statutes, section 256B.441, subdivision 1,
504.7paragraph (c), the commissioner shall begin
504.8to phase in the new reimbursement system
504.9for nursing facilities on or after October 1,
504.102009.
504.11Long-Term Care Consultation Funding
504.12Increase. For the rate year beginning
504.13October 1, 2008, the county long-term
504.14care consultation allocations in Minnesota
504.15Statutes, section 256B.0911, subdivision
504.166, must be increased based on the number
504.17of transitional long-term care consultation
504.18visits projected by the commissioner in
504.19each county. For the rate year beginning
504.20October 1, 2009, final allocations must be
504.21determined based on the average between
504.22the actual number of transitional long-term
504.23care visits that were conducted in the prior
504.2412-month period and the projected number
504.25of consultations that will be provided in
504.26the rate year beginning October 1, 2009.
504.27Notwithstanding section 7, this rider expires
504.28June 30, 2010.
504.29Life Safety Code Compliance. Of the
504.30general fund appropriation, $1,000,000 in
504.31fiscal year 2008 is for payments to nursing
504.32facilities for life safety code compliance
504.33under Minnesota Statutes, section 256B.434,
504.34subdivision 4, paragraph (e). This is a
505.1onetime appropriation and available until
505.2spent.

505.3 505.4

(d) Medical Assistance Grants - Long-Term Care Waivers and Home Care Grants

505.5

General

966,623,000

1,099,540,000

505.6

(e) Mental Health Grants

505.7	Appropriations by Fund
505.8	General	57,522,000	60,678,000
505.9	Health Care Access	750,000	750,000
505.10	Lottery Prize	1,733,000	1,633,000

505.11Dual Diagnosis; Demonstration Project.
505.12Of the general fund appropriation, $800,000
505.13in fiscal year 2008 and $1,600,000 in fiscal
505.14year 2009 are to the commissioner of
505.15human services to fund the dual diagnosis
505.16demonstration project.
505.17Mobile Mental Health Crisis Services. Of
505.18the general fund appropriation, $2,500,000
505.19in fiscal year 2008 and $3,625,000 in fiscal
505.20year 2009 are to the commissioner of human
505.21services for statewide funding of adult mobile
505.22mental health crisis services. Providers must
505.23utilize all available funding streams.
505.24National Council on Problem Gambling.
505.25(1) $225,000 in fiscal year 2008 and $225,000
505.26in fiscal year 2009 are appropriated from
505.27the lottery prize fund to the commissioner
505.28of human services for a grant to the state
505.29affiliate recognized by the National Council
505.30on Problem Gambling. The affiliate must
505.31provide services to increase public awareness
505.32of problem gambling, education, and training
505.33for individuals and organizations providing
505.34effective treatment services to problem
505.35gamblers and their families, and research
506.1relating to problem gambling. These
506.2services must be complementary to and not
506.3duplicative of the services provided through
506.4the problem gambling program administered
506.5by the commissioner of human services. This
506.6grant does not prevent the commissioner
506.7from regular monitoring and oversight of the
506.8grant or the ability to reallocate the funds to
506.9other services within the problem gambling
506.10program for nonperformance of duties by
506.11the grantee.
506.12(2) Of this appropriation, $100,000 in
506.13fiscal year 2008 and $100,000 in fiscal year
506.142009 are contingent on the contribution
506.15of nonstate matching funds. Matching
506.16funds may be either cash or qualifying
506.17in-kind contributions. The commissioner of
506.18finance may disburse the state portion of the
506.19matching funds in increments of $25,000
506.20upon receipt of a commitment for an equal
506.21amount of matching nonstate funds. The
506.22general fund base shall be $100,000 in fiscal
506.23year 2010 and $100,000 in fiscal year 2011
506.24(3) $100,000 in fiscal year 2008 is
506.25appropriated from the lottery prize fund to
506.26the commissioner of human services for a
506.27grant or grants to be awarded competitively
506.28to develop programs and services for
506.29problem gambling treatment, prevention,
506.30and education in immigrant communities.
506.31This appropriation is available until June
506.3230, 2009, at which time the project must
506.33be completed and final products delivered,
506.34unless an earlier completion date is specified
506.35in the work program.
507.1Compulsive Gambling. $300,000 in fiscal
507.2year 2008 and $100,000 in fiscal year 2009
507.3are appropriated from the lottery prize fund
507.4to the commissioner of human services for
507.5purposes of compulsive gambling education,
507.6assessment, and treatment under Minnesota
507.7Statutes, section 245.98.
507.8Compulsive Gambling Study. $100,000
507.9in fiscal year 2008 is to continue the
507.10study currently being done on compulsive
507.11gambling treatment effectiveness and
507.12long-term effects of gambling.
507.13Base Adjustment. The general fund base is
507.14increased by $266,000 in fiscal year 2010.

507.15

(f) Deaf and Hard-of-Hearing Grants

507.16

General

1,932,000

2,380,000

507.17Hearing Loss Mentors. Of the general fund
507.18appropriation, $80,000 is to provide mentors
507.19who have a hearing loss to parents of newly
507.20identified infants and children with hearing
507.21loss.
507.22Base Adjustment. The general fund base
507.23is increased by $7,000 in fiscal year 2010
507.24and $7,000 in fiscal year 2011 for deaf and
507.25hard-of-hearing grants.

507.26

(g) Chemical Dependency Entitlement Grants

507.27

General

78,749,000

89,946,000

507.28 507.29

(h) Chemical Dependency Nonentitlement Grants

507.30

General

1,055,000

1,055,000

507.31

(i) Other Continuing Care Grants

507.32	Appropriations by Fund
507.33	General	23,668,000	20,169,000

508.1Native American Juvenile Treatment
508.2Center. Of the general fund appropriation,
508.3$50,000 is to conduct a feasibility study
508.4of and to predesign a Native American
508.5juvenile treatment center on or near the
508.6White Earth Reservation. The facility must
508.7house and treat Native American juveniles
508.8and provide culturally specific programming
508.9to juveniles placed in the treatment center.
508.10The commissioner of human services may
508.11contract with parties who have experience
508.12in the design and construction of juvenile
508.13treatment centers to assist in the feasibility
508.14study and predesign. On or before January
508.1515, 2008, the commissioner shall present
508.16the results of the feasibility study and the
508.17predesign of the facility to the chairs of house
508.18of representatives and senate committees
508.19having jurisdiction over human services
508.20finance, public safety finance, and capital
508.21investment.
508.22Leech Lake Youth Treatment Center. Of
508.23the general fund appropriation, $75,000 in
508.24fiscal year 2008 and $75,000 in fiscal year
508.252009 are for a grant to the Leech Lake Youth
508.26Treatment Center project partners, in order
508.27to pay the salaries and other directly related
508.28costs associated with the development of this
508.29project.
508.30Assistive Technology. Of the general fund
508.31appropriation, $300,000 in fiscal year 2008 is
508.32to the Minnesota State Council on Disability
508.33for the purposes of providing $100,000
508.34in financial support to the Minnesota
508.35Regions Assistive Technology Collaborative
508.36and $200,000 in fiscal year 2008 is for
509.1a local match required to access the
509.2federal Technology-Related Assistance for
509.3Individuals with Disabilities Act, alternate
509.4finance project.
509.5Repayment. For the fiscal year ending June
509.630, 2008, $5,287,000 is appropriated to the
509.7commissioner of human services to repay
509.8the amount of overspending in the waiver
509.9program for persons with developmental
509.10disabilities incurred by affected counties in
509.11calendar years 2004 and 2005.
509.12Base Adjustment. The general fund base
509.13is $20,276,000 in fiscal year 2010 and
509.14$20,332,000 in fiscal year 2011 for other
509.15continuing care grants.

509.16

Subd. 9.Continuing Care Management

20,248,000

19,400,000

509.17	Appropriations by Fund
509.18	General	19,384,000	19,123,000
509.19 509.20	State Government Special Revenue	121,000	123,000
509.21	Health Care Access	292,000	-0-
509.22	Lottery Prize	451,000	154,000

509.23Community Trainee and Consultation.
509.24Of the general fund appropriation, $125,000
509.25in fiscal year 2008 is to the commissioner
509.26of human services to contract for training
509.27and consultation for clinical supervisors and
509.28staff of community mental health centers
509.29who provide services to children and adults.
509.30The purpose of the training and consultation
509.31is to improve clinical supervision of
509.32staff, strengthen compliance with federal
509.33and state rules and regulations, and to
509.34recommend strategies for standardization and
510.1simplification of administrative functions
510.2among community mental health centers.
510.3Mental Health Tracking System. Of the
510.4general fund appropriation, $448,000 in fiscal
510.5year 2008 and $324,000 in fiscal year 2009
510.6are to the commissioner of human services
510.7to fund implementation of the mental health
510.8services outcomes and tracking system.
510.9Quality Management; Assurance; and
510.10Improvement System for Minnesotans
510.11Receiving Disability Services. Of the
510.12general fund appropriation, up to $300,000
510.13for the biennium beginning July 1, 2007,
510.14may be used for the purposes of the quality
510.15management, assurance, and improvement
510.16system for Minnesotans receiving disability
510.17services. Federal Medicaid matching funds
510.18obtained for this purpose shall be dedicated
510.19to the commissioner for this purpose.
510.20Base Adjustment. The health care access
510.21fund base is $0 in each of the fiscal years 2010
510.22and 2011 for continuing care management.
510.23Disability Linkage Line. Of the general
510.24fund appropriation, $650,000 in fiscal year
510.252008 and $626,000 in fiscal year 2009 are to
510.26establish and maintain the disability linkage
510.27line.

510.28

Subd. 10.State-Operated Services

266,645,000

267,718,000

510.29

General

266,645,000

267,718,000

510.30Remembering With Dignity Project. (1)
510.31$200,000 is appropriated from the general
510.32fund to the commissioner of human services
510.33to be available until September 30, 2008, to
510.34make a grant to Advocating Change Together
511.1for the purposes of the Remembering With
511.2Dignity project in paragraph (2).
511.3(2) As part of the Remembering With Dignity
511.4project, the grant recipient shall:
511.5(i) conduct necessary research on persons
511.6buried in state cemeteries who were residents
511.7of state hospitals or regional treatment
511.8centers and buried in numbered or unmarked
511.9graves;
511.10(ii) purchase and install headstones that are
511.11properly inscribed with their names on the
511.12graves of those persons; and
511.13(iii) collaborate with community groups
511.14and state and local government agencies to
511.15build community involvement and public
511.16awareness, ensure public access to the
511.17graves, and ensure appropriate perpetual
511.18maintenance of state cemeteries.
511.19(3) This rider is effective the day following
511.20final enactment.
511.21Transfer Authority Related to
511.22State-Operated Services. Money
511.23appropriated to finance state-operated
511.24services programs and administrative
511.25services may be transferred between fiscal
511.26years of the biennium with the approval of
511.27the commissioner of finance.
511.28The amounts that may be spent from the
511.29appropriation for each purpose are as follows:

511.30

(a) Mental Health Services

511.31

General

116,270,000

120,095,000

511.32Appropriation Limitation. No part of
511.33the appropriation in this article to the
511.34commissioner for mental health treatment
512.1services at the regional treatment centers
512.2shall be used for the Minnesota sex offender
512.3program.

512.4

(b) Minnesota Sex Offender Services

512.5

General

67,719,000

62,787,000

512.6 512.7

(c) Minnesota Security Hospital and METO Services

512.8

General

82,656,000

84,836,000

512.9Minnesota Security Hospital. For the
512.10purposes of enhancing the safety of
512.11the public, improving supervision, and
512.12enhancing community-based mental health
512.13treatment, state-operated services may
512.14establish additional community capacity
512.15for providing treatment and supervision
512.16of clients who have been ordered into a
512.17less restrictive alternative care from the
512.18state-operated services transitional services
512.19program consistent with Minnesota Statutes,
512.20section 246.014.

512.21

Sec. 4. COMMISSIONER OF HEALTH

512.22

Subdivision 1.Total Appropriation

$

54,357,000

$

45,785,000

512.23	Appropriations by Fund
512.24		2008	2009
512.25	General	18,185,000	16,213,000
512.26 512.27	State Government Special Revenue	13,309,000	13,309,000
512.28	Health Care Access	22,863,000	16,263,000

512.29 512.30

Subd. 2.Community and Family Health Promotion

512.31	Appropriations by Fund
512.32	General	46,707,000	46,443,000
512.33 512.34	State Government Special Revenue	468,000	471,000
512.35	Health Care Access	3,539,000	3,562,000
512.36	Federal TANF	8,667,000	9,002,000

513.1TANF Appropriations. (a) $3,579,000 of
513.2the TANF funds is appropriated in each year
513.3of the biennium to the commissioner for
513.4home visiting and nutritional services listed
513.5under Minnesota Statutes, section 145.882,
513.6subdivision 7, clauses (6) and (7). Funding
513.7shall be distributed to community health
513.8boards based on Minnesota Statutes, section
513.9145A.131, subdivision 1.
513.10(b) $5,088,000 in the first year and $5,423,000
513.11in the second year are appropriated to the
513.12commissioner of health for the family home
513.13visiting grant program. The commissioner
513.14shall distribute funds to community health
513.15boards using a formula developed in
513.16conjunction with the state Community
513.17Health Services Advisory Committee. The
513.18commissioner may use five percent of the
513.19funds appropriated in each fiscal year to
513.20conduct the ongoing evaluations required
513.21under Minnesota Statutes, section 145A.17,
513.22subdivision 7, and may use ten percent of
513.23the funds appropriated each fiscal year to
513.24provide training and technical assistance as
513.25required under Minnesota Statutes, section
513.26145A.17, subdivisions 4 and 5.
513.27TANF Carryforward. Any unexpended
513.28balance of the TANF appropriation in the
513.29first year of the biennium does not cancel but
513.30is available for the second year.
513.31Loan Forgiveness. $605,000 the first year
513.32and $775,000 the second year and thereafter
513.33are for the loan forgiveness program under
513.34Minnesota Statutes, section 144.1501. This
514.1funding is in addition to the loan forgiveness
514.2program base.
514.3MN ENABL. Base level funding for the MN
514.4ENABL program, under Minnesota Statutes,
514.5section 145.9255, is reduced by $220,000
514.6each year of the biennium beginning July 1,
514.72007.
514.8Fetal Alcohol Spectrum Disorder. (a)
514.9$900,000 each year is added to the base for
514.10fetal alcohol spectrum disorder. On July 1
514.11each fiscal year, the portion of the general
514.12fund appropriation to the commissioner of
514.13health for fetal alcohol spectrum disorder
514.14administration and grants shall be transferred
514.15to a statewide organization that focuses
514.16solely on prevention of and intervention with
514.17fetal alcohol spectrum disorder as follows:
514.18(1) on July 1, 2007, $2,090,000; and
514.19(2) on July 2, 2008, and annually thereafter,
514.20$2,090,000.
514.21(b) The money shall be used for prevention
514.22and intervention services and programs,
514.23including, but not limited to, community
514.24grants, professional education, public
514.25awareness, and diagnosis. The organization
514.26may retain $60,000 of the transferred money
514.27for administrative costs. The organization
514.28shall report to the commissioner annually
514.29by January 15 on the services and programs
514.30funded by the appropriation.
514.31Deaf or Hearing Loss Support. $100,000
514.32for the first year and $100,000 for the second
514.33year is for the purpose of providing family
514.34support and assistance to families with
514.35children who are deaf or have a hearing
515.1loss. The family support provided must
515.2include direct parent-to-parent assistance and
515.3information on communication, educational,
515.4and medical options. The commissioner
515.5may contract with a nonprofit organization
515.6that has the ability to provide these services
515.7throughout the state.
515.8Heart Disease and Stroke Prevention.
515.9$200,000 is appropriated in the first year for
515.10the heart disease and stroke prevention unit
515.11of the Department of Health to fund data
515.12collection and other activities to improve
515.13cardiovascular health and reduce the burden
515.14of heart disease and stroke in Minnesota.
515.15This is a onetime appropriation.
515.16Family Planning Grants. $1,000,000 each
515.17year is for family planning grants under
515.18Minnesota Statutes, section 145.925.
515.19Bright Smiles Pilot Project. (a) $384,000
515.20in the first year and $50,000 in the second
515.21year is to fund a grant for the Bright Smiles
515.22pilot project.
515.23(b) Of these amounts, $50,000 each year is to
515.24fund a dental health coordinator position.
515.25(c) The commissioner of health shall
515.26establish a pilot project to fund a Bright
515.27Smiles program designed to increase access
515.28to oral health care for low-income and
515.29immigrant children, ages birth to five
515.30years, and their families and to build the
515.31knowledge and ability of parents to care
515.32for the oral health of their children. Under
515.33this pilot project, a Bright Smiles program
515.34shall serve the medically underserved areas
516.1in Minneapolis and the Bemidji area, as
516.2determined by the commissioner of health.
516.3(d) A grant shall be used to fund costs related
516.4to improving oral health outreach, education,
516.5screening, and access to care for families
516.6with children, ages birth to five years.
516.7(e) Grant applicants shall submit to
516.8the commissioner a written plan that
516.9demonstrates the ability to provide the
516.10following:
516.11(1) new programs or continued expansion
516.12of current access programs that have
516.13demonstrated success in providing dental
516.14services in underserved areas of Minneapolis
516.15and the Bemidji area;
516.16(2) programs for screening children entering
516.17the Minneapolis and the Bemidji area public
516.18school systems and facilitating access to care
516.19for their families;
516.20(3) programs testing new models of care
516.21that are sensitive to cultural needs of the
516.22recipients;
516.23(4) programs creating new educational
516.24campaigns that inform individuals of the
516.25importance of good oral health and the
516.26link between dental diseases, overall health
516.27status, and success in school; and
516.28(5) programs testing new delivery models
516.29by creating partnerships between local early
516.30childhood and school-age education and
516.31community clinic dental providers.
516.32(f) Qualified applicants are partnerships
516.33among early childhood experts, Minneapolis
516.34or Bemidji area public schools, and nonprofit
517.1clinics that are established to provide health
517.2services to low-income patients, provide
517.3preventive and dental care services, and
517.4utilize a sliding-scale fee or other method of
517.5providing charity care that ensures that no
517.6person is denied services because of inability
517.7to pay.
517.8(g) Applicants shall submit to the
517.9commissioner an application and supporting
517.10documentation, in the form and manner
517.11specified by the commissioner. Applicants
517.12must be able to provide culturally appropriate
517.13outreach, screenings, and access to dental
517.14care for children, ages birth to five years,
517.15their parents, and pregnant women most at
517.16risk of poor oral health due to lack of access
517.17to dental care. Applicants must also meet the
517.18following criteria:
517.19(1) have the potential to successfully increase
517.20access to families with children, ages birth
517.21to five years;
517.22(2) incorporate quality program evaluation;
517.23(3) maximize use of grant funds; and
517.24(4) have experience in providing services to
517.25the target populations of this program.
517.26(h) The commissioner shall evaluate the
517.27effectiveness of this pilot program on the
517.28oral health of children and their families and
517.29report to the house of representatives and
517.30senate committees with jurisdiction over
517.31public health policy and finance by January
517.321, 2009, with recommendations as to how to
517.33develop programs throughout Minnesota that
517.34provide education and access to oral health
517.35care for low-income and immigrant children.
518.1Suicide prevention programs. $600,000
518.2each year is to fund the suicide prevention
518.3program. The base for fiscal years 2010 and
518.42011 is reduced by $300,000.

518.5

Subd. 3.Policy, Quality, and Compliance

51,557,000

45,785,000

518.6	Appropriations by Fund
518.7	General	18,185,000	16,213,000
518.8 518.9	State Government Special Revenue	13,309,000	13,309,000
518.10	Health Care Access	22,863,000	16,263,000

518.11Health Care Access Survey. Of the
518.12health care access fund appropriation,
518.13$600,000 in fiscal year 2008 is appropriated
518.14to the commissioner to conduct a health
518.15insurance survey of Minnesota households,
518.16in partnership with the State Health Access
518.17Data Assistance Center at the University
518.18of Minnesota. The commissioner shall
518.19contract with the State Health Access Data
518.20Assistance Center to conduct a survey that
518.21provides information on the characteristics
518.22of the uninsured in Minnesota and the
518.23reasons for changing patterns of insurance
518.24coverage and access to health care services.
518.25This appropriation shall become part of the
518.26agency's base budget for even-numbered
518.27fiscal years.
518.28MERC. Of the general fund appropriation,
518.29$8,000,000 each fiscal year is for distribution
518.30of MERC grants as follows:
518.31(1) $5,000,000 according to Minnesota
518.32Statutes, section 62J.692, subdivision 4,
518.33paragraph (c);
519.1(2) $900,000 according to Minnesota
519.2Statutes, section 62J.692, subdivision 4,
519.3paragraph (d);
519.4(3) $100,000 according to Minnesota
519.5Statutes, section 62J.692, subdivision 4,
519.6paragraph (e); and
519.7(4) $2,000,000 according to Minnesota
519.8Statutes, section 62J.692, subdivision 7a,
519.9paragraph (b).
519.10Health Information Technology. Of
519.11the health care access fund appropriation,
519.12$6,750,000 each fiscal year is to implement
519.13Minnesota Statutes, section 144.3345. Up
519.14to $350,000 each fiscal year is available for
519.15grant administration and health information
519.16technology technical assistance and
519.17$6,400,000 each year is to be transferred
519.18to the commissioner of finance to establish
519.19and implement a revolving account under
519.20Minnesota Statutes, section 62J.496. This
519.21appropriation shall not be included in the
519.22agency's base budget for the fiscal year
519.23beginning July 1, 2009.
519.24Health Insurance Exchange. Of the health
519.25care access fund appropriation, $6,000,000
519.26in fiscal year 2008 is appropriated to
519.27the commissioner to establish the health
519.28insurance exchange in Minnesota Statutes,
519.29section 62A.76. Up to $50,000 in fiscal year
519.302008 is available for administrative costs
519.31incurred by the Department of Health in
519.32establishing and providing grant funding to
519.33the legal entity responsible for implementing
519.34the health insurance exchange. This is a
519.35onetime appropriation.
520.1Hearing Aid Loan Bank. Of the general
520.2fund appropriation, $70,000 in fiscal year
520.32008 and $70,000 in fiscal year 2009 are
520.4for the purpose of providing a statewide
520.5hearing aid and instrument loan bank to
520.6families with children newly diagnosed with
520.7hearing loss from birth to the age of ten. This
520.8appropriation shall cover the administrative
520.9costs of the program.
520.10Uncompensated Care Fund. Of the general
520.11fund appropriation, $65,000 in fiscal year
520.122008 is for the commissioner of health to
520.13study and present recommendations to the
520.14governor and the legislature by January
520.1515, 2008, on the design, operation, and
520.16funding of an uncompensated care fund to
520.17be used to provide subsidies to hospitals,
520.18community clinics, federally qualified health
520.19centers, community mental health centers,
520.20and other health care providers that serve
520.21a disproportionately large percentage of
520.22uninsured patients. An organization must not
520.23provide or perform abortion services under
520.24this program.
520.25Community Collaboratives. Of the
520.26general fund appropriation, $300,000 for the
520.27biennium beginning July 1, 2007, is to the
520.28commissioner of health to provide grants
520.29to community collaboratives to cover the
520.30uninsured. This is a onetime appropriation.
520.31Uniform Electronic Transactions. Of the
520.32general fund appropriation, $146,000 in fiscal
520.33year 2008 is for development of uniform
520.34electronic transactions and implementation
521.1guide standards under Minnesota Statutes,
521.2section 62J.536.
521.3Medical Home Learning Collaborative.
521.4Of the general fund appropriation, $500,000
521.5in fiscal year 2008 and $500,000 in fiscal
521.6year 2009 are to expand the medical
521.7home learning collaborative initiative in
521.8collaboration with the commissioner of
521.9human services. Services provided under
521.10this funding must support a medical home
521.11model for children with special health care
521.12needs. The collaborative shall report back to
521.13the legislature on use of the funds by January
521.1415, 2010.
521.15Federally Qualified Health Centers. Of the
521.16general fund appropriation, $3,000,000 in
521.17fiscal year 2008 and $3,900,000 in fiscal year
521.182009 are for subsidies to federally qualified
521.19health centers under Minnesota Statutes,
521.20section 145.9269.
521.21Pandemic Influenza Preparedness. Of
521.22the general fund appropriation to the
521.23commissioner, $2,800,000 in fiscal year 2008
521.24is for preparation, planning, and response
521.25to a pandemic influenza outbreak. This
521.26appropriation is available until June 30, 2009.
521.27Base funding for the 2010-2011 biennium is
521.28$0 each fiscal year.

521.29

Subd. 4.Health Protection

521.30	Appropriations by Fund
521.31	General	17,744,000	13,900,000
521.32 521.33	State Government Special Revenue	25,980,000	26,674,000
521.34	Environmental	300,000	300,000

522.1Pandemic Influenza Preparedness. Of
522.2the general fund appropriation to the
522.3commissioner, $3,235,000 in fiscal year 2008
522.4is for preparation, planning, and response
522.5to a pandemic influenza outbreak. This
522.6appropriation is available until June 30, 2009.
522.7Base funding for the 2010-2011 biennium is
522.8$0 each fiscal year.
522.9Environmental Health Tracking and
522.10Biomonitoring. (a) $500,000 in the first
522.11year and $900,000 in the second year are
522.12for the environmental health tracking and
522.13biomonitoring program. The base for fiscal
522.14year 2010 and fiscal year 2011 is increased
522.15by $300,000 each year.
522.16(b) $300,000 each year is from the
522.17environmental fund to the Pollution Control
522.18Agency for transfer to the Department
522.19of Health for the health tracking and
522.20biomonitoring program. The base for the
522.21environmental fund is $0 in fiscal year 2010
522.22and after.
522.23AIDS Prevention Initiative Focusing
522.24on African-born Residents. $300,000 in
522.252008 is for an AIDS prevention initiative
522.26focusing on African-born residents. This
522.27appropriation is a onetime appropriation
522.28and shall not become part of the base-level
522.29funding for the 2010-2011 biennium.
522.30The commissioner of health shall award
522.31grants in accordance with Minnesota Statutes,
522.32section 145.924, paragraph (b), for a public
522.33education and awareness campaign targeting
522.34communities of African-born Minnesota
522.35residents. The grants shall be designed to
523.1promote knowledge and understanding about
523.2HIV and to increase knowledge in order
523.3to eliminate and reduce the risk for HIV
523.4infection; to encourage screening and testing
523.5for HIV; and to link individuals to public
523.6health and health care resources. The grants
523.7must be awarded to collaborative efforts that
523.8bring together nonprofit community-based
523.9groups with demonstrated experience in
523.10addressing the public health, health care,
523.11and social service needs of African-born
523.12communities.
523.13Arsenic Health Risk Standard. $920,000 in
523.14the first year and $461,000 in the second year
523.15is to fund the study relating to arsenic health
523.16risk standards, under Minnesota Statutes,
523.17section 144.967.
523.18Lindane and Bisphenol-A Studies.
523.19$114,000 in the first year is for the Lindane
523.20committee and the study of bisphenol-A,
523.21under Minnesota Statutes, section 145.958.
523.22This is a onetime appropriation.
523.23Decabromodiphenyl Ether Study.
523.24$118,000 in the first year is for transfer to the
523.25commissioner of the pollution control agency
523.26for the study of decabromodiphenyl ether
523.27under Minnesota Statutes, section 325E.387.
523.28This is a onetime appropriation.
523.29Radiation Study. $45,000 in the first year
523.30from the general fund and $15,000 in the
523.31first year from the state government special
523.32revenue fund are for the radiation study in
523.33section 62. This is a onetime appropriation.
523.34Lead Abatement. $925,000 in the first
523.35year and $950,000 in the second year are
524.1for changes in lead abatement requirements.
524.2Of this amount, $6,000 in the first year and
524.3$11,000 in the second year are for transfer
524.4to the commissioner of human services for
524.5increased medical assistance costs. A portion
524.6of this amount may be used to reimburse
524.7local governments for costs of implementing
524.8the new requirements.
524.9Water Treatment. $40,000 in fiscal year
524.102008 is to augment any appropriation from the
524.11remediation fund to conduct an evaluation of
524.12point of use water treatment units at removing
524.13perfluorooctanoic acid, perfluorooctane
524.14sulfonate, and perfluorobutanoic acid from
524.15known concentrations of these compounds
524.16in drinking water. The evaluation shall be
524.17completed by December 31, 2007, and the
524.18commissioner may contract for services to
524.19complete the evaluation. This is a onetime
524.20appropriation.
524.21Environmental Justice Mapping. $137,000
524.22in the first year and $53,000 in the second
524.23year is for environmental justice mapping.
524.24HIV Information. $80,000 each year
524.25is to fund a community-based nonprofit
524.26organization with demonstrated capacity to
524.27operate a statewide HIV information and
524.28referral service using telephone, Internet, and
524.29other appropriate technologies.
524.30Lead Hazard Reduction. $250,000 is
524.31appropriated each year of the biennium for a
524.32grant to a nonprofit organization operating
524.33the CLEARCorps to conduct a pilot project
524.34to determine the incidence of lead hazards in
524.35pre-1978 rental property. Any balance in the
525.1first year does not cancel but is available in
525.2the second year.
525.3Minnesota Birth Defects Information
525.4System. $750,000 each year is to maintain
525.5the birth defects information system that was
525.6established by Minnesota Statutes, section
525.7144.2215.

525.8

Subd. 5.Minority and Multicultural Health

525.9	Appropriations by Fund
525.10	General	5,042,000	5,052,000
525.11	Federal TANF	2,683,000	2,998,000

525.12TANF Appropriations. (a) $2,421,000 of
525.13the TANF funds is appropriated in each year
525.14of the biennium to the commissioner for
525.15home visiting and nutritional services listed
525.16under Minnesota Statutes, section 145.882,
525.17subdivision 7, clauses (6) and (7). Funding
525.18shall be distributed to tribal governments
525.19based on Minnesota Statutes, section
525.20145A.14, subdivision 2a, paragraph (b).
525.21(b) $262,000 in the first year and $577,000
525.22in the second year are appropriated
525.23to the commissioner of health for the
525.24family home visiting grant program. The
525.25commissioner shall distribute funds to tribal
525.26governments using a formula developed in
525.27conjunction with tribal governments. The
525.28commissioner may use five percent of the
525.29funds appropriated in each fiscal year to
525.30conduct the ongoing evaluations required
525.31under Minnesota Statutes, section 145A.17,
525.32subdivision 7, and may use ten percent of
525.33the funds appropriated each fiscal year to
525.34provide training and technical assistance as
526.1required under Minnesota Statutes, section
526.2145A.17, subdivisions 4 and 5.
526.3TANF Carryforward. Any unexpended
526.4balance of the TANF appropriation in the
526.5first year of the biennium does not cancel but
526.6is available for the second year.

526.7

Subd. 6.Administrative Support Services

526.8	Appropriations by Fund
526.9	General	11,047,000	11,197,000

526.10Disease Surveillance. $2,000,000 each fiscal
526.11year is for redesigning and implementing
526.12coordinated and modern disease surveillance
526.13systems for the department, ensuring that
526.14occupational and residential histories are
526.15included in the database. Base level funding
526.16for the 2012-2013 biennium will be $600,000
526.17each fiscal year for maintaining and operating
526.18the systems.

526.19 526.20

Sec. 5. VETERANS NURSING HOMES BOARD

$

44,124,000

$

46,244,000

526.21Veterans Homes Special Revenue Account.
526.22The general fund appropriations made to
526.23the board may be transferred to a veterans
526.24homes special revenue account in the
526.25special revenue fund in the same manner
526.26as other receipts are deposited according to
526.27Minnesota Statutes, section 198.34, and are
526.28appropriated to the board for the operation of
526.29board facilities and programs.
526.30Repair and Betterment. Of this
526.31appropriation, $4,000,000 in fiscal year
526.322008 and $4,000,000 in fiscal year 2009
526.33are to be used for repair, maintenance,
527.1rehabilitation, and betterment activities at
527.2facilities statewide.
527.3Base Adjustment. The general fund base is
527.4decreased by $2,000,000 in fiscal year 2010
527.5and $2,000,000 in fiscal year 2011.

527.6

Sec. 6. HEALTH-RELATED BOARDS

527.7 527.8

Subdivision 1.Total Appropriation; State Government Special Revenue Fund

$

14,654,000

$

14,527,000

527.9The commissioner of finance shall not permit
527.10the allotment, encumbrance, or expenditure
527.11of money appropriated in this section in
527.12excess of the anticipated biennial revenues
527.13or accumulated surplus revenues from fees
527.14collected by the boards.

527.15

Subd. 2.Board of Chiropractic Examiners

450,000

447,000

527.16

Subd. 3.Board of Dentistry

987,000

1,009,000

527.17 527.18

Subd. 4.Board of Dietetic and Nutrition Practice

103,000

119,000

527.19Base Adjustment. Of this appropriation in
527.20fiscal year 2009, $14,000 is onetime.

527.21 527.22

Subd. 5.Board of Marriage and Family Therapy

134,000

154,000

527.23Base Adjustment. Of this appropriation in
527.24fiscal year 2009, $17,000 is onetime.

527.25

Subd. 6.Board of Medical Practice

4,120,000

3,674,000

527.26

Subd. 7.Board of Nursing

3,985,000

4,146,000

527.27 527.28

Subd. 8.Board of Nursing Home Administrators

633,000

647,000

527.29Administrative Services Unit. Of this
527.30appropriation, $430,000 in fiscal year
527.312008 and $439,000 in fiscal year 2009 are
527.32for the administrative services unit. The
527.33administrative services unit may receive
528.1and expend reimbursements for services
528.2performed by other agencies.

528.3

Subd. 9.Board of Optometry

98,000

114,000

528.4Base Adjustment. Of this appropriation in
528.5fiscal year 2009, $13,000 is onetime.

528.6

Subd. 10.Board of Pharmacy

1,375,000

1,442,000

528.7Base Adjustment. Of this appropriation in
528.8fiscal year 2009, $29,000 is onetime.

528.9

Subd. 11.Board of Physical Therapy

306,000

295,000

528.10

Subd. 12.Board of Podiatry

54,000

63,000

528.11Base Adjustment. Of this appropriation in
528.12fiscal year 2009, $7,000 is onetime.

528.13

Subd. 13.Board of Psychology

788,000

806,000

528.14

Subd. 14.Board of Social Work

997,000

1,022,000

528.15

Subd. 15.Board of Veterinary Medicine

230,000

195,000

528.16 528.17

Subd. 16.Board of Behavioral Health and Therapy

394,000

394,000

528.18 528.19

Sec. 7. EMERGENCY MEDICAL SERVICES BOARD

$

3,710,000

$

3,745,000

528.20	Appropriations by Fund
528.21		2008	2009
528.22	General	3,023,000	3,041,000
528.23 528.24	State Government Special Revenue	687,000	704,000

528.25Regional Emergency Medical Services
528.26Programs. $400,000 each year is for
528.27regional emergency medical services
528.28programs, to be distributed equally to the
528.29eight emergency medical service regions.
528.30This amount shall be added to the base
528.31funding. Notwithstanding Minnesota
528.32Statutes, section 144E.50, 100 percent of
529.1the appropriation shall be passed on to the
529.2emergency medical service regions.
529.3Health Professional Services Program.
529.4$687,000 in fiscal year 2008 and $704,000 in
529.5fiscal year 2009 from the state government
529.6special revenue fund are for the health
529.7professional services program.

529.8

Sec. 8. COUNCIL ON DISABILITY

$

582,000

$

590,000

529.9Options Too. (a) $75,000 for the first
529.10year and $75,000 for the second year are
529.11to continue the work of the Options Too
529.12disability services interagency work group
529.13established under Laws 2005, First Special
529.14Session chapter 4, article 7, section 57.
529.15Funds shall be used to monitor and assist the
529.16work group and the Options Too Steering
529.17Committee in the implementation of the
529.18recommendations in the Options Too report
529.19dated February 15, 2007.
529.20(b) For purposes of this section, the Options
529.21Too Steering Committee shall consist of the
529.22following members:
529.23(1) a representative from the Minnesota
529.24Housing Finance Agency;
529.25(2) a representative from the Minnesota State
529.26Council on Disability;
529.27(3) a representative from the Department of
529.28Veterans Affairs;
529.29(4) a representative from the Department of
529.30Transportation;
529.31(5) a representative from the Department of
529.32Human Services; and
530.1(6) representatives from interested
530.2stakeholders including counties, local
530.3public housing authorities, the Metropolitan
530.4Council, disability service providers, and
530.5disability advocacy organizations who are
530.6appointed by the Minnesota State Council on
530.7Disability for two-year terms.
530.8(c) Notwithstanding Laws 2005, First Special
530.9Session chapter 4, article 7, section 57, the
530.10interagency work group shall be administered
530.11by the Minnesota Housing Finance Agency,
530.12the Minnesota State Council on Disability,
530.13Department of Human Services, and the
530.14Department of Transportation.
530.15(d) The Options Too Steering Committee
530.16shall report to the chairs of the health
530.17and human services policy and finance
530.18committees of the senate and house of
530.19representatives by October 15, 2007, and
530.20October 15, 2008, on the continued progress
530.21of the work group towards implementing the
530.22recommendations in the Options Too report
530.23dated February 15, 2007.

530.24 530.25 530.26

Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,567,000

$

1,621,000

530.27

Sec. 10. OMBUDSMAN FOR FAMILIES

$

251,000

$

257,000

530.28    Sec. 11. TRANSFERS.
530.29    Subdivision 1. Grants. The commissioner of human services, with the approval
530.30of the commissioner of finance and after notifying the chairs of the senate and house
530.31committees with jurisdiction, may transfer unencumbered appropriation balances for the
530.32biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance;
530.33general assistance medical care; medical assistance; MFIP child care assistance under
530.34Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential
531.1housing programs; and the entitlement portion of the chemical dependency consolidated
531.2treatment fund and between fiscal years of the biennium.
531.3    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
531.4money may be transferred within the Departments of Human Services and Health and
531.5within the programs operated by the Veterans Nursing Homes Board as the commissioners
531.6and the board consider necessary, with the advance approval of the commissioner of
531.7finance. The commissioner or the board shall inform the chairs of the house and senate
531.8committees with jurisdiction quarterly about transfers made under this provision.

531.9    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.
531.10    The commissioners of health and of human services shall not use indirect cost
531.11allocations to pay for the operational costs of any program for which they are responsible.

531.12    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.
531.13    All uncodified language contained in this article expires on June 30, 2009, unless a
531.14different expiration date is explicit.

531.15    Sec. 14. EFFECTIVE DATE.
531.16    The provisions in this article are effective July 1, 2007, unless a different effective
531.17date is specified.